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Galimberti V, Tironi R, Lerario A, Scali M, Del Bo R, Rodolico C, Brizzi T, Gibertini S, Maggi L, Mora M, Toscano A, Comi GP, Sciacco M, Moggio M, Peverelli L. Value of insoluble PABPN1 accumulation in the diagnosis of oculopharyngeal muscular dystrophy. Eur J Neurol 2019; 27:709-715. [DOI: 10.1111/ene.14131] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2019] [Accepted: 11/18/2019] [Indexed: 12/13/2022]
Affiliation(s)
- V. Galimberti
- Neuromuscular and Rare Disease Unit Department of Neuroscience Foundation IRCCS Ca’ Granda Ospedale Maggiore Policlinico Milano Italy
| | - R. Tironi
- Neuromuscular and Rare Disease Unit Department of Neuroscience Foundation IRCCS Ca’ Granda Ospedale Maggiore Policlinico Milano Italy
| | - A. Lerario
- Neuromuscular and Rare Disease Unit Department of Neuroscience Foundation IRCCS Ca’ Granda Ospedale Maggiore Policlinico Milano Italy
| | - M. Scali
- Neuromuscular and Rare Disease Unit Department of Neuroscience Foundation IRCCS Ca’ Granda Ospedale Maggiore Policlinico Milano Italy
| | - R. Del Bo
- Dino Ferrari Centre Neuroscience Section Department of Pathophysiology and Transplantation (DEPT) University of Milan MilanoItaly
- Neurology Unit IRCCS Foundation Ca’ Granda Ospedale Maggiore Policlinico Milano Italy
| | - C. Rodolico
- Neurology and Neuromuscular Diseases Unit Department of Clinical and Experimental Medicine University of Messina Messina Italy
| | - T. Brizzi
- Neurology and Neuromuscular Diseases Unit Department of Clinical and Experimental Medicine University of Messina Messina Italy
- DIBIMIS University of Palermo Palermo Italy
| | - S. Gibertini
- Neuromuscular Diseases and Neuroimmunology Unit Fondazione IRCCS Istituto Neurologico Carlo Besta Milano Italy
| | - L. Maggi
- Neuromuscular Diseases and Neuroimmunology Unit Fondazione IRCCS Istituto Neurologico Carlo Besta Milano Italy
| | - M. Mora
- Neuromuscular Diseases and Neuroimmunology Unit Fondazione IRCCS Istituto Neurologico Carlo Besta Milano Italy
| | - A. Toscano
- Neurology and Neuromuscular Diseases Unit Department of Clinical and Experimental Medicine University of Messina Messina Italy
| | - G. P. Comi
- Dino Ferrari Centre Neuroscience Section Department of Pathophysiology and Transplantation (DEPT) University of Milan MilanoItaly
- Neurology Unit IRCCS Foundation Ca’ Granda Ospedale Maggiore Policlinico Milano Italy
| | - M. Sciacco
- Neuromuscular and Rare Disease Unit Department of Neuroscience Foundation IRCCS Ca’ Granda Ospedale Maggiore Policlinico Milano Italy
| | - M. Moggio
- Neuromuscular and Rare Disease Unit Department of Neuroscience Foundation IRCCS Ca’ Granda Ospedale Maggiore Policlinico Milano Italy
| | - L. Peverelli
- Neuromuscular and Rare Disease Unit Department of Neuroscience Foundation IRCCS Ca’ Granda Ospedale Maggiore Policlinico Milano Italy
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Maggi L, Verardo M, Rubegni A, Bruno C, Lupica A, Berardinelli A, Ripolone M, Vattemi G, Ruggiero L, D'Amico A, Rodolico C, Sciacco M, Nigro V, Santorelli F, Tonin P, Fiorillo C, Mora M. P.110Clinical, morphological and genetic data in Italian patients with fiber-type-disproportion. Neuromuscul Disord 2019. [DOI: 10.1016/j.nmd.2019.06.166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Ripolone M, Violano R, Ronchi D, Mondello S, Nascimbeni A, Colombo I, Fagiolari G, Bordoni A, Fortunato F, Lucchini V, Saredi S, Filosto M, Musumeci O, Tonin P, Mongini T, Previtali S, Morandi L, Angelini C, Mora M, Sandri M, Sciacco M, Toscano A, Comi GP, Moggio M. Effects of short-to-long term enzyme replacement therapy (ERT) on skeletal muscle tissue in late onset Pompe disease (LOPD). Neuropathol Appl Neurobiol 2017; 44:449-462. [PMID: 28574618 DOI: 10.1111/nan.12414] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [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: 03/17/2017] [Revised: 05/26/2017] [Accepted: 06/02/2017] [Indexed: 12/31/2022]
Abstract
AIMS Pompe disease is an autosomal recessive lysosomal storage disorder resulting from deficiency of acid α-glucosidase (GAA) enzyme. Histopathological hallmarks in skeletal muscle tissue are fibre vacuolization and autophagy. Since 2006, enzyme replacement therapy (ERT) is the only approved treatment with human recombinant GAA alglucosidase alfa. We designed a study to examine ERT-related skeletal muscle changes in 18 modestly to moderately affected late onset Pompe disease (LOPD) patients along with the relationship between morphological/biochemical changes and clinical outcomes. Treatment duration was short-to-long term. METHODS We examined muscle biopsies from 18 LOPD patients at both histopathological and biochemical level. All patients underwent two muscle biopsies, before and after ERT administration respectively. The study is partially retrospective because the first biopsies were taken before the study was designed, whereas the second biopsy was always performed after at least 6 months of ERT administration. RESULTS After ERT, 15 out of 18 patients showed improved 6-min walking test (6MWT; P = 0.0007) and most of them achieved respiratory stabilization. Pretreatment muscle biopsies disclosed marked histopathological variability, ranging from an almost normal pattern to a severe vacuolar myopathy. After treatment, we detected morphological improvement in 15 patients and worsening in three patients. Post-ERT GAA enzymatic activity was mildly increased compared with pretreatment levels in all patients. Protein levels of the mature enzyme increased in 14 of the 18 patients (mean increase = +35%; P < 0.05). Additional studies demonstrated an improved autophagic flux after ERT in some patients. CONCLUSIONS ERT positively modified skeletal muscle pathology as well as motor and respiratory outcomes in the majority of LOPD patients.
