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Oyama M, Holzer MT, Ohnuki Y, Saito Y, Nishimori Y, Suzuki S, Shiina T, Leonard-Louis S, Benveniste O, Schneider U, Stenzel W, Nishino I, Suzuki S, Uruha A. Pathologic Features of Anti-Ku Myositis. Neurology 2024; 102:e209268. [PMID: 38547417 DOI: 10.1212/wnl.0000000000209268] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Accepted: 01/16/2024] [Indexed: 04/02/2024] Open
Abstract
OBJECTIVE Characteristics of myositis with anti-Ku antibodies are poorly understood. The purpose of this study was to elucidate the pathologic features of myositis associated with anti-Ku antibodies, compared with immune-mediated necrotizing myopathy (IMNM) with anti-signal recognition particle (SRP) and anti-3-hydroxy-3-methylglutaryl-coenzyme A reductase (HMGCR) antibodies, in muscle biopsy-oriented registration cohorts in Japan and Germany. METHODS We performed a retrospective pathology review of patients with anti-Ku myositis samples diagnosed in the Japanese and German cohorts. We evaluated histologic features and performed HLA phenotyping. RESULTS Fifty biopsied muscle samples in the Japanese cohort and 10 in the German cohort were obtained. After exclusion of myositis-specific autoantibodies or other autoimmune connective tissue diseases, 26 samples (43%) of anti-Ku antibody-positive myositis were analyzed. All the samples shared some common features with IMNM, whereas they showed expression of MHC class II and clusters of perivascular inflammatory cells more frequently than the anti-SRP/HMGCR IMNM samples (71% vs 7%/16%; p < 0.005/<0.005; 64% vs 0%/0%; p < 0.005/<0.005). Anti-Ku myositis biopsies could be divided into 2 subgroups based on the extent of necrosis and regeneration. The group with more abundant necrosis and regeneration showed a higher frequency of MHC class II expression and perivascular inflammatory cell clusters. HLA phenotyping in the 44 available patients showed possible associations of HLA-DRB1*03:01, HLA-DRB1*11:01, and HLA-DQB1*03:01 (p = 0.0045, 0.019, and 0.027; odds ratio [OR] 50.2, 4.6, and 2.8; 95% CI 2.6-2942.1, 1.1-14.5, and 1.0-7.0) in the group with less conspicuous necrosis and regeneration. On the contrary, in the group of more abundant necrosis and regeneration, the allele frequencies of HLA-A*24:02, HLA-B*52:01, HLA-C*12:02, and HLA-DRB1*15:02 were lower than those of healthy controls (p = 0.0036, 0.027, 0.016, and 0.026; OR = 0.27, 0, 0, and 0; 95% CI 0.1-0.7, 0-0.8, 0-0.8, and 0-0.8). However, these HLA associations did not remain significant after statistical correction for multiple testing. DISCUSSION While anti-Ku myositis shows necrotizing myopathy features, they can be distinguished from anti-SRP/HMGCR IMNM by their MHC class II expression and clusters of perivascular inflammatory cells. The HLA analyses suggest that anti-Ku myositis may have different subsets associated with myopathologic subgroups.
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Affiliation(s)
- Munenori Oyama
- From the Department of Neurology (M.O., S. Suzuki), Keio University School of Medicine, Tokyo, Japan; Department of Medicine for Nephrology, Rheumatology and Endocrinology (M.-T.H.), Division of Rheumatology and Systemic Inflammatory Diseases, III, University Medical Center Hamburg-Eppendorf, Germany; Department of Medical Ethics (Y.O.), Tokai University School of Medicine; Department of Clinical Genetics (Y.O.), Tokai University Hospital, Kanagawa; Department of Neuromuscular Research (Y.S., Y.N., I.N.), National Institute of Neuroscience, and Department of Genome Medicine Development (Y.S., Y.N., I.N.), Medical Genome Center, National Center of Neurology and Psychiatry, Tokyo; Department of Neurology (Y.N.), Nara Medical University; Department of Molecular Life Science (S. Suzuki, T.S.), Tokai University School of Medicine, Kanagawa, Japan; Department of Neuropathology (S.L.-L.), Sorbonne Université, Assistance Publique-Hôpitaux de Paris, Pitié-Salpêtrière University Hospital; Department of Neuromyology (S.L.-L.), National Reference Center of Neuromuscular Disorders, Sorbonne Université, Assistance Publique-Hôpitaux de Paris, Pitié-Salpêtrière University Hospital; Department of Internal Medicine and Clinical Immunology (O.B.), Inflammatory Myopathies Reference Center, Research Center in Myology UMR974, Sorbonne Université, Assistance Publique-Hôpitaux de Paris, Pitié-Salpêtrière Universi, France; Department of Rheumatology (U.S.), and Department of Neuropathology (W.S.), Charité-Universitätsmedizin, Freie Universität Berlin, Humboldt-Universtät zu Berlin, and Berlin Institute of Health; Leibniz ScienceCampus Chronic Inflammation (W.S.), Berlin, Germany; and Department of Neurology (A.U.), Tokyo Metropolitan Neurological Hospital, Japan
| | - Marie-Therese Holzer
- From the Department of Neurology (M.O., S. Suzuki), Keio University School of Medicine, Tokyo, Japan; Department of Medicine for Nephrology, Rheumatology and Endocrinology (M.-T.H.), Division of Rheumatology and Systemic Inflammatory Diseases, III, University Medical Center Hamburg-Eppendorf, Germany; Department of Medical Ethics (Y.O.), Tokai University School of Medicine; Department of Clinical Genetics (Y.O.), Tokai University Hospital, Kanagawa; Department of Neuromuscular Research (Y.S., Y.N., I.N.), National Institute of Neuroscience, and Department of Genome Medicine Development (Y.S., Y.N., I.N.), Medical Genome Center, National Center of Neurology and Psychiatry, Tokyo; Department of Neurology (Y.N.), Nara Medical University; Department of Molecular Life Science (S. Suzuki, T.S.), Tokai University School of Medicine, Kanagawa, Japan; Department of Neuropathology (S.L.-L.), Sorbonne Université, Assistance Publique-Hôpitaux de Paris, Pitié-Salpêtrière University Hospital; Department of Neuromyology (S.L.-L.), National Reference Center of Neuromuscular Disorders, Sorbonne Université, Assistance Publique-Hôpitaux de Paris, Pitié-Salpêtrière University Hospital; Department of Internal Medicine and Clinical Immunology (O.B.), Inflammatory Myopathies Reference Center, Research Center in Myology UMR974, Sorbonne Université, Assistance Publique-Hôpitaux de Paris, Pitié-Salpêtrière Universi, France; Department of Rheumatology (U.S.), and Department of Neuropathology (W.S.), Charité-Universitätsmedizin, Freie Universität Berlin, Humboldt-Universtät zu Berlin, and Berlin Institute of Health; Leibniz ScienceCampus Chronic Inflammation (W.S.), Berlin, Germany; and Department of Neurology (A.U.), Tokyo Metropolitan Neurological Hospital, Japan
| | - Yuko Ohnuki
- From the Department of Neurology (M.O., S. Suzuki), Keio University School of Medicine, Tokyo, Japan; Department of Medicine for Nephrology, Rheumatology and Endocrinology (M.-T.H.), Division of Rheumatology and Systemic Inflammatory Diseases, III, University Medical Center Hamburg-Eppendorf, Germany; Department of Medical Ethics (Y.O.), Tokai University School of Medicine; Department of Clinical Genetics (Y.O.), Tokai University Hospital, Kanagawa; Department of Neuromuscular Research (Y.S., Y.N., I.N.), National Institute of Neuroscience, and Department of Genome Medicine Development (Y.S., Y.N., I.N.), Medical Genome Center, National Center of Neurology and Psychiatry, Tokyo; Department of Neurology (Y.N.), Nara Medical University; Department of Molecular Life Science (S. Suzuki, T.S.), Tokai University School of Medicine, Kanagawa, Japan; Department of Neuropathology (S.L.-L.), Sorbonne Université, Assistance Publique-Hôpitaux de Paris, Pitié-Salpêtrière University Hospital; Department of Neuromyology (S.L.-L.), National Reference Center of Neuromuscular Disorders, Sorbonne Université, Assistance Publique-Hôpitaux de Paris, Pitié-Salpêtrière University Hospital; Department of Internal Medicine and Clinical Immunology (O.B.), Inflammatory Myopathies Reference Center, Research Center in Myology UMR974, Sorbonne Université, Assistance Publique-Hôpitaux de Paris, Pitié-Salpêtrière Universi, France; Department of Rheumatology (U.S.), and Department of Neuropathology (W.S.), Charité-Universitätsmedizin, Freie Universität Berlin, Humboldt-Universtät zu Berlin, and Berlin Institute of Health; Leibniz ScienceCampus Chronic Inflammation (W.S.), Berlin, Germany; and Department of Neurology (A.U.), Tokyo Metropolitan Neurological Hospital, Japan
| | - Yoshihiko Saito
- From the Department of Neurology (M.O., S. Suzuki), Keio University School of Medicine, Tokyo, Japan; Department of Medicine for Nephrology, Rheumatology and Endocrinology (M.-T.H.), Division of Rheumatology and Systemic Inflammatory Diseases, III, University Medical Center Hamburg-Eppendorf, Germany; Department of Medical Ethics (Y.O.), Tokai University School of Medicine; Department of Clinical Genetics (Y.O.), Tokai University Hospital, Kanagawa; Department of Neuromuscular Research (Y.S., Y.N., I.N.), National Institute of Neuroscience, and Department of Genome Medicine Development (Y.S., Y.N., I.N.), Medical Genome Center, National Center of Neurology and Psychiatry, Tokyo; Department of Neurology (Y.N.), Nara Medical University; Department of Molecular Life Science (S. Suzuki, T.S.), Tokai University School of Medicine, Kanagawa, Japan; Department of Neuropathology (S.L.-L.), Sorbonne Université, Assistance Publique-Hôpitaux de Paris, Pitié-Salpêtrière University Hospital; Department of Neuromyology (S.L.-L.), National Reference Center of Neuromuscular Disorders, Sorbonne Université, Assistance Publique-Hôpitaux de Paris, Pitié-Salpêtrière University Hospital; Department of Internal Medicine and Clinical Immunology (O.B.), Inflammatory Myopathies Reference Center, Research Center in Myology UMR974, Sorbonne Université, Assistance Publique-Hôpitaux de Paris, Pitié-Salpêtrière Universi, France; Department of Rheumatology (U.S.), and Department of Neuropathology (W.S.), Charité-Universitätsmedizin, Freie Universität Berlin, Humboldt-Universtät zu Berlin, and Berlin Institute of Health; Leibniz ScienceCampus Chronic Inflammation (W.S.), Berlin, Germany; and Department of Neurology (A.U.), Tokyo Metropolitan Neurological Hospital, Japan
| | - Yukako Nishimori
- From the Department of Neurology (M.O., S. Suzuki), Keio University School of Medicine, Tokyo, Japan; Department of Medicine for Nephrology, Rheumatology and Endocrinology (M.-T.H.), Division of Rheumatology and Systemic Inflammatory Diseases, III, University Medical Center Hamburg-Eppendorf, Germany; Department of Medical Ethics (Y.O.), Tokai University School of Medicine; Department of Clinical Genetics (Y.O.), Tokai University Hospital, Kanagawa; Department of Neuromuscular Research (Y.S., Y.N., I.N.), National Institute of Neuroscience, and Department of Genome Medicine Development (Y.S., Y.N., I.N.), Medical Genome Center, National Center of Neurology and Psychiatry, Tokyo; Department of Neurology (Y.N.), Nara Medical University; Department of Molecular Life Science (S. Suzuki, T.S.), Tokai University School of Medicine, Kanagawa, Japan; Department of Neuropathology (S.L.-L.), Sorbonne Université, Assistance Publique-Hôpitaux de Paris, Pitié-Salpêtrière University Hospital; Department of Neuromyology (S.L.-L.), National Reference Center of Neuromuscular Disorders, Sorbonne Université, Assistance Publique-Hôpitaux de Paris, Pitié-Salpêtrière University Hospital; Department of Internal Medicine and Clinical Immunology (O.B.), Inflammatory Myopathies Reference Center, Research Center in Myology UMR974, Sorbonne Université, Assistance Publique-Hôpitaux de Paris, Pitié-Salpêtrière Universi, France; Department of Rheumatology (U.S.), and Department of Neuropathology (W.S.), Charité-Universitätsmedizin, Freie Universität Berlin, Humboldt-Universtät zu Berlin, and Berlin Institute of Health; Leibniz ScienceCampus Chronic Inflammation (W.S.), Berlin, Germany; and Department of Neurology (A.U.), Tokyo Metropolitan Neurological Hospital, Japan
| | - Shingo Suzuki
- From the Department of Neurology (M.O., S. Suzuki), Keio University School of Medicine, Tokyo, Japan; Department of Medicine for Nephrology, Rheumatology and Endocrinology (M.-T.H.), Division of Rheumatology and Systemic Inflammatory Diseases, III, University Medical Center Hamburg-Eppendorf, Germany; Department of Medical Ethics (Y.O.), Tokai University School of Medicine; Department of Clinical Genetics (Y.O.), Tokai University Hospital, Kanagawa; Department of Neuromuscular Research (Y.S., Y.N., I.N.), National Institute of Neuroscience, and Department of Genome Medicine Development (Y.S., Y.N., I.N.), Medical Genome Center, National Center of Neurology and Psychiatry, Tokyo; Department of Neurology (Y.N.), Nara Medical University; Department of Molecular Life Science (S. Suzuki, T.S.), Tokai University School of Medicine, Kanagawa, Japan; Department of Neuropathology (S.L.-L.), Sorbonne Université, Assistance Publique-Hôpitaux de Paris, Pitié-Salpêtrière University Hospital; Department of Neuromyology (S.L.-L.), National Reference Center of Neuromuscular Disorders, Sorbonne Université, Assistance Publique-Hôpitaux de Paris, Pitié-Salpêtrière University Hospital; Department of Internal Medicine and Clinical Immunology (O.B.), Inflammatory Myopathies Reference Center, Research Center in Myology UMR974, Sorbonne Université, Assistance Publique-Hôpitaux de Paris, Pitié-Salpêtrière Universi, France; Department of Rheumatology (U.S.), and Department of Neuropathology (W.S.), Charité-Universitätsmedizin, Freie Universität Berlin, Humboldt-Universtät zu Berlin, and Berlin Institute of Health; Leibniz ScienceCampus Chronic Inflammation (W.S.), Berlin, Germany; and Department of Neurology (A.U.), Tokyo Metropolitan Neurological Hospital, Japan
| | - Takashi Shiina
- From the Department of Neurology (M.O., S. Suzuki), Keio University School of Medicine, Tokyo, Japan; Department of Medicine for Nephrology, Rheumatology and Endocrinology (M.-T.H.), Division of Rheumatology and Systemic Inflammatory Diseases, III, University Medical Center Hamburg-Eppendorf, Germany; Department of Medical Ethics (Y.O.), Tokai University School of Medicine; Department of Clinical Genetics (Y.O.), Tokai University Hospital, Kanagawa; Department of Neuromuscular Research (Y.S., Y.N., I.N.), National Institute of Neuroscience, and Department of Genome Medicine Development (Y.S., Y.N., I.N.), Medical Genome Center, National Center of Neurology and Psychiatry, Tokyo; Department of Neurology (Y.N.), Nara Medical University; Department of Molecular Life Science (S. Suzuki, T.S.), Tokai University School of Medicine, Kanagawa, Japan; Department of Neuropathology (S.L.-L.), Sorbonne Université, Assistance Publique-Hôpitaux de Paris, Pitié-Salpêtrière University Hospital; Department of Neuromyology (S.L.-L.), National Reference Center of Neuromuscular Disorders, Sorbonne Université, Assistance Publique-Hôpitaux de Paris, Pitié-Salpêtrière University Hospital; Department of Internal Medicine and Clinical Immunology (O.B.), Inflammatory Myopathies Reference Center, Research Center in Myology UMR974, Sorbonne Université, Assistance Publique-Hôpitaux de Paris, Pitié-Salpêtrière Universi, France; Department of Rheumatology (U.S.), and Department of Neuropathology (W.S.), Charité-Universitätsmedizin, Freie Universität Berlin, Humboldt-Universtät zu Berlin, and Berlin Institute of Health; Leibniz ScienceCampus Chronic Inflammation (W.S.), Berlin, Germany; and Department of Neurology (A.U.), Tokyo Metropolitan Neurological Hospital, Japan
| | - Sarah Leonard-Louis
- From the Department of Neurology (M.O., S. Suzuki), Keio University School of Medicine, Tokyo, Japan; Department of Medicine for Nephrology, Rheumatology and Endocrinology (M.-T.H.), Division of Rheumatology and Systemic Inflammatory Diseases, III, University Medical Center Hamburg-Eppendorf, Germany; Department of Medical Ethics (Y.O.), Tokai University School of Medicine; Department of Clinical Genetics (Y.O.), Tokai University Hospital, Kanagawa; Department of Neuromuscular Research (Y.S., Y.N., I.N.), National Institute of Neuroscience, and Department of Genome Medicine Development (Y.S., Y.N., I.N.), Medical Genome Center, National Center of Neurology and Psychiatry, Tokyo; Department of Neurology (Y.N.), Nara Medical University; Department of Molecular Life Science (S. Suzuki, T.S.), Tokai University School of Medicine, Kanagawa, Japan; Department of Neuropathology (S.L.-L.), Sorbonne Université, Assistance Publique-Hôpitaux de Paris, Pitié-Salpêtrière University Hospital; Department of Neuromyology (S.L.-L.), National Reference Center of Neuromuscular Disorders, Sorbonne Université, Assistance Publique-Hôpitaux de Paris, Pitié-Salpêtrière University Hospital; Department of Internal Medicine and Clinical Immunology (O.B.), Inflammatory Myopathies Reference Center, Research Center in Myology UMR974, Sorbonne Université, Assistance Publique-Hôpitaux de Paris, Pitié-Salpêtrière Universi, France; Department of Rheumatology (U.S.), and Department of Neuropathology (W.S.), Charité-Universitätsmedizin, Freie Universität Berlin, Humboldt-Universtät zu Berlin, and Berlin Institute of Health; Leibniz ScienceCampus Chronic Inflammation (W.S.), Berlin, Germany; and Department of Neurology (A.U.), Tokyo Metropolitan Neurological Hospital, Japan
| | - Olivier Benveniste
- From the Department of Neurology (M.O., S. Suzuki), Keio University School of Medicine, Tokyo, Japan; Department of Medicine for Nephrology, Rheumatology and Endocrinology (M.-T.H.), Division of Rheumatology and Systemic Inflammatory Diseases, III, University Medical Center Hamburg-Eppendorf, Germany; Department of Medical Ethics (Y.O.), Tokai University School of Medicine; Department of Clinical Genetics (Y.O.), Tokai University Hospital, Kanagawa; Department of Neuromuscular Research (Y.S., Y.N., I.N.), National Institute of Neuroscience, and Department of Genome Medicine Development (Y.S., Y.N., I.N.), Medical Genome Center, National Center of Neurology and Psychiatry, Tokyo; Department of Neurology (Y.N.), Nara Medical University; Department of Molecular Life Science (S. Suzuki, T.S.), Tokai University School of Medicine, Kanagawa, Japan; Department of Neuropathology (S.L.-L.), Sorbonne Université, Assistance Publique-Hôpitaux de Paris, Pitié-Salpêtrière University Hospital; Department of Neuromyology (S.L.-L.), National Reference Center of Neuromuscular Disorders, Sorbonne Université, Assistance Publique-Hôpitaux de Paris, Pitié-Salpêtrière University Hospital; Department of Internal Medicine and Clinical Immunology (O.B.), Inflammatory Myopathies Reference Center, Research Center in Myology UMR974, Sorbonne Université, Assistance Publique-Hôpitaux de Paris, Pitié-Salpêtrière Universi, France; Department of Rheumatology (U.S.), and Department of Neuropathology (W.S.), Charité-Universitätsmedizin, Freie Universität Berlin, Humboldt-Universtät zu Berlin, and Berlin Institute of Health; Leibniz ScienceCampus Chronic Inflammation (W.S.), Berlin, Germany; and Department of Neurology (A.U.), Tokyo Metropolitan Neurological Hospital, Japan
| | - Udo Schneider
- From the Department of Neurology (M.O., S. Suzuki), Keio University School of Medicine, Tokyo, Japan; Department of Medicine for Nephrology, Rheumatology and Endocrinology (M.-T.H.), Division of Rheumatology and Systemic Inflammatory Diseases, III, University Medical Center Hamburg-Eppendorf, Germany; Department of Medical Ethics (Y.O.), Tokai University School of Medicine; Department of Clinical Genetics (Y.O.), Tokai University Hospital, Kanagawa; Department of Neuromuscular Research (Y.S., Y.N., I.N.), National Institute of Neuroscience, and Department of Genome Medicine Development (Y.S., Y.N., I.N.), Medical Genome Center, National Center of Neurology and Psychiatry, Tokyo; Department of Neurology (Y.N.), Nara Medical University; Department of Molecular Life Science (S. Suzuki, T.S.), Tokai University School of Medicine, Kanagawa, Japan; Department of Neuropathology (S.L.-L.), Sorbonne Université, Assistance Publique-Hôpitaux de Paris, Pitié-Salpêtrière University Hospital; Department of Neuromyology (S.L.-L.), National Reference Center of Neuromuscular Disorders, Sorbonne Université, Assistance Publique-Hôpitaux de Paris, Pitié-Salpêtrière University Hospital; Department of Internal Medicine and Clinical Immunology (O.B.), Inflammatory Myopathies Reference Center, Research Center in Myology UMR974, Sorbonne Université, Assistance Publique-Hôpitaux de Paris, Pitié-Salpêtrière Universi, France; Department of Rheumatology (U.S.), and Department of Neuropathology (W.S.), Charité-Universitätsmedizin, Freie Universität Berlin, Humboldt-Universtät zu Berlin, and Berlin Institute of Health; Leibniz ScienceCampus Chronic Inflammation (W.S.), Berlin, Germany; and Department of Neurology (A.U.), Tokyo Metropolitan Neurological Hospital, Japan
| | - Werner Stenzel
- From the Department of Neurology (M.O., S. Suzuki), Keio University School of Medicine, Tokyo, Japan; Department of Medicine for Nephrology, Rheumatology and Endocrinology (M.-T.H.), Division of Rheumatology and Systemic Inflammatory Diseases, III, University Medical Center Hamburg-Eppendorf, Germany; Department of Medical Ethics (Y.O.), Tokai University School of Medicine; Department of Clinical Genetics (Y.O.), Tokai University Hospital, Kanagawa; Department of Neuromuscular Research (Y.S., Y.N., I.N.), National Institute of Neuroscience, and Department of Genome Medicine Development (Y.S., Y.N., I.N.), Medical Genome Center, National Center of Neurology and Psychiatry, Tokyo; Department of Neurology (Y.N.), Nara Medical University; Department of Molecular Life Science (S. Suzuki, T.S.), Tokai University School of Medicine, Kanagawa, Japan; Department of Neuropathology (S.L.-L.), Sorbonne Université, Assistance Publique-Hôpitaux de Paris, Pitié-Salpêtrière University Hospital; Department of Neuromyology (S.L.-L.), National Reference Center of Neuromuscular Disorders, Sorbonne Université, Assistance Publique-Hôpitaux de Paris, Pitié-Salpêtrière University Hospital; Department of Internal Medicine and Clinical Immunology (O.B.), Inflammatory Myopathies Reference Center, Research Center in Myology UMR974, Sorbonne Université, Assistance Publique-Hôpitaux de Paris, Pitié-Salpêtrière Universi, France; Department of Rheumatology (U.S.), and Department of Neuropathology (W.S.), Charité-Universitätsmedizin, Freie Universität Berlin, Humboldt-Universtät zu Berlin, and Berlin Institute of Health; Leibniz ScienceCampus Chronic Inflammation (W.S.), Berlin, Germany; and Department of Neurology (A.U.), Tokyo Metropolitan Neurological Hospital, Japan
| | - Ichizo Nishino
- From the Department of Neurology (M.O., S. Suzuki), Keio University School of Medicine, Tokyo, Japan; Department of Medicine for Nephrology, Rheumatology and Endocrinology (M.-T.H.), Division of Rheumatology and Systemic Inflammatory Diseases, III, University Medical Center Hamburg-Eppendorf, Germany; Department of Medical Ethics (Y.O.), Tokai University School of Medicine; Department of Clinical Genetics (Y.O.), Tokai University Hospital, Kanagawa; Department of Neuromuscular Research (Y.S., Y.N., I.N.), National Institute of Neuroscience, and Department of Genome Medicine Development (Y.S., Y.N., I.N.), Medical Genome Center, National Center of Neurology and Psychiatry, Tokyo; Department of Neurology (Y.N.), Nara Medical University; Department of Molecular Life Science (S. Suzuki, T.S.), Tokai University School of Medicine, Kanagawa, Japan; Department of Neuropathology (S.L.-L.), Sorbonne Université, Assistance Publique-Hôpitaux de Paris, Pitié-Salpêtrière University Hospital; Department of Neuromyology (S.L.-L.), National Reference Center of Neuromuscular Disorders, Sorbonne Université, Assistance Publique-Hôpitaux de Paris, Pitié-Salpêtrière University Hospital; Department of Internal Medicine and Clinical Immunology (O.B.), Inflammatory Myopathies Reference Center, Research Center in Myology UMR974, Sorbonne Université, Assistance Publique-Hôpitaux de Paris, Pitié-Salpêtrière Universi, France; Department of Rheumatology (U.S.), and Department of Neuropathology (W.S.), Charité-Universitätsmedizin, Freie Universität Berlin, Humboldt-Universtät zu Berlin, and Berlin Institute of Health; Leibniz ScienceCampus Chronic Inflammation (W.S.), Berlin, Germany; and Department of Neurology (A.U.), Tokyo Metropolitan Neurological Hospital, Japan
| | - Shigeaki Suzuki
- From the Department of Neurology (M.O., S. Suzuki), Keio University School of Medicine, Tokyo, Japan; Department of Medicine for Nephrology, Rheumatology and Endocrinology (M.-T.H.), Division of Rheumatology and Systemic Inflammatory Diseases, III, University Medical Center Hamburg-Eppendorf, Germany; Department of Medical Ethics (Y.O.), Tokai University School of Medicine; Department of Clinical Genetics (Y.O.), Tokai University Hospital, Kanagawa; Department of Neuromuscular Research (Y.S., Y.N., I.N.), National Institute of Neuroscience, and Department of Genome Medicine Development (Y.S., Y.N., I.N.), Medical Genome Center, National Center of Neurology and Psychiatry, Tokyo; Department of Neurology (Y.N.), Nara Medical University; Department of Molecular Life Science (S. Suzuki, T.S.), Tokai University School of Medicine, Kanagawa, Japan; Department of Neuropathology (S.L.-L.), Sorbonne Université, Assistance Publique-Hôpitaux de Paris, Pitié-Salpêtrière University Hospital; Department of Neuromyology (S.L.-L.), National Reference Center of Neuromuscular Disorders, Sorbonne Université, Assistance Publique-Hôpitaux de Paris, Pitié-Salpêtrière University Hospital; Department of Internal Medicine and Clinical Immunology (O.B.), Inflammatory Myopathies Reference Center, Research Center in Myology UMR974, Sorbonne Université, Assistance Publique-Hôpitaux de Paris, Pitié-Salpêtrière Universi, France; Department of Rheumatology (U.S.), and Department of Neuropathology (W.S.), Charité-Universitätsmedizin, Freie Universität Berlin, Humboldt-Universtät zu Berlin, and Berlin Institute of Health; Leibniz ScienceCampus Chronic Inflammation (W.S.), Berlin, Germany; and Department of Neurology (A.U.), Tokyo Metropolitan Neurological Hospital, Japan
| | - Akinori Uruha
- From the Department of Neurology (M.O., S. Suzuki), Keio University School of Medicine, Tokyo, Japan; Department of Medicine for Nephrology, Rheumatology and Endocrinology (M.-T.H.), Division of Rheumatology and Systemic Inflammatory Diseases, III, University Medical Center Hamburg-Eppendorf, Germany; Department of Medical Ethics (Y.O.), Tokai University School of Medicine; Department of Clinical Genetics (Y.O.), Tokai University Hospital, Kanagawa; Department of Neuromuscular Research (Y.S., Y.N., I.N.), National Institute of Neuroscience, and Department of Genome Medicine Development (Y.S., Y.N., I.N.), Medical Genome Center, National Center of Neurology and Psychiatry, Tokyo; Department of Neurology (Y.N.), Nara Medical University; Department of Molecular Life Science (S. Suzuki, T.S.), Tokai University School of Medicine, Kanagawa, Japan; Department of Neuropathology (S.L.-L.), Sorbonne Université, Assistance Publique-Hôpitaux de Paris, Pitié-Salpêtrière University Hospital; Department of Neuromyology (S.L.-L.), National Reference Center of Neuromuscular Disorders, Sorbonne Université, Assistance Publique-Hôpitaux de Paris, Pitié-Salpêtrière University Hospital; Department of Internal Medicine and Clinical Immunology (O.B.), Inflammatory Myopathies Reference Center, Research Center in Myology UMR974, Sorbonne Université, Assistance Publique-Hôpitaux de Paris, Pitié-Salpêtrière Universi, France; Department of Rheumatology (U.S.), and Department of Neuropathology (W.S.), Charité-Universitätsmedizin, Freie Universität Berlin, Humboldt-Universtät zu Berlin, and Berlin Institute of Health; Leibniz ScienceCampus Chronic Inflammation (W.S.), Berlin, Germany; and Department of Neurology (A.U.), Tokyo Metropolitan Neurological Hospital, Japan
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Chen Y, Zhang W, Lv H, Wang Z, Hao H, Yuan Y, Zheng Y. Pathological findings with vacuoles in anti-mitochondrial antibody-positive inflammatory myopathy. BMC Musculoskelet Disord 2024; 25:257. [PMID: 38566087 PMCID: PMC10985968 DOI: 10.1186/s12891-023-06941-6] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Accepted: 10/06/2023] [Indexed: 04/04/2024] Open
Abstract
BACKGROUND A few patients with inflammatory myopathy showed anti-mitochondrial antibody (AMA) positivity. This study aimed to report the clinical and pathological findings with vacuoles in 3 cases of such patients. METHODS Three cases with myositis from the Myositis Clinical Database of Peking University First Hospital were identified with AMA positivity. Their clinical records were retrospectively reviewed and the data was extracted. All the 3 cases underwent muscle biopsy. RESULTS Three middle-aged patients presented with chronic-onset weakness of proximal limbs, marked elevation of creatine kinase, and AMA-positivity. Two of the 3 cases meet the criteria of primary biliary cholangitis. All the 3 cases presented with cardiac involvement and proteinuria. Two cases developed type 2 respiratory failure. MRI of the thigh muscle showed multiple patches of edema bilaterally in both cases, mostly in the adductor magnus. Pathological findings include degeneration of muscle fibers, diffused MHC-I positivity, and complement deposits on cell membranes. Vacuoles without rims of different sizes were discovered under the membrane of the muscle fibers. A few RBFs were discovered in case 1, while a diffused proliferation of endomysium and perimysium was shown in case 2. CONCLUSIONS AMA-positive inflammatory myopathy is a disease that could affect multiple systems. Apart from inflammatory changes, the pathological findings of muscle can also present vacuoles.
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Affiliation(s)
- Yuanchong Chen
- Department of Neurology, Peking University First Hospital, No.8 Xishiku Street, Xicheng District, Beijing, 100034, China
- Department of Radiology, Peking University First Hospital, No.8 Xishiku Street, Xicheng District, Beijing, 100034, China
| | - Wei Zhang
- Department of Neurology, Peking University First Hospital, No.8 Xishiku Street, Xicheng District, Beijing, 100034, China
| | - He Lv
- Department of Neurology, Peking University First Hospital, No.8 Xishiku Street, Xicheng District, Beijing, 100034, China
| | - Zhaoxia Wang
- Department of Neurology, Peking University First Hospital, No.8 Xishiku Street, Xicheng District, Beijing, 100034, China
| | - Hongjun Hao
- Department of Neurology, Peking University First Hospital, No.8 Xishiku Street, Xicheng District, Beijing, 100034, China
| | - Yun Yuan
- Department of Neurology, Peking University First Hospital, No.8 Xishiku Street, Xicheng District, Beijing, 100034, China
| | - Yiming Zheng
- Department of Neurology, Peking University First Hospital, No.8 Xishiku Street, Xicheng District, Beijing, 100034, China.
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3
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Schon KR, O'Donovan DG, Briggs M, Rowe JB, Wijesekera L, Chinnery PF, van den Ameele J. Multisystem pathology in McLeod syndrome. Neuropathology 2024; 44:109-114. [PMID: 37438874 DOI: 10.1111/neup.12935] [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: 05/05/2023] [Revised: 06/12/2023] [Accepted: 06/24/2023] [Indexed: 07/14/2023]
Abstract
We present a comprehensive characterization of clinical, neuropathological, and multisystem features of a man with genetically confirmed McLeod neuroacanthocytosis syndrome, including video and autopsy findings. A 61-year-old man presented with a movement disorder and behavioral change. Examination showed dystonic choreiform movements in all four limbs, reduced deep-tendon reflexes, and wide-based gait. He had oromandibular dyskinesia causing severe dysphagia. Elevated serum creatinine kinase (CK) was first noted in his thirties, but investigations, including muscle biopsy at that time, were inconclusive. Brain magnetic resonance imaging showed white matter volume loss, atrophic basal ganglia, and chronic small vessel ischemia. Despite raised CK, electromyography did not show myopathic changes. Exome gene panel testing was negative, but targeted genetic analysis revealed a hemizygous pathogenic variant in the XK gene c.895C > T p.(Gln299Ter), consistent with a diagnosis of McLeod syndrome. The patient died of sepsis, and autopsy showed astrocytic gliosis and atrophy of the basal ganglia, diffuse iron deposition in the putamen, and mild Alzheimer's pathology. Muscle pathology was indicative of mild chronic neurogenic atrophy without overt myopathic features. He had non-specific cardiomyopathy and splenomegaly. McLeod syndrome is an ultra-rare neurodegenerative disorder caused by X-linked recessive mutations in the XK gene. Diagnosis has management implications since patients are at risk of severe transfusion reactions and cardiac complications. When a clinical diagnosis is suspected, candidate genes should be interrogated rather than solely relying on exome panels.
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Affiliation(s)
- Katherine R Schon
- Department of Clinical Neurosciences, School of Clinical Medicine, University of Cambridge, Cambridge, UK
- Medical Research Council Mitochondrial Biology Unit, University of Cambridge, Cambridge, UK
- East Anglian Medical Genetics Service, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Dominic G O'Donovan
- Department of Pathology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Mayen Briggs
- Department of Clinical Neurosciences, School of Clinical Medicine, University of Cambridge, Cambridge, UK
- Department of Pathology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - James B Rowe
- Department of Clinical Neurosciences, School of Clinical Medicine, University of Cambridge, Cambridge, UK
| | - Lokesh Wijesekera
- Department of Clinical Neurophysiology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Patrick F Chinnery
- Department of Clinical Neurosciences, School of Clinical Medicine, University of Cambridge, Cambridge, UK
- Medical Research Council Mitochondrial Biology Unit, University of Cambridge, Cambridge, UK
| | - Jelle van den Ameele
- Department of Clinical Neurosciences, School of Clinical Medicine, University of Cambridge, Cambridge, UK
- Medical Research Council Mitochondrial Biology Unit, University of Cambridge, Cambridge, UK
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4
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Guo Q, Luo Q, Song G. Control of muscle satellite cell function by specific exercise-induced cytokines and their applications in muscle maintenance. J Cachexia Sarcopenia Muscle 2024; 15:466-476. [PMID: 38375571 PMCID: PMC10995279 DOI: 10.1002/jcsm.13440] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2023] [Revised: 01/05/2024] [Accepted: 01/14/2024] [Indexed: 02/21/2024] Open
Abstract
Exercise is recognized to play an observable role in improving human health, especially in promoting muscle hypertrophy and intervening in muscle mass loss-related diseases, including sarcopenia. Recent rapid advances have demonstrated that exercise induces the release of abundant cytokines from several tissues (e.g., liver, muscle, and adipose tissue), and multiple cytokines improve the functions or expand the numbers of adult stem cells, providing candidate cytokines for alleviating a wide range of diseases. Muscle satellite cells (SCs) are a population of muscle stem cells that are mitotically quiescent but exit from the dormancy state to become activated in response to physical stimuli, after which SCs undergo asymmetric divisions to generate new SCs (stem cell pool maintenance) and commit to later differentiation into myocytes (skeletal muscle replenishment). SCs are essential for the postnatal growth, maintenance, and regeneration of skeletal muscle. Emerging evidence reveals that exercise regulates muscle function largely via the exercise-induced cytokines that govern SC potential, but this phenomenon is complicated and confusing. This review provides a comprehensive integrative overview of the identified exercise-induced cytokines and the roles of these cytokines in SC function, providing a more complete picture regarding the mechanism of SC homeostasis and rejuvenation therapies for skeletal muscle.
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Affiliation(s)
- Qian Guo
- Key Laboratory of Biorheological Science and Technology, Ministry of Education, College of BioengineeringChongqing UniversityChongqingChina
| | - Qing Luo
- Key Laboratory of Biorheological Science and Technology, Ministry of Education, College of BioengineeringChongqing UniversityChongqingChina
| | - Guanbin Song
- Key Laboratory of Biorheological Science and Technology, Ministry of Education, College of BioengineeringChongqing UniversityChongqingChina
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5
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Mughal S, Sabater-Arcis M, Artero R, Ramón-Azcón J, Fernández-Costa JM. Taurine activates the AKT-mTOR axis to restore muscle mass and contractile strength in human 3D in vitro models of steroid myopathy. Dis Model Mech 2024; 17:dmm050540. [PMID: 38655653 DOI: 10.1242/dmm.050540] [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: 10/13/2023] [Accepted: 02/06/2024] [Indexed: 04/26/2024] Open
Abstract
Steroid myopathy is a clinically challenging condition exacerbated by prolonged corticosteroid use or adrenal tumors. In this study, we engineered a functional three-dimensional (3D) in vitro skeletal muscle model to investigate steroid myopathy. By subjecting our bioengineered muscle tissues to dexamethasone treatment, we reproduced the molecular and functional aspects of this disease. Dexamethasone caused a substantial reduction in muscle force, myotube diameter and induced fatigue. We observed nuclear translocation of the glucocorticoid receptor (GCR) and activation of the ubiquitin-proteasome system within our model, suggesting their coordinated role in muscle atrophy. We then examined the therapeutic potential of taurine in our 3D model for steroid myopathy. Our findings revealed an upregulation of phosphorylated AKT by taurine, effectively countering the hyperactivation of the ubiquitin-proteasomal pathway. Importantly, we demonstrate that discontinuing corticosteroid treatment was insufficient to restore muscle mass and function. Taurine treatment, when administered concurrently with corticosteroids, notably enhanced contractile strength and protein turnover by upregulating the AKT-mTOR axis. Our model not only identifies a promising therapeutic target, but also suggests combinatorial treatment that may benefit individuals undergoing corticosteroid treatment or those diagnosed with adrenal tumors.
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Affiliation(s)
- Sheeza Mughal
- Institute for Bioengineering of Catalonia (IBEC), The Barcelona Institute of Science and Technology (BIST), C/Baldiri Reixac 10-12, E08028 Barcelona, Spain
| | - Maria Sabater-Arcis
- University Institute for Biotechnology and Biomedicine (BIOTECMED), University of Valencia, Dr Moliner 50, E46100 Burjassot, Valencia, Spain
- Translational Genomics Group, Incliva Health Research Institute, Dr Moliner 50, E46100 Burjassot, Valencia, Spain
- Joint Unit Incliva- CIPF, Dr Moliner 50, E46100 Burjassot, Valencia, Spain
| | - Ruben Artero
- University Institute for Biotechnology and Biomedicine (BIOTECMED), University of Valencia, Dr Moliner 50, E46100 Burjassot, Valencia, Spain
- Translational Genomics Group, Incliva Health Research Institute, Dr Moliner 50, E46100 Burjassot, Valencia, Spain
- Joint Unit Incliva- CIPF, Dr Moliner 50, E46100 Burjassot, Valencia, Spain
| | - Javier Ramón-Azcón
- Institute for Bioengineering of Catalonia (IBEC), The Barcelona Institute of Science and Technology (BIST), C/Baldiri Reixac 10-12, E08028 Barcelona, Spain
- Institució Catalana de Reserca i Estudis Avançats (ICREA), Passeig de Lluís Companys, 23, E08010 Barcelona, Spain
| | - Juan M Fernández-Costa
- Institute for Bioengineering of Catalonia (IBEC), The Barcelona Institute of Science and Technology (BIST), C/Baldiri Reixac 10-12, E08028 Barcelona, Spain
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6
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D'Costa MS, Bugiardini E, Merve A, Morrow JM. PYROXD1-associated myopathy. BMJ Case Rep 2024; 17:e259907. [PMID: 38553017 PMCID: PMC10982700 DOI: 10.1136/bcr-2024-259907] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/02/2024] Open
Abstract
PYROXD1-associated myopathy is a rare genetic form of limb-girdle muscular dystrophy (LGMD) with only 23 previous cases having been reported in the literature. The exact role of PYROXD1 in the pathophysiology of LGMD remains unclear. We describe two brothers who presented to the neuromuscular clinic with progressive weakness of their upper and lower limbs over the preceding decades. Our case highlights how recent advancements in genetic sequencing have revolutionised the diagnostic classification process for LGMD and provided opportunities to establish diagnoses for previously unclassified myopathies. We also illustrate how the increased adoption of muscle MRI to identify disease and target muscle biopsy can provide better quality and more informative samples for classification. Finally, our report details the clinical and histopathological findings found in both cases adding valuable data to the currently limited information published on PYROXD1-associated myopathy.
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Affiliation(s)
| | - Enrico Bugiardini
- Queen Square Centre for Neuromuscular Diseases, Queen Square UCL Institute of Neurology, London, UK
| | - Ashirwad Merve
- Neuropathology, Great Ormond Street Hospital for Children, London, UK
| | - Jasper M Morrow
- Queen Square Centre for Neuromuscular Diseases, Queen Square UCL Institute of Neurology, London, UK
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7
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Donkervoort S, Mohassel P, O'Leary M, Bonner DE, Hartley T, Acquaye N, Brull A, Mozaffar T, Saporta MA, Dyment DA, Sampson JB, Pajusalu S, Austin-Tse C, Hurth K, Cohen JS, McWalter K, Warman-Chardon J, Crunk A, Foley AR, Mammen AL, Wheeler MT, O'Donnell-Luria A, Bönnemann CG. Recurring homozygous ACTN2 variant (p.Arg506Gly) causes a recessive myopathy. Ann Clin Transl Neurol 2024; 11:629-640. [PMID: 38311799 DOI: 10.1002/acn3.51983] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Revised: 12/10/2023] [Accepted: 12/16/2023] [Indexed: 02/06/2024] Open
Abstract
OBJECTIVE ACTN2, encoding alpha-actinin-2, is essential for cardiac and skeletal muscle sarcomeric function. ACTN2 variants are a known cause of cardiomyopathy without skeletal muscle involvement. Recently, specific dominant monoallelic variants were reported as a rare cause of core myopathy of variable clinical onset, although the pathomechanism remains to be elucidated. The possibility of a recessively inherited ACTN2-myopathy has also been proposed in a single series. METHODS We provide clinical, imaging, and histological characterization of a series of patients with a novel biallelic ACTN2 variant. RESULTS We report seven patients from five families with a recurring biallelic variant in ACTN2: c.1516A>G (p.Arg506Gly), all manifesting with a consistent phenotype of asymmetric, progressive, proximal, and distal lower extremity predominant muscle weakness. None of the patients have cardiomyopathy or respiratory insufficiency. Notably, all patients report Palestinian ethnicity, suggesting a possible founder ACTN2 variant, which was confirmed through haplotype analysis in two families. Muscle biopsies reveal an underlying myopathic process with disruption of the intermyofibrillar architecture, Type I fiber predominance and atrophy. MRI of the lower extremities demonstrate a distinct pattern of asymmetric muscle involvement with selective involvement of the hamstrings and adductors in the thigh, and anterior tibial group and soleus in the lower leg. Using an in vitro splicing assay, we show that c.1516A>G ACTN2 does not impair normal splicing. INTERPRETATION This series further establishes ACTN2 as a muscle disease gene, now also including variants with a recessive inheritance mode, and expands the clinical spectrum of actinopathies to adult-onset progressive muscle disease.
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Affiliation(s)
- Sandra Donkervoort
- Neuromuscular and Neurogenetic Disorders of Childhood Section, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, Maryland, USA
| | - Payam Mohassel
- Neuromuscular and Neurogenetic Disorders of Childhood Section, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, Maryland, USA
| | - Melanie O'Leary
- Program in Medical and Population Genetics, Broad Institute of MIT and Harvard, Cambridge, Massachusetts, USA
| | - Devon E Bonner
- Stanford Center for Undiagnosed Diseases, Stanford University, Stanford, California, USA
- Department of Pediatrics, Medical Genetics, Stanford University School of Medicine, Stanford, California, USA
| | - Taila Hartley
- Children's Hospital of Eastern Ontario Research Institute, University of Ottawa, Ottawa, Ontario, Canada
| | - Nicole Acquaye
- Neuromuscular and Neurogenetic Disorders of Childhood Section, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, Maryland, USA
| | - Astrid Brull
- Neuromuscular and Neurogenetic Disorders of Childhood Section, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, Maryland, USA
| | - Tahseen Mozaffar
- Department of Neurology, University of California, Irvine, California, USA
- Department of Pathology & Laboratory Medicine, University of California, Irvine, California, USA
| | - Mario A Saporta
- Department of Neurology, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - David A Dyment
- Children's Hospital of Eastern Ontario Research Institute, University of Ottawa, Ottawa, Ontario, Canada
| | - Jacinda B Sampson
- Stanford Center for Undiagnosed Diseases, Stanford University, Stanford, California, USA
- Department of Neurology, Stanford University School of Medicine, Stanford, California, USA
| | - Sander Pajusalu
- Program in Medical and Population Genetics, Broad Institute of MIT and Harvard, Cambridge, Massachusetts, USA
- Genetics and Personalized Medicine Clinic, Tartu University Hospital, Tartu, Estonia
- Department of Clinical Genetics, Institute of Clinical Medicine, University of Tartu, Tartu, Estonia
| | - Christina Austin-Tse
- Program in Medical and Population Genetics, Broad Institute of MIT and Harvard, Cambridge, Massachusetts, USA
- Center for Genomic Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Kyle Hurth
- Department of Pathology, Keck School of Medicine, University of Southern California, Los Angeles, California, USA
| | - Julie S Cohen
- Department of Neurology and Developmental Medicine, Hugo W. Moser Research Institute, Kennedy Krieger Institute, Baltimore, Maryland, USA
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | | | - Jodi Warman-Chardon
- Department of Medicine, The Ottawa Hospital, University of Ottawa, Ottawa, Ontario, Canada
| | | | - A Reghan Foley
- Neuromuscular and Neurogenetic Disorders of Childhood Section, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, Maryland, USA
| | - Andrew L Mammen
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
- Muscle Disease Unit, National Institute of Arthritis and Musculoskeletal and Skin Diseases, National Institutes of Health, Bethesda, Maryland, USA
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Matthew T Wheeler
- Stanford Center for Undiagnosed Diseases, Stanford University, Stanford, California, USA
- Division of Cardiovascular Medicine, Stanford University School of Medicine, Stanford, California, USA
| | - Anne O'Donnell-Luria
- Program in Medical and Population Genetics, Broad Institute of MIT and Harvard, Cambridge, Massachusetts, USA
- Center for Genomic Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
- Division of Genetics and Genomics, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Carsten G Bönnemann
- Neuromuscular and Neurogenetic Disorders of Childhood Section, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, Maryland, USA
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8
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Töpf A, Cox D, Zaharieva IT, Di Leo V, Sarparanta J, Jonson PH, Sealy IM, Smolnikov A, White RJ, Vihola A, Savarese M, Merteroglu M, Wali N, Laricchia KM, Venturini C, Vroling B, Stenton SL, Cummings BB, Harris E, Marini-Bettolo C, Diaz-Manera J, Henderson M, Barresi R, Duff J, England EM, Patrick J, Al-Husayni S, Biancalana V, Beggs AH, Bodi I, Bommireddipalli S, Bönnemann CG, Cairns A, Chiew MT, Claeys KG, Cooper ST, Davis MR, Donkervoort S, Erasmus CE, Fassad MR, Genetti CA, Grosmann C, Jungbluth H, Kamsteeg EJ, Lornage X, Löscher WN, Malfatti E, Manzur A, Martí P, Mongini TE, Muelas N, Nishikawa A, O'Donnell-Luria A, Ogonuki N, O'Grady GL, O'Heir E, Paquay S, Phadke R, Pletcher BA, Romero NB, Schouten M, Shah S, Smuts I, Sznajer Y, Tasca G, Taylor RW, Tuite A, Van den Bergh P, VanNoy G, Voermans NC, Wanschitz JV, Wraige E, Yoshimura K, Oates EC, Nakagawa O, Nishino I, Laporte J, Vilchez JJ, MacArthur DG, Sarkozy A, Cordell HJ, Udd B, Busch-Nentwich EM, Muntoni F, Straub V. Digenic inheritance involving a muscle-specific protein kinase and the giant titin protein causes a skeletal muscle myopathy. Nat Genet 2024; 56:395-407. [PMID: 38429495 PMCID: PMC10937387 DOI: 10.1038/s41588-023-01651-0] [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: 03/29/2021] [Accepted: 12/19/2023] [Indexed: 03/03/2024]
Abstract
In digenic inheritance, pathogenic variants in two genes must be inherited together to cause disease. Only very few examples of digenic inheritance have been described in the neuromuscular disease field. Here we show that predicted deleterious variants in SRPK3, encoding the X-linked serine/argenine protein kinase 3, lead to a progressive early onset skeletal muscle myopathy only when in combination with heterozygous variants in the TTN gene. The co-occurrence of predicted deleterious SRPK3/TTN variants was not seen among 76,702 healthy male individuals, and statistical modeling strongly supported digenic inheritance as the best-fitting model. Furthermore, double-mutant zebrafish (srpk3-/-; ttn.1+/-) replicated the myopathic phenotype and showed myofibrillar disorganization. Transcriptome data suggest that the interaction of srpk3 and ttn.1 in zebrafish occurs at a post-transcriptional level. We propose that digenic inheritance of deleterious changes impacting both the protein kinase SRPK3 and the giant muscle protein titin causes a skeletal myopathy and might serve as a model for other genetic diseases.
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Affiliation(s)
- Ana Töpf
- John Walton Muscular Dystrophy Research Centre, Translational and Clinical Research Institute, Newcastle University and Newcastle Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK.
| | - Dan Cox
- John Walton Muscular Dystrophy Research Centre, Translational and Clinical Research Institute, Newcastle University and Newcastle Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Irina T Zaharieva
- Dubowitz Neuromuscular Centre, UCL Great Ormond Street Institute of Child Health & Great Ormond Street Hospital, London, UK
| | - Valeria Di Leo
- John Walton Muscular Dystrophy Research Centre, Translational and Clinical Research Institute, Newcastle University and Newcastle Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
- Department of Life Sciences, University of Trieste, Trieste, Italy
| | - Jaakko Sarparanta
- Folkhälsan Research Center, Helsinki, Finland
- Department of Medical and Clinical Genetics, Medicum, University of Helsinki, Helsinki, Finland
| | - Per Harald Jonson
- Folkhälsan Research Center, Helsinki, Finland
- Department of Medical and Clinical Genetics, Medicum, University of Helsinki, Helsinki, Finland
| | - Ian M Sealy
- School of Biological and Behavioural Sciences, Queen Mary University of London, London, UK
- Cambridge Institute of Therapeutic Immunology & Infectious Disease (CITIID), Department of Medicine, Jeffrey Cheah Biomedical Centre, University of Cambridge, Cambridge, UK
| | - Andrei Smolnikov
- School of Biotechnology and Biomolecular Sciences, University of New South Wales, Sydney, New South Wales, Australia
| | - Richard J White
- School of Biological and Behavioural Sciences, Queen Mary University of London, London, UK
- Cambridge Institute of Therapeutic Immunology & Infectious Disease (CITIID), Department of Medicine, Jeffrey Cheah Biomedical Centre, University of Cambridge, Cambridge, UK
| | - Anna Vihola
- Folkhälsan Research Center, Helsinki, Finland
- Department of Medical and Clinical Genetics, Medicum, University of Helsinki, Helsinki, Finland
- Neuromuscular Research Centre, Tampere University and University Hospital, Tampere, Finland
| | - Marco Savarese
- Folkhälsan Research Center, Helsinki, Finland
- Department of Medical and Clinical Genetics, Medicum, University of Helsinki, Helsinki, Finland
| | - Munise Merteroglu
- School of Biological and Behavioural Sciences, Queen Mary University of London, London, UK
- Laboratory of Angiogenesis and Cancer Metabolism, Department of Biology, University of Padua, Padua, Italy
| | - Neha Wali
- Wellcome Sanger Institute, Wellcome Genome Campus, Hinxton, UK
| | - Kristen M Laricchia
- Program in Medical and Population Genetics, Broad Institute of MIT and Harvard, Cambridge, MA, USA
- Analytic and Translational Genetics Unit, Massachusetts General Hospital, Boston, MA, USA
| | - Cristina Venturini
- Division of Infection and Immunity, University College London, London, UK
| | | | - Sarah L Stenton
- Program in Medical and Population Genetics, Broad Institute of MIT and Harvard, Cambridge, MA, USA
- Division of Genetics & Genomics, Department of Pediatrics, Boston Children's Hospital, Boston, MA, USA
| | - Beryl B Cummings
- Laboratory of Angiogenesis and Cancer Metabolism, Department of Biology, University of Padua, Padua, Italy
| | - Elizabeth Harris
- John Walton Muscular Dystrophy Research Centre, Translational and Clinical Research Institute, Newcastle University and Newcastle Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
- Northern Genetics Service, Institute of Genetics Medicine, Newcastle upon Tyne, UK
| | - Chiara Marini-Bettolo
- John Walton Muscular Dystrophy Research Centre, Translational and Clinical Research Institute, Newcastle University and Newcastle Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Jordi Diaz-Manera
- John Walton Muscular Dystrophy Research Centre, Translational and Clinical Research Institute, Newcastle University and Newcastle Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Matt Henderson
- Muscle Immunoanalysis Unit, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
| | | | - Jennifer Duff
- John Walton Muscular Dystrophy Research Centre, Translational and Clinical Research Institute, Newcastle University and Newcastle Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Eleina M England
- Program in Medical and Population Genetics, Broad Institute of MIT and Harvard, Cambridge, MA, USA
| | - Jane Patrick
- Wellcome Sanger Institute, Wellcome Genome Campus, Hinxton, UK
| | - Sundos Al-Husayni
- The Manton Center for Orphan Disease Research, Division of Genetics and Genomics, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
| | - Valerie Biancalana
- Institut de Génétique et de Biologie Moléculaire et Cellulaire (IGBMC), Inserm U1258, Cnrs UMR7104, Université de Strasbourg, Illkirch, France
| | - Alan H Beggs
- The Manton Center for Orphan Disease Research, Division of Genetics and Genomics, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
| | - Istvan Bodi
- Department of Clinical Neuropathology, King's College Hospital NHS Foundation Trust, London, UK
| | - Shobhana Bommireddipalli
- Kids Neuroscience Centre, the Children's Hospital at Westmead, the University of Sydney and the Children's Medical Research Institute, Westmead, New South Wales, Australia
| | - Carsten G Bönnemann
- Neuromuscular and Neurogenetic Disorders of Childhood Section, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA
| | - Anita Cairns
- Neurosciences Department, Queensland Children's Hospital, Brisbane, Queensland, Australia
| | - Mei-Ting Chiew
- Department of Diagnostic Genomics, PathWest Laboratory Medicine, Perth, Western Australia, Australia
| | - Kristl G Claeys
- Department of Neurology, University Hospitals Leuven, Leuven, Belgium
- Laboratory for Muscle Diseases and Neuropathies, Department of Neurosciences, KU Leuven, Leuven, Belgium
| | - Sandra T Cooper
- Kids Neuroscience Centre, the Children's Hospital at Westmead, the University of Sydney and the Children's Medical Research Institute, Westmead, New South Wales, Australia
| | - Mark R Davis
- Department of Diagnostic Genomics, PathWest Laboratory Medicine, Perth, Western Australia, Australia
| | - Sandra Donkervoort
- Neuromuscular and Neurogenetic Disorders of Childhood Section, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA
| | - Corrie E Erasmus
- Department of Paediatric Neurology, Donders Institute for Brain, Cognition and Behavior, Radboud University Medical Centre, Amalia Children's Hospital, Nijmegen, The Netherlands
| | - Mahmoud R Fassad
- Wellcome Centre for Mitochondrial Research, Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
- NHS Highly Specialised Service for Rare Mitochondrial Disorders, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Casie A Genetti
- The Manton Center for Orphan Disease Research, Division of Genetics and Genomics, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
| | - Carla Grosmann
- Department of Neurology, Rady Children's Hospital University of California San Diego, San Diego, CA, USA
| | - Heinz Jungbluth
- Department of Paediatric Neurology, Neuromuscular Service, Evelina's Children Hospital, Guy's & St. Thomas' Hospital NHS Foundation Trust, London, UK
- Randall Centre for Cell and Molecular Biophysics, Muscle Signalling Section, Faculty of Life Sciences and Medicine (FoLSM), King's College London, London, UK
| | - Erik-Jan Kamsteeg
- Department of Human Genetics, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Xavière Lornage
- Institut de Génétique et de Biologie Moléculaire et Cellulaire (IGBMC), Inserm U1258, Cnrs UMR7104, Université de Strasbourg, Illkirch, France
| | - Wolfgang N Löscher
- Department of Neurology, Medical University Innsbruck, Innsbruck, Austria
| | - Edoardo Malfatti
- APHP, Neuromuscular Reference Center Nord-Est-Ile-de-France, Henri Mondor Hospital, Université Paris Est, U955, INSERM, Creteil, France
| | - Adnan Manzur
- Dubowitz Neuromuscular Centre, UCL Great Ormond Street Institute of Child Health & Great Ormond Street Hospital, London, UK
| | - Pilar Martí
- Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), Madrid, Spain
- Neuromuscular Research Group, IIS La Fe, Valencia, Spain
| | - Tiziana E Mongini
- Department of Neurosciences Rita Levi Montalcini, Università degli Studi di Torino, Torino, Italy
| | - Nuria Muelas
- Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), Madrid, Spain
- Neuromuscular Research Group, IIS La Fe, Valencia, Spain
- Department of Medicine, Universitat de Valencia, Valencia, Spain
- Neuromuscular Diseases Unit, Neurology Department, Hospital Universitari I Politècnic La Fe, Valencia, Spain
| | - Atsuko Nishikawa
- Department of Neuromuscular Research, National Institute of Neuroscience, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Anne O'Donnell-Luria
- Program in Medical and Population Genetics, Broad Institute of MIT and Harvard, Cambridge, MA, USA
- Division of Genetics & Genomics, Department of Pediatrics, Boston Children's Hospital, Boston, MA, USA
| | | | - Gina L O'Grady
- Starship Children's Health, Auckland District Health Board, Auckland, New Zealand
| | - Emily O'Heir
- Program in Medical and Population Genetics, Broad Institute of MIT and Harvard, Cambridge, MA, USA
| | - Stéphanie Paquay
- Cliniques Universitaires St-Luc, Centre de Référence Neuromusculaire, Université de Louvain, Brussels, Belgium
| | - Rahul Phadke
- Dubowitz Neuromuscular Centre, UCL Great Ormond Street Institute of Child Health & Great Ormond Street Hospital, London, UK
| | - Beth A Pletcher
- Division of Clinical Genetics, Department of Pediatrics, Rutgers New Jersey Medical School, Newark, NJ, USA
| | - Norma B Romero
- Neuromuscular Morphology Unit, Myology Institute, Sorbonne Université, Centre de Référence de Pathologie Neuromusculaire Nord/Est/Ile-de-France (APHP), GH Pitié-Salpêtrière, Paris, France
| | - Meyke Schouten
- Department of Human Genetics, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Snehal Shah
- Department of Neurology, Perth Children's Hospital, Nedlands, Western Australia, Australia
| | - Izelle Smuts
- Department of Paediatrics, Steve Biko Academic Hospital, University of Pretoria, Pretoria, South Africa
| | - Yves Sznajer
- Center for Human Genetic, Cliniques Universitaires Saint Luc, UCLouvain, Brussels, Belgium
| | - Giorgio Tasca
- John Walton Muscular Dystrophy Research Centre, Translational and Clinical Research Institute, Newcastle University and Newcastle Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Robert W Taylor
- Wellcome Centre for Mitochondrial Research, Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
- NHS Highly Specialised Service for Rare Mitochondrial Disorders, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Allysa Tuite
- Division of Clinical Genetics, Department of Pediatrics, Rutgers New Jersey Medical School, Newark, NJ, USA
| | - Peter Van den Bergh
- Cliniques Universitaires St-Luc, Centre de Référence Neuromusculaire, Université de Louvain, Brussels, Belgium
| | - Grace VanNoy
- Program in Medical and Population Genetics, Broad Institute of MIT and Harvard, Cambridge, MA, USA
| | - Nicol C Voermans
- Department of Neurology, Donders Institute for Brain, Cognition and Behavior, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Julia V Wanschitz
- Department of Neurology, Medical University Innsbruck, Innsbruck, Austria
| | - Elizabeth Wraige
- Evelina's Children Hospital, Guy's & St. Thomas' Hospital NHS Foundation Trust, London, UK
| | | | - Emily C Oates
- School of Biotechnology and Biomolecular Sciences, University of New South Wales, Sydney, New South Wales, Australia
| | - Osamu Nakagawa
- Department of Molecular Physiology, National Cerebral and Cardiovascular Center Research Institute, Osaka, Japan
| | - Ichizo Nishino
- Department of Neuromuscular Research, National Institute of Neuroscience, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Jocelyn Laporte
- Institut de Génétique et de Biologie Moléculaire et Cellulaire (IGBMC), Inserm U1258, Cnrs UMR7104, Université de Strasbourg, Illkirch, France
| | - Juan J Vilchez
- Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), Madrid, Spain
- Neuromuscular Research Group, IIS La Fe, Valencia, Spain
| | - Daniel G MacArthur
- Program in Medical and Population Genetics, Broad Institute of MIT and Harvard, Cambridge, MA, USA
- Centre for Population Genomics, Garvan Institute of Medical Research and UNSW, Sydney, New South Wales, Australia
- Centre for Population Genomics, Murdoch Children's Research Institute, Melbourne, Victoria, Australia
| | - Anna Sarkozy
- Dubowitz Neuromuscular Centre, UCL Great Ormond Street Institute of Child Health & Great Ormond Street Hospital, London, UK
| | - Heather J Cordell
- Population Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
| | - Bjarne Udd
- Folkhälsan Research Center, Helsinki, Finland
- Department of Medical and Clinical Genetics, Medicum, University of Helsinki, Helsinki, Finland
- Neuromuscular Research Centre, Tampere University and University Hospital, Tampere, Finland
| | - Elisabeth M Busch-Nentwich
- School of Biological and Behavioural Sciences, Queen Mary University of London, London, UK
- Cambridge Institute of Therapeutic Immunology & Infectious Disease (CITIID), Department of Medicine, Jeffrey Cheah Biomedical Centre, University of Cambridge, Cambridge, UK
| | - Francesco Muntoni
- Dubowitz Neuromuscular Centre, UCL Great Ormond Street Institute of Child Health & Great Ormond Street Hospital, London, UK
- NIHR Great Ormond Street Hospital Biomedical Research Centre, Great Ormond Street Institute of Child Health, UCL & Great Ormond Street Hospital Trust, London, UK
| | - Volker Straub
- John Walton Muscular Dystrophy Research Centre, Translational and Clinical Research Institute, Newcastle University and Newcastle Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK.
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Traverso M, Baratto S, Iacomino M, Di Duca M, Panicucci C, Casalini S, Grandis M, Falace A, Torella A, Picillo E, Onore ME, Politano L, Nigro V, Innes AM, Barresi R, Bruno C, Zara F, Fiorillo C, Scala M. DAG1 haploinsufficiency is associated with sporadic and familial isolated or pauci-symptomatic hyperCKemia. Eur J Hum Genet 2024; 32:342-349. [PMID: 38177406 PMCID: PMC10923780 DOI: 10.1038/s41431-023-01516-4] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Revised: 10/31/2023] [Accepted: 11/27/2023] [Indexed: 01/06/2024] Open
Abstract
DAG1 encodes for dystroglycan, a key component of the dystrophin-glycoprotein complex (DGC) with a pivotal role in skeletal muscle function and maintenance. Biallelic loss-of-function DAG1 variants cause severe muscular dystrophy and muscle-eye-brain disease. A possible contribution of DAG1 deficiency to milder muscular phenotypes has been suggested. We investigated the genetic background of twelve subjects with persistent mild-to-severe hyperCKemia to dissect the role of DAG1 in this condition. Genetic testing was performed through exome sequencing (ES) or custom NGS panels including various genes involved in a spectrum of muscular disorders. Histopathological and Western blot analyses were performed on muscle biopsy samples obtained from three patients. We identified seven novel heterozygous truncating variants in DAG1 segregating with isolated or pauci-symptomatic hyperCKemia in all families. The variants were rare and predicted to lead to nonsense-mediated mRNA decay or the formation of a truncated transcript. In four cases, DAG1 variants were inherited from similarly affected parents. Histopathological analysis revealed a decreased expression of dystroglycan subunits and Western blot confirmed a significantly reduced expression of beta-dystroglycan in muscle samples. This study supports the pathogenic role of DAG1 haploinsufficiency in isolated or pauci-symptomatic hyperCKemia, with implications for clinical management and genetic counseling.
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Affiliation(s)
- Monica Traverso
- Pediatric Neurology and Muscular Diseases Unit, IRCCS Istituto Giannina Gaslini, Genoa, Italy
| | - Serena Baratto
- Centre of Translational and Experimental Myology, IRCCS Istituto Giannina Gaslini, Genoa, Italy
| | - Michele Iacomino
- Medical Genetics Unit, IRCCS Istituto Giannina Gaslini, Genoa, Italy
| | - Marco Di Duca
- Medical Genetics Unit, IRCCS Istituto Giannina Gaslini, Genoa, Italy
| | - Chiara Panicucci
- Centre of Translational and Experimental Myology, IRCCS Istituto Giannina Gaslini, Genoa, Italy
| | - Sara Casalini
- Centre of Translational and Experimental Myology, IRCCS Istituto Giannina Gaslini, Genoa, Italy
| | | | - Antonio Falace
- Pediatric Neurology and Muscular Diseases Unit, IRCCS Istituto Giannina Gaslini, Genoa, Italy
| | - Annalaura Torella
- Department of Precision Medicine, University "Luigi Vanvitelli", Naples, Italy
- Telethon Institute of Genetics and Medicine (TIGEM), Pozzuoli, Italy
| | - Esther Picillo
- Department of Precision Medicine, University "Luigi Vanvitelli", Naples, Italy
- Telethon Institute of Genetics and Medicine (TIGEM), Pozzuoli, Italy
| | - Maria Elena Onore
- Department of Precision Medicine, University "Luigi Vanvitelli", Naples, Italy
- Telethon Institute of Genetics and Medicine (TIGEM), Pozzuoli, Italy
| | - Luisa Politano
- Department of Precision Medicine, University "Luigi Vanvitelli", Naples, Italy
- Telethon Institute of Genetics and Medicine (TIGEM), Pozzuoli, Italy
| | - Vincenzo Nigro
- Department of Precision Medicine, University "Luigi Vanvitelli", Naples, Italy
- Telethon Institute of Genetics and Medicine (TIGEM), Pozzuoli, Italy
| | - A Micheil Innes
- Department of Medical Genetics and Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- Alberta Children's Hospital Research Institute, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | | | - Claudio Bruno
- Centre of Translational and Experimental Myology, IRCCS Istituto Giannina Gaslini, Genoa, Italy
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, Genoa, Italy
| | - Federico Zara
- Medical Genetics Unit, IRCCS Istituto Giannina Gaslini, Genoa, Italy.
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, Genoa, Italy.
| | - Chiara Fiorillo
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, Genoa, Italy.
- Child Neuropsychiatry Unit, IRCCS Istituto Giannina Gaslini, Genoa, Italy.
| | - Marcello Scala
- Medical Genetics Unit, IRCCS Istituto Giannina Gaslini, Genoa, Italy.
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, Genoa, Italy.
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10
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Wang Y, Huang Z, Lei J, Lu X, Li S, Wang G, Xie S, Zhang L. Fatty infiltration in the posterior muscles of the lower extremities as an MRI feature in antimitochondrial antibody-associated myopathy. Clin Rheumatol 2024; 43:1127-1133. [PMID: 38285373 DOI: 10.1007/s10067-024-06877-9] [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: 05/03/2023] [Revised: 12/05/2023] [Accepted: 01/16/2024] [Indexed: 01/30/2024]
Abstract
OBJECTIVE Idiopathic inflammatory myopathy (IIM) with antimitochondrial M2 antibody (AMA-M2) has been associated with distinct clinical characteristics. In this study, we explore the magnetic resonance imaging (MRI) findings of the muscles of the lower extremities in AMA-M2-positive IIM to gain more insight. METHODS MRI of 22 lower extremity muscles was retrospectively evaluated in 14 patients with AMA-M2-positive IIM and 37 age- and sex-matched patients with AMA-M2-negative IIM. Muscles with inflammatory edema and fatty infiltration were assessed according to the Stramare and Mercuri criteria. RESULTS Patients with AMA-M2-positive IIM had significantly higher incidence of MRI involvement with fatty infiltration in five lower extremity muscles, namely the adductor magnus (AM) (13/14 VS 14/37, p < 0.001), semimembranosus (SM) (13/14 VS 17/37, p = 0.002), biceps femoris (BF) (12/14 VS 15/37, p = 0.004), soleus (13/14 VS 23/37, p = 0.041), and the medial head of the gastrocnemius (Gastroc M) (13/14 VS 17/37, p = 0.002) than patients with AMA-M2-negative IIM. Furthermore, the severity scores of fatty infiltrations of the above five muscles in AMA-M2-positive IIM were significantly higher than those in patients with AMA-M2-negative IIM (p < 0.001). CONCLUSIONS Severe fatty infiltrations of the AM, SM, BF, soleus, and Gastroc M in the posterior muscles of the lower extremities are dominant MRI features in our patients with AMA-M2-positive IIM. This unique muscle MRI character may be a helpful indicator in clinical practice for patients with AMA-M2-positive IIM. Key Points • Striking involvement and prominent fatty infiltrations of five lower extremity muscles (adductor magnus, semimembranosus, biceps femoris, soleus, and the medial head of the gastrocnemius) are interesting MRI performances. • Severe fatty infiltrations in the posterior muscles of the lower extremities are dominant MRI features in AMA-M2-positive IIM. • This unique muscle MRI character may be very helpful for the diagnosis of the AMA-M2-positive IIM.
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Affiliation(s)
- Yuli Wang
- Department of Radiology, China-Japan Friendship Hospital, Beijing, 100029, China
| | - Zhenguo Huang
- Department of Radiology, China-Japan Friendship Hospital, Beijing, 100029, China
| | - Jieping Lei
- Department of Clinical Research and Data Management, China-Japan Friendship Hospital, Beijing, 100029, China
| | - Xin Lu
- Department of Rheumatology, China-Japan Friendship Hospital, 2 Yinghua Road, Chaoyang District, Beijing, 100029, China
| | - Sizhao Li
- Department of Rheumatology, China-Japan Friendship Hospital, 2 Yinghua Road, Chaoyang District, Beijing, 100029, China
| | - Guochun Wang
- Department of Rheumatology, China-Japan Friendship Hospital, 2 Yinghua Road, Chaoyang District, Beijing, 100029, China
| | - Sheng Xie
- Department of Radiology, China-Japan Friendship Hospital, Beijing, 100029, China
| | - Lu Zhang
- Department of Rheumatology, China-Japan Friendship Hospital, 2 Yinghua Road, Chaoyang District, Beijing, 100029, China.
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11
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Shi Y, Cao C, Zeng Y, Ding Y, Chen L, Zheng F, Chen X, Zhou F, Yang X, Li J, Xu L, Xu G, Lin M, Ishiura H, Tsuji S, Wang N, Wang Z, Chen WJ, Yang K. CGG repeat expansion in LOC642361/NUTM2B-AS1 typically presents as oculopharyngodistal myopathy. J Genet Genomics 2024; 51:184-196. [PMID: 38159879 DOI: 10.1016/j.jgg.2023.12.009] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Revised: 12/25/2023] [Accepted: 12/25/2023] [Indexed: 01/03/2024]
Abstract
CGG repeat expansions in LOC642361/NUTM2B-AS1 have recently been identified as a cause of oculopharyngeal myopathy with leukoencephalopathy. However, since only three patients from a single family were reported, it remains unknown whether their clinicopathological features are typical for CGG repeat expansions in LOC642361/NUTM2B-AS1. Here, using repeat-primed-polymerase chain reaction and long-read sequencing, we identify 12 individuals from 3 unrelated families with CGG repeat expansions in LOC642361/NUTM2B-AS1, typically presenting with oculopharyngodistal myopathy. The CGG repeat expansions range from 161 to 669 repeat units. Most of the patients present with ptosis, restricted eye movements, dysphagia, dysarthria, and diffuse limb muscle weakness. Only one patient shows T2-weighted hyperintensity in the cerebellar white matter surrounding the deep cerebellar nuclei on brain magnetic resonance imaging. Muscle biopsies from three patients show a myopathic pattern and rimmed vacuoles. Analyses of muscle biopsies suggest that CGG repeat expansions in LOC642361/NUTM2B-AS1 may deleteriously affect aggrephagic capacity, suggesting that RNA toxicity and mitochondrial dysfunction may contribute to pathogenesis. Our study thus expands the phenotypic spectrum for the CGG repeat expansion of LOC642361/NUTM2B-AS1 and indicates that this genetic variant typically manifests as oculopharyngodistal myopathy with chronic myopathic changes with rimmed vacuoles and filamentous intranuclear inclusions in muscle fibers.
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Affiliation(s)
- Yan Shi
- Department of Neurology and Institute of Neurology of First Affiliated Hospital, Institute of Neuroscience, Fujian Key Laboratory of Molecular Neurology, Fujian Medical University, Fuzhou, Fujian 350005, China; Department of Neurology, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, Fuzhou, Fujian 350212, China
| | - Chunyan Cao
- Department of Neurology and Institute of Neurology of First Affiliated Hospital, Institute of Neuroscience, Fujian Key Laboratory of Molecular Neurology, Fujian Medical University, Fuzhou, Fujian 350005, China; The First Affiliated Hospital, College of Clinical Medicine of Henan University of Science and Technology, Luoyang, Henan 471000, China
| | - Yiheng Zeng
- Department of Neurology and Institute of Neurology of First Affiliated Hospital, Institute of Neuroscience, Fujian Key Laboratory of Molecular Neurology, Fujian Medical University, Fuzhou, Fujian 350005, China; Department of Neurology, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, Fuzhou, Fujian 350212, China
| | - Yuanliang Ding
- Department of Neurology and Institute of Neurology of First Affiliated Hospital, Institute of Neuroscience, Fujian Key Laboratory of Molecular Neurology, Fujian Medical University, Fuzhou, Fujian 350005, China; Department of Neurology, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, Fuzhou, Fujian 350212, China
| | - Long Chen
- Department of Neurology and Institute of Neurology of First Affiliated Hospital, Institute of Neuroscience, Fujian Key Laboratory of Molecular Neurology, Fujian Medical University, Fuzhou, Fujian 350005, China; Department of Neurology, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, Fuzhou, Fujian 350212, China
| | - Fuze Zheng
- Department of Neurology and Institute of Neurology of First Affiliated Hospital, Institute of Neuroscience, Fujian Key Laboratory of Molecular Neurology, Fujian Medical University, Fuzhou, Fujian 350005, China; Department of Neurology, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, Fuzhou, Fujian 350212, China
| | - Xuejiao Chen
- Department of Neurology, Zhangzhou Municipal Hospital of Fujian Province and Zhangzhou Affiliated Hospital of Fujian Medical University, Zhangzhou, Fujian 363000, China
| | - Fanggui Zhou
- Department of Neurology, Jian'ou Municipal Hospital of Fujian Province, Jian'ou, Fujian 353100, China
| | - Xiefeng Yang
- Department of Radiology, First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian 350005, China
| | - Jinjing Li
- Department of Neurology and Institute of Neurology of First Affiliated Hospital, Institute of Neuroscience, Fujian Key Laboratory of Molecular Neurology, Fujian Medical University, Fuzhou, Fujian 350005, China; Department of Neurology, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, Fuzhou, Fujian 350212, China
| | - Liuqing Xu
- Department of Neurology and Institute of Neurology of First Affiliated Hospital, Institute of Neuroscience, Fujian Key Laboratory of Molecular Neurology, Fujian Medical University, Fuzhou, Fujian 350005, China; Department of Neurology, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, Fuzhou, Fujian 350212, China
| | - Guorong Xu
- Department of Neurology and Institute of Neurology of First Affiliated Hospital, Institute of Neuroscience, Fujian Key Laboratory of Molecular Neurology, Fujian Medical University, Fuzhou, Fujian 350005, China; Department of Neurology, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, Fuzhou, Fujian 350212, China
| | - Minting Lin
- Department of Neurology and Institute of Neurology of First Affiliated Hospital, Institute of Neuroscience, Fujian Key Laboratory of Molecular Neurology, Fujian Medical University, Fuzhou, Fujian 350005, China; Department of Neurology, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, Fuzhou, Fujian 350212, China
| | - Hiroyuki Ishiura
- Department of Neurology, Graduate School of Medicine, The University of Tokyo, Tokyo 113-8655, Japan; Department of Neurology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama 700-8558, Japan
| | - Shoji Tsuji
- Department of Neurology, Graduate School of Medicine, The University of Tokyo, Tokyo 113-8655, Japan; Institute of Medical Genomics, International University of Health and Welfare, Chiba 286-0048, Japan
| | - Ning Wang
- Department of Neurology and Institute of Neurology of First Affiliated Hospital, Institute of Neuroscience, Fujian Key Laboratory of Molecular Neurology, Fujian Medical University, Fuzhou, Fujian 350005, China; Department of Neurology, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, Fuzhou, Fujian 350212, China
| | - Zhiqiang Wang
- Department of Neurology and Institute of Neurology of First Affiliated Hospital, Institute of Neuroscience, Fujian Key Laboratory of Molecular Neurology, Fujian Medical University, Fuzhou, Fujian 350005, China; Department of Neurology, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, Fuzhou, Fujian 350212, China.
| | - Wan-Jin Chen
- Department of Neurology and Institute of Neurology of First Affiliated Hospital, Institute of Neuroscience, Fujian Key Laboratory of Molecular Neurology, Fujian Medical University, Fuzhou, Fujian 350005, China; Department of Neurology, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, Fuzhou, Fujian 350212, China.
| | - Kang Yang
- Department of Neurology and Institute of Neurology of First Affiliated Hospital, Institute of Neuroscience, Fujian Key Laboratory of Molecular Neurology, Fujian Medical University, Fuzhou, Fujian 350005, China; Department of Neurology, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, Fuzhou, Fujian 350212, China.
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12
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Wang J, Ma X, Zhao K, Yang S, Yang K, Yu S, Yin G, Dong Z, Song Y, Cui C, Li J, Zhao S, Chen X. Association between left atrial myopathy and sarcomere mutation in patients with hypertrophic cardiomyopathy: insights into left atrial strain by MRI feature tracking. Eur Radiol 2024; 34:1026-1036. [PMID: 37635167 DOI: 10.1007/s00330-023-10128-x] [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: 05/16/2023] [Revised: 06/14/2023] [Accepted: 07/04/2023] [Indexed: 08/29/2023]
Abstract
OBJECTIVES Left atrial (LA) myopathy, characterized by LA enlargement and mechanical dysfunction, is associated with worse prognosis in hypertrophic cardiomyopathy (HCM) while the impact of sarcomere mutation on LA myopathy remains unclear. We aimed to assess the association between LA myopathy and sarcomere mutation and to explore the incremental utility of LA strain in mutation prediction. METHODS A total of 105 consecutive HCM patients (mean age 47.8 ± 11.9 years, 71% male) who underwent HCM-related gene screening and cardiac MRI were retrospectively enrolled. LA volume, ejection fraction and strain indices in reservoir, conduit, and booster-pump phases were investigated respectively. RESULTS Fifty mutation-positive patients showed higher LA maximal volume index (59.4 ± 28.2 vs 43.8 ± 18.1 mL/m2, p = 0.001), lower reservoir (21.3 ± 7.9 vs 26.2 ± 6.6%, p < 0.001), and booster-pump strain (12.1 ± 5.4 vs 17.1 ± 5.0%, p < 0.001) but similar conduit strain (9.2 ± 4.5 vs 9.1 ± 4.5%, p = 0.909) compared with mutation-negative patients. In multivariate logistic regression, LA booster-pump strain was associated with sarcomere mutation (odds ratio = 0.86, 95% confidence interval: 0.77-0.96, p = 0.010) independent of maximal wall thickness, late gadolinium enhancement, and LA volume. Furthermore, LA booster-pump strain showed incremental value for mutation prediction added to Mayo II score (AUC 0.798 vs 0.709, p = 0.024). CONCLUSIONS In HCM, mutation-positive patients suffered worse LA enlargement and worse reservoir and booster-pump functions. LA booster-pump strain was a strong factor for sarcomere mutation prediction added to Mayo II score. CLINICAL RELEVANCE STATEMENT The independent association between sarcomere mutation and left atrial mechanical dysfunction provide new insights into the pathogenesis of atrial myopathy and is helpful to understand the adverse prognosis regarding atrial fibrillation and stroke in mutation-positive patients. KEY POINTS • In patients with hypertrophic cardiomyopathy, left atrial (LA) reservoir and booster-pump function, but not conduit function, were significantly impaired in mutation-positive patients compared with mutation-negative patients. • LA booster-pump strain measured by MRI-derived feature tracking is feasible to predict sarcomere mutation with high incremental value added to Mayo II score.
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Affiliation(s)
- Jiaxin Wang
- MR Center, Stata Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases of China, Chinese Academy of Medical Sciences and Peking Union Medical College, Beilishi Road No. 167, Xicheng District, Beijing, 100037, China
| | - Xuan Ma
- MR Center, Stata Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases of China, Chinese Academy of Medical Sciences and Peking Union Medical College, Beilishi Road No. 167, Xicheng District, Beijing, 100037, China
| | - Kankan Zhao
- Paul C. Lauterbur Research Center for Biomedical Imaging, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, SZ University Town, Shenzhen, 518055, China
| | - Shujuan Yang
- MR Center, Stata Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases of China, Chinese Academy of Medical Sciences and Peking Union Medical College, Beilishi Road No. 167, Xicheng District, Beijing, 100037, China
| | - Kai Yang
- MR Center, Stata Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases of China, Chinese Academy of Medical Sciences and Peking Union Medical College, Beilishi Road No. 167, Xicheng District, Beijing, 100037, China
| | - Shiqin Yu
- MR Center, Stata Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases of China, Chinese Academy of Medical Sciences and Peking Union Medical College, Beilishi Road No. 167, Xicheng District, Beijing, 100037, China
| | - Gang Yin
- MR Center, Stata Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases of China, Chinese Academy of Medical Sciences and Peking Union Medical College, Beilishi Road No. 167, Xicheng District, Beijing, 100037, China
| | - Zhixiang Dong
- MR Center, Stata Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases of China, Chinese Academy of Medical Sciences and Peking Union Medical College, Beilishi Road No. 167, Xicheng District, Beijing, 100037, China
| | - Yanyan Song
- MR Center, Stata Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases of China, Chinese Academy of Medical Sciences and Peking Union Medical College, Beilishi Road No. 167, Xicheng District, Beijing, 100037, China
| | - Chen Cui
- MR Center, Stata Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases of China, Chinese Academy of Medical Sciences and Peking Union Medical College, Beilishi Road No. 167, Xicheng District, Beijing, 100037, China
| | - Jinghui Li
- MR Center, Stata Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases of China, Chinese Academy of Medical Sciences and Peking Union Medical College, Beilishi Road No. 167, Xicheng District, Beijing, 100037, China
| | - Shihua Zhao
- MR Center, Stata Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases of China, Chinese Academy of Medical Sciences and Peking Union Medical College, Beilishi Road No. 167, Xicheng District, Beijing, 100037, China.
| | - Xiuyu Chen
- MR Center, Stata Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases of China, Chinese Academy of Medical Sciences and Peking Union Medical College, Beilishi Road No. 167, Xicheng District, Beijing, 100037, China.
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Shahriyari H, Ramezani M, Nilipour Y, Okhovat AA, Kariminejad A, Aghaghazvini L, Fatehi F, Nafissi S. Neutral lipid storage disease with myopathy: clinicopathological and genetic features of nine Iranian patients. Neuromuscul Disord 2024; 35:19-24. [PMID: 38194732 DOI: 10.1016/j.nmd.2023.12.012] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2023] [Revised: 11/12/2023] [Accepted: 12/20/2023] [Indexed: 01/11/2024]
Abstract
The rare disorder known as Neutral Lipid Storage Disease with Myopathy presents with a variety of clinical manifestations, including myopathy, cardiac dysfunction, and other organ complications. Early diagnosis is crucial due to the increased risk of cardiomyopathy. We describe the clinical, histopathological, muscle imaging, and genetic findings of nine neutral lipid storage myopathy patients. Proximal weakness and asymmetric involvement may suggest lipid storage myopathy. While skeletal muscle weakness was the main manifestation in our patients, one case presented only with hyperCKemia. Additionally, three patients had fertility issues, two suffered from diabetes mellitus, two had cardiomyopathy, and one had a history of hypothyroidism. Muscle histopathology revealed lipid depositions and rimmed vacuoles, prompting peripheral blood smears to detect Jordan Anomalies. All muscle biopsies and peripheral blood smear showed lipid droplets, rimmed vacuoles, and Jordan anomaly. Identifying PNPLA2 gene mutations is important for diagnosing neutral lipid storage myopathy; our cases showed some novel mutations. This study highlights the importance of early diagnosis and comprehensive evaluation in managing neutral lipid storage myopathy cases.
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Affiliation(s)
- Hamed Shahriyari
- Neuromuscular Research Center, Tehran University of Medical Sciences, Tehran, Iran; Neurology Department, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Mahtab Ramezani
- Neuromuscular Research Center, Tehran University of Medical Sciences, Tehran, Iran; Neurology Department, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Yalda Nilipour
- Neuromuscular Research Center, Tehran University of Medical Sciences, Tehran, Iran; Pediatric Pathology Research Center, Research Institute for Children's Health, Shahid Beheshti University of Medical sciences, Tehran, Iran
| | - Ali Asghar Okhovat
- Neuromuscular Research Center, Tehran University of Medical Sciences, Tehran, Iran; Neurology Department, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Leila Aghaghazvini
- Radiology Department, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Farzad Fatehi
- Neuromuscular Research Center, Tehran University of Medical Sciences, Tehran, Iran; Neurology Department, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Shahriar Nafissi
- Neuromuscular Research Center, Tehran University of Medical Sciences, Tehran, Iran; Neurology Department, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran.
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14
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Lorenzoni PJ, Kay CSK, Ducci RDP, Fustes OJH, Rodrigues PRDVP, Arndt RC, Scola RH, Werneck LC. Myopathy due to carnitine palmitoyltransferase II deficiency: updating genetic aspects of the first publication in Brazil. Arq Neuropsiquiatr 2024; 82:1-4. [PMID: 38395422 PMCID: PMC10890914 DOI: 10.1055/s-0044-1779508] [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] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Accepted: 12/15/2023] [Indexed: 02/25/2024]
Abstract
Carnitine palmitoyltransferase II (CPT II) deficiency is an autosomal recessive inherited disorder related to lipid metabolism affecting skeletal muscle. The first cases of CPT II deficiency causing myopathy were reported in 1973. In 1983, Werneck et al published the first two Brazilian patients with myopathy due to CPT II deficiency, where the biochemical analysis confirmed deficient CPT activity in the muscle of both cases. Over the past 40 years since the pioneering publication, clinical phenotypes and genetic loci in the CPT2 gene have been described, and pathogenic mechanisms have been better elucidated. Genetic analysis of one of the original cases disclosed compound heterozygous pathogenic variants (p.Ser113Leu/p.Pro50His) in the CPT2 gene. Our report highlights the historical aspects of the first Brazilian publication of the myopathic form of CPT II deficiency and updates the genetic background of this pioneering publication.
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Affiliation(s)
- Paulo José Lorenzoni
- Universidade Federal do Paraná, Hospital de Clínicas, Departamento de Clínica Médica, Serviço de Neurologia, Serviço de Doenças Neuromusculares, Curitiba PR, Brazil.
| | - Cláudia Suemi Kamoi Kay
- Universidade Federal do Paraná, Hospital de Clínicas, Departamento de Clínica Médica, Serviço de Neurologia, Serviço de Doenças Neuromusculares, Curitiba PR, Brazil.
| | - Renata Dal-Pra Ducci
- Universidade Federal do Paraná, Hospital de Clínicas, Departamento de Clínica Médica, Serviço de Neurologia, Serviço de Doenças Neuromusculares, Curitiba PR, Brazil.
| | - Otto Jesus Hernandez Fustes
- Universidade Federal do Paraná, Hospital de Clínicas, Departamento de Clínica Médica, Serviço de Neurologia, Serviço de Doenças Neuromusculares, Curitiba PR, Brazil.
| | - Paula Raquel do Vale Pascoal Rodrigues
- Universidade Federal do Paraná, Hospital de Clínicas, Departamento de Clínica Médica, Serviço de Neurologia, Serviço de Doenças Neuromusculares, Curitiba PR, Brazil.
| | - Raquel Cristina Arndt
- Universidade Federal do Paraná, Hospital de Clínicas, Departamento de Clínica Médica, Serviço de Neurologia, Serviço de Doenças Neuromusculares, Curitiba PR, Brazil.
| | - Rosana Herminia Scola
- Universidade Federal do Paraná, Hospital de Clínicas, Departamento de Clínica Médica, Serviço de Neurologia, Serviço de Doenças Neuromusculares, Curitiba PR, Brazil.
| | - Lineu Cesar Werneck
- Universidade Federal do Paraná, Hospital de Clínicas, Departamento de Clínica Médica, Serviço de Neurologia, Serviço de Doenças Neuromusculares, Curitiba PR, Brazil.
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15
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Wallgren-Pettersson C, Jokela M, Lehtokari VL, Tyynismaa H, Sainio MT, Ylikallio E, Tynninen O, Pelin K, Auranen M. Variants in tropomyosins TPM2 and TPM3 causing muscle hypertonia. Neuromuscul Disord 2024; 35:29-32. [PMID: 38219297 DOI: 10.1016/j.nmd.2023.12.006] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Revised: 11/28/2023] [Accepted: 12/11/2023] [Indexed: 01/16/2024]
Abstract
Patients with myopathies caused by pathogenic variants in tropomyosin genes TPM2 and TPM3 usually have muscle hypotonia and weakness, their muscle biopsies often showing fibre size disproportion and nemaline bodies. Here, we describe a series of patients with hypercontractile molecular phenotypes, high muscle tone, and mostly non-specific myopathic biopsy findings without nemaline bodies. Three of the patients had trismus, whilst in one patient, the distal joints of her fingers flexed on extension of the wrists. In one biopsy from a patient with a rare TPM3 pathogenic variant, cores and minicores were observed, an unusual finding in TPM3-caused myopathy. The variants alter conserved contact sites between tropomyosin and actin.
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Affiliation(s)
- Carina Wallgren-Pettersson
- The Folkhälsan Institute of Genetics, the Folkhälsan Research Center, Helsinki, Finland, and the Department of Medical and Clinical Genetics, Medicum, University of Helsinki, Helsinki, Finland.
| | - Manu Jokela
- Division of Clinical Neurosciences, Turku University Hospital and University of Turku, Turku, Finland
| | - Vilma-Lotta Lehtokari
- The Folkhälsan Institute of Genetics, the Folkhälsan Research Center, Helsinki, Finland, and the Department of Medical and Clinical Genetics, Medicum, University of Helsinki, Helsinki, Finland
| | - Henna Tyynismaa
- Stem Cells and Metabolism Research Programme, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Markus T Sainio
- Clinical Neurosciences, Neurology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Emil Ylikallio
- Clinical Neurosciences, Neurology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Olli Tynninen
- Olli Tynninen, Department of Pathology, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Katarina Pelin
- The Folkhälsan Institute of Genetics, the Folkhälsan Research Center, Helsinki, Finland, and the Department of Medical and Clinical Genetics, Medicum, University of Helsinki, Helsinki, Finland; Molecular and Integrative Biosciences Research Programme, Faculty of Biological and Environmental Sciences, University of Helsinki, Helsinki, Finland
| | - Mari Auranen
- Clinical Neurosciences, Neurology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
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16
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Soendenbroe C, Karlsen A, Svensson RB, Kjaer M, Andersen JL, Mackey AL. Marked irregular myofiber shape is a hallmark of human skeletal muscle ageing and is reversed by heavy resistance training. J Cachexia Sarcopenia Muscle 2024; 15:306-318. [PMID: 38123165 PMCID: PMC10834339 DOI: 10.1002/jcsm.13405] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Revised: 11/08/2023] [Accepted: 11/09/2023] [Indexed: 12/23/2023] Open
Abstract
BACKGROUND Age-related loss of strength is disproportionally greater than the loss of mass, suggesting maladaptations in the neuro-myo-tendinous system. Myofibers are often misshaped in aged and diseased muscle, but systematic analyses of large sample sets are lacking. Our aim was to investigate myofiber shape in relation to age, exercise, myofiber type, species and sex. METHODS Vastus lateralis muscle biopsies (n = 265) from 197 males and females, covering an age span of 20-97 years, were examined. The gastrocnemius and soleus muscles of 11 + 22-month-old male C57BL/6 mice were also examined. Immunofluorescence and ATPase stainings of muscle cross-sections were used to measure myofiber cross-sectional area (CSA) and perimeter. From these, a shape factor index (SFI) was calculated in a fibre-type-specific manner (type I/II in humans; type I/IIa/IIx/IIb in mice), with higher values indicating increased deformity. Heavy resistance training (RT) was performed three times per week for 3-4 months by a subgroup (n = 59). Correlation analyses were performed comparing SFI and CSA with age, muscle mass, maximal voluntary contraction (MVC), rate of force development and specific force (MVC/muscle mass). RESULTS In human muscle, SFI was positively correlated with age for both type I (R2 = 0.20) and II (R2 = 0.38) myofibers. When subjects were separated into age cohorts, SFI was lower for type I (4%, P < 0.001) and II (6%, P < 0.001) myofibers in young (20-36) compared with old (60-80) and higher for type I (5%, P < 0.05) and II (14%, P < 0.001) myofibers in the oldest old (>80) compared with old. The increased SFI in old muscle was observed in myofibers of all sizes. Within all three age cohorts, type II myofiber SFI was higher than that for type I myofiber (4-13%, P < 0.001), which was also the case in mice muscles (8-9%, P < 0.001). Across age cohorts, there was no difference between males and females in SFI for either type I (P = 0.496/0.734) or II (P = 0.176/0.585) myofibers. Multiple linear regression revealed that SFI, after adjusting for age and myofiber CSA, has independent explanatory power for 8/10 indices of muscle mass and function. RT reduced SFI of type II myofibers in both young and old (3-4%, P < 0.001). CONCLUSIONS Here, we identify type I and II myofiber shape in humans as a hallmark of muscle ageing that independently predicts volumetric and functional assessments of muscle health. RT reverts the shape of type II myofibers, suggesting that a lack of myofiber recruitment might lead to myofiber deformity.
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Affiliation(s)
- Casper Soendenbroe
- Department of Orthopedic SurgeryInstitute of Sports Medicine Copenhagen, Copenhagen University Hospital ‐ Bispebjerg and FrederiksbergCopenhagenDenmark
- Department of Clinical MedicineCenter for Healthy Aging, University of CopenhagenCopenhagenDenmark
| | - Anders Karlsen
- Department of Orthopedic SurgeryInstitute of Sports Medicine Copenhagen, Copenhagen University Hospital ‐ Bispebjerg and FrederiksbergCopenhagenDenmark
- Department of Clinical MedicineCenter for Healthy Aging, University of CopenhagenCopenhagenDenmark
- Department of Biomedical Sciences, Faculty of Health and Medical SciencesXlab, Center for Healthy Aging, University of CopenhagenCopenhagenDenmark
| | - Rene B. Svensson
- Department of Orthopedic SurgeryInstitute of Sports Medicine Copenhagen, Copenhagen University Hospital ‐ Bispebjerg and FrederiksbergCopenhagenDenmark
- Department of Clinical MedicineCenter for Healthy Aging, University of CopenhagenCopenhagenDenmark
| | - Michael Kjaer
- Department of Orthopedic SurgeryInstitute of Sports Medicine Copenhagen, Copenhagen University Hospital ‐ Bispebjerg and FrederiksbergCopenhagenDenmark
- Department of Clinical MedicineCenter for Healthy Aging, University of CopenhagenCopenhagenDenmark
| | - Jesper L. Andersen
- Department of Orthopedic SurgeryInstitute of Sports Medicine Copenhagen, Copenhagen University Hospital ‐ Bispebjerg and FrederiksbergCopenhagenDenmark
- Department of Clinical MedicineCenter for Healthy Aging, University of CopenhagenCopenhagenDenmark
| | - Abigail L. Mackey
- Department of Orthopedic SurgeryInstitute of Sports Medicine Copenhagen, Copenhagen University Hospital ‐ Bispebjerg and FrederiksbergCopenhagenDenmark
- Department of Clinical MedicineCenter for Healthy Aging, University of CopenhagenCopenhagenDenmark
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17
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Endo Y, Groom L, Wang SM, Pannia E, Griffiths NW, Van Gennip JLM, Ciruna B, Laporte J, Dirksen RT, Dowling JJ. Two zebrafish cacna1s loss-of-function variants provide models of mild and severe CACNA1S-related myopathy. Hum Mol Genet 2024; 33:254-269. [PMID: 37930228 PMCID: PMC10800018 DOI: 10.1093/hmg/ddad178] [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: 07/03/2023] [Revised: 09/25/2023] [Accepted: 10/09/2023] [Indexed: 11/07/2023] Open
Abstract
CACNA1S-related myopathy, due to pathogenic variants in the CACNA1S gene, is a recently described congenital muscle disease. Disease associated variants result in loss of gene expression and/or reduction of Cav1.1 protein stability. There is an incomplete understanding of the underlying disease pathomechanisms and no effective therapies are currently available. A barrier to the study of this myopathy is the lack of a suitable animal model that phenocopies key aspects of the disease. To address this barrier, we generated knockouts of the two zebrafish CACNA1S paralogs, cacna1sa and cacna1sb. Double knockout fish exhibit severe weakness and early death, and are characterized by the absence of Cav1.1 α1 subunit expression, abnormal triad structure, and impaired excitation-contraction coupling, thus mirroring the severe form of human CACNA1S-related myopathy. A double mutant (cacna1sa homozygous, cacna1sb heterozygote) exhibits normal development, but displays reduced body size, abnormal facial structure, and cores on muscle pathologic examination, thus phenocopying the mild form of human CACNA1S-related myopathy. In summary, we generated and characterized the first cacna1s zebrafish loss-of-function mutants, and show them to be faithful models of severe and mild forms of human CACNA1S-related myopathy suitable for future mechanistic studies and therapy development.
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Affiliation(s)
- Yukari Endo
- Program for Genetics and Genome Biology, Hospital for Sick Children, 686 Bay Street, Toronto, ON M5G 0A4, Canada
| | - Linda Groom
- Department of Pharmacology and Physiology, University of Rochester Medical Center, 601 Elmwood Ave, Rochester, NY 14642, United States
| | - Sabrina M Wang
- Program for Genetics and Genome Biology, Hospital for Sick Children, 686 Bay Street, Toronto, ON M5G 0A4, Canada
| | - Emanuela Pannia
- Program for Genetics and Genome Biology, Hospital for Sick Children, 686 Bay Street, Toronto, ON M5G 0A4, Canada
- Zebrafish Genetics and Disease Models Core Facility, Hospital for Sick Children, 686 Bay Street, Toronto, ON M5G 0A4, Canada
| | - Nigel W Griffiths
- Program in Developmental and Stem Cell Biology, Hospital for Sick Children, 686 Bay Street, Toronto, ON M5G 0A4, Canada
| | - Jenica L M Van Gennip
- Program in Developmental and Stem Cell Biology, Hospital for Sick Children, 686 Bay Street, Toronto, ON M5G 0A4, Canada
| | - Brian Ciruna
- Program in Developmental and Stem Cell Biology, Hospital for Sick Children, 686 Bay Street, Toronto, ON M5G 0A4, Canada
- Department of Molecular Genetics, University of Toronto, 1 King's College Circle, Toronto, ON M5S 1A8, Canada
| | - Jocelyn Laporte
- Institut de Génétique et de Biologie Moléculaire et Cellulaire (IGBMC), Inserm U1258, Cnrs UMR7104, Université de Strasbourg, 1 Rue Laurent Fries, Illkirch 67400, France
| | - Robert T Dirksen
- Department of Pharmacology and Physiology, University of Rochester Medical Center, 601 Elmwood Ave, Rochester, NY 14642, United States
| | - James J Dowling
- Program for Genetics and Genome Biology, Hospital for Sick Children, 686 Bay Street, Toronto, ON M5G 0A4, Canada
- Department of Molecular Genetics, University of Toronto, 1 King's College Circle, Toronto, ON M5S 1A8, Canada
- Division of Neurology, Hospital for Sick Children, 555 University Ave, Toronto, ON M5G 1X8, Canada
- Department of Paediatrics, University of Toronto, 555 University Ave, Toronto, ON M5G 1X8, Canada
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18
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Sadeh M, Dory A, Lev D, Yosovich K, Dabby R. Riboflavin-responsive lipid-storage myopathy in elderly patients. J Neurol Sci 2024; 456:122808. [PMID: 38043332 DOI: 10.1016/j.jns.2023.122808] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Revised: 10/19/2023] [Accepted: 11/20/2023] [Indexed: 12/05/2023]
Abstract
There are scarce reports of riboflavin-responsive lipid storage myopathy in elderly patients with onset in their sixties. We describe three elderly patients with riboflavin-responsive lipid-storage myopathy. All three patients (aged 67-71 years on first examination) had subacute onset of neck extensors and proximal limb weakness progressing to inability to rise from a sitting position or to walk. Muscle biopsies showed vacuoles with lipid content, mainly in type 1 fibers. Genetic analysis failed to identify any pathogenic variant in one patient, identified a heterozygous variant of uncertain significance c.812 A > G; p.Tyr271Cys in the ETFDH gene in the second patient, and revealed a heterozygote likely pathogenic variant c.1286-2 A > C in the ETFDH gene predicted to cause abnormal splicing in the third patient. All patients responded to treatment with riboflavin and carnitine, and regained normal strength. This report emphasizes the importance of muscle biopsy in revealing treatable lipid storage myopathy in elderly patients with progressive myopathy of unidentifiable cause.
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Affiliation(s)
- Menachem Sadeh
- Edith Wolfson Medical Center, Department of Neurology, Holon, Faculty of Medicine, Tel Aviv University, Israel.
| | - Amir Dory
- Sheba Medical Center, Department of Neurology, Tel Hashomer, Faculty of Medicine, Tel Aviv University, Israel
| | - Dorit Lev
- Edith Wolfson Medical Center, Department of Genetics, Holon, Faculty of Medicine, Tel Aviv University, Israel
| | - Keren Yosovich
- Edith Wolfson Medical Center, Department of Genetics, Holon, Israel
| | - Ron Dabby
- Edith Wolfson Medical Center, Department of Neurology, Holon, Faculty of Medicine, Tel Aviv University, Israel
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19
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Covert LT, Patel H, Osman A, Duncan L, Dvergsten J, Truskey GA. Effect of type I interferon on engineered pediatric skeletal muscle: a promising model for juvenile dermatomyositis. Rheumatology (Oxford) 2024; 63:209-217. [PMID: 37094222 PMCID: PMC10765138 DOI: 10.1093/rheumatology/kead186] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [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: 02/03/2023] [Revised: 03/24/2023] [Accepted: 04/14/2023] [Indexed: 04/26/2023] Open
Abstract
OBJECTIVE To investigate pathogenic mechanisms underlying JDM, we defined the effect of type I IFN, IFN-α and IFN-β, on pediatric skeletal muscle function and expression of myositis-related proteins using an in vitro engineered human skeletal muscle model (myobundle). METHODS Primary myoblasts were isolated from three healthy pediatric donors and used to create myobundles that mimic functioning skeletal muscle in structural architecture and physiologic function. Myobundles were exposed to 0, 5, 10 or 20 ng/ml IFN-α or IFN-β for 7 days and then functionally tested under electrical stimulation and analyzed immunohistochemically for structural and myositis-related proteins. Additionally, IFN-β-exposed myobundles were treated with Janus kinase inhibitors (JAKis) tofacitinib and baricitinib. These myobundles were also analyzed for contractile force and immunohistochemistry. RESULTS IFN-β, but not IFN-α, was associated with decreased contractile tetanus force and slowed twitch kinetics. These effects were reversed by tofacitinib and baricitinib. Type I IFN paradoxically reduced myobundle fatigue, which did not reverse after JAKi. Additionally, type I IFN correlated with MHC I upregulation, which normalized after JAKi treatment, but expression of myositis-specific autoantigens Mi-2, melanocyte differentiation-associated protein 5 and the endoplasmic reticulum stress marker GRP78 were variable and donor specific after type I IFN exposure. CONCLUSION IFN-α and IFN-β have distinct effects on pediatric skeletal muscle and these effects can partially be reversed by JAKi treatment. This is the first study illustrating effective use of a three-dimensional human skeletal muscle model to investigate JDM pathogenesis and test novel therapeutics.
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Affiliation(s)
- Lauren T Covert
- Department of Pediatrics, Duke University Health System, Durham, NC, USA
| | - Hailee Patel
- Department of Biomedical Engineering, Duke University, Durham, NC, USA
| | - Alaa Osman
- Department of Biomedical Engineering, Duke University, Durham, NC, USA
| | - Lavonia Duncan
- Department of Biomedical Engineering, Duke University, Durham, NC, USA
| | - Jeffrey Dvergsten
- Department of Pediatrics, Duke University Health System, Durham, NC, USA
| | - George A Truskey
- Department of Biomedical Engineering, Duke University, Durham, NC, USA
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20
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Honda M, Shimizu F, Sato R, Nakamori M. Contribution of Complement, Microangiopathy and Inflammation in Idiopathic Inflammatory Myopathies. J Neuromuscul Dis 2024; 11:5-16. [PMID: 38143369 PMCID: PMC10789353 DOI: 10.3233/jnd-230168] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/20/2023] [Indexed: 12/26/2023]
Abstract
PURPOSE OF REVIEW Idiopathic inflammatory myopathies (IIMs) are a heterogeneous group characterized by muscle weakness and skin symptoms and are categorized into six subtypes: dermatomyositis (DM), polymyositis (PM), anti-synthetase syndrome (ASS), immune-mediated myopathy (IMNM), inclusion body myopathy (IBM), and overlap myositis. Myositis-specific autoantibodies were detected for the diagnosis and classification of IIM. This review highlights the pathogenic contributions of the complement system, microangiopathy, and inflammation in IIM. RECENT FINDINGS Deposition of complement around capillaries and/or the sarcolemma was observed in muscle biopsy specimens from patients with DM, ASS, and IMNM, suggesting the pathomechanism of complement-dependent muscle and endothelial cell injury. A recent study using human muscle microvascular endothelial cells showed that Jo-1 antibodies from ASS induce complement-dependent cellular cytotoxicity in vitro. Based on both clinical and pathological observations, antibody- and complement-mediated microangiopathy may contribute to the development of DM and anti-Jo-1 ASS. Juvenile DM is characterized by the loss of capillaries, perivascular inflammation, and small-vessel angiopathies, which may be related to microinfarction and perifascicular atrophy. Several serum biomarkers that reflect the IFN1 signature and microangiopathy are elevated in patients with DM. The pathological observation of myxovirus resistance protein A (MxA), which suggests a type 1 interferon (IFN1) signature in DM, supports the diagnosis and further understanding of the pathomechanism of IIM. A recent report showed that an increase in triggering receptor expressed on myeloid cells (TREM-1) around perimysial blood vessels and muscles in patients with IIM plays a role in triggering inflammation and promoting the migration of inflammatory cells by secreting proinflammatory cytokines, such as tumor necrosis factor α. SUMMARY The deposition of complement in muscles and capillaries is a characteristic feature of DM, ASS, and IMNM. Microangiopathy plays a pathogenic role in DM, possibly resulting in perifascicular atrophy. Further understanding of the detailed pathomechanism regarding complement, microangiopathy, and inflammation may lead to novel therapeutic approaches for IIM.
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Affiliation(s)
- Masaya Honda
- Department of Neurology and Clinical Neuroscience, Yamaguchi University Graduate School of Medicine, Ube, Yamaguchi, Japan
| | - Fumitaka Shimizu
- Department of Neurology and Clinical Neuroscience, Yamaguchi University Graduate School of Medicine, Ube, Yamaguchi, Japan
| | - Ryota Sato
- Department of Neurology and Clinical Neuroscience, Yamaguchi University Graduate School of Medicine, Ube, Yamaguchi, Japan
| | - Masayuki Nakamori
- Department of Neurology and Clinical Neuroscience, Yamaguchi University Graduate School of Medicine, Ube, Yamaguchi, Japan
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21
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Castor-Macias JA, Larouche JA, Wallace EC, Spence BD, Eames A, Duran P, Yang BA, Fraczek PM, Davis CA, Brooks SV, Maddipati KR, Markworth JF, Aguilar CA. Maresin 1 repletion improves muscle regeneration after volumetric muscle loss. eLife 2023; 12:e86437. [PMID: 38131691 PMCID: PMC10807862 DOI: 10.7554/elife.86437] [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: 01/26/2023] [Accepted: 12/21/2023] [Indexed: 12/23/2023] Open
Abstract
The acute traumatic or surgical loss of skeletal muscle, known as volumetric muscle loss (VML), is a devastating type of injury that results in exacerbated and persistent inflammation followed by fibrosis. The mechanisms that mediate the magnitude and duration of the inflammatory response and ensuing fibrosis after VML remain understudied, and as such, the development of regenerative therapies has been limited. To address this need, we profiled how lipid mediators, which are potent regulators of the immune response after injury, varied with VML injuries that heal or result in fibrosis. We observed that non-healing VML injuries displayed increased pro-inflammatory eicosanoids and a lack of pro-resolving lipid mediators. Treatment of VML with a pro-resolving lipid mediator synthesized from docosahexaenoic acid, called Maresin 1, ameliorated fibrosis through reduction of neutrophils and macrophages and enhanced recovery of muscle strength. These results expand our knowledge of the dysregulated immune response that develops after VML and identify a novel immuno-regenerative therapeutic modality in Maresin 1.
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Affiliation(s)
- Jesus A Castor-Macias
- Department of Biomedical Engineering, University of MichiganAnn ArborUnited States
- Biointerfaces Institute, University of MichiganAnn ArborUnited States
| | - Jacqueline A Larouche
- Department of Biomedical Engineering, University of MichiganAnn ArborUnited States
- Biointerfaces Institute, University of MichiganAnn ArborUnited States
| | - Emily C Wallace
- Department of Biomedical Engineering, University of MichiganAnn ArborUnited States
| | - Bonnie D Spence
- Department of Biomedical Engineering, University of MichiganAnn ArborUnited States
| | - Alec Eames
- Department of Biomedical Engineering, University of MichiganAnn ArborUnited States
| | - Pamela Duran
- Department of Biomedical Engineering, University of MichiganAnn ArborUnited States
- Biointerfaces Institute, University of MichiganAnn ArborUnited States
| | - Benjamin A Yang
- Department of Biomedical Engineering, University of MichiganAnn ArborUnited States
- Biointerfaces Institute, University of MichiganAnn ArborUnited States
| | - Paula M Fraczek
- Department of Biomedical Engineering, University of MichiganAnn ArborUnited States
- Biointerfaces Institute, University of MichiganAnn ArborUnited States
| | - Carol A Davis
- Department of Molecular & Integrative Physiology, University of MichiganAnn ArborUnited States
| | - Susan V Brooks
- Department of Biomedical Engineering, University of MichiganAnn ArborUnited States
- Department of Molecular & Integrative Physiology, University of MichiganAnn ArborUnited States
| | - Krishna Rao Maddipati
- Department of Pathology, Lipidomics Core Facility, Wayne State UniversityDetroitUnited States
| | - James F Markworth
- Department of Animal Sciences, Purdue UniversityWest Lafayette, IndianaUnited States
| | - Carlos A Aguilar
- Department of Biomedical Engineering, University of MichiganAnn ArborUnited States
- Biointerfaces Institute, University of MichiganAnn ArborUnited States
- Program in Cellular and Molecular Biology, University of MichiganAnn ArborUnited States
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22
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Nagatomo R, Higuchi Y, Takei J, Nakamura T, Hashiguchi H, Takashima H. [A case of myofibrillary myopathy due to Bcl2-Associated Athanogene 3 (BAG3) mutation complicated by peripheral neuropathy]. Rinsho Shinkeigaku 2023; 63:836-842. [PMID: 37989284 DOI: 10.5692/clinicalneurol.cn-001915] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2023]
Abstract
A 19-year-old female, normal at birth, grew up without neck movement when getting up. She needed a handrail to climb stairs since the age of 10 years old, and walked slowly since the age of 16 years old. Neurological examination revealed loss of deep tendon reflexes, decreased vibratory sensation, weakness of distal muscles of the lower extremities, and weakness of mainly cervical trunk muscles suspected to be due to myopathy. Nerve conduction studies suggested axonal polyneuropathy, and needle EMG showed short duration MUP, myotonic discharge, and rimmed vacuoles on muscle biopsy. Genetic analysis revealed a previously reported pathological mutation (p.P209L, heterozygous) in Bcl2-Associated Athanogene 3 (BAG3), and a diagnosis of MFM6 was made. P209L is a poor prognosis myopathy that develops in childhood and is associated with cardiomyopathy. P209L is a solitary myopathy associated with axonal neuropathy and characterized by apex foot contracture and weak neck to trunk flexion. This disease is suspected in young-onset neuromyopathy.
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Affiliation(s)
- Risa Nagatomo
- Department of Neurology and Geriatrics, Kagoshima University Graduate School of Medical and Dental Sciences
| | - Yujiro Higuchi
- Department of Neurology and Geriatrics, Kagoshima University Graduate School of Medical and Dental Sciences
| | - Jun Takei
- Department of Neurology and Geriatrics, Kagoshima University Graduate School of Medical and Dental Sciences
| | - Tomonori Nakamura
- Department of Neurology and Geriatrics, Kagoshima University Graduate School of Medical and Dental Sciences
| | - Hiroaki Hashiguchi
- Department of Neurology and Geriatrics, Kagoshima University Graduate School of Medical and Dental Sciences
| | - Hiroshi Takashima
- Department of Neurology and Geriatrics, Kagoshima University Graduate School of Medical and Dental Sciences
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23
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Dandasena T, Ingle V, Singhai A, Saigal S. Anti-SRP-positive necrotising myopathy concurrent with breast malignancy. BMJ Case Rep 2023; 16:e254702. [PMID: 38081733 PMCID: PMC10729263 DOI: 10.1136/bcr-2023-254702] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2023] Open
Abstract
Anti-signal recognition particle (anti-SRP)-positive necrotising myopathy causes severe progressive proximal weakness with a propensity to involve pharyngeal, laryngeal and respiratory muscles. It is one of the aggressive inflammatory myopathies. First-line treatment is with high-dose steroids followed by other immunosuppressants, but this conventional therapy is often ineffective. Second-line treatment involves use of either rituximab or intravenous immunonoglobulin (IVIG). Anti-SRP-positive necrotising myopathy is frequently treated as refractory myositis due to its poor responsiveness to steroid monotherapy and conventional immunosuppressive therapies. Therefore, anti-SRP-positive necrotising myopathy differs from immune-mediated myopathy. Although anti-SRP autoantibody is found in only 4-6% of patients with idiopathic inflammatory myopathy, the actual proportion of patients with refractory anti-SRP-positive necrotising myopathy is unknown. We describe a patient with multiple comorbidities who had subacute-onset anti-SRP-positive immune-mediated necrotising myopathy (IMNM). After failing steroids, methotrexate and IVIG therapy, she made a considerable recovery with rituximab. She was later diagnosed to have breast malignancy. Malignancy-associated anti-SRP-positive IMNM is rarely reported.
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Affiliation(s)
- Tarini Dandasena
- Department of General Medicine, All India Institute of Medical Science-Bhopal, Bhopal, India
| | - Vaibhav Ingle
- All India Institute of Medical Science-Bhopal, Bhopal, India
| | - Abhishek Singhai
- All India Institute of Medical Science-Bhopal, Bhopal, Madhya Pradesh, India
| | - Saurabh Saigal
- All India Institute of Medical Science-Bhopal, Bhopal, India
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24
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Esteller D, Schiava M, Verdú-Díaz J, Villar-Quiles RN, Dibowski B, Venturelli N, Laforet P, Alonso-Pérez J, Olive M, Domínguez-González C, Paradas C, Vélez B, Kostera-Pruszczyk A, Kierdaszuk B, Rodolico C, Claeys K, Pál E, Malfatti E, Souvannanorath S, Alonso-Jiménez A, de Ridder W, De Smet E, Papadimas G, Papadopoulos C, Xirou S, Luo S, Muelas N, Vilchez JJ, Ramos-Fransi A, Monforte M, Tasca G, Udd B, Palmio J, Sri S, Krause S, Schoser B, Fernández-Torrón R, López de Munain A, Pegoraro E, Farrugia ME, Vorgerd M, Manousakis G, Chanson JB, Nadaj-Pakleza A, Cetin H, Badrising U, Warman-Chardon J, Bevilacqua J, Earle N, Campero M, Díaz J, Ikenaga C, Lloyd TE, Nishino I, Nishimori Y, Saito Y, Oya Y, Takahashi Y, Nishikawa A, Sasaki R, Marini-Bettolo C, Guglieri M, Straub V, Stojkovic T, Carlier RY, Díaz-Manera J. Analysis of muscle magnetic resonance imaging of a large cohort of patient with VCP-mediated disease reveals characteristic features useful for diagnosis. J Neurol 2023; 270:5849-5865. [PMID: 37603075 PMCID: PMC10632218 DOI: 10.1007/s00415-023-11862-4] [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: 05/06/2023] [Revised: 06/29/2023] [Accepted: 07/01/2023] [Indexed: 08/22/2023]
Abstract
BACKGROUND The diagnosis of patients with mutations in the VCP gene can be complicated due to their broad phenotypic spectrum including myopathy, motor neuron disease and peripheral neuropathy. Muscle MRI guides the diagnosis in neuromuscular diseases (NMDs); however, comprehensive muscle MRI features for VCP patients have not been reported so far. METHODS We collected muscle MRIs of 80 of the 255 patients who participated in the "VCP International Study" and reviewed the T1-weighted (T1w) and short tau inversion recovery (STIR) sequences. We identified a series of potential diagnostic MRI based characteristics useful for the diagnosis of VCP disease and validated them in 1089 MRIs from patients with other genetically confirmed NMDs. RESULTS Fat replacement of at least one muscle was identified in all symptomatic patients. The most common finding was the existence of patchy areas of fat replacement. Although there was a wide variability of muscles affected, we observed a common pattern characterized by the involvement of periscapular, paraspinal, gluteal and quadriceps muscles. STIR signal was enhanced in 67% of the patients, either in the muscle itself or in the surrounding fascia. We identified 10 diagnostic characteristics based on the pattern identified that allowed us to distinguish VCP disease from other neuromuscular diseases with high accuracy. CONCLUSIONS Patients with mutations in the VCP gene had common features on muscle MRI that are helpful for diagnosis purposes, including the presence of patchy fat replacement and a prominent involvement of the periscapular, paraspinal, abdominal and thigh muscles.
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Affiliation(s)
- Diana Esteller
- Neurology Department, Hospital Clinic de Barcelona, Universitat de Barcelona, Barcelona, Spain
| | - Marianela Schiava
- John Walton Muscular Dystrophy Research Centre, Newcastle University Translational and Clinical Research Institute and Newcastle Hospitals NHS Foundation Trust, Center for Life, Central Parkway, Newcastle Upon Tyne, NE13BZ, United Kingdom
| | - José Verdú-Díaz
- John Walton Muscular Dystrophy Research Centre, Newcastle University Translational and Clinical Research Institute and Newcastle Hospitals NHS Foundation Trust, Center for Life, Central Parkway, Newcastle Upon Tyne, NE13BZ, United Kingdom
| | - Rocío-Nur Villar-Quiles
- APHP, Centre de Référence des Maladies Neuromusculaires, Institut de Myologie, Centre de Recherche en Myologie, Sorbonne Université, APHP, Hôpital Pitié-Salpêtrière, Paris, France
| | - Boris Dibowski
- Department of Radiology, Assistance Publique-Hôpitaux de Paris (AP-HP), DMU Start Imaging, Raymond Poincaré Teaching Hospital, Garches, France
| | - Nadia Venturelli
- Department of Radiology, Assistance Publique-Hôpitaux de Paris (AP-HP), DMU Start Imaging, Raymond Poincaré Teaching Hospital, Garches, France
| | - Pascal Laforet
- Département de Neurologie Hôpital Raymond-Poincaré Garches France Inserm U1179, Garches, France
| | - Jorge Alonso-Pérez
- Servicio de Neurología. Hospital Virgen de la Candelaria, Tenerife, Spain
- Neuromuscular Diseases Unit, Neurology Department, Institut d'Investigació Biomèdica Sant Pau (IIB SANT PAU), Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Montse Olive
- Neuromuscular Diseases Unit, Neurology Department, Institut d'Investigació Biomèdica Sant Pau (IIB SANT PAU), Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
- Center for Biomedical Network Research on Rare Diseases (CIBERER), Instituto de Salud Carlos III, Madrid, Spain
| | - Cristina Domínguez-González
- Center for Biomedical Network Research on Rare Diseases (CIBERER), Instituto de Salud Carlos III, Madrid, Spain
- Unidad de Enfermedades Neuromusculares, Servicio de Neurología, Instituto de Investigación imas12, Hospital 12 de Octubre, Madrid, Spain
| | - Carmen Paradas
- Unidad de Enfermedades Neuromusculares, Servicio de Neurología, Hospital Virgen del Rocio, Seville, Spain
- Centro de Investigación Biomédica en Red en Enfermedades Neurodegenerativas (CIBERNED), Barcelona, Spain
| | - Beatriz Vélez
- Unidad de Enfermedades Neuromusculares, Servicio de Neurología, Hospital Virgen del Rocio, Seville, Spain
- Centro de Investigación Biomédica en Red en Enfermedades Neurodegenerativas (CIBERNED), Barcelona, Spain
| | - Anna Kostera-Pruszczyk
- Department of Neurology, Medical University of Warsaw, ERN EURO NMD, Warsaw, Poland
- Neuromuscular Reference Centre, ERN-EURO-NMD, Warsaw, Poland
| | - Biruta Kierdaszuk
- Department of Neurology, Medical University of Warsaw, ERN EURO NMD, Warsaw, Poland
- Neuromuscular Reference Centre, ERN-EURO-NMD, Warsaw, Poland
| | - Carmelo Rodolico
- UOC di Neurologia e Malattie Neuromuscolari, AOU Policlinico "G. Martino", Rome, Italy
| | - Kristl Claeys
- Neurologie, Neuromusculair Referentiecentrum, Universitaire Ziekenhuizen, Leuven, Belgium
| | - Endre Pál
- Neurology Department, University of Pécs, Pécs, Hungary
| | - Edoardo Malfatti
- Université Paris Est, U955 INSERM, Centre de Référence de Pathologie Neuromusculaire Nord-Est-Ile-de-France, Henri Mondor Hospital, EURO-NMD, 94010, Creteil, France
| | - Sarah Souvannanorath
- Université Paris Est, U955 INSERM, Centre de Référence de Pathologie Neuromusculaire Nord-Est-Ile-de-France, Henri Mondor Hospital, EURO-NMD, 94010, Creteil, France
| | | | - Willem de Ridder
- Neurology Department, Universitary Hospital Antwerpen, Edegem, Belgium
| | - Eline De Smet
- Neurology Department, Universitary Hospital Antwerpen, Edegem, Belgium
| | - George Papadimas
- Department of Neurology, Eginition Hospital, Medical School, NKUA, ERN, EURO NMD, Athens, Greece
| | | | - Sofia Xirou
- Department of Neurology, Eginition Hospital, Medical School, NKUA, ERN, EURO NMD, Athens, Greece
| | - Sushan Luo
- Neurology Department, Huashan Hospital, Fudan University, Shangai, China
| | - Nuria Muelas
- Center for Biomedical Network Research on Rare Diseases (CIBERER), Instituto de Salud Carlos III, Madrid, Spain
- Neuromuscular Diseases Unit, Neurology Department, Hospital Universitari I Politècnic La Fe, Valencia, Spain
- Neuromuscular and Ataxias Research Group, Instituto de Investigación Sanitaria La Fe, Valencia, Spain
- Department of Medicine, Universitat de València, Valencia, Spain
| | - Juan J Vilchez
- Center for Biomedical Network Research on Rare Diseases (CIBERER), Instituto de Salud Carlos III, Madrid, Spain
- Neuromuscular Diseases Unit, Neurology Department, Hospital Universitari I Politècnic La Fe, Valencia, Spain
- Neuromuscular and Ataxias Research Group, Instituto de Investigación Sanitaria La Fe, Valencia, Spain
- Department of Medicine, Universitat de València, Valencia, Spain
| | - Alba Ramos-Fransi
- Unitat de Malalties Neuromusculars, Servei de Neurologia, Hospital Germans Tries I Pujol, Badalona, Spain
| | - Mauro Monforte
- UOC di Neurologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Giorgio Tasca
- John Walton Muscular Dystrophy Research Centre, Newcastle University Translational and Clinical Research Institute and Newcastle Hospitals NHS Foundation Trust, Center for Life, Central Parkway, Newcastle Upon Tyne, NE13BZ, United Kingdom
| | - Bjarne Udd
- Tampere Neuromuscular Center, Tampere University Hospital, Tampere, Finland
- Folkhalsan Genetic Institute, Helsinki University, Helsinki, Finland
| | - Johanna Palmio
- Tampere Neuromuscular Center, Tampere University Hospital, Tampere, Finland
- Folkhalsan Genetic Institute, Helsinki University, Helsinki, Finland
| | - Srtuhi Sri
- Sree Chitra Tirunal Insitute for Medical Sciences and Technology, Thiruvananthapuram, India
| | - Sabine Krause
- Department of Neurology, Friedrich-Baur-Institute, LMU Clinics, Munich, Germany
| | - Benedikt Schoser
- Department of Neurology, Friedrich-Baur-Institute, LMU Clinics, Munich, Germany
| | - Roberto Fernández-Torrón
- Centro de Investigación Biomédica en Red en Enfermedades Neurodegenerativas (CIBERNED), Barcelona, Spain
- Neurology Department, Biodonostia Health Research Institute, Donostia, Spain
| | - Adolfo López de Munain
- Centro de Investigación Biomédica en Red en Enfermedades Neurodegenerativas (CIBERNED), Barcelona, Spain
- Neurