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1
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López-Rodríguez M, Torralba-Cabeza MA, de Pedro IP, Rivera A, Gil RS, Gómez-Belda A, de la Peña JLP, de Los Santos Moreno A, Selva-O'Callaghan A, Gárate IG, García AG, Hurtado R, de Ureta PT, Barba-Romero MÁ, Milisenda JC, Grau-Junyent JM. Screening for late-onset Pompe disease in Internal Medicine departments in Spain. Orphanet J Rare Dis 2023; 18:256. [PMID: 37653444 PMCID: PMC10472593 DOI: 10.1186/s13023-023-02887-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Accepted: 08/25/2023] [Indexed: 09/02/2023] Open
Abstract
BACKGROUND The screening of high-risk populations using dried blood spots (DBS) has allowed the rapid identification of patients with Pompe disease, mostly in Neurology departments. The aim of the study was to determine the prevalence of late-onset Pompe disease (LOPD) among patients not previously diagnosed or tested for this entity despite presenting possible signs or symptoms of the disease in Internal Medicine departments in Spain. METHODS This epidemiological, observational, cross-sectional, multicenter study included a single cohort of individuals with clinical suspicion of LOPD seen at Internal Medicine departments in Spain. The diagnosis of LOPD was initially established on the basis of the result of DBS. If decreased enzyme acid-alpha-1,4-glucosidase (GAA) activity was detected in DBS, additional confirmatory diagnostic measurements were conducted, including GAA activity in lymphocytes, fibroblasts, or muscle and/or genetic testing. RESULTS The diagnosis of LOPD was confirmed in 2 out of 322 patients (0.6%). Reasons for suspecting LOPD diagnosis were polymyositis or any type of myopathy of unknown etiology (in one patient), and asymptomatic or pauci-symptomatic hyperCKemia (in the other). The time between symptom onset and LOPD diagnosis was 2.0 and 0.0 years. Both patients were asymptomatic, with no muscle weakness. Additionally, 19.7% of the non-LOPD cases received an alternative diagnosis. CONCLUSIONS Our study highlights the existence of a hidden population of LOPD patients in Internal Medicine departments who might benefit from early diagnosis and early initiation of potential treatments.
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Affiliation(s)
| | | | - Iván Pérez de Pedro
- Internal Medicine Department, Málaga Regional University Hospital, Málaga, Spain
| | - Alberto Rivera
- Internal Medicine Department, University Hospital Complex of Vigo, Vigo, Spain
| | - Roi Suarez Gil
- Internal Medicine Department, Lucus Augusti University Hospital, Lugo, Spain
| | - Ana Gómez-Belda
- Internal Medicine Department, Dr. Peset University Hospital, Valencia, Spain
| | | | | | | | - Igor Gómez Gárate
- Internal Medicine Department, Araba University Hospital, Álaba, Spain
| | | | - Roberto Hurtado
- Internal Medicine Department, Vega Baja Hospital, Alicante, Spain
| | - Pablo Tutor de Ureta
- Internal Medicine Department, Puerta de Hierro-Majadahonda University Hospital, Madrid, Spain
| | | | - José C Milisenda
- Internal Medicine Department, Hospital Clínic, University of Barcelona and CIBERER (Madrid), C/Villarroel 170, 08036, Barcelona, Spain
| | - Josep M Grau-Junyent
- Internal Medicine Department, Hospital Clínic, University of Barcelona and CIBERER (Madrid), C/Villarroel 170, 08036, Barcelona, Spain.
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Cantó-Santos J, Valls-Roca L, Tobías E, Oliva C, García-García FJ, Guitart-Mampel M, Andújar-Sánchez F, Esteve-Codina A, Martín-Mur B, Padrosa J, Aránega R, Moreno-Lozano PJ, Milisenda JC, Artuch R, Grau-Junyent JM, Garrabou G. Integrated Multi-Omics Analysis for Inferring Molecular Players in Inclusion Body Myositis. Antioxidants (Basel) 2023; 12:1639. [PMID: 37627634 PMCID: PMC10452026 DOI: 10.3390/antiox12081639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Revised: 08/11/2023] [Accepted: 08/14/2023] [Indexed: 08/27/2023] Open
Abstract
Inclusion body myositis (IBM) is an acquired inflammatory myopathy affecting proximal and distal muscles that leads to weakness in patients over 50. It is diagnosed based on clinical and histological findings in muscle related to inflammation, degeneration, and mitochondria. In relation to IBM, a shortage of validated disease models and a lack of biomarkers and effective treatments constitute an unmet medical need. To overcome these hurdles, we performed an omics analysis of multiple samples from IBM patients (saliva, fibroblasts, urine, plasma, and muscle) to gain insight into the pathophysiology of IBM. Degeneration was evident due to the presence of amyloid β peptide 1-42 (Aβ1-42) in the saliva of the analyzed IBM patients. The presence of metabolic disarrangements in IBM was indicated by an imbalanced organic acid profile in fibroblasts and urine. Specifically, abnormal levels of L-pyroglutamic and orotic acid were supported by the abnormal expression of related metabolites in plasma and urine (glutathione and pyrimidines) and the aberrant expression of upstream gene regulators (L2HGDH, IDH2, OPLAH, and ASL) in muscle. Combined levels of L-pyroglutamic and orotic acid displayed an outstanding biomarker signature in urine with 100% sensitivity and specificity. The confirmation of systemic metabolic disarrangements in IBM and the identification of novel biomarkers reported herein unveil novel insights that require validation in larger cohorts.
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Affiliation(s)
- Judith Cantó-Santos
- Inherited Metabolic Disorders and Muscular Diseases Research Group, Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS) and Faculty of Medicine and Health Sciences, University of Barcelona, 08036 Barcelona, Spain; (J.C.-S.); (L.V.-R.); (E.T.); (F.J.G.-G.); (M.G.-M.); (F.A.-S.); (J.P.); (R.A.); (P.J.M.-L.)
- Department of Internal Medicine, Hospital Clinic of Barcelona, 08036 Barcelona, Spain
- CIBERER—Spanish Biomedical Research Centre in Rare Diseases, 28029 Madrid, Spain
| | - Laura Valls-Roca
- Inherited Metabolic Disorders and Muscular Diseases Research Group, Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS) and Faculty of Medicine and Health Sciences, University of Barcelona, 08036 Barcelona, Spain; (J.C.-S.); (L.V.-R.); (E.T.); (F.J.G.-G.); (M.G.-M.); (F.A.-S.); (J.P.); (R.A.); (P.J.M.-L.)
- Department of Internal Medicine, Hospital Clinic of Barcelona, 08036 Barcelona, Spain
- CIBERER—Spanish Biomedical Research Centre in Rare Diseases, 28029 Madrid, Spain
| | - Ester Tobías
- Inherited Metabolic Disorders and Muscular Diseases Research Group, Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS) and Faculty of Medicine and Health Sciences, University of Barcelona, 08036 Barcelona, Spain; (J.C.-S.); (L.V.-R.); (E.T.); (F.J.G.-G.); (M.G.-M.); (F.A.-S.); (J.P.); (R.A.); (P.J.M.-L.)
- Department of Internal Medicine, Hospital Clinic of Barcelona, 08036 Barcelona, Spain
- CIBERER—Spanish Biomedical Research Centre in Rare Diseases, 28029 Madrid, Spain
| | - Clara Oliva
- Department of Clinical Biochemistry, Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, 08950 Barcelona, Spain; (C.O.); (R.A.)
| | - Francesc Josep García-García
- Inherited Metabolic Disorders and Muscular Diseases Research Group, Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS) and Faculty of Medicine and Health Sciences, University of Barcelona, 08036 Barcelona, Spain; (J.C.-S.); (L.V.-R.); (E.T.); (F.J.G.-G.); (M.G.-M.); (F.A.-S.); (J.P.); (R.A.); (P.J.M.-L.)
- Department of Internal Medicine, Hospital Clinic of Barcelona, 08036 Barcelona, Spain
- CIBERER—Spanish Biomedical Research Centre in Rare Diseases, 28029 Madrid, Spain
| | - Mariona Guitart-Mampel
- Inherited Metabolic Disorders and Muscular Diseases Research Group, Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS) and Faculty of Medicine and Health Sciences, University of Barcelona, 08036 Barcelona, Spain; (J.C.-S.); (L.V.-R.); (E.T.); (F.J.G.-G.); (M.G.-M.); (F.A.-S.); (J.P.); (R.A.); (P.J.M.-L.)
- Department of Internal Medicine, Hospital Clinic of Barcelona, 08036 Barcelona, Spain
- CIBERER—Spanish Biomedical Research Centre in Rare Diseases, 28029 Madrid, Spain
| | - Félix Andújar-Sánchez
- Inherited Metabolic Disorders and Muscular Diseases Research Group, Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS) and Faculty of Medicine and Health Sciences, University of Barcelona, 08036 Barcelona, Spain; (J.C.-S.); (L.V.-R.); (E.T.); (F.J.G.-G.); (M.G.-M.); (F.A.-S.); (J.P.); (R.A.); (P.J.M.-L.)
- Department of Internal Medicine, Hospital Clinic of Barcelona, 08036 Barcelona, Spain
- CIBERER—Spanish Biomedical Research Centre in Rare Diseases, 28029 Madrid, Spain
| | - Anna Esteve-Codina
- CNAG-CRG, Centre for Genomic Regulation, Barcelona Institute of Science and Technology, 08028 Barcelona, Spain; (A.E.-C.); (B.M.-M.)
- Department of Medicine and Health Sciences, Universitat Pompeu Fabra (UPF), 08003 Barcelona, Spain
| | - Beatriz Martín-Mur
- CNAG-CRG, Centre for Genomic Regulation, Barcelona Institute of Science and Technology, 08028 Barcelona, Spain; (A.E.-C.); (B.M.-M.)
| | - Joan Padrosa
- Inherited Metabolic Disorders and Muscular Diseases Research Group, Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS) and Faculty of Medicine and Health Sciences, University of Barcelona, 08036 Barcelona, Spain; (J.C.-S.); (L.V.-R.); (E.T.); (F.J.G.-G.); (M.G.-M.); (F.A.-S.); (J.P.); (R.A.); (P.J.M.-L.)
- Department of Internal Medicine, Hospital Clinic of Barcelona, 08036 Barcelona, Spain
- CIBERER—Spanish Biomedical Research Centre in Rare Diseases, 28029 Madrid, Spain
| | - Raquel Aránega
- Inherited Metabolic Disorders and Muscular Diseases Research Group, Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS) and Faculty of Medicine and Health Sciences, University of Barcelona, 08036 Barcelona, Spain; (J.C.-S.); (L.V.-R.); (E.T.); (F.J.G.-G.); (M.G.-M.); (F.A.-S.); (J.P.); (R.A.); (P.J.M.-L.)
- Department of Internal Medicine, Hospital Clinic of Barcelona, 08036 Barcelona, Spain
- CIBERER—Spanish Biomedical Research Centre in Rare Diseases, 28029 Madrid, Spain
| | - Pedro J. Moreno-Lozano
- Inherited Metabolic Disorders and Muscular Diseases Research Group, Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS) and Faculty of Medicine and Health Sciences, University of Barcelona, 08036 Barcelona, Spain; (J.C.-S.); (L.V.-R.); (E.T.); (F.J.G.-G.); (M.G.-M.); (F.A.-S.); (J.P.); (R.A.); (P.J.M.-L.)
- Department of Internal Medicine, Hospital Clinic of Barcelona, 08036 Barcelona, Spain
- CIBERER—Spanish Biomedical Research Centre in Rare Diseases, 28029 Madrid, Spain
| | - José César Milisenda
- Inherited Metabolic Disorders and Muscular Diseases Research Group, Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS) and Faculty of Medicine and Health Sciences, University of Barcelona, 08036 Barcelona, Spain; (J.C.-S.); (L.V.-R.); (E.T.); (F.J.G.-G.); (M.G.-M.); (F.A.-S.); (J.P.); (R.A.); (P.J.M.-L.)
- Department of Internal Medicine, Hospital Clinic of Barcelona, 08036 Barcelona, Spain
- CIBERER—Spanish Biomedical Research Centre in Rare Diseases, 28029 Madrid, Spain
| | - Rafael Artuch
- Department of Clinical Biochemistry, Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, 08950 Barcelona, Spain; (C.O.); (R.A.)
| | - Josep M. Grau-Junyent
- Inherited Metabolic Disorders and Muscular Diseases Research Group, Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS) and Faculty of Medicine and Health Sciences, University of Barcelona, 08036 Barcelona, Spain; (J.C.-S.); (L.V.-R.); (E.T.); (F.J.G.-G.); (M.G.-M.); (F.A.-S.); (J.P.); (R.A.); (P.J.M.-L.)
- Department of Internal Medicine, Hospital Clinic of Barcelona, 08036 Barcelona, Spain
- CIBERER—Spanish Biomedical Research Centre in Rare Diseases, 28029 Madrid, Spain
| | - Glòria Garrabou
- Inherited Metabolic Disorders and Muscular Diseases Research Group, Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS) and Faculty of Medicine and Health Sciences, University of Barcelona, 08036 Barcelona, Spain; (J.C.-S.); (L.V.-R.); (E.T.); (F.J.G.-G.); (M.G.-M.); (F.A.-S.); (J.P.); (R.A.); (P.J.M.-L.)
- Department of Internal Medicine, Hospital Clinic of Barcelona, 08036 Barcelona, Spain
- CIBERER—Spanish Biomedical Research Centre in Rare Diseases, 28029 Madrid, Spain
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3
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Nascimento A, Bruels CC, Donkervoort S, Foley AR, Codina A, Milisenda JC, Estrella EA, Li C, Pijuan J, Draper I, Hu Y, Stafki SA, Pais LS, Ganesh VS, O'Donnell-Luria A, Syeda SB, Carrera-García L, Expósito-Escudero J, Yubero D, Martorell L, Pinal-Fernandez I, Lidov HGW, Mammen AL, Grau-Junyent JM, Ortez C, Palau F, Ghosh PS, Darras BT, Jou C, Kunkel LM, Hoenicka J, Bönnemann CG, Kang PB, Natera-de Benito D. Variants in DTNA cause a mild, dominantly inherited muscular dystrophy. Acta Neuropathol 2023; 145:479-496. [PMID: 36799992 PMCID: PMC10923638 DOI: 10.1007/s00401-023-02551-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Revised: 02/10/2023] [Accepted: 02/10/2023] [Indexed: 02/18/2023]
Abstract
DTNA encodes α-dystrobrevin, a component of the macromolecular dystrophin-glycoprotein complex (DGC) that binds to dystrophin/utrophin and α-syntrophin. Mice lacking α-dystrobrevin have a muscular dystrophy phenotype, but variants in DTNA have not previously been associated with human skeletal muscle disease. We present 12 individuals from four unrelated families with two different monoallelic DTNA variants affecting the coiled-coil domain of α-dystrobrevin. The five affected individuals from family A harbor a c.1585G > A; p.Glu529Lys variant, while the recurrent c.1567_1587del; p.Gln523_Glu529del DTNA variant was identified in the other three families (family B: four affected individuals, family C: one affected individual, and family D: two affected individuals). Myalgia and exercise intolerance, with variable ages of onset, were reported in 10 of 12 affected individuals. Proximal lower limb weakness with onset in the first decade of life was noted in three individuals. Persistent elevations of serum creatine kinase (CK) levels were detected in 11 of 12 affected individuals, 1 of whom had an episode of rhabdomyolysis at 20 years of age. Autism spectrum disorder or learning disabilities were reported in four individuals with the c.1567_1587 deletion. Muscle biopsies in eight affected individuals showed mixed myopathic and dystrophic findings, characterized by fiber size variability, internalized nuclei, and slightly increased extracellular connective tissue and inflammation. Immunofluorescence analysis of biopsies from five affected individuals showed reduced α-dystrobrevin immunoreactivity and variably reduced immunoreactivity of other DGC proteins: dystrophin, α, β, δ and γ-sarcoglycans, and α and β-dystroglycans. The DTNA deletion disrupted an interaction between α-dystrobrevin and syntrophin. Specific variants in the coiled-coil domain of DTNA cause skeletal muscle disease with variable penetrance. Affected individuals show a spectrum of clinical manifestations, with severity ranging from hyperCKemia, myalgias, and exercise intolerance to childhood-onset proximal muscle weakness. Our findings expand the molecular etiologies of both muscular dystrophy and paucisymptomatic hyperCKemia, to now include monoallelic DTNA variants as a novel cause of skeletal muscle disease in humans.
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Affiliation(s)
- Andres Nascimento
- Neuromuscular Unit, Department of Neurology, Hospital Sant Joan de Déu, Passeig Sant Joan de Déu 2, Esplugues de Llobregat, Barcelona, Spain
- Applied Research in Neuromuscular Diseases, Institut de Recerca Sant Joan de Déu, Barcelona, Spain
- Center for Biomedical Research Network on Rare Diseases (CIBERER), ISCIII, Madrid, Spain
| | - Christine C Bruels
- Department of Neurology, Paul and Sheila Wellstone Muscular Dystrophy Center, University of Minnesota Medical School, 420 Delaware Street SE, MMC 295, Minneapolis, MN, 55455, USA
| | - Sandra Donkervoort
- Neuromuscular and Neurogenetic Disorders of Childhood Section, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA
| | - A Reghan Foley
- Neuromuscular and Neurogenetic Disorders of Childhood Section, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA
| | - Anna Codina
- Applied Research in Neuromuscular Diseases, Institut de Recerca Sant Joan de Déu, Barcelona, Spain
- Department of Pathology, Hospital Sant Joan de Déu, Barcelona, Spain
| | - Jose C Milisenda
- Department of Internal Medicine, Hospital Clinic of Barcelona, University of Barcelona, Barcelona, Spain
| | - Elicia A Estrella
- Division of Genetics and Genomics, Boston Children's Hospital and Harvard Medical School, Boston, MA, USA
- Department of Neurology, Boston Children's Hospital and Harvard Medical School, Boston, MA, USA
| | - Chengcheng Li
- Division of Pediatric Neurology, University of Florida College of Medicine, Gainesville, FL, 32610, USA
| | - Jordi Pijuan
- Center for Biomedical Research Network on Rare Diseases (CIBERER), ISCIII, Madrid, Spain
- Laboratory of Neurogenetics and Molecular Medicine-IPER, Institut de Recerca Sant Joan de Déu, Barcelona, Spain
| | - Isabelle Draper
- Molecular Cardiology Research Institute, Tufts Medical Center, Boston, MA, 02111, USA
| | - Ying Hu
- Neuromuscular and Neurogenetic Disorders of Childhood Section, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA
| | - Seth A Stafki
- Department of Neurology, Paul and Sheila Wellstone Muscular Dystrophy Center, University of Minnesota Medical School, 420 Delaware Street SE, MMC 295, Minneapolis, MN, 55455, USA
| | - Lynn S Pais
- Division of Genetics and Genomics, Boston Children's Hospital and Harvard Medical School, Boston, MA, USA
- Program in Medical and Population Genetics, Center for Mendelian Genomics, Broad Institute of MIT and Harvard, Cambridge, MA, USA
- Analytic and Translational Genetics Unit and Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, USA
| | - Vijay S Ganesh
- Division of Genetics and Genomics, Boston Children's Hospital and Harvard Medical School, Boston, MA, USA
- Program in Medical and Population Genetics, Center for Mendelian Genomics, Broad Institute of MIT and Harvard, Cambridge, MA, USA
- Analytic and Translational Genetics Unit and Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, USA
- Department of Neurology, Brigham and Women's Hospital, Boston, MA, USA
| | - Anne O'Donnell-Luria
- Division of Genetics and Genomics, Boston Children's Hospital and Harvard Medical School, Boston, MA, USA
- Program in Medical and Population Genetics, Center for Mendelian Genomics, Broad Institute of MIT and Harvard, Cambridge, MA, USA
- Analytic and Translational Genetics Unit and Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, USA
| | - Safoora B Syeda
- Neuromuscular and Neurogenetic Disorders of Childhood Section, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA
| | - Laura Carrera-García
- Neuromuscular Unit, Department of Neurology, Hospital Sant Joan de Déu, Passeig Sant Joan de Déu 2, Esplugues de Llobregat, Barcelona, Spain
- Applied Research in Neuromuscular Diseases, Institut de Recerca Sant Joan de Déu, Barcelona, Spain
| | - Jessica Expósito-Escudero
- Neuromuscular Unit, Department of Neurology, Hospital Sant Joan de Déu, Passeig Sant Joan de Déu 2, Esplugues de Llobregat, Barcelona, Spain
- Applied Research in Neuromuscular Diseases, Institut de Recerca Sant Joan de Déu, Barcelona, Spain
| | - Delia Yubero
- Center for Biomedical Research Network on Rare Diseases (CIBERER), ISCIII, Madrid, Spain
- Department of Genetic and Molecular Medicine-IPER, Hospital Sant Joan de Déu and Institut de Recerca Sant Joan de Déu, Barcelona, Spain
| | - Loreto Martorell
- Center for Biomedical Research Network on Rare Diseases (CIBERER), ISCIII, Madrid, Spain
- Department of Genetic and Molecular Medicine-IPER, Hospital Sant Joan de Déu and Institut de Recerca Sant Joan de Déu, Barcelona, Spain
| | - Iago Pinal-Fernandez
- National Institute of Arthritis and Musculoskeletal and Skin Diseases, National Institutes of Health, Bethesda, MD, USA
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Hart G W Lidov
- Department of Pathology, Boston Children's Hospital and Harvard Medical School, Boston, MA, USA
| | - Andrew L Mammen
- National Institute of Arthritis and Musculoskeletal and Skin Diseases, National Institutes of Health, Bethesda, MD, USA
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Josep M Grau-Junyent
- Center for Biomedical Research Network on Rare Diseases (CIBERER), ISCIII, Madrid, Spain
- Department of Internal Medicine, Hospital Clinic of Barcelona, University of Barcelona, Barcelona, Spain
| | - Carlos Ortez
- Neuromuscular Unit, Department of Neurology, Hospital Sant Joan de Déu, Passeig Sant Joan de Déu 2, Esplugues de Llobregat, Barcelona, Spain
- Applied Research in Neuromuscular Diseases, Institut de Recerca Sant Joan de Déu, Barcelona, Spain
- Center for Biomedical Research Network on Rare Diseases (CIBERER), ISCIII, Madrid, Spain
| | - Francesc Palau
- Center for Biomedical Research Network on Rare Diseases (CIBERER), ISCIII, Madrid, Spain
- Laboratory of Neurogenetics and Molecular Medicine-IPER, Institut de Recerca Sant Joan de Déu, Barcelona, Spain
- Department of Genetic and Molecular Medicine-IPER, Hospital Sant Joan de Déu and Institut de Recerca Sant Joan de Déu, Barcelona, Spain
| | - Partha S Ghosh
- Department of Neurology, Boston Children's Hospital and Harvard Medical School, Boston, MA, USA
| | - Basil T Darras
- Department of Neurology, Boston Children's Hospital and Harvard Medical School, Boston, MA, USA
| | - Cristina Jou
- Applied Research in Neuromuscular Diseases, Institut de Recerca Sant Joan de Déu, Barcelona, Spain
- Center for Biomedical Research Network on Rare Diseases (CIBERER), ISCIII, Madrid, Spain
- Department of Pathology, Hospital Sant Joan de Déu, Barcelona, Spain
| | - Louis M Kunkel
- Division of Genetics and Genomics, Boston Children's Hospital and Harvard Medical School, Boston, MA, USA
| | - Janet Hoenicka
- Center for Biomedical Research Network on Rare Diseases (CIBERER), ISCIII, Madrid, Spain
- Laboratory of Neurogenetics and Molecular Medicine-IPER, Institut de Recerca Sant Joan de Déu, Barcelona, Spain
| | - Carsten G Bönnemann
- Neuromuscular and Neurogenetic Disorders of Childhood Section, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA
| | - Peter B Kang
- Department of Neurology, Paul and Sheila Wellstone Muscular Dystrophy Center, University of Minnesota Medical School, 420 Delaware Street SE, MMC 295, Minneapolis, MN, 55455, USA.
- Institute for Translational Neuroscience, University of Minnesota, Minneapolis, MN, USA.
| | - Daniel Natera-de Benito
- Neuromuscular Unit, Department of Neurology, Hospital Sant Joan de Déu, Passeig Sant Joan de Déu 2, Esplugues de Llobregat, Barcelona, Spain.
- Applied Research in Neuromuscular Diseases, Institut de Recerca Sant Joan de Déu, Barcelona, Spain.
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4
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Cantó-Santos J, Valls-Roca L, Tobías E, García-García FJ, Guitart-Mampel M, Esteve-Codina A, Martín-Mur B, Casado M, Artuch R, Solsona-Vilarrasa E, Fernandez-Checa JC, García-Ruiz C, Rentero C, Enrich C, Moreno-Lozano PJ, Milisenda JC, Cardellach F, Grau-Junyent JM, Garrabou G. Unravelling inclusion body myositis using a patient-derived fibroblast model. J Cachexia Sarcopenia Muscle 2023; 14:964-977. [PMID: 36860172 PMCID: PMC10067507 DOI: 10.1002/jcsm.13178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Revised: 11/24/2022] [Accepted: 01/02/2023] [Indexed: 03/03/2023] Open
Abstract
BACKGROUND Inclusion body myositis (IBM) is an inflammatory myopathy clinically characterized by proximal and distal muscle weakness, with inflammatory infiltrates, rimmed vacuoles and mitochondrial changes in muscle histopathology. There is scarce knowledge on IBM aetiology, and non-established biomarkers or effective treatments are available, partly due to the lack of validated disease models. METHODS We have performed transcriptomics and functional validation of IBM muscle pathological hallmarks in fibroblasts from IBM patients (n = 14) and healthy controls (n = 12), paired by age and sex. The results comprise an mRNA-seq, together with functional inflammatory, autophagy, mitochondrial and metabolic changes between patients and controls. RESULTS Gene expression profile of IBM vs control fibroblasts revealed 778 differentially expressed genes (P-value adj < 0.05) related to inflammation, mitochondria, cell cycle regulation and metabolism. Functionally, an increased inflammatory profile was observed in IBM fibroblasts with higher supernatant cytokine secretion (three-fold increase). Autophagy was reduced considering basal protein mediators (18.4% reduced), time-course autophagosome formation (LC3BII 39% reduced, P-value < 0.05), and autophagosome microscopic evaluation. Mitochondria displayed reduced genetic content (by 33.9%, P-value < 0.05) and function (30.2%-decrease in respiration, 45.6%-decline in enzymatic activity (P-value < 0.001), 14.3%-higher oxidative stress, 135.2%-increased antioxidant defence (P-value < 0.05), 11.6%-reduced mitochondrial membrane potential (P-value < 0.05) and 42.8%-reduced mitochondrial elongation (P-value < 0.05)). In accordance, at the metabolite level, organic acid showed a 1.8-fold change increase, with conserved amino acid profile. Correlating to disease evolution, oxidative stress and inflammation emerge as potential markers of prognosis. CONCLUSIONS These findings confirm the presence of molecular disturbances in peripheral tissues from IBM patients and prompt patients' derived fibroblasts as a promising disease model, which may eventually be exported to other neuromuscular disorders. We additionally identify new molecular players in IBM associated with disease progression, setting the path to deepen in disease aetiology, in the identification of novel biomarkers or in the standardization of biomimetic platforms to assay new therapeutic strategies for preclinical studies.
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Affiliation(s)
- Judith Cantó-Santos
- Muscle Research and Mitochondrial Function Lab, Centre de Recerca Biomèdica CELLEX - Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS) and Faculty of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain.,Department of Internal Medicine, Hospital Clinic of Barcelona, Barcelona, Spain.,CIBERER-Spanish Biomedical Research Centre in Rare Diseases, Madrid, Spain
| | - Laura Valls-Roca
- Muscle Research and Mitochondrial Function Lab, Centre de Recerca Biomèdica CELLEX - Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS) and Faculty of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain.,Department of Internal Medicine, Hospital Clinic of Barcelona, Barcelona, Spain.,CIBERER-Spanish Biomedical Research Centre in Rare Diseases, Madrid, Spain
| | - Ester Tobías
- Muscle Research and Mitochondrial Function Lab, Centre de Recerca Biomèdica CELLEX - Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS) and Faculty of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain.,Department of Internal Medicine, Hospital Clinic of Barcelona, Barcelona, Spain.,CIBERER-Spanish Biomedical Research Centre in Rare Diseases, Madrid, Spain
| | - Francesc Josep García-García
- Muscle Research and Mitochondrial Function Lab, Centre de Recerca Biomèdica CELLEX - Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS) and Faculty of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain.,Department of Internal Medicine, Hospital Clinic of Barcelona, Barcelona, Spain.,CIBERER-Spanish Biomedical Research Centre in Rare Diseases, Madrid, Spain
| | - Mariona Guitart-Mampel
- Muscle Research and Mitochondrial Function Lab, Centre de Recerca Biomèdica CELLEX - Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS) and Faculty of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain.,Department of Internal Medicine, Hospital Clinic of Barcelona, Barcelona, Spain.,CIBERER-Spanish Biomedical Research Centre in Rare Diseases, Madrid, Spain
| | - Anna Esteve-Codina
- CNAG-CRG, Centre for Genomic Regulation, Barcelona Institute of Science and Technology, Barcelona, Spain.,Universitat Pompeu Fabra (UPF), Barcelona, Spain
| | - Beatriz Martín-Mur
- CNAG-CRG, Centre for Genomic Regulation, Barcelona Institute of Science and Technology, Barcelona, Spain
| | - Mercedes Casado
- CIBERER-Spanish Biomedical Research Centre in Rare Diseases, Madrid, Spain.,Department of Clinical Biochemistry, Institut de Recerca Sant Joan de Déu; Esplugues de Llobregat, Barcelona, Spain
| | - Rafael Artuch
- CIBERER-Spanish Biomedical Research Centre in Rare Diseases, Madrid, Spain.,Department of Clinical Biochemistry, Institut de Recerca Sant Joan de Déu; Esplugues de Llobregat, Barcelona, Spain
| | - Estel Solsona-Vilarrasa
- Department of Cell Death and Proliferation, Institute of Biomedical Research of Barcelona (IIBB-CSIC), Liver Unit-HCB-IDIBAPS, Barcelona, Spain.,CIBEREHD-Spanish Biomedical Research Centre in Hepatic and Digestive Diseases, Madrid, Spain
| | - José Carlos Fernandez-Checa
- Department of Cell Death and Proliferation, Institute of Biomedical Research of Barcelona (IIBB-CSIC), Liver Unit-HCB-IDIBAPS, Barcelona, Spain.,CIBEREHD-Spanish Biomedical Research Centre in Hepatic and Digestive Diseases, Madrid, Spain
| | - Carmen García-Ruiz
- Department of Cell Death and Proliferation, Institute of Biomedical Research of Barcelona (IIBB-CSIC), Liver Unit-HCB-IDIBAPS, Barcelona, Spain.,CIBEREHD-Spanish Biomedical Research Centre in Hepatic and Digestive Diseases, Madrid, Spain
| | - Carles Rentero
- Department of Biomedicine, Cell Biology Unit, CELLEX-IDIBAPS, Faculty of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain
| | - Carlos Enrich
- Department of Biomedicine, Cell Biology Unit, CELLEX-IDIBAPS, Faculty of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain
| | - Pedro J Moreno-Lozano
- Muscle Research and Mitochondrial Function Lab, Centre de Recerca Biomèdica CELLEX - Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS) and Faculty of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain.,Department of Internal Medicine, Hospital Clinic of Barcelona, Barcelona, Spain.,CIBERER-Spanish Biomedical Research Centre in Rare Diseases, Madrid, Spain
| | - José César Milisenda
- Muscle Research and Mitochondrial Function Lab, Centre de Recerca Biomèdica CELLEX - Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS) and Faculty of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain.,Department of Internal Medicine, Hospital Clinic of Barcelona, Barcelona, Spain.,CIBERER-Spanish Biomedical Research Centre in Rare Diseases, Madrid, Spain
| | - Francesc Cardellach
- Muscle Research and Mitochondrial Function Lab, Centre de Recerca Biomèdica CELLEX - Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS) and Faculty of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain.,Department of Internal Medicine, Hospital Clinic of Barcelona, Barcelona, Spain.,CIBERER-Spanish Biomedical Research Centre in Rare Diseases, Madrid, Spain
| | - Josep M Grau-Junyent
- Muscle Research and Mitochondrial Function Lab, Centre de Recerca Biomèdica CELLEX - Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS) and Faculty of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain.,Department of Internal Medicine, Hospital Clinic of Barcelona, Barcelona, Spain.,CIBERER-Spanish Biomedical Research Centre in Rare Diseases, Madrid, Spain
| | - Glòria Garrabou
- Muscle Research and Mitochondrial Function Lab, Centre de Recerca Biomèdica CELLEX - Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS) and Faculty of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain.,Department of Internal Medicine, Hospital Clinic of Barcelona, Barcelona, Spain.,CIBERER-Spanish Biomedical Research Centre in Rare Diseases, Madrid, Spain
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5
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Trifunov S, Paredes-Fuentes AJ, Badosa C, Codina A, Montoya J, Ruiz-Pesini E, Jou C, Garrabou G, Grau-Junyent JM, Yubero D, Montero R, Muchart J, Ortigoza-Escobar JD, O'Callaghan MM, Nascimento A, Català A, Garcia-Cazorla À, Jimenez-Mallebrera C, Artuch R. Circulating Cell-Free Mitochondrial DNA in Cerebrospinal Fluid as a Biomarker for Mitochondrial Diseases. Clin Chem 2021; 67:1113-1121. [PMID: 34352085 DOI: 10.1093/clinchem/hvab091] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Accepted: 05/05/2021] [Indexed: 12/14/2022]
Abstract
BACKGROUND Mitochondrial diseases (MD) are genetic metabolic disorders that impair normal mitochondrial structure or function. The aim of this study was to investigate the status of circulating cell-free mitochondrial DNA (ccfmtDNA) in cerebrospinal fluid (CSF), together with other biomarkers (growth differentiation factor-15 [GDF-15], alanine, and lactate), in a cohort of 25 patients with a molecular diagnosis of MD. METHODS Measurement of ccfmtDNA was performed by using droplet digital PCR. RESULTS The mean copy number of ccfmtDNA was approximately 6 times higher in the MD cohort compared to the control group; patients with mitochondrial deletion and depletion syndromes (MDD) had the higher levels. We also detected the presence of both wild-type mtDNA and mtDNA deletions in CSF samples of patients with single deletions. Patients with MDD with single deletions had significantly higher concentrations of GDF-15 in CSF than controls, whereas patients with point mutations in mitochondrial DNA presented no statistically significant differences. Additionally, we found a significant positive correlation between ccfmtDNA levels and GDF-15 concentrations (r = 0.59, P = 0.016). CONCLUSION CSF ccfmtDNA levels are significantly higher in patients with MD in comparison to controls and, thus, they can be used as a novel biomarker for MD research. Our results could also be valuable to support the clinical outcome assessment of MD patients.
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Affiliation(s)
- Selena Trifunov
- Neuromuscular Unit, Department of Neuropediatrics, Institut de Recerca Sant Joan de Déu, Hospital Sant Joan de Déu, Barcelona, Spain
| | - Abraham J Paredes-Fuentes
- Department of Clinical Biochemistry, Institut de Recerca Sant Joan de Déu, Hospital Sant Joan de Déu, Barcelona, Spain
| | - Carmen Badosa
- Neuromuscular Unit, Department of Neuropediatrics, Institut de Recerca Sant Joan de Déu, Hospital Sant Joan de Déu, Barcelona, Spain
| | - Anna Codina
- Neuromuscular Unit, Department of Neuropediatrics, Institut de Recerca Sant Joan de Déu, Hospital Sant Joan de Déu, Barcelona, Spain
| | - Julio Montoya
- Biomedical Network Research Centre on Rare Diseases (CIBERER), Instituto de Salud Carlos III, Madrid, Spain
- Department of Biochemistry and Molecular Biology, Institute for Health Research of Aragón (IISAragón), University of Zaragoza, Zaragoza, Spain
| | - Eduardo Ruiz-Pesini
- Biomedical Network Research Centre on Rare Diseases (CIBERER), Instituto de Salud Carlos III, Madrid, Spain
- Department of Biochemistry and Molecular Biology, Institute for Health Research of Aragón (IISAragón), University of Zaragoza, Zaragoza, Spain
| | - Cristina Jou
- Neuromuscular Unit, Department of Neuropediatrics, Institut de Recerca Sant Joan de Déu, Hospital Sant Joan de Déu, Barcelona, Spain
- Biomedical Network Research Centre on Rare Diseases (CIBERER), Instituto de Salud Carlos III, Madrid, Spain
- Department of Pathology, Hospital Sant Joan de Déu, Barcelona, Spain
| | - Glòria Garrabou
- Biomedical Network Research Centre on Rare Diseases (CIBERER), Instituto de Salud Carlos III, Madrid, Spain
- Department of Internal Medicine, Laboratory of Muscle Research and Mitochondrial Function-Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Faculty of Medicine and Health Science, University of Barcelona (UB), Hospital Clínic of Barcelona (HCB), Barcelona, Spain
| | - Josep M Grau-Junyent
- Biomedical Network Research Centre on Rare Diseases (CIBERER), Instituto de Salud Carlos III, Madrid, Spain
- Department of Internal Medicine, Laboratory of Muscle Research and Mitochondrial Function-Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Faculty of Medicine and Health Science, University of Barcelona (UB), Hospital Clínic of Barcelona (HCB), Barcelona, Spain
| | - Dèlia Yubero
- Department of Genetics and Molecular Medicine, Institut de Recerca Sant Joan de Déu, Barcelona, Spain
| | - Raquel Montero
- Department of Clinical Biochemistry, Institut de Recerca Sant Joan de Déu, Hospital Sant Joan de Déu, Barcelona, Spain
| | - Jordi Muchart
- Department of Radiology, Institut de Recerca Sant Joan de Déu, Hospital Sant Joan de Déu, Barcelona, Spain
| | | | | | - Andrés Nascimento
- Neuromuscular Unit, Department of Neuropediatrics, Institut de Recerca Sant Joan de Déu, Hospital Sant Joan de Déu, Barcelona, Spain
| | - Albert Català
- Biomedical Network Research Centre on Rare Diseases (CIBERER), Instituto de Salud Carlos III, Madrid, Spain
- Department of Hematology, Institut de Recerca Sant Joan de Déu, Hospital Sant Joan de Déu, Barcelona, Spain
| | | | - Cecilia Jimenez-Mallebrera
- Neuromuscular Unit, Department of Neuropediatrics, Institut de Recerca Sant Joan de Déu, Hospital Sant Joan de Déu, Barcelona, Spain
- Biomedical Network Research Centre on Rare Diseases (CIBERER), Instituto de Salud Carlos III, Madrid, Spain
| | - Rafael Artuch
- Neuromuscular Unit, Department of Neuropediatrics, Institut de Recerca Sant Joan de Déu, Hospital Sant Joan de Déu, Barcelona, Spain
- Biomedical Network Research Centre on Rare Diseases (CIBERER), Instituto de Salud Carlos III, Madrid, Spain
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6
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Catalán-García M, García-García FJ, Moreno-Lozano PJ, Alcarraz-Vizán G, Tort-Merino A, Milisenda JC, Cantó-Santos J, Barcos-Rodríguez T, Cardellach F, Lladó A, Novials A, Garrabou G, Grau-Junyent JM. Mitochondrial Dysfunction: A Common Hallmark Underlying Comorbidity between sIBM and Other Degenerative and Age-Related Diseases. J Clin Med 2020; 9:E1446. [PMID: 32413985 PMCID: PMC7290779 DOI: 10.3390/jcm9051446] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Revised: 05/01/2020] [Accepted: 05/05/2020] [Indexed: 01/22/2023] Open
Abstract
Sporadic inclusion body myositis (sIBM) is an inflammatory myopathy associated, among others, with mitochondrial dysfunction. Similar molecular features are found in Alzheimer's disease (AD) and Type 2 Diabetes Mellitus (T2DM), underlying potential comorbidity. This study aims to evaluate common clinical and molecular hallmarks among sIBM, AD, and T2DM. Comorbidity with AD was assessed in n = 14 sIBM patients by performing neuropsychological and cognitive tests, cranial magnetic resonance imaging, AD cerebrospinal fluid biomarkers (levels of amyloid beta, total tau, and phosphorylated tau at threonine-181), and genetic apolipoprotein E genotyping. In the same sIBM cohort, comorbidity with T2DM was assessed by collecting anthropometric measures and performing an oral glucose tolerance test and insulin determinations. Results were compared to the standard population and other myositis (n = 7 dermatomyositis and n = 7 polymyositis). Mitochondrial contribution into disease was tested by measurement of oxidative/anaerobic and oxidant/antioxidant balances, respiration fluxes, and enzymatic activities in sIBM fibroblasts subjected to different glucose levels. Comorbidity of sIBM with AD was not detected. Clinically, sIBM patients showed signs of misbalanced glucose homeostasis, similar to other myositis. Such misbalance was further confirmed at the molecular level by the metabolic inability of sIBM fibroblasts to adapt to different glucose conditions. Under the standard condition, sIBM fibroblasts showed decreased respiration (0.71 ± 0.08 vs. 1.06 ± 0.04 nmols O2/min; p = 0.024) and increased anaerobic metabolism (5.76 ± 0.52 vs. 3.79 ± 0.35 mM lactate; p = 0.052). Moreover, when glucose conditions were changed, sIBM fibroblasts presented decreased fold change in mitochondrial enzymatic activities (-12.13 ± 21.86 vs. 199.22 ± 62.52 cytochrome c oxidase/citrate synthase ratio; p = 0.017) and increased oxidative stress per mitochondrial activity (203.76 ± 82.77 vs. -69.55 ± 21.00; p = 0.047), underlying scarce metabolic plasticity. These findings do not demonstrate higher prevalence of AD in sIBM patients, but evidences of prediabetogenic conditions were found. Glucose deregulation in myositis suggests the contribution of lifestyle conditions, such as restricted mobility. Additionally, molecular evidences from sIBM fibroblasts confirm that mitochondrial dysfunction may play a role. Monitoring T2DM development and mitochondrial contribution to disease in myositis patients could set a path for novel therapeutic options.
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Affiliation(s)
- Marc Catalán-García
- Muscle Research and Mitochondrial Function Laboratory, CELLEX-IDIBAPS, Faculty of Medicine, University of Barcelona, 08036 Barcelona, Spain; (M.C.-G.); (F.J.G.-G.); (P.J.M.-L.); (J.C.M.); (J.C.-S.); (T.B.-R.); (F.C.); (J.M.G.-J.)
- Internal Medicine Department, Hospital Clinic of Barcelona, 08036 Barcelona, Spain
- CIBERER—Spanish Biomedical Research Centre in Rare Diseases, 28029 Madrid, Spain
| | - Francesc Josep García-García
- Muscle Research and Mitochondrial Function Laboratory, CELLEX-IDIBAPS, Faculty of Medicine, University of Barcelona, 08036 Barcelona, Spain; (M.C.-G.); (F.J.G.-G.); (P.J.M.-L.); (J.C.M.); (J.C.-S.); (T.B.-R.); (F.C.); (J.M.G.-J.)
- Internal Medicine Department, Hospital Clinic of Barcelona, 08036 Barcelona, Spain
- CIBERER—Spanish Biomedical Research Centre in Rare Diseases, 28029 Madrid, Spain
| | - Pedro J. Moreno-Lozano
- Muscle Research and Mitochondrial Function Laboratory, CELLEX-IDIBAPS, Faculty of Medicine, University of Barcelona, 08036 Barcelona, Spain; (M.C.-G.); (F.J.G.-G.); (P.J.M.-L.); (J.C.M.); (J.C.-S.); (T.B.-R.); (F.C.); (J.M.G.-J.)
- Internal Medicine Department, Hospital Clinic of Barcelona, 08036 Barcelona, Spain
- CIBERER—Spanish Biomedical Research Centre in Rare Diseases, 28029 Madrid, Spain
| | - Gema Alcarraz-Vizán
- Diabetes and Obesity Laboratory Research, Institut d’Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), 08036 Barcelona, Spain;
- CIBERDEM—Spanish Biomedical Research Centre in Diabetes and Associated Metabolic Disorders, 28029 Madrid, Spain
| | - Adrià Tort-Merino
- Alzheimer’s Disease and Other Cognitive Disorders Unit, Hospital Clínic and Institut d’Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), 08036 Barcelona, Spain;
| | - José César Milisenda
- Muscle Research and Mitochondrial Function Laboratory, CELLEX-IDIBAPS, Faculty of Medicine, University of Barcelona, 08036 Barcelona, Spain; (M.C.-G.); (F.J.G.-G.); (P.J.M.-L.); (J.C.M.); (J.C.-S.); (T.B.-R.); (F.C.); (J.M.G.-J.)
- Internal Medicine Department, Hospital Clinic of Barcelona, 08036 Barcelona, Spain
- CIBERER—Spanish Biomedical Research Centre in Rare Diseases, 28029 Madrid, Spain
| | - Judith Cantó-Santos
- Muscle Research and Mitochondrial Function Laboratory, CELLEX-IDIBAPS, Faculty of Medicine, University of Barcelona, 08036 Barcelona, Spain; (M.C.-G.); (F.J.G.-G.); (P.J.M.-L.); (J.C.M.); (J.C.-S.); (T.B.-R.); (F.C.); (J.M.G.-J.)
- Internal Medicine Department, Hospital Clinic of Barcelona, 08036 Barcelona, Spain
- CIBERER—Spanish Biomedical Research Centre in Rare Diseases, 28029 Madrid, Spain
| | - Tamara Barcos-Rodríguez
- Muscle Research and Mitochondrial Function Laboratory, CELLEX-IDIBAPS, Faculty of Medicine, University of Barcelona, 08036 Barcelona, Spain; (M.C.-G.); (F.J.G.-G.); (P.J.M.-L.); (J.C.M.); (J.C.-S.); (T.B.-R.); (F.C.); (J.M.G.-J.)
- Internal Medicine Department, Hospital Clinic of Barcelona, 08036 Barcelona, Spain
- CIBERER—Spanish Biomedical Research Centre in Rare Diseases, 28029 Madrid, Spain
| | - Francesc Cardellach
- Muscle Research and Mitochondrial Function Laboratory, CELLEX-IDIBAPS, Faculty of Medicine, University of Barcelona, 08036 Barcelona, Spain; (M.C.-G.); (F.J.G.-G.); (P.J.M.-L.); (J.C.M.); (J.C.-S.); (T.B.-R.); (F.C.); (J.M.G.-J.)
- Internal Medicine Department, Hospital Clinic of Barcelona, 08036 Barcelona, Spain
- CIBERER—Spanish Biomedical Research Centre in Rare Diseases, 28029 Madrid, Spain
| | - Albert Lladó
- Alzheimer’s Disease and Other Cognitive Disorders Unit, Hospital Clínic and Institut d’Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), 08036 Barcelona, Spain;
| | - Anna Novials
- Diabetes and Obesity Laboratory Research, Institut d’Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), 08036 Barcelona, Spain;
- CIBERDEM—Spanish Biomedical Research Centre in Diabetes and Associated Metabolic Disorders, 28029 Madrid, Spain
| | - Glòria Garrabou
- Muscle Research and Mitochondrial Function Laboratory, CELLEX-IDIBAPS, Faculty of Medicine, University of Barcelona, 08036 Barcelona, Spain; (M.C.-G.); (F.J.G.-G.); (P.J.M.-L.); (J.C.M.); (J.C.-S.); (T.B.-R.); (F.C.); (J.M.G.-J.)
- Internal Medicine Department, Hospital Clinic of Barcelona, 08036 Barcelona, Spain
- CIBERER—Spanish Biomedical Research Centre in Rare Diseases, 28029 Madrid, Spain
| | - Josep M. Grau-Junyent
- Muscle Research and Mitochondrial Function Laboratory, CELLEX-IDIBAPS, Faculty of Medicine, University of Barcelona, 08036 Barcelona, Spain; (M.C.-G.); (F.J.G.-G.); (P.J.M.-L.); (J.C.M.); (J.C.-S.); (T.B.-R.); (F.C.); (J.M.G.-J.)
- Internal Medicine Department, Hospital Clinic of Barcelona, 08036 Barcelona, Spain
- CIBERER—Spanish Biomedical Research Centre in Rare Diseases, 28029 Madrid, Spain
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7
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Seto N, Torres-Ruiz JJ, Carmona-Rivera C, Pinal-Fernandez I, Pak K, Purmalek MM, Hosono Y, Fernandes-Cerqueira C, Gowda P, Arnett N, Gorbach A, Benveniste O, Gómez-Martín D, Selva-O'Callaghan A, Milisenda JC, Grau-Junyent JM, Christopher-Stine L, Miller FW, Lundberg IE, Kahlenberg JM, Schiffenbauer AI, Mammen A, Rider LG, Kaplan MJ. Neutrophil dysregulation is pathogenic in idiopathic inflammatory myopathies. JCI Insight 2020; 5:134189. [PMID: 31945019 DOI: 10.1172/jci.insight.134189] [Citation(s) in RCA: 54] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2019] [Accepted: 01/09/2020] [Indexed: 12/11/2022] Open
Abstract
Idiopathic inflammatory myopathies (IIM) are characterized by muscle inflammation and weakness, myositis-specific autoantibodies (MSAs), and extramuscular organ damage. The role of neutrophil dysregulation and neutrophil extracellular traps (NETs) in IIM is unclear. We assessed whether pathogenic neutrophil subsets (low-density granulocytes [LDGs]) and NETs were elevated in IIM, associated with clinical presentation and MSAs, and their effect on skeletal myoblasts and myotubes. Circulating NETs and LDGs were quantified and correlated with clinical measures. Specific MSAs were tested for their ability to induce NETs. NETs and neutrophil gene expression were measured in IIM biopsies. Whether NETs damage skeletal myoblasts and myotubes was tested. Circulating LDGs and NETs were increased in IIM. IIM LDGs had an enhanced ability to form NETs. LDGs and NETs correlated with IIM disease activity and muscle damage. The serum MSA anti-MDA5 correlated with circulating and tissue NETs and directly enhanced NET formation. An enhanced neutrophil gene signature was present in IIM muscle and associated with muscle injury and tissue IFN gene signatures. IIM NETs decreased the viability of myotubes in a citrullinated histone-dependent manner. Dysregulated neutrophil pathways may play pathogenic roles in IIM through their ability to directly injure muscle cells and other affected tissues.
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Affiliation(s)
- Nickie Seto
- Systemic Autoimmunity Branch, Intramural Research Program, National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), NIH, Bethesda, Maryland, USA
| | - Jose Jiram Torres-Ruiz
- Systemic Autoimmunity Branch, Intramural Research Program, National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), NIH, Bethesda, Maryland, USA.,Instituto Nacional de Ciencias Medicas y de la Nutrición Salvador Zubiran, Mexico City, México
| | - Carmelo Carmona-Rivera
- Systemic Autoimmunity Branch, Intramural Research Program, National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), NIH, Bethesda, Maryland, USA
| | - Iago Pinal-Fernandez
- Muscle Disease Unit, NIAMS, NIH, Bethesda, Maryland, USA.,Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.,Faculty of Health Sciences and Faculty of Computer Science, Universitat Oberta de Catalunya, Barcelona, Spain
| | - Katherine Pak
- Muscle Disease Unit, NIAMS, NIH, Bethesda, Maryland, USA
| | - Monica M Purmalek
- Systemic Autoimmunity Branch, Intramural Research Program, National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), NIH, Bethesda, Maryland, USA
| | - Yuji Hosono
- Muscle Disease Unit, NIAMS, NIH, Bethesda, Maryland, USA
| | - Catia Fernandes-Cerqueira
- Division of Rheumatology, Department of Medicine, Solna, Karolinska Institutet, and Rheumatology Clinic, Karolinska University Hospital, Stockholm, Sweden
| | - Prateek Gowda
- Infrared Imaging and Thermometry Unit, National Institute of Biomedical Imaging and Bioengineering, NIH, Bethesda, Maryland, USA
| | - Nathan Arnett
- Infrared Imaging and Thermometry Unit, National Institute of Biomedical Imaging and Bioengineering, NIH, Bethesda, Maryland, USA
| | - Alexander Gorbach
- Infrared Imaging and Thermometry Unit, National Institute of Biomedical Imaging and Bioengineering, NIH, Bethesda, Maryland, USA
| | - Olivier Benveniste
- Department of Internal Medicine and Clinical Immunology, CHU Paris-GH La Pitié-Salpêtrière-Charles Foix-Hôpital Pitié Salpêtrière, Paris, France
| | - Diana Gómez-Martín
- Instituto Nacional de Ciencias Medicas y de la Nutrición Salvador Zubiran, Mexico City, México
| | - Albert Selva-O'Callaghan
- Hospital General Universitario Vall d'Hebron, Universidad Autónoma de Barcelona, Barcelona, Spain
| | - José C Milisenda
- Hospital Clinic de Barcelona and Universidad de Barcelona, Barcelona, Spain
| | | | | | - Frederick W Miller
- Environmental Autoimmunity Group, Clinical Research Branch, National Institute of Environmental Health Sciences (NIEHS), NIH, Research Triangle Park, North Carolina and Bethesda, Maryland, USA
| | - Ingrid E Lundberg
- Division of Rheumatology, Department of Medicine, Solna, Karolinska Institutet, and Rheumatology Clinic, Karolinska University Hospital, Stockholm, Sweden
| | - J Michelle Kahlenberg
- Division of Rheumatology, University of Michigan Medical School, Ann Arbor, Michigan, USA
| | - Adam I Schiffenbauer
- Environmental Autoimmunity Group, Clinical Research Branch, National Institute of Environmental Health Sciences (NIEHS), NIH, Bethesda, Maryland, USA
| | - Andrew Mammen
- Muscle Disease Unit, NIAMS, NIH, Bethesda, Maryland, USA.,Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Lisa G Rider
- Environmental Autoimmunity Group, Clinical Research Branch, National Institute of Environmental Health Sciences (NIEHS), NIH, Bethesda, Maryland, USA
| | - Mariana J Kaplan
- Systemic Autoimmunity Branch, Intramural Research Program, National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), NIH, Bethesda, Maryland, USA
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8
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Pinal-Fernandez I, Casal-Dominguez M, Derfoul A, Pak K, Plotz P, Miller FW, Milisenda JC, Grau-Junyent JM, Selva-O'Callaghan A, Paik J, Albayda J, Christopher-Stine L, Lloyd TE, Corse AM, Mammen AL. Identification of distinctive interferon gene signatures in different types of myositis. Neurology 2019; 93:e1193-e1204. [PMID: 31434690 DOI: 10.1212/wnl.0000000000008128] [Citation(s) in RCA: 101] [Impact Index Per Article: 20.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2019] [Accepted: 04/30/2019] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE Activation of the type 1 interferon (IFN1) pathway is a prominent feature of dermatomyositis (DM) muscle and may play a role in the pathogenesis of this disease. However, the relevance of the IFN1 pathway in patients with other types of myositis such as the antisynthetase syndrome (AS), immune-mediated necrotizing myopathy (IMNM), and inclusion body myositis (IBM) is largely unknown. Moreover, the activation of the type 2 interferon (IFN2) pathway has not been comprehensively explored in myositis. In this cross-sectional study, our objective was to determine whether IFN1 and IFN2 pathways are differentially activated in different types of myositis by performing RNA sequencing on muscle biopsy samples from 119 patients with DM, IMNM, AS, or IBM and on 20 normal muscle biopsies. METHODS The expression of IFN1- and IFN2-inducible genes was compared between the different groups. RESULTS The expression of IFN1-inducible genes was high in DM, moderate in AS, and low in IMNM and IBM. In contrast, the expression of IFN2-inducible genes was high in DM, IBM, and AS but low in IMNM. The expression of IFN-inducible genes correlated with the expression of genes associated with inflammation and muscle regeneration. Of note, ISG15 expression levels alone performed as well as composite scores relying on multiple genes to monitor activation of the IFN1 pathway in myositis muscle biopsies. CONCLUSIONS IFN1 and IFN2 pathways are differentially activated in different forms of myositis. This observation may have therapeutic implications because immunosuppressive medications may preferentially target each of these pathways.
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Affiliation(s)
- Iago Pinal-Fernandez
- From the National Institute of Arthritis and Musculoskeletal and Skin Diseases (I.P.-F, M.C.-D, A.D., K.P., P.P., F.W.M., A.L.M.), NIH, Bethesda; Johns Hopkins University School of Medicine (I.P.-F., M.C.-D., J.P., J.A., L.C.-S., T.E.L., A.M.C., A.L.M.), Baltimore, MD; Clinic Hospital and the University of Barcelona (J.C.M., J.M.G.-J.); Vall d'Hebron Hospital and Autonomous University of Barcelona (A.S.-O.); and Faculty of Health Sciences (I.P.-F.), Universitat Oberta de Catalunya, Barcelona, Spain.
| | - Maria Casal-Dominguez
- From the National Institute of Arthritis and Musculoskeletal and Skin Diseases (I.P.-F, M.C.-D, A.D., K.P., P.P., F.W.M., A.L.M.), NIH, Bethesda; Johns Hopkins University School of Medicine (I.P.-F., M.C.-D., J.P., J.A., L.C.-S., T.E.L., A.M.C., A.L.M.), Baltimore, MD; Clinic Hospital and the University of Barcelona (J.C.M., J.M.G.-J.); Vall d'Hebron Hospital and Autonomous University of Barcelona (A.S.-O.); and Faculty of Health Sciences (I.P.-F.), Universitat Oberta de Catalunya, Barcelona, Spain
| | - Assia Derfoul
- From the National Institute of Arthritis and Musculoskeletal and Skin Diseases (I.P.-F, M.C.-D, A.D., K.P., P.P., F.W.M., A.L.M.), NIH, Bethesda; Johns Hopkins University School of Medicine (I.P.-F., M.C.-D., J.P., J.A., L.C.-S., T.E.L., A.M.C., A.L.M.), Baltimore, MD; Clinic Hospital and the University of Barcelona (J.C.M., J.M.G.-J.); Vall d'Hebron Hospital and Autonomous University of Barcelona (A.S.-O.); and Faculty of Health Sciences (I.P.-F.), Universitat Oberta de Catalunya, Barcelona, Spain
| | - Katherine Pak
- From the National Institute of Arthritis and Musculoskeletal and Skin Diseases (I.P.-F, M.C.-D, A.D., K.P., P.P., F.W.M., A.L.M.), NIH, Bethesda; Johns Hopkins University School of Medicine (I.P.-F., M.C.-D., J.P., J.A., L.C.-S., T.E.L., A.M.C., A.L.M.), Baltimore, MD; Clinic Hospital and the University of Barcelona (J.C.M., J.M.G.-J.); Vall d'Hebron Hospital and Autonomous University of Barcelona (A.S.-O.); and Faculty of Health Sciences (I.P.-F.), Universitat Oberta de Catalunya, Barcelona, Spain
| | - Paul Plotz
- From the National Institute of Arthritis and Musculoskeletal and Skin Diseases (I.P.-F, M.C.-D, A.D., K.P., P.P., F.W.M., A.L.M.), NIH, Bethesda; Johns Hopkins University School of Medicine (I.P.-F., M.C.-D., J.P., J.A., L.C.-S., T.E.L., A.M.C., A.L.M.), Baltimore, MD; Clinic Hospital and the University of Barcelona (J.C.M., J.M.G.-J.); Vall d'Hebron Hospital and Autonomous University of Barcelona (A.S.-O.); and Faculty of Health Sciences (I.P.-F.), Universitat Oberta de Catalunya, Barcelona, Spain
| | - Frederick W Miller
- From the National Institute of Arthritis and Musculoskeletal and Skin Diseases (I.P.-F, M.C.-D, A.D., K.P., P.P., F.W.M., A.L.M.), NIH, Bethesda; Johns Hopkins University School of Medicine (I.P.-F., M.C.-D., J.P., J.A., L.C.-S., T.E.L., A.M.C., A.L.M.), Baltimore, MD; Clinic Hospital and the University of Barcelona (J.C.M., J.M.G.-J.); Vall d'Hebron Hospital and Autonomous University of Barcelona (A.S.-O.); and Faculty of Health Sciences (I.P.-F.), Universitat Oberta de Catalunya, Barcelona, Spain
| | - Jose C Milisenda
- From the National Institute of Arthritis and Musculoskeletal and Skin Diseases (I.P.-F, M.C.-D, A.D., K.P., P.P., F.W.M., A.L.M.), NIH, Bethesda; Johns Hopkins University School of Medicine (I.P.-F., M.C.-D., J.P., J.A., L.C.-S., T.E.L., A.M.C., A.L.M.), Baltimore, MD; Clinic Hospital and the University of Barcelona (J.C.M., J.M.G.-J.); Vall d'Hebron Hospital and Autonomous University of Barcelona (A.S.-O.); and Faculty of Health Sciences (I.P.-F.), Universitat Oberta de Catalunya, Barcelona, Spain
| | - Josep M Grau-Junyent
- From the National Institute of Arthritis and Musculoskeletal and Skin Diseases (I.P.-F, M.C.-D, A.D., K.P., P.P., F.W.M., A.L.M.), NIH, Bethesda; Johns Hopkins University School of Medicine (I.P.-F., M.C.-D., J.P., J.A., L.C.-S., T.E.L., A.M.C., A.L.M.), Baltimore, MD; Clinic Hospital and the University of Barcelona (J.C.M., J.M.G.-J.); Vall d'Hebron Hospital and Autonomous University of Barcelona (A.S.-O.); and Faculty of Health Sciences (I.P.-F.), Universitat Oberta de Catalunya, Barcelona, Spain
| | - Albert Selva-O'Callaghan
- From the National Institute of Arthritis and Musculoskeletal and Skin Diseases (I.P.-F, M.C.-D, A.D., K.P., P.P., F.W.M., A.L.M.), NIH, Bethesda; Johns Hopkins University School of Medicine (I.P.-F., M.C.-D., J.P., J.A., L.C.-S., T.E.L., A.M.C., A.L.M.), Baltimore, MD; Clinic Hospital and the University of Barcelona (J.C.M., J.M.G.-J.); Vall d'Hebron Hospital and Autonomous University of Barcelona (A.S.-O.); and Faculty of Health Sciences (I.P.-F.), Universitat Oberta de Catalunya, Barcelona, Spain
| | - Julie Paik
- From the National Institute of Arthritis and Musculoskeletal and Skin Diseases (I.P.-F, M.C.-D, A.D., K.P., P.P., F.W.M., A.L.M.), NIH, Bethesda; Johns Hopkins University School of Medicine (I.P.-F., M.C.-D., J.P., J.A., L.C.-S., T.E.L., A.M.C., A.L.M.), Baltimore, MD; Clinic Hospital and the University of Barcelona (J.C.M., J.M.G.-J.); Vall d'Hebron Hospital and Autonomous University of Barcelona (A.S.-O.); and Faculty of Health Sciences (I.P.-F.), Universitat Oberta de Catalunya, Barcelona, Spain
| | - Jemima Albayda
- From the National Institute of Arthritis and Musculoskeletal and Skin Diseases (I.P.-F, M.C.-D, A.D., K.P., P.P., F.W.M., A.L.M.), NIH, Bethesda; Johns Hopkins University School of Medicine (I.P.-F., M.C.-D., J.P., J.A., L.C.-S., T.E.L., A.M.C., A.L.M.), Baltimore, MD; Clinic Hospital and the University of Barcelona (J.C.M., J.M.G.-J.); Vall d'Hebron Hospital and Autonomous University of Barcelona (A.S.-O.); and Faculty of Health Sciences (I.P.-F.), Universitat Oberta de Catalunya, Barcelona, Spain
| | - Lisa Christopher-Stine
- From the National Institute of Arthritis and Musculoskeletal and Skin Diseases (I.P.-F, M.C.-D, A.D., K.P., P.P., F.W.M., A.L.M.), NIH, Bethesda; Johns Hopkins University School of Medicine (I.P.-F., M.C.-D., J.P., J.A., L.C.-S., T.E.L., A.M.C., A.L.M.), Baltimore, MD; Clinic Hospital and the University of Barcelona (J.C.M., J.M.G.-J.); Vall d'Hebron Hospital and Autonomous University of Barcelona (A.S.-O.); and Faculty of Health Sciences (I.P.-F.), Universitat Oberta de Catalunya, Barcelona, Spain
| | - Thomas E Lloyd
- From the National Institute of Arthritis and Musculoskeletal and Skin Diseases (I.P.-F, M.C.-D, A.D., K.P., P.P., F.W.M., A.L.M.), NIH, Bethesda; Johns Hopkins University School of Medicine (I.P.-F., M.C.-D., J.P., J.A., L.C.-S., T.E.L., A.M.C., A.L.M.), Baltimore, MD; Clinic Hospital and the University of Barcelona (J.C.M., J.M.G.-J.); Vall d'Hebron Hospital and Autonomous University of Barcelona (A.S.-O.); and Faculty of Health Sciences (I.P.-F.), Universitat Oberta de Catalunya, Barcelona, Spain
| | - Andrea M Corse
- From the National Institute of Arthritis and Musculoskeletal and Skin Diseases (I.P.-F, M.C.-D, A.D., K.P., P.P., F.W.M., A.L.M.), NIH, Bethesda; Johns Hopkins University School of Medicine (I.P.-F., M.C.-D., J.P., J.A., L.C.-S., T.E.L., A.M.C., A.L.M.), Baltimore, MD; Clinic Hospital and the University of Barcelona (J.C.M., J.M.G.-J.); Vall d'Hebron Hospital and Autonomous University of Barcelona (A.S.-O.); and Faculty of Health Sciences (I.P.-F.), Universitat Oberta de Catalunya, Barcelona, Spain
| | - Andrew L Mammen
- From the National Institute of Arthritis and Musculoskeletal and Skin Diseases (I.P.-F, M.C.-D, A.D., K.P., P.P., F.W.M., A.L.M.), NIH, Bethesda; Johns Hopkins University School of Medicine (I.P.-F., M.C.-D., J.P., J.A., L.C.-S., T.E.L., A.M.C., A.L.M.), Baltimore, MD; Clinic Hospital and the University of Barcelona (J.C.M., J.M.G.-J.); Vall d'Hebron Hospital and Autonomous University of Barcelona (A.S.-O.); and Faculty of Health Sciences (I.P.-F.), Universitat Oberta de Catalunya, Barcelona, Spain.
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9
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Pinal-Fernandez I, Amici DR, Parks CA, Derfoul A, Casal-Dominguez M, Pak K, Yeker R, Plotz P, Milisenda JC, Grau-Junyent JM, Selva-O'Callaghan A, Paik JJ, Albayda J, Corse AM, Lloyd TE, Christopher-Stine L, Mammen AL. Myositis Autoantigen Expression Correlates With Muscle Regeneration but Not Autoantibody Specificity. Arthritis Rheumatol 2019; 71:1371-1376. [PMID: 30861336 DOI: 10.1002/art.40883] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2018] [Accepted: 03/07/2019] [Indexed: 02/02/2023]
Abstract
OBJECTIVE Although more than a dozen myositis-specific autoantibodies (MSAs) have been identified, most patients with myositis are positive for a single MSA. The specific overexpression of a given myositis autoantigen in myositis muscle has been proposed as initiating and/or propagating autoimmunity against that particular autoantigen. The present study was undertaken to test this hypothesis. METHODS In order to quantify autoantigen RNA expression, RNA sequencing was performed on muscle biopsy samples from control subjects, MSA-positive patients with myositis, regenerating mouse muscles, and cultured human muscle cells. RESULTS Muscle biopsy samples were available from 20 control subjects and 106 patients with autoantibodies recognizing hydroxymethylglutaryl-coenzyme A reductase (n = 40), signal recognition particles (n = 9), Jo-1 (n = 18), nuclear matrix protein 2 (n = 12), Mi-2 (n = 11), transcription intermediary factor 1γ (n = 11), or melanoma differentiation-associated protein 5 (n = 5). The increased expression of a given autoantigen in myositis muscle was not associated with autoantibodies recognizing that autoantigen (all q > 0.05). In biopsy specimens from both myositis muscle and regenerating mouse muscles, autoantigen expression correlated directly with the expression of muscle regeneration markers and correlated inversely with the expression of genes encoding mature muscle proteins. Myositis autoantigens were also expressed at high levels in cultured human muscle cells. CONCLUSION Most myositis autoantigens are highly expressed during muscle regeneration, which may relate to the propagation of autoimmunity. However, factors other than overexpression of specific autoantigens are likely to govern the development of unique autoantibodies in individual patients with myositis.
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Affiliation(s)
- Iago Pinal-Fernandez
- National Institute of Arthritis and Musculoskeletal and Skin Diseases, NIH, Bethesda, Maryland, Johns Hopkins University School of Medicine, Baltimore, Maryland, and Universitat Oberta de Catalunya, Barcelona, Spain
| | - David R Amici
- National Institute of Arthritis and Musculoskeletal and Skin Diseases, NIH, Bethesda, Maryland
| | - Cassie A Parks
- National Institute of Arthritis and Musculoskeletal and Skin Diseases, NIH, Bethesda, Maryland
| | - Assia Derfoul
- National Institute of Arthritis and Musculoskeletal and Skin Diseases, NIH, Bethesda, Maryland
| | - Maria Casal-Dominguez
- National Institute of Arthritis and Musculoskeletal and Skin Diseases, NIH, Bethesda, Maryland, and Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Katherine Pak
- National Institute of Arthritis and Musculoskeletal and Skin Diseases, NIH, Bethesda, Maryland
| | - Richard Yeker
- National Institute of Arthritis and Musculoskeletal and Skin Diseases, NIH, Bethesda, Maryland
| | - Paul Plotz
- National Institute of Arthritis and Musculoskeletal and Skin Diseases, NIH, Bethesda, Maryland
| | - Jose C Milisenda
- Clinic Hospital and the University of Barcelona, Barcelona, Spain
| | | | | | - Julie J Paik
- Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Jemima Albayda
- Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Andrea M Corse
- Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Thomas E Lloyd
- Johns Hopkins University School of Medicine, Baltimore, Maryland
| | | | - Andrew L Mammen
- National Institute of Arthritis and Musculoskeletal and Skin Diseases, NIH, Bethesda, Maryland, and Johns Hopkins University School of Medicine, Baltimore, Maryland
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10
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Pinal-Fernandez I, Ferrer-Fabregas B, Trallero-Araguas E, Balada E, Martínez MA, Milisenda JC, Aparicio-Español G, Labrador-Horrillo M, Garcia-Patos V, Grau-Junyent JM, Selva-O'Callaghan A. Tumour TIF1 mutations and loss of heterozygosity related to cancer-associated myositis. Rheumatology (Oxford) 2018; 57:388-396. [PMID: 29149307 DOI: 10.1093/rheumatology/kex413] [Citation(s) in RCA: 55] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2017] [Indexed: 01/21/2023] Open
Abstract
Objectives To analyse the influence of genetic alterations and differential expression of transcription intermediary factor 1 (TIF1) genes in the pathophysiology of cancer-associated myositis (CAM). Methods Paired blood and tumour DNA samples from patients with anti-TIF1γ-positive CAM and from controls were analysed by whole-exome sequencing for the presence of somatic mutations and loss of heterozygosity (LOH) in their TIF1 genes. The genesis and maintenance of the autoimmune process were investigated immunohistochemically by studying TIF1γ expression in the different tissues involved in CAM (skin, muscle and tumour) based on the immunohistochemical H-score. Results From seven patients with anti-TIF1γ-positive CAM, we detected one somatic mutation and five cases of LOH in one or more of the four TIF1 genes compared with just one case of LOH in tumours from TIF1γ-negative myositis patients (86% vs 17%; P = 0.03). Compared with type-matched control tumours from non-myositis patients, TIF1γ staining was more intense in tumours from anti-TIF1γ-positive patients (H-score 255 vs 196; P = 0.01). Also, TIF1γ staining in muscle was slightly more intense in anti-TIF1γ-positive than in anti-TIF1γ-negative myositis (H-score 22 vs 5; P = 0.03). In contrast, intense TIF1γ staining was detected in the skin of both myositis and control patients. Conclusion Tumours from paraneoplastic anti-TIF1γ-positive patients showed an increased number of genetic alterations, such as mutations and LOH, in TIF1 genes. These genetic alterations, in the context of a high expression of TIF1γ in the tumour, muscle and skin of these patients may be key to understanding the genesis of paraneoplastic myositis.
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Affiliation(s)
- Iago Pinal-Fernandez
- Internal Medicine Department, Vall d'Hebron University Hospital, Barcelona, Spain.,Medicine Department, Universitat Autónoma de Barcelona, Barcelona, Spain.,NIAMS, National Institutes of Health, Muscle Diseases Unit, Bethesda, MD, USA
| | | | | | - Eva Balada
- Internal Medicine Department, Vall d'Hebron University Hospital, Barcelona, Spain
| | | | - Jose César Milisenda
- Muscle Research Group and Ciberer, Hospital Clinic Provincial, Institut d'Investigacions Biomédiques August Pi I Sunyer, Universitat de Barcelona, Barcelona, Spain
| | | | | | - Vicente Garcia-Patos
- Medicine Department, Universitat Autónoma de Barcelona, Barcelona, Spain.,Dermatology Department, Vall d'Hebron University Hospital, Barcelona, Spain
| | - Josep M Grau-Junyent
- Muscle Research Group and Ciberer, Hospital Clinic Provincial, Institut d'Investigacions Biomédiques August Pi I Sunyer, Universitat de Barcelona, Barcelona, Spain
| | - Albert Selva-O'Callaghan
- Internal Medicine Department, Vall d'Hebron University Hospital, Barcelona, Spain.,Medicine Department, Universitat Autónoma de Barcelona, Barcelona, Spain
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11
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Affiliation(s)
- Andrea Combalia
- Department of Dermatology, Hospital Clinic de Barcelona, University of Barcelona, Barcelona, Spain
| | - Priscila Giavedoni
- Department of Dermatology, Hospital Clinic de Barcelona, University of Barcelona, Barcelona, Spain
| | - Lorena Tamez
- Department of Dermatology, Hospital Clinic de Barcelona, University of Barcelona, Barcelona, Spain
| | - Josep M. Grau-Junyent
- Department of Internal Medicine, Hospital Clinic de Barcelona, University of Barcelona, Barcelona, Spain
| | - Jose M. Mascaró
- Department of Dermatology, Hospital Clinic de Barcelona, University of Barcelona, Barcelona, Spain
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12
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Pérez-López J, Ceberio-Hualde L, García-Morillo JS, Grau-Junyent JM, Hermida Ameijeiras A, López-Rodríguez M, Milisenda JC, Moltó Abad M, Morales-Conejo M, Nava Mateos JJ. Clinical characteristics of adult patients with inborn errors of metabolism in Spain: A review of 500 cases from university hospitals. Mol Genet Metab Rep 2017; 10:92-95. [PMID: 28224082 PMCID: PMC5310594 DOI: 10.1016/j.ymgmr.2017.01.011] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2016] [Revised: 01/26/2017] [Accepted: 01/26/2017] [Indexed: 11/29/2022] Open
Abstract
Patients with inborn errors of metabolism (IEMs) have become an emerging and challenging group in the adult healthcare system whose needs should be known in order to implement appropriate policies and to adapt adult clinical departments. We aimed to analyze the clinical characteristics of adult patients with IEMs who attend the most important Spanish hospitals caring for these conditions. A cohort study was conducted in 500 patients, categorized by metabolic subtype according to pathophysiological classification. The most prevalent group of IEMs was amino acid disorders, with 108 (21.6%) patients diagnosed with phenylketonuria. Lysosomal storage disorders were the second group, in which 32 (6.4%) and 25 (5%) patients had Fabry disease and Gaucher disease respectively. The great clinical heterogeneity, the significant delay in diagnosis after symptom onset, the existence of some degree of physical dependence in a great number of patients, the need for a multidisciplinary and coordinated approach, and the lack of specific drug treatment are common features in this group of conditions.
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Affiliation(s)
- J Pérez-López
- Errores Congénitos del Metabolismo del Adulto, Unidad de Enfermedades Minoritarias, Hospital Universitario Vall d'Hebron, CSUR de Errores Congénitos del Metabolismo, Barcelona, Spain
| | - L Ceberio-Hualde
- Servicio de Medicina Interna, Hospital Universitario de Cruces, CSUR de Errores Congénitos del Metabolismo, Baracaldo, Bizkaia, Spain
| | - J S García-Morillo
- Unidad de Enfermedades Minoritarias, Área de Medicina Interna en la Unidad Clínica de Atención Médica Integral (UCAMI), Hospital Virgen del Rocío, Sevilla, Spain
| | - J M Grau-Junyent
- Servicio de Medicina Interna, Grupo de Enfermedades Minoritarias, Hospital Clínic, CIBERER, Barcelona, Spain
| | - A Hermida Ameijeiras
- Unidad de Enfermedades Metabólicas Congénitas, Servicio de Medicina Interna, Hospital Clínico Universitario de Santiago, CSUR de Errores Congénitos del Metabolismo, Santiago de Compostela, Spain
| | - M López-Rodríguez
- Servicio de Medicina Interna, Hospital Central de la Cruz Roja, Madrid, Spain
| | - J C Milisenda
- Servicio de Medicina Interna, Grupo de Enfermedades Minoritarias, Hospital Clínic, CIBERER, Barcelona, Spain
| | - M Moltó Abad
- Errores Congénitos del Metabolismo del Adulto, Unidad de Enfermedades Minoritarias, Hospital Universitario Vall d'Hebron, CSUR de Errores Congénitos del Metabolismo, Barcelona, Spain
| | - M Morales-Conejo
- Servicio de Medicina Interna, Hospital Universitario 12 de Octubre, CSUR de Errores Congénitos del Metabolismo, Madrid, Spain
| | - J J Nava Mateos
- Servicio de Medicina Interna, Hospital Universitario Ramón y Cajal, CSUR de Errores Congénitos del Metabolismo, Madrid, Spain
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13
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Pérez-López J, Ceberio-Hualde L, García Morillo JS, Grau-Junyent JM, Hermida Ameijeiras Á, López-Rodríguez M, Morales-Conejo M, Nava Mateos JJ, Aldámiz Echevarri Azuara LJ, Campistol J, Couce ML, García-Silva MT, González Gutiérrez-Solana L, Del Toro M. [Transition process from paediatric to adult care in patients with inborn errors of metabolism. Consensus statement]. Med Clin (Barc) 2016; 147:506.e1-506.e7. [PMID: 27816186 DOI: 10.1016/j.medcli.2016.09.018] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2016] [Revised: 08/02/2016] [Accepted: 09/08/2016] [Indexed: 11/28/2022]
Abstract
BACKGROUND AND OBJECTIVE The transition process from paediatric to adult care is a subject of great interest in recent years, especially in chronic diseases with childhood onset, such as inborn errors of metabolism (IEM). Advances in diagnosis and treatment of these diseases have improved their prognosis, with a high number of patients with IEM who currently reach adult age and need to be attended to by non-paediatric professionals. The objective of this work is to establish action guidelines so that the specialists involved can guarantee a successful transition of these patients' healthcare. METHODOLOGY After carrying out a bibliographic review of the subject, the authors, beginning with their own experience, produced an initial document which was subjected to successive debates until the final document was obtained. The consensus recommendation was decided by the majority in case of criterion discrepancy. RESULTS A series of recommendations are presented for the best clinical management of the transitions of care of patients with IEM from the paediatric to adult care setting in order to achieve the best results in this process given the special characteristics of this patient subgroup and the main difficulties entailed in the transition process. CONCLUSIONS The role of the internal medicine doctor in this transition process and correct interrelation with the paediatric and social setting is stressed. Furthermore, actions and attitudes are suggested to improve the quality of said transition.
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Affiliation(s)
- Jordi Pérez-López
- Errores Congénitos del Metabolismo del Adulto, Unidad de Enfermedades Minoritarias, Hospital Universitario Vall d'Hebron, CSUR de Errores Congénitos del Metabolismo, Grupo de Trabajo de Enfermedades Minoritarias de la SEMI, Barcelona, España.
| | - Leticia Ceberio-Hualde
- Servicio de Medicina Interna, Hospital Universitario de Cruces, CSUR de Errores Congénitos del Metabolismo, Baracaldo, Bizkaia, España
| | - José Salvador García Morillo
- Unidad de Enfermedades Minoritarias y Unidad Clínica de Atención Médica Integral (UCAMI), Servicio de Medicina Interna, Hospital Virgen del Rocío, Sevilla, España
| | - Josep M Grau-Junyent
- Servicio de Medicina Interna, Grupo de Enfermedades Minoritarias, Hospital Clínic, Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), Barcelona, España
| | - Álvaro Hermida Ameijeiras
- Unidad de Enfermedades Metabólicas Congénitas, Servicio de Medicina Interna, Hospital Clínico Universitario de Santiago, CSUR de Errores Congénitos del Metabolismo, Santiago de Compostela, A Coruña, España
| | - Mónica López-Rodríguez
- Servicio de Medicina Interna, Hospital Central de la Cruz Roja, Grupo de Trabajo de Enfermedades Minoritarias de la SEMI, Madrid, España
| | - Montserrat Morales-Conejo
- Servicio de Medicina Interna, Hospital Universitario 12 de Octubre, CSUR de Errores Congénitos del Metabolismo, Madrid, España
| | - Juan José Nava Mateos
- Servicio de Medicina Interna, Hospital Universitario Ramón y Cajal, CSUR de Errores Congénitos del Metabolismo, Madrid, España
| | - Luis José Aldámiz Echevarri Azuara
- Unidad de Trastornos Congénitos del Metabolismo, Hospital Universitario de Cruces, CSUR de Errores Congénitos del Metabolismo, Barakaldo, Bizkaia, España
| | - Jaume Campistol
- Servicio de Neurología, Hospital Sant Joan de Déu, CSUR de Errores Congénitos del Metabolismo, Barcelona, España
| | - M Luz Couce
- Unidad de Enfermedades Metabólicas Congénitas, Servicio de Medicina Interna, Hospital Clínico Universitario de Santiago, CSUR de Errores Congénitos del Metabolismo, Santiago de Compostela, A Coruña, España
| | - María Teresa García-Silva
- Unidad de Enfermedades Mitocondriales y Enfermedades Metabólicas Hereditarias, Unidad Pediátrica de Enfermedades Raras, Hospital Universitario 12 de Octubre, CSUR de Errores Congénitos del Metabolismo, Madrid, España
| | | | - Mireia Del Toro
- Servicio de Neuropediatría, Hospital Universitario Vall d'Hebron, CSUR de Errores Congénitos del Metabolismo, Barcelona, España
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14
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Alvarado-Cardenas M, Marin-Sánchez A, Martínez MA, Martínez-Martínez L, Pinal-Fernandez I, Labrador-Horrillo M, Balada E, Mundet-Tuduri X, Gonzalez-Mera L, Casademont J, Acebes EM, Moreno PJ, Juarez C, Grau-Junyent JM, Pujol-Borrell R, Selva-O'Callaghan A. Statin-associated autoimmune myopathy: A distinct new IFL pattern can increase the rate of HMGCR antibody detection by clinical laboratories. Autoimmun Rev 2016; 15:1161-1166. [PMID: 27640317 DOI: 10.1016/j.autrev.2016.09.005] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2016] [Accepted: 07/17/2016] [Indexed: 11/17/2022]
Abstract
BACKGROUND AND OBJECTIVE Statin-associated autoimmune myopathy (SAAM) with anti-HMGCR antibodies has recently been described. Several specific immunoassays are in use to detect HMGCR antibodies. In the course of systematic autoantibody screening we recognized a new distinct IFL staining pattern on rat liver sections that regularly coincided with anti-HMGCR antibodies. In this study we investigated whether this new IFL pattern is specifically associated to statin-associated autoimmune myopathy and corresponds to anti-HMGCR antibodies. PATIENTS AND METHODS Twenty-three patients positive for anti-HMGCR antibodies (14 diagnosed with SAAM) were investigated for anti-HMGCR antibodies by two ELISA assays and confirmed by immmunoblot. HMGCR associated liver IFL pattern (HALIP) was detected by indirect IFL and the reactivity against HMGCR was confirmed by immunoabsorption using purified human HMGCR antigen. 90 patients with other autoimmune diseases and 45 non-autoimmune statin treated patients were studied as controls. RESULTS 21 out of 23 (91%) anti-HMGCR positive patients were HALIP positive. The staining was completely and specifically removed by immunoabsorption with human purified HMGCR. None of the control sera from autoimmune patients or non-autoimmune statin treated subjects was positive for HALIP. Statistical concordance between HALIP and anti-HMGCR antibody specific tests was 98.7%, kappa 0.95. CONCLUSIONS A new and distinct IFL staining pattern (HALIP) is associated to HMGCR associated myopathy. Absorption and concordance studies indicate that the antigen recognized in the liver by HALIP is HMGCR or a closely related protein. Awareness of this new pattern can help to detect HMGCR autoantibodies in statin treated patients tested for autoimmune serology.
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Affiliation(s)
- M Alvarado-Cardenas
- Internal Medicine Department, Hospital Universitari Vall d'Hebron, Universitat Autonoma de Barcelona, Barcelona, Spain
| | - A Marin-Sánchez
- Immunology Division, Hospital Universitari Vall d'Hebron, Vall d'Hebron Research Institute (VHIR), Barcelona, Spain
| | - M A Martínez
- Immunology Department, Hospital de la Santa Creu i Sant Pau, IIB Sant Pau, Universitat Autonoma de Barcelona, Barcelona, Spain
| | - L Martínez-Martínez
- Immunology Department, Hospital de la Santa Creu i Sant Pau, IIB Sant Pau, Universitat Autonoma de Barcelona, Barcelona, Spain
| | - I Pinal-Fernandez
- Internal Medicine Department, Hospital Universitari Vall d'Hebron, Universitat Autonoma de Barcelona, Barcelona, Spain
| | - M Labrador-Horrillo
- Internal Medicine Department, Hospital Universitari Vall d'Hebron, Universitat Autonoma de Barcelona, Barcelona, Spain
| | - E Balada
- Internal Medicine Department, Hospital Universitari Vall d'Hebron, Universitat Autonoma de Barcelona, Barcelona, Spain
| | - X Mundet-Tuduri
- Unitat de Suport a la Recerca Barcelona ciutat, IDIAP Jordi Gol, Universitat Autónoma de Barcelona, Barcelona, Spain
| | | | - J Casademont
- Internal Medicine, Sant Pau Hospital, Universitat Autonoma de Barcelona, Barcelona, Spain
| | | | - P J Moreno
- Muscle Research Group, Internal Medicine, Hospital Clinic, Universitat de Barcelona, Barcelona, and CIBERER, Spain
| | - C Juarez
- Immunology Department, Hospital de la Santa Creu i Sant Pau, IIB Sant Pau, Universitat Autonoma de Barcelona, Barcelona, Spain
| | - J M Grau-Junyent
- Muscle Research Group, Internal Medicine, Hospital Clinic, Universitat de Barcelona, Barcelona, and CIBERER, Spain
| | - R Pujol-Borrell
- Immunology Division, Hospital Universitari Vall d'Hebron, Vall d'Hebron Research Institute (VHIR), Barcelona, Spain; Department of Cell Biology, Physiology and Immunology, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - A Selva-O'Callaghan
- Internal Medicine Department, Hospital Universitari Vall d'Hebron, Universitat Autonoma de Barcelona, Barcelona, Spain.
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Pérez-López J, Selva-O'Callaghan A, Grau-Junyent JM, Gallego-Galindo L, Coll MJ, García-Morillo S, Torralba-Cabeza MA, Vilardell-Tarrés M. Delayed diagnosis of late-onset Pompe disease in patients with myopathies of unknown origin and/or hyperCKemia. Mol Genet Metab 2015; 114:580-3. [PMID: 25752415 DOI: 10.1016/j.ymgme.2015.02.004] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2015] [Revised: 02/14/2015] [Accepted: 02/14/2015] [Indexed: 11/24/2022]
Abstract
Pompe disease is a rare metabolic myopathy whose diagnosis is sometimes delayed despite being essential for improving clinical outcomes. We aimed to investigate the prevalence of late-onset Pompe disease among patients with a myopathy of unknown etiology, including polymyositis, or with idiopathic rise of creatine kinase (CK) levels, in a department of internal medicine. A cohort study was conducted in 241 subjects: 140 patients with myopathies of unknown origin or increased CK levels, 30 with polymyositis and 71 who constituted the control group of other myopathies. Acid α-glucosidase (GAA) activity was tested in dried blood spots. If a positive result was obtained, GAA activity in isolated lymphocytes and/or genetic testing was performed as a confirmatory diagnosis. Out of the 140 investigated patients, 2 patients with myopathies of unknown origin were confirmed to be positive for Pompe disease. Thus, late-onset Pompe disease should be considered among adult patients with myopathy of unknown origin.
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Affiliation(s)
- Jordi Pérez-López
- Department of Internal Medicine, Hospital Vall d'Hebron, 119-129, 08035, Barcelona, Spain.
| | | | - Josep M Grau-Junyent
- Department of Internal Medicine, Hospital Clínic, Carrer Villarroel, 170, 08036, Barcelona, Spain.
| | - Luis Gallego-Galindo
- Department of Internal Medicine, Hospital Vall d'Hebron, 119-129, 08035, Barcelona, Spain.
| | - M Josep Coll
- Department of Biochemistry and Molecular Genetics, Hospital Clínic, Carrer Villarroel, 170, 08036, Barcelona, Spain.
| | - Salvador García-Morillo
- Department of Internal Medicine, Hospital Virgen del Rocío, Avenida Manuel Siurot, s/n, 41013, Sevilla, Spain.
| | - Miguel A Torralba-Cabeza
- Department of Internal Medicine, Hospital Lozano Blesa, Avenida San Juan Bosco, 15, 50009 Zaragoza, Spain.
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Labrador-Horrillo M, Martínez MA, Selva-O'Callaghan A, Trallero-Araguás E, Grau-Junyent JM, Vilardell-Tarrés M, Juarez C. Identification of a novel myositis-associated antibody directed against cortactin. Autoimmun Rev 2014; 13:1008-12. [DOI: 10.1016/j.autrev.2014.08.038] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/25/2014] [Indexed: 02/06/2023]
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Estrada-Reventós D, López-Poyato M, Martin-Robles E, Soriano-Giménez RM, Grau-Junyent JM. [Unscheduled hospital readmissions]. Rev Calid Asist 2014; 29:59-60. [PMID: 23827197 DOI: 10.1016/j.cali.2013.05.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/02/2013] [Accepted: 05/06/2013] [Indexed: 06/02/2023]
Affiliation(s)
| | | | - E Martin-Robles
- Servicio Medicina Interna, Hospital Clínico, Barcelona, España
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Affiliation(s)
- L I Jubany
- Department of Internal Medicine, Vall d'Hebron General Hospital, Barcelona, Spain
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Vargas-Leguás H, Selva-O’Callaghan A, Campins-Martí M, Hermosilla Pérez E, Grau-Junyent JM, Martínez Gómez X, Vaqué Rafart J. Polimiositis y dermatomiositis: incidencia en España (1997-2004). Med Clin (Barc) 2007; 129:721-4. [DOI: 10.1157/13113285] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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20
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Selva-O'Callaghan A, Casellas F, de Torres I, Palou E, Grau-Junyent JM, Vilardell-Tarrés M. Celiac disease and antibodies associated with celiac disease in patients with inflammatory myopathy. Muscle Nerve 2007; 35:49-54. [PMID: 16967485 DOI: 10.1002/mus.20652] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Celiac disease is usually associated with autoimmune disorders and has occasionally been reported in patients with inflammatory myopathies. Our aim was to determine the presence of celiac disease and antibodies associated with celiac disease in patients with inflammatory myopathies and to investigate their relationship. Serum antigliadin, anti-tissue transglutaminase, and antiendomysial antibodies were determined in 51 patients with inflammatory myopathies. HLA-DQ2 and -DQ8 alleles were studied to assess their complementary diagnostic value. Jejunal biopsy was performed in patients with moderate to high levels of antigliadin antibodies. Patients with jejunal histology consistent with celiac disease initiated a gluten-free diet. Seventeen patients (31%) were positive for antigliadin antibodies, which were significantly more frequent in patients with inclusion-body myositis than dermatomyositis (P < 0.001). Positive status to HLA-DQ2 and/or -DQ8 did not differ between antigliadin-positive (75% and 12.5%) or -negative (60% and 15%) patients. Three of five jejunal biopsies were diagnostic for celiac disease with histological normalization after a gluten-free diet. Thus, celiac disease is more prevalent in patients with inflammatory myopathies than in the general population. Positive status to HLA-DQ2 allele, which is known to be more frequent in patients with inflammatory myopathies, could explain the high prevalence of antigliadin antibodies in this population. The diagnostic value of HLA-DQ2 or -DQ8 haplotypes to detect celiac disease in patients with inflammatory myopathy is limited.
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Affiliation(s)
- Albert Selva-O'Callaghan
- Internal Medicine Department, Vall D'Hebron General Hospital, Universitat Autonoma Barcelona, C/Siracusa No. 12 Bis A, Barcelona, Spain.
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Selva-O'Callaghan A, Tura JM, Grau-Junyent JM, Labrador-Horrillo M, Solans-Laque R, Vilardell-Tarrés M. Silicone gel filled breast implants and dermatomyositis. Clin Exp Rheumatol 2004; 22:376. [PMID: 15144138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/29/2023]
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Bosch X, González-Clemente JM, Cervera R, Grau-Junyent JM. Sjögren's disease with adult onset Still's disease. J Rheumatol Suppl 1989; 16:847-8. [PMID: 2778770] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
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23
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Cervera R, Grau-Junyent JM, Abós J, Font J, Monforte R, Urbano-Márquez A. Adult Still's disease. Analysis of a series of 7 patients. J Rheumatol Suppl 1987; 14:1206-7. [PMID: 3437432] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
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