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Affiliation(s)
- M Ripolone
- Neuromuscular and Rare Diseases Unit, Department of Neuroscience, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - R Violano
- Neuromuscular and Rare Diseases Unit, Department of Neuroscience, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - D Ronchi
- Neurology Unit, Neuroscience Section, Department of Pathophysiology and Transplantation, Dino Ferrari Centre, IRCCS Foundation Ca' Granda Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
| | - S Mondello
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Messina, Italy
| | - A Nascimbeni
- Department of Neurosciences, University of Padova, Padova, Italy
| | - I Colombo
- Neuromuscular and Rare Diseases Unit, Department of Neuroscience, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - G Fagiolari
- Neuromuscular and Rare Diseases Unit, Department of Neuroscience, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - A Bordoni
- Neurology Unit, Neuroscience Section, Department of Pathophysiology and Transplantation, Dino Ferrari Centre, IRCCS Foundation Ca' Granda Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
| | - F Fortunato
- Neurology Unit, Neuroscience Section, Department of Pathophysiology and Transplantation, Dino Ferrari Centre, IRCCS Foundation Ca' Granda Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
| | - V Lucchini
- Neuromuscular and Rare Diseases Unit, Department of Neuroscience, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - S Saredi
- Neuromuscular Diseases and Neuroimmunology, Fondazione IRCCS Istituto Neurologico "Carlo Besta", Milan, Italy
| | - M Filosto
- Unit of Neurology, Center for Neuromuscular Diseases and Neuropathies, University Hospital "Spedali Civili", Brescia, Italy
| | - O Musumeci
- Department of Clinical and Experimental Medicine, Centro di Riferimento Regionale per le Malattie Neuromuscolari rare, University of Messina, Messina, Italy
| | - P Tonin
- Section of Clinical Neurology, Department of Neurological, Biomedical and Movement Sciences, University of Verona, Verona, Italy
| | - T Mongini
- Department of Neurosciences "Rita Levi Montalcini", University of Turin, Turin, Italy
| | - S Previtali
- Division of Neuroscience, Inspe, San Raffaele, Milan, Italy
| | - L Morandi
- Neuromuscular Diseases and Neuroimmunology, Fondazione IRCCS Istituto Neurologico "Carlo Besta", Milan, Italy
| | - C Angelini
- Fondazione San Camillo Hospital IRCCS, Venice, Italy
| | - M Mora
- Neuromuscular Diseases and Neuroimmunology, Fondazione IRCCS Istituto Neurologico "Carlo Besta", Milan, Italy
| | - M Sandri
- Department of Biomedical Science, University of Padova, Padova, Italy.,Dulbecco Telethon Institute at Venetian Institute of Molecular Medicine, Padova, Italy
| | - M Sciacco
- Neuromuscular and Rare Diseases Unit, Department of Neuroscience, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - A Toscano
- Department of Clinical and Experimental Medicine, Centro di Riferimento Regionale per le Malattie Neuromuscolari rare, University of Messina, Messina, Italy
| | - G P Comi
- Neurology Unit, Neuroscience Section, Department of Pathophysiology and Transplantation, Dino Ferrari Centre, IRCCS Foundation Ca' Granda Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
| | - M Moggio
- Neuromuscular and Rare Diseases Unit, Department of Neuroscience, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
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Magri F, Govoni A, Brusa R, Angelini C, D’Angelo M, Mongini T, Toscano A, Siciliano G, Tomelleri G, Mora M, Nigro V, Pegoraro E, Morandi L, Musumeci O, Sciacco M, Ricci G, Moroni I, Gandossini S, Bo RD, Fortunato F, Ronchi D, Corti S, Moggio M, Bresolin N, Comi G. G.P.251. Neuromuscul Disord 2014. [DOI: 10.1016/j.nmd.2014.06.327] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Kornblum C, Nicholls T, Haack T, Schoeler S, Peeva V, Danhauser K, Hallmann K, Zsurka G, Rorbach J, Iuso A, Wieland T, Sciacco M, Ronchi D, Comi G, Moggio M, Quinzii C, DiMauro S, Calvo S, Mootha V, Klopstock T, Strom T, Meitinger T, Minczuk M, Kunz W, Prokisch H. O.24 Loss of function of MGME1, a novel player in mitochondrial DNA replication, causes a distinct autosomal recessive mitochondrial disorder. Neuromuscul Disord 2013. [DOI: 10.1016/j.nmd.2013.06.734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Violano R, Ripolone M, Lucchini V, Villa L, Sciacco M, Comi G, Tonin P, Filosto M, Previtali S, Mongini T, Vercelli L, Vittonatto E, Toscano A, Musumeci O, Barca E, Angelini C, Ravaglia S, Lamperti C, Mora M, Morandi L, Moggio M. Evaluation of muscle biopsy in late-onset GSDII patients before and after enzyme replacement therapy (ERT). BMC Musculoskelet Disord 2013. [PMCID: PMC3667002 DOI: 10.1186/1471-2474-14-s2-p13] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Berardinelli A, Fagiolari G, Vallejo D, Lucchini V, Bordoni A, Lamperti C, Ripolone M, Corti S, Balottin U, Bresolin N, Comi G, Sciacco M, Moggio M. P3.5 Oxidative defect in a large cohort of genetically-determined SMA cases. Neuromuscul Disord 2011. [DOI: 10.1016/j.nmd.2011.06.899] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Gandossini S, d’Angelo M, Bonato S, Comi G, Magri F, Moggio M, Sciacco M, Turconi A, C. Sciorati, Bresolin N, Clementi E. T.P.3.04 Clinical trial using nitric oxide releasing drug and nonsteroidal antiinflammatory drugs in muscular dystrophy: Design of a study. Neuromuscul Disord 2009. [DOI: 10.1016/j.nmd.2009.06.211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Del Bo R, Bordoni A, Sciacco M, Di Fonzo A, Galbiati S, Crimi M, Bresolin N, Comi GP. Remarkable infidelity of polymerase A associated with mutations in POLG1 exonuclease domain. Neurology 2003; 61:903-8. [PMID: 14557557 DOI: 10.1212/01.wnl.0000092303.13864.be] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.1] [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: 11/15/2022] Open
Abstract
OBJECTIVE To better understand the still unknown pathologic mechanism involved in the accumulation of multiple mtDNA deletions in stable tissues. METHODS A large-scale screening of mtDNA molecules from skeletal muscle was performed in 14 patients with progressive external ophthalmoplegia (PEO) and 2 patients with mitochondrial neurogastrointestinal encephalomyopathy carrying mutations on ANT1, C10ORF2 or POLG1, and TP genes. RESULTS Patients with at least one mutation in the exonuclease domain of POLG1 showed the highest frequency of individually rare point mutations only in the mtDNA control region; in addition, high levels, in terms of frequency and heteroplasmy, of recurrent mutations (A189G, T408A, and T414G) and alterations affecting the (HT)D310 region were detectable in many of the patients. Two homozygous POLG1 mutations, within the exonuclease domain, were able to induce an increased mutational burden also in fibroblasts from patients with PEO. CONCLUSIONS Specific POLG1 mutations directly affect the integrity of the mtDNA by reducing its proof-reading exonuclease activity, resulting in the accumulation of heteroplasmic levels of both randomly rare and recurrent point mutations in the skeletal muscle tissue and fibroblasts.
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Affiliation(s)
- R Del Bo
- Centro Dino Ferrari, Dipartimento di Scienze Neurologiche, Università degli Studi di Milano, I.R.C.C.S. Ospedale Maggiore Policlinico, Milan.
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Prelle A, Sciacco M, Tancredi L, Fagiolari G, Comi GP, Ciscato P, Serafini M, Fortunato F, Zecca C, Gallanti A, Chiveri L, Bresolin N, Scarlato G, Moggio M. Clinical, morphological and immunological evaluation of six patients with dysferlin deficiency. Acta Neuropathol 2003; 105:537-42. [PMID: 12734659 DOI: 10.1007/s00401-002-0654-1] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2002] [Accepted: 10/31/2002] [Indexed: 10/25/2022]
Abstract
Limb girdle muscular dystrophy (LGMD) type 2B and distal Miyoshi myopathy (MM) are caused by mutations in a recently discovered mammalian gene coding for a skeletal muscle protein called dysferlin. The protein is normally expressed at the skeletal muscle level and absent or reduced in affected patients. We selected a clinically heterogeneous population of Italian myopathic patients with clinical evidence of myopathy and/or hyperCKemia, EMG myopathic pattern, and no alterations of the dystrophin-sarcoglycan complex. Calpain, merosin, emerin and caveolin were also tested and found normal in all patients. Dysferlin immunohistochemical and Western blot analyses allowed us to identify six patients with dysferlin deficiency: one with distal myopathy, four with limb girdle myopathy and one with hyperCKemia. No apoptosis was found in any of the six muscle specimens, although expression of the pro-apoptotic Fas antigen was mildly increased in two cases. Inflammatory reactions were present in two of the six cases, but we found no evidence of immune-mediated processes.
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Affiliation(s)
- A Prelle
- Centro Dino Ferrari, Department of Neurological Sciences, University of Milan, Ospedale Maggiore-Policlinico IRCCS, Via F. Sforza 35, 20122, Milan, Italy.
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Crimi M, Galbiati S, Perini MP, Bordoni A, Malferrari G, Sciacco M, Biunno I, Strazzer S, Moggio M, Bresolin N, Comi GP. A mitochondrial tRNA(His) gene mutation causing pigmentary retinopathy and neurosensorial deafness. Neurology 2003; 60:1200-3. [PMID: 12682337 DOI: 10.1212/01.wnl.0000055865.30580.39] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
We have identified a heteroplasmic G to A mutation at position 12,183 of the mitochondrial transfer RNA Histidine (tRNA(His)) gene in three related patients. These phenotypes varied according to mutation heteroplasmy: one had severe pigmentary retinopathy, neurosensorial deafness, testicular dysfunction, muscle hypotrophy, and ataxia; the other two had only retinal and inner ear involvement. The mutation is in a highly conserved region of the T(psi)C stem of the tRNA(His) gene and may alter secondary structure formation. This is the first described pathogenic, maternally inherited mutation of the mitochondrial tRNA(His) gene.
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Affiliation(s)
- M Crimi
- Centro Dino Ferrari, Dipartimento di Scienze Neurologiche, Università degli Studi di Milano, I.R.C.C.S. Ospedale Maggiore Policlinico and Centro di Eccellenza per le Malattie Neurodegenerative, Italy.
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Messina S, Fagiolari G, Lamperti C, Cavaletti G, Prelle A, Scarlato G, Bresolin M, Moggio M, Sciacco M. Women with pregnancy-related polymyositis and high serum CK levels in the newborn. Neurology 2002; 58:482-4. [PMID: 11839858 DOI: 10.1212/wnl.58.3.482] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Two previously healthy women developed an inflammatory myopathy before the term of their first pregnancy. Skeletal muscle biopsy led to a diagnosis of T cell-mediated polymyositis. Both babies were healthy, but their serum creatine kinase levels remained elevated for a few months after birth. Their mothers did well after corticosteroid treatment.
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Affiliation(s)
- S Messina
- Centro Dino Ferrari, Department of Neurological Sciences, University of Milan, Milan, Italy
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Napoli L, Bordoni A, Zeviani M, Hadjigeorgiou GM, Sciacco M, Tiranti V, Terentiou A, Moggio M, Papadimitriou A, Scarlato G, Comi GP. A novel missense adenine nucleotide translocator-1 gene mutation in a Greek adPEO family. Neurology 2001; 57:2295-8. [PMID: 11756613 DOI: 10.1212/wnl.57.12.2295] [Citation(s) in RCA: 68] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Autosomal dominant progressive external ophthalmoplegia (adPEO) is caused by mutations in at least three different genes: ANT1 (chromosome 4q34-35), TWINKLE, and POLG. The ANT1 gene encodes the adenine nucleotide translocator-1 (ANT1). We identified a heterozygous T293C mutation of the ANT1 gene in a Greek family with adPEO. The resulting leucine to proline substitution likely modifies the secondary structure of the ANT1 protein. ANT1 gene mutations may account for adPEO in families with different ethnic backgrounds.
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Affiliation(s)
- L Napoli
- Centro Dino Ferrari, Dipartimento di Scienze Neurologiche, Università degli Studi di Milano, I.R.C.C.S. Ospedale Maggiore Policlinico, Milano, Italy
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Sciacco M, Prelle A, Comi GP, Napoli L, Battistel A, Bresolin N, Tancredi L, Lamperti C, Bordoni A, Fagiolari G, Ciscato P, Chiveri L, Perini MP, Fortunato F, Adobbati L, Messina S, Toscano A, Martinelli-Boneschi F, Papadimitriou A, Scarlato G, Moggio M. Retrospective study of a large population of patients affected with mitochondrial disorders: clinical, morphological and molecular genetic evaluation. J Neurol 2001; 248:778-88. [PMID: 11596783 DOI: 10.1007/s004150170094] [Citation(s) in RCA: 37] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Mitochondrial disorders are human genetic diseases with extremely variable clinical and genetic features. To better define them, we made a genotype-phenotype correlation in a series of 207 affected patients, and we examined most of them with six laboratory examinations (serum CK and basal lactate levels, EMG, cardiac and EEG studies, neuroradiology). We found that, depending on the genetic abnormality, hyperckemia occurs most often with either chronic progressive external ophthalmoplegia (CPEO) and ptosis or with limb weakness. Myopathic EMGs are more common than limb weakness, except in patients with A8344G mutations. Peripheral neuropathy, when present, is always axonal. About 80% of patients with A3243G and A8344G mutations have high basal lactate levels, whereas pure CPEO is never associated with increased lactate levels. Cardiac abnormalities mostly consist of conduction defects. Abnormalities on CT or MRI of the brain are relatively common in A3243G mutations independently of the clinical phenotype. Patients with multiple mtDNA deletions are somehow "protected" against the development of abnormalities with any of the tests. We conclude that, despite the phenotypic heterogeneity of mitochondrial disorders, correlation of clinical features and laboratory findings may give the clinician important clues to the genetic defect, allowing earlier diagnosis and counselling.
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Affiliation(s)
- M Sciacco
- Centro Dino Ferrari, Istituto di Clinica Neurologica, University of Milan, Italy
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Sciacco M, Fagiolari G, Lamperti C, Messina S, Bazzi P, Napoli L, Chiveri L, Prelle A, Comi GP, Bresolin N, Scarlato G, Moggio M. Lack of apoptosis in mitochondrial encephalomyopathies. Neurology 2001; 56:1070-4. [PMID: 11320180 DOI: 10.1212/wnl.56.8.1070] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND/OBJECTIVE Apoptosis, or programmed cell death, is an evolutionary conserved mechanism essential for morphogenesis and tissue homeostasis, but it plays an important role also in pathologic conditions, including neurologic disorders. Its execution pathway is critically regulated at the mitochondrial level. Evidence of apoptosis in muscle specimens was investigated in patients with genetically defined mitochondrial encephalomyopathies. METHODS Thirty-three muscle biopsies from patients with genotypically different mitochondrial diseases (single and multiple deletions, A3243G/A8344G point mutations of the mitochondrial DNA) were studied. The terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling (TUNEL) reaction was used as a marker of nuclear DNA fragmentation, as well as antibodies against pro- (Fas) or anti- (Bcl-2) apoptotic factors. Also, because one hallmark of apoptosis is morphologic, ultrastructural studies were performed on skeletal muscle from 18 of 33 patients, examining both phenotypically normal and ragged red fibers. RESULTS In all muscle biopsies, no significant expression of either pro (Fas) and inhibiting (Bcl-2) apoptosis-related proteins was found, nor TUNEL positivity. This latter finding is confirmed by lack of morphologic evidence of apoptosis in all the fibers examined at the ultrastructural level. CONCLUSION The authors' findings suggest that genetically determined defects of oxidative phosphorylation do not induce the apoptotic process and that apoptosis is not involved in the pathogenesis of mitochondrial disorders.
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Affiliation(s)
- M Sciacco
- Centro Dino Ferrari, Istituto di Clinica Neurologica, University of Milan, Ospedale Maggiore IRCCS, Milan, Italy
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Prelle A, Sciacco M, Comi GP, Messina S, Carpo M, Ciscato P, Nobile Orazio E, Fortunato F, Mora G, Bignotti V, Fagiolari G, Moggio M, Scarlato G. A sporadic, atypical case of desminopathy: morphological and immunological characterization. Clin Neuropathol 2000; 19:208-12. [PMID: 10919353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2023] Open
Abstract
Recently, abnormal expression of cyclin-dependent kinases was proposed as a possible cause of desminopathy. We describe an atypical case clinically characterized by severe respiratory distress. Muscle biopsy showed subsarcolemmal and intracytoplasmic accumulation areas, which intensively stained with anti-desmin antibodies and contained electrondense filamentous material at ultrastructural level. WB analysis showed 30% increased desmin signal compared to controls. Positive immunostain for CDC2 kinase, CDK2 and emerin and nuclear matrix-associated protein were, found in desmin-positive fibres.
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Affiliation(s)
- A Prelle
- Centro Dino Ferrari, Istituto di Clinica Neurologica, Ospedale Maggiore IRCCS, Milano, Italy
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Bazzi P, Tancredi L, Scarpini E, Messina S, Sciacco M, Livraghi S, Vanoli M, Prelle A, Scarlato G, Moggio M. Severe polyneuropathy in a patient with Churg-Strauss syndrome. J Peripher Nerv Syst 2000; 5:106-10. [PMID: 10905470 DOI: 10.1046/j.1529-8027.2000.00010.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [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
We describe the clinicopathologic features of a 56-year-old woman affected with Churg-Strauss syndrome with major peripheral nerve involvement. The patient presented with a 1-month history of mainly distal upper-limb symmetrical paresthesias and hypostenia (bilateral "wrist drop"), palpable purpura and eosinophilia. Multiple pulmonary infiltrates and asthma had been present since the age of 52. Skin biopsy demonstrated an eosinophilic necrotizing vasculitis. During the hospitalization she was submitted to cardiac, bronchopulmonary, renal, and gastrointestinal evaluation and EMG. Peripheral nerve and skeletal muscle biopsies were performed. Sural nerve biopsy showed a marked degree of demyelination. A perivascular cellular infiltrate within the epineurium was immunoreactive for T lymphocytes and macrophages. Strong HLA-DR immunostaining was present in the endoneurium. IgM, IgE and fibrinogen deposition was found in some epi- and endoneurial vessels. Muscle biopsy showed neurogenic changes and 1 thrombosed vessel surrounded by mononuclear cells. Membrane attack complex (MAC) deposition was present in a few capillaries and major histocompatibility complex products I (MHCP I) was expressed at the subsarcolemmal level in a few isolated perivascular muscle fibers. After immunosuppressive therapy, the patient showed progressive improvement of both clinical symptoms and neurophysiological parameters.
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Affiliation(s)
- P Bazzi
- Centro Dino Ferrari, Istituto di Clinica Neurologica, Ospedale Maggiore Policlinico, IRCCS, Milan, Italy
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Bazzi P, Moggio M, Prelle A, Sciacco M, Messina S, Barbieri S, Tonin P, Tomelleri G, Battistel A, Adobbati L, Checcarelli N, Veschi G, Scarlato G. Critically ill patients: immunological evidence of inflammation in muscle biopsy. Clin Neuropathol 1999; 18:23-30. [PMID: 9988135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/10/2023] Open
Abstract
AIM AND METHOD To verify whether muscle necrosis in critically ill patients could be due to an inflammatory process, we tested muscle biopsies from five intensive care patients with different inflammation-specific immunocytochemical markers (antibodies anti-class I major histocompatibility complex products (class I MHCP or HLA I), membrane attack complex (MAC), T lymphocytes helper-inducer (CD4), cytotoxic (CD8) and pan-B-lymphocytes). RESULTS In three patients muscle biopsy showed class I MHCP positivity on the surface membrane of several groups of fibres, mainly perifascicular, and scattered microvascular deposits of MAC. In the other two patients muscle biopsy did not show class I MHCP and MAC positivity. CONCLUSION Our results suggest that inflammation may be a component of muscle damage in some critically ill patients.
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Affiliation(s)
- P Bazzi
- Centro Dino Ferrari, Istituto di Clinica Neurologica dell' Università di Milano, IRCCS, Ospedale Maggiore, Policlinico, Italy
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19
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Franceschina L, Salani S, Bordoni A, Sciacco M, Napoli L, Comi GP, Prelle A, Fortunato F, Hadjigeorgiou GM, Farina E, Bresolin N, D'Angelo MG, Scarlato G. A novel mitochondrial tRNA(Ile) point mutation in chronic progressive external ophthalmoplegia. J Neurol 1998; 245:755-8. [PMID: 9808249 DOI: 10.1007/s004150050283] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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20
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Sciacco M, Gasparo-Rippa P, Vu TH, Tanji K, Shanske S, Mendell JR, Schon EA, DiMauro S, Bonilla E. Study of mitochondrial DNA depletion in muscle by single-fiber polymerase chain reaction. Muscle Nerve 1998; 21:1374-81. [PMID: 9771659 DOI: 10.1002/(sici)1097-4598(199811)21:11<1374::aid-mus3>3.0.co;2-6] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
We studied muscle biopsies from 3 children with a mitochondrial myopathy characterized histochemically by the presence of ragged-red fibers (RRF) and various numbers of cytochrome c oxidase (COX)-negative fibers. We quantitated the absolute amounts of total mitochondrial DNA (mtDNA) in isolated normal COX-positive muscle fibers and in COX-negative RRF. There was severe mtDNA depletion in all fibers from the two most severe cases. In the third case mtDNA depletion could not be established with conventional diagnostic tools, but it was documented in single COX-negative fibers; COX-positive fibers showed the same amounts of mtDNA as fibers from aged-matched controls. Our observations indicate that mtDNA single-fiber PCR quantitation is a highly sensitive and specific method for diagnosing cases with focal mtDNA depletion. This method also allows one to correlate amounts of mtDNA with histochemical phenotypes in individual fibers from patients and age-matched controls, thereby providing important information about the functional role of residual mtDNA.
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Affiliation(s)
- M Sciacco
- Department of Neurology, College of Physicians and Surgeons of Columbia University, New York, New York 10032, USA
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21
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Prelle A, Comi GP, Tancredi L, Rigoletto C, Ciscato P, Fortunato F, Nesti S, Sciacco M, Robotti M, Bazzi P, Felisari G, Moggio M, Scarlato G. Sarcoglycan deficiency in a large Italian population of myopathic patients. Acta Neuropathol 1998; 96:509-14. [PMID: 9829815 DOI: 10.1007/s004010050926] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Autosomal recessive limb-girdle muscular dystrophies are a heterogeneous group of genetic diseases with a wide spectrum of clinical severity and age of onset; mutations in the gene encoding the dystrophin-associated sarcoglycan proteins (alpha, beta, gamma and delta) have recently been shown to cause some cases of these myopathies (primary sarcoglycanopathies, types 2D, 2E, 2C and 2F, respectively). In this study we have examined a large population of Italian myopathic patients to determine the frequency of (alpha-, beta- and gamma-sarcoglycan deficiency and to correlate molecular defects with clinical phenotypes; to exclude the presence of primary dystrophinopathies both genetic and immunological analysis of dystrophin was performed. We report 12 patients (10 male and 2 female) with deficiency of either one or more sarcoglycan proteins. They were aged 8-56 years with onset between 4 and 30 years of age; they all presented with either mild, moderate or severe limb-girdle involvement associated with elevated blood creatine kinase levels and myopathic pattern at EMG; one was also affected with a mild dilation cardiomyopathy. All patients, except one, showed pathological muscle histological changes. Absence of all three proteins always correlates with severe forms, whereas mild protein deficiencies or isolated partial alpha-sarcoglycan deficiency correlate with either severe, moderate or mild forms.
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Affiliation(s)
- A Prelle
- Centro Dino Ferrari, Istituto di Clinica Neurologica, Ospedale Maggiore Policlinico, IRCCS, Milan, Italy.
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22
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Papadimitriou A, Comi GP, Hadjigeorgiou GM, Bordoni A, Sciacco M, Napoli L, Prelle A, Moggio M, Fagiolari G, Bresolin N, Salani S, Anastasopoulos I, Giassakis G, Divari R, Scarlato G. Partial depletion and multiple deletions of muscle mtDNA in familial MNGIE syndrome. Neurology 1998; 51:1086-92. [PMID: 9781534 DOI: 10.1212/wnl.51.4.1086] [Citation(s) in RCA: 79] [Impact Index Per Article: 3.0] [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: 11/15/2022] Open
Abstract
OBJECTIVE To describe the unique combination of partial depletion and multiple deletions of mitochondrial DNA (mtDNA) on muscle DNA analysis of three siblings with mitochondrial neurogastrointestinal encephalomyopathy (MNGIE). BACKGROUND MNGIE is a relatively homogeneous autosomal recessive disorder characterized by gastrointestinal dysmobility, ophthalmoparesis, peripheral neuropathy, mitochondrial myopathy, and altered white matter signal at brain imaging. Muscle multiple mtDNA deletions have been found in about half of the described cases. METHODS We studied three affected siblings (two were monozygotic twins) born to nonconsanguineous parents. Muscle mtDNA was investigated by quantitative Southern and Slot blot techniques and by PCR analysis. Morphologic confirmation in the muscle tissue was achieved by using in situ hybridization with a mtDNA probe complementary to an undeleted region and by DNA immunohistochemistry. RESULTS All three patients showed ragged red (RRF) and cytochrome c oxidase-negative fibers, as well as partial deficiency of complexes I and IV. Southern and Slot blot analyses showed mtDNA depletion in all patients. Multiple mtDNA deletions were also detected by PCR analysis. In situ hybridization demonstrated an overall signal weaker than controls, with a relatively higher signal in RRF. Antibodies against DNA showed a decreased cytoplasmic network. CONCLUSIONS The muscle histopathology and respiratory chain enzyme defects may be accounted for by the decreased mtDNA amount and by the presence of mtDNA deleted molecules; however, relative levels of mtDNA seem to correlate with life span in these patients. The combination of partial depletion and multiple deletions of mtDNA might indicate the derangement of a common genetic mechanism controlling mtDNA copy number and integrity.
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23
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Vu TH, Sciacco M, Tanji K, Nichter C, Bonilla E, Chatkupt S, Maertens P, Shanske S, Mendell J, Koenigsberger MR, Sharer L, Schon EA, DiMauro S, DeVivo DC. Clinical manifestations of mitochondrial DNA depletion. Neurology 1998; 50:1783-90. [PMID: 9633728 DOI: 10.1212/wnl.50.6.1783] [Citation(s) in RCA: 100] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE We studied five new patients with mitochondrial DNA (mtDNA) depletion to better define the clinical spectrum of this disorder. BACKGROUND mtDNA depletion has been associated with myopathy or hepatopathy, or both, in infants and young children. Involvement of the CNS and peripheral nervous system has not been clearly established. METHODS We reviewed the clinical course and performed morphologic, biochemical, and genetic analyses of muscle samples from five patients. RESULTS Age at onset ranged from 3 months to 5 years, and one patient survived until age 10 1/2 years. Two patients had laboratory and clinical features reminiscent of dystrophinopathy, two had evidence of brain involvement, and two had peripheral neuropathy. Muscle biopsy specimens in all patients showed abundant ragged-red fibers. Biochemistry showed cytochrome c oxidase deficiency in all patients tested and decreased activities of other respiratory chain complexes in some. CONCLUSIONS Inheritance appeared to be autosomal recessive, suggesting that mutations in nuclear DNA are responsible for mtDNA depletion. mtDNA depletion should be considered in children with mitochondrial disorders of uncertain etiology, and criteria for diagnosis are proposed.
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Affiliation(s)
- T H Vu
- H. Houston Merritt Clinical Research Center for Muscular Dystrophy and Related Diseases, Columbia University, New York, NY 10032, USA
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24
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Comi GP, Bordoni A, Salani S, Franceschina L, Sciacco M, Prelle A, Fortunato F, Zeviani M, Napoli L, Bresolin N, Moggio M, Ausenda CD, Taanman JW, Scarlato G. Cytochrome c oxidase subunit I microdeletion in a patient with motor neuron disease. Ann Neurol 1998; 43:110-6. [PMID: 9450776 DOI: 10.1002/ana.410430119] [Citation(s) in RCA: 167] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
An out-of-frame mutation of the mitochondrial DNA-encoded subunit I of cytochrome c oxidase (COX) was discovered during investigation of a severe isolated muscle COX deficiency in a patient with motor neuron-like degeneration. The mutation is a heteroplasmic 5-bp microdeletion located in the 5' end of the COI gene, leading to premature termination of the corresponding translation product. Western blot analysis, immunohistochemistry, and single-fiber polymerase chain reaction demonstrated a tight correlation between COX defect, COX I expression, and percentage of mutation. COX subunits II, III, and IV were decreased as well, suggesting a defective assembly of COX holoenzyme. The mutation was associated with a clinical phenotype unusual for a mitochondrial disorder, that is, an isolated motor neuron disease (MND) with some atypical findings, including early onset, preferential involvement of the upper motor neuron, and increased cerebrospinal fluid protein content. MND may arise from impaired scavenging and overproduction of free oxygen radicals, a by-product of oxidative phosphorylation (OXPHOS). Our observation suggests that OXPHOS impairment could play a role in the pathogenesis of some MND cases.
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Affiliation(s)
- G P Comi
- Centro Dino Ferrari, Universita' degli Studi di Milano, IRCCS Ospedale Maggiore Policlinico, Milan, Italy
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25
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Prelle A, Rigoletto C, Moggio M, Sciacco M, Comi GP, Ciscato P, Fagiolari G, Rapuzzi S, Bignotti V, Scarlato G. Asymptomatic familial hyperCKemia associated with desmin accumulation in skeletal muscle. J Neurol Sci 1996; 140:132-6. [PMID: 8866439 DOI: 10.1016/0022-510x(96)00129-3] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.5] [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: 02/02/2023]
Abstract
We describe a family, two brothers and their mother, who came to our observation because of slight to moderate hyperCKemia. The younger brother, who had the highest CK values, was only suffering from episodic myalgia, the other two members of the family were asymptomatic. Neurological examination was normal. Both brothers underwent muscle biopsy which was significant for the presence of abnormal sarcoplasmic areas of desmin accumulation. So far, desmin abnormalities have never been reported in patients with such a mild neuromuscular pattern. We discuss possible correlations between severity of clinical phenotype and degree of desmin accumulation.
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Affiliation(s)
- A Prelle
- Istituto di Clinica Neurologica, Università di Milano, Centro Dino Ferrari, Italy
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26
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Santorelli FM, Sciacco M, Tanji K, Shanske S, Vu TH, Golzi V, Griggs RC, Mendell JR, Hays AP, Bertorini TE, Pestronk A, Bonilla E, DiMauro S. Multiple mitochondrial DNA deletions in sporadic inclusion body myositis: a study of 56 patients. Ann Neurol 1996; 39:789-95. [PMID: 8651651 DOI: 10.1002/ana.410390615] [Citation(s) in RCA: 77] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Inclusion body myositis, a chronic inflammatory disorder, is the most common cause of myopathy in adults over the age of 50. Diagnosis is based on clinical features and distinctive morphological findings by both light and electron microscopy. The causes of inclusion body myositis are still unknown. Ultrastructural mitochondrial changes and ragged-red fibers are common in patients with sporadic inclusion body myositis, and multiple [correction of mutiple] mitochondrial DNA (mtDNA) deletions have been reported in 3 such patients, suggesting that mtDNA mutations may have a pathogenetic role. We studied 56 patients with sporadic inclusion body myositis, using a combination of clinical, morphological, biochemical, and molecular genetic analyses to determine the frequency and the distribution of mtDNA deletions. Using the polymerase chain reaction, we found multiple mtDNA deletions in 73% of patients, compared to 40% of normal age-matched control subjects and 47% of disease control subjects. The presence of deletions correlated with morphological evidence of ragged-red, cytochrome c oxidase-negative fibers, and with defects of complexes I and IV of the electron transport chain. Although aging may account for a proportion of mtDNA deletions in patients with sporadic inclusion body myositis and control subjects, mtDNA alterations may be accelerated in sporadic inclusion body myositis.
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Affiliation(s)
- F M Santorelli
- H. Houston Merritt Clinical Research Center for Muscular Dystrophy and Related Diseases--Department of Neurology, Columbia University, New York, NY, USA
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27
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Affiliation(s)
- M Sciacco
- Department of Neurology, College of Physicians and Surgeons, Columbia University, New York, New York 10032, USA
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Chen X, Bonilla E, Sciacco M, Schon EA. Paucity of deleted mitochondrial DNAs in brain regions of Huntington's disease patients. Biochim Biophys Acta 1995; 1271:229-33. [PMID: 7599213 DOI: 10.1016/0925-4439(95)00032-y] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Mitochondrial DNA deletions (delta-mtDNAs), originally found at high levels in patients with sporadic mitochondrial encephalomyopathies, have also been found to accumulate at extremely low levels during normal human aging, especially in long-lived postmitotic tissues such as muscle and brain. We have now quantitated the amount of one such delta-mtDNA species, the so-called 'common deletion', in brain regions from patients with Huntington's disease (HD). Surprisingly, we found a marked decrease in the amount of this delta-mtDNA in the occipital cortex and putamen as compared to age-matched controls; however, no change was found in caudate. Using immunohistochemistry of brain sections, we found no differences in the staining pattern for selected respiratory chain polypeptides between the HD and control tissues. The reduction in the amount of delta-mtDNAs in HD may be related in part to the astrocytic gliosis in the affected areas, in which the deletion-rich neurons are replaced by relatively deletion-poor astrocytes.
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Affiliation(s)
- X Chen
- Department of Neurology, Columbia University, New York, NY 10032, USA
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29
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Moraes CT, Sciacco M, Ricci E, Tengan CH, Hao H, Bonilla E, Schon EA, DiMauro S. Phenotype-genotype correlations in skeletal muscle of patients with mtDNA deletions. Muscle Nerve 1995; 3:S150-3. [PMID: 7603517 DOI: 10.1002/mus.880181429] [Citation(s) in RCA: 26] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Large-scale deletions of mitochondrial DNA (mtDNA) have been associated with a subgroup of mitochondrial encephalomyopathies, usually characterized by progressive external ophthalmoplegia (PEO) and mitochondrial proliferation in muscle fibers. We and others have shown that muscle from patients with mtDNA deletions have variable cytochrome c oxidase (COX) deficiency and reduction of mitochondrially-synthesized polypeptides in affected muscle fibers. The present work summarizes the phenotype-genotype correlations observed in patients' muscle. In situ hybridization revealed that, while most COX-deficient fibers had increased levels of mutant mtDNA, they almost invariably had reduced levels of normal mtDNA. PCR quantitation of both deleted and wild-type mtDNAs in normal and respiration-deficient muscle fibers from patients with the "common deletion" showed that deleted mtDNAs were present in normal fibers (31 +/- 26%), but their percentages were much higher in affected fibers (95% +/- 2%). Absolute levels of deleted mtDNA were also increased in affected fibers, whereas absolute levels of wild-type mtDNA were significantly reduced. Taken together, our results suggest that although a specific ratio between mutant and wild-type mitochondrial genomes is probably the major determinant of the respiratory chain deficiency associated with mtDNA deletions, the reduction in the absolute amounts of wild-type mtDNA may also play a significant pathogenetic role.
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Affiliation(s)
- C T Moraes
- Department of Neurology, University of Miami, FL 33136, USA
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30
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Moggio M, Prelle A, Fagiolari G, Checcarelli N, Sciacco M, Ciscato P, Scarlato G. Anionic phospholipids calcium binding sites in Duchenne and murine X-linked muscular dystrophy. Muscle Nerve 1994; 17:485-8. [PMID: 8159177 DOI: 10.1002/mus.880170503] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
Duchenne muscular dystrophy (DMD) and murine X-linked muscular dystrophy (mdx) are genetically homologous and both characterized by absence of dystrophin. The function of this protein is not defined nor is the pathogenesis of the severe muscle necrosis and progressive weakness found in DMD but not in mdx. Recently we found that anionic phospholipid (AP) calcium binding sites are lacking at the muscle cell surface in DMD and we correlated these data with dystrophin deficiency and muscle necrosis. In order to verify the role of AP lack in the pathogenesis of muscle necrosis in DMD we studied the ultrastructural localization of these Ca++ receptors in mdx muscle membrane showing that they are normally represented as they are in control mouse and normal human muscle. The absence of AP in DMD compared with a normal distribution in mdx suggests that these calcium binding site alterations play an important and specific role in muscle fiber necrosis.
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Affiliation(s)
- M Moggio
- Instituto di Clinica Neurologica, Università di Milano, Centro Dino Ferrari, Italy
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31
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Sciacco M, Bonilla E, Schon EA, DiMauro S, Moraes CT. Distribution of wild-type and common deletion forms of mtDNA in normal and respiration-deficient muscle fibers from patients with mitochondrial myopathy. Hum Mol Genet 1994; 3:13-9. [PMID: 8162014 DOI: 10.1093/hmg/3.1.13] [Citation(s) in RCA: 238] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Abstract
We studied the cellular distribution of both deleted (delta) and wild-type (wt) mitochondrial DNAs (mtDNAs) in 'normal' and respiration-deficient muscle fibers from four patients with mitochondrial myopathy. PCR-based methods were used to quantitate both relative and absolute amounts of delta- and wt-mtDNAs in microdissected fiber segments. Although delta-mtDNAs were present in normal fibers (31% +/- 26), their percentages were much higher in affected fibers (95% +/- 2). Absolute levels of delta-mtDNA were also increased in affected fibers, whereas levels of wt-mtDNA were significantly reduced in these fibers. These results indicate that a threshold ratio of delta-/wt-mtDNA must be achieved before an impairment of respiration is observed in muscle. Moreover, the marked reduction in wt-mtDNA observed in affected fibers suggests that absolute amounts of mtDNA may play a role in the pathogenesis of mitochondrial myopathies.
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Affiliation(s)
- M Sciacco
- H. Houston Merritt Clinical Research Center for Muscular Dystrophy, Columbia University, New York, NY 10032
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32
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Scarpini E, Bianchi R, Moggio M, Sciacco M, Fiori MG, Scarlato G. Decrease of nerve Na+,K(+)-ATPase activity in the pathogenesis of human diabetic neuropathy. J Neurol Sci 1993; 120:159-67. [PMID: 8138805 DOI: 10.1016/0022-510x(93)90268-4] [Citation(s) in RCA: 38] [Impact Index Per Article: 1.2] [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: 01/29/2023]
Abstract
A decrease in Na+,K(+)-ATPase activity is claimed to play a central role in the pathogenesis of electrophysiological and morphological abnormalities that characterize the neuropathic complications in different animal models of diabetes mellitus. The peripheral nerves from 17 patients with either type I or type II diabetes mellitus were studied to assess the importance of changes in Na+,K(+)-ATPase activity in chronic human diabetic neuropathy. Sixteen nerves from age- and sex-matched normal individuals, and 12 nerves from non-diabetic neuropathic subjects undergoing vascular or orthopedic surgery served as negative and positive controls, respectively. All specimens were processed blind. Ouabain-sensitive ATPase activity was measured by a modified spectrophotometric coupled-enzyme assay. Standard histology, fiber teasing and electron microscopy were used to establish the normal or neuropathological patterns of surgical material. Morphometric analysis permitted calculation of fiber density in each nerve specimen and correlation of this figure with the relevant enzymatic activity. Na+,K(+)-ATPase activity was approximately 59% lower in nerves from diabetic patients than in normal controls (P < 0.01) and approximately 38% lower in nerves from non-diabetic patients with neuropathy (P < 0.01). Although nerves from both neuropathic conditions had significantly fewer fibers than those from normal individuals (diabetic -33%, and non-diabetic -22%), the decreases in Na+,K(+)-ATPase activity and fiber density were not correlated only in specimens from diabetic patients (r2 = 0.096; P = 0.22). Taken together with data from experimental animal models, these results suggest that the reduction in Na+,K(+)-ATPase activity in diabetic nerves is not an epiphenomenon secondary to fiber loss; rather, it may be an important factor in the pathogenesis and self-maintenance of human diabetic neuropathy.
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Affiliation(s)
- E Scarpini
- Department of Neurology, Dino Ferrari Center, University of Milan, Italy
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Moraes CT, Ciacci F, Silvestri G, Shanske S, Sciacco M, Hirano M, Schon EA, Bonilla E, DiMauro S. Atypical clinical presentations associated with the MELAS mutation at position 3243 of human mitochondrial DNA. Neuromuscul Disord 1993; 3:43-50. [PMID: 8392410 DOI: 10.1016/0960-8966(93)90040-q] [Citation(s) in RCA: 180] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
Mitochondrial encephalopathy, lactic acidosis and stroke-like episodes (MELAS) is commonly associated with an A-->G transition at position 3243 of the mitochondrial DNA. To determine the diversity of clinical syndromes associated with this mutation, 91 patients with mitochondrial encephalomyopathies that did not conform to the MELAS phenotype were screened. Twenty one patients with the 3243 mutation, most of whom had progressive external ophthalmoplegia (PEO) were found. Clinical features did not distinguish PEO patients with the 3243 mutation from those with large-scale deletions of mtDNA. However, most cases with single large-scale mtDNA deletions were sporadic, whereas most patients with the 3243 mutation had affected maternal relatives. Histochemical studies of muscle showed that cytochrome c oxidase (COX) deficiency was more severe in patients with PEO than in patients with typical MELAS, even though PEO patients had a lower percentage of mutant genomes in muscle. These data imply that the 3243 mutation is a major cause of familial PEO, and suggests that the threshold number of mtDNAs harboring the 3243 mutation necessary to affect a particular tissue vary in different patients. The proportion of mutant genomes in combination with other, still undefined, tissue-specific modulating factors seem to determine the overall clinical syndrome.
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Affiliation(s)
- C T Moraes
- H. Houston Merritt Clinical Research Center for Muscular Dystrophy and Related Disorders, College of Physicians and Surgeons, Columbia University, New York, NY 10032
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Sparaco M, Rosoklija G, Tanji K, Sciacco M, Latov N, DiMauro S, Bonilla E. Immunolocalization of heat shock proteins in ragged-red fibers of patients with mitochondrial encephalomyopathies. Neuromuscul Disord 1993; 3:71-6. [PMID: 8101114 DOI: 10.1016/0960-8966(93)90044-k] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Monoclonal antibodies against the 60 kDa heat shock protein (HSP-60) and against ubiquitin (UB) were used to study the expression of these proteins in muscle samples from patients with qualitative and quantitative alterations of mitochondrial DNA (mtDNA). We found an enhanced expression of HSP-60 and UB that was preferentially localized in ragged-red fibers (RRFs). HSP-60 may act as a protein repair enzyme catalyzing the refolding of misfolded proteins in the matrix of mitochondria of RRFs. On the other hand, UB could promote the elimination of abnormal proteins by its covalent interaction to substrates.
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Affiliation(s)
- M Sparaco
- Department of Neurology, College of Physicians and Surgeons of Columbia University, New York, NY 10032
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Gallanti A, Prelle A, Moggio M, Ciscato P, Checcarelli N, Sciacco M, Comini A, Scarlato G. Desmin and vimentin as markers of regeneration in muscle diseases. Acta Neuropathol 1992; 85:88-92. [PMID: 1285499 DOI: 10.1007/bf00304637] [Citation(s) in RCA: 64] [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: 12/26/2022]
Abstract
Localization and distribution of desmin and vimentin have been studied in different neuromuscular disorders using monoclonal antibodies. We have demonstrated that vimentin, although virtually absent in normal human muscle fibers, is expressed in regenerating fibers in different neuromuscular disorders. Moreover, these fibers showed a strong positivity with desmin antibodies. In normal muscle fibers desmin is only localized at Z-line level. These results suggest that desmin and vimentin may be over-expressed during muscle regeneration processes, probably because of their importance in the structural organization of the sarcomere.
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Affiliation(s)
- A Gallanti
- Istituto di Clinica Neurologica, Centro Dino Ferrari, Università degli Studi, Milano, Italy
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Nobile-Orazio E, Carpo M, Meucci N, Grassi MP, Capitani E, Sciacco M, Mangoni A, Scarlato G. Guillain-Barré syndrome associated with high titers of anti-GM1 antibodies. J Neurol Sci 1992; 109:200-6. [PMID: 1634903 DOI: 10.1016/0022-510x(92)90169-l] [Citation(s) in RCA: 96] [Impact Index Per Article: 3.0] [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: 12/28/2022]
Abstract
We found high titers of anti-GM1 antibodies (1/1280 or more) in 3 of 14 consecutive patients (21%) with Guillain-Barré syndrome (GBS) and in 2 additional patients who developed GBS, 10-11 days after starting parenteral treatment with gangliosides. Antibodies were IgG in 4 patients and IgM in one, and they all bound to asialo-GM1, and, in 3, to GD1b as well. Although the clinical features in all the patients with high anti-GM1 titers fulfilled the criteria for the diagnosis of GBS and in 4 of them, proteins but not cells were elevated in cerebrospinal fluid, electrodiagnostic studies in 3 patients showed prominent signs of axonal degeneration, that in one case were confirmed by morphological studies on sural nerve biopsy. No recent antecedent infection was reported by these patients, but in 3, including patients treated with gangliosides, anti-Campylobacter jejuni antibodies were elevated. In 3 patients a consistent decrease in anti-GM1 levels was observed after the acute phase of the disease suggesting that the frequent occurrence of these antibodies in patients with GBS and their frequent association with a prominent axonal impairment may have pathogenetic relevance.
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Affiliation(s)
- E Nobile-Orazio
- Institute of Clinical Neurology, Centro Dino Ferrari, Ospedale Maggiore Policlinico, Milan, Italy
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Abstract
Molecular genetics, biochemistry, immunology and morphology, are being applied in a coordinated fashion to unveil the molecular basis of the mitochondrial encephalomyopathies. Mutations of mitochondrial DNA (mtDNA) have been found in well characterized clinical groups of these disorders. New and old morphologic methods have been applied to investigate muscle biopsies from patients with mtDNA mutations. Important observations have been made on the cellular localization of normal and mutated mtDNA and on the expression of mtDNA-encoded polypeptides. These observations have provided insight into the pathogenesis of respiratory chain enzyme deficiency at the level of individual muscle fibers. Application of immunocytochemical and in situ hybridization techniques at the electron microscopic level will extend these studies to the level of individual mitochondria.
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Affiliation(s)
- E Bonilla
- Department of Neurology, College of Physicians and Surgeons, Columbia University, New York, NY 10032
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Sciacco M, Scarpini E, Baron PL, Doronzo R, Moggio M, Passerini D, Scarlato G. Sural nerve immunoreactivity for nerve growth factor receptor in a case of localized hypertrophic neuropathy. Acta Neuropathol 1992; 83:547-53. [PMID: 1320324 DOI: 10.1007/bf00310035] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.5] [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: 12/26/2022]
Abstract
Immunoreactivity for nerve growth factor receptor (NGFR) was examined using a monoclonal antibody against human NGFR in the sural nerve of a 24-year-old woman, affected by localized hypertrophic neuropathy (LHN). NGFR expression was correlated with electron microscopy and with immunoreactivity for S-100 protein, laminin, HLA-DR, HNK-1, P0 glycoprotein and neurofilament peptides. Our results indicate that in LHN most of whorl-forming cells are NGFR positive and S-100 protein or HLA-DR negative. These data along with the ultrastructural features suggest their origin from perineurium.
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Affiliation(s)
- M Sciacco
- Institute of Neurology, Centro Dino Ferrari, University of Milan, Italy
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Moggio M, Fagiolari G, Prelle A, Gallanti A, Sciacco M, Scarlato G. Lack of anionic phospholipid calcium binding sites in Duchenne muscular dystrophy. Muscle Nerve 1992; 15:325-31. [PMID: 1557080 DOI: 10.1002/mus.880150311] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
We studied membrane ultrastructural localization of anionic phospholipids (AP) and sialic acid (SA) calcium binding sites in muscle biopsies from Duchenne muscular dystrophy (DMD) and 3 Becker's muscular dystrophy (BMD) patients using polymyxin B (PXB) and limulus polyphemus (LP) as cytochemical markers. We found that AP calcium binding sites are lacking at muscle cell surface in all DMD muscle tissues, in both intact and degenerating muscle fibers. In BMD, AP have an unusual distribution along plasma membrane. Sialic acid calcium binding sites have the same localization along plasma membrane and basal lamina in DMD, BMD, and control muscles. The absence or alterations of structures involved in calcium binding in DMD and BMD may alter membrane calcium permeability, leading to abnormal Ca2+ influx into cells causing muscle necrosis.
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Affiliation(s)
- M Moggio
- Department of Neurology, Centro Dino Ferrar, University of Milan, Italy
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Prelle A, Chianese L, Moggio M, Gallanti A, Sciacco M, Checcarelli N, Comi G, Scarpini E, Bonilla E, Scarlato G. Appearance and localization of dystrophin in normal human fetal muscle. Int J Dev Neurosci 1991; 9:607-12. [PMID: 1803857 DOI: 10.1016/0736-5748(91)90022-e] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
We studied the localization of dystrophin in normal human fetal muscle by immunohistochemistry. Our results show the appearance of dystrophin at week 11 and a progressive organization of the protein along membrane in the following weeks of gestation. At week 22 almost all fibers show a clear membrane immunostaining. Concomitant analysis of muscle fiber-type composition reveals no correlation between progressive appearance of dystrophin and muscle fiber-type differentiation. Our findings suggest that synthesis and localization of dystrophin in developing human skeletal muscle is time-related and probably independent of neuronal influences.
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Affiliation(s)
- A Prelle
- Centro Dino Ferrari, Università di Milano, Italy
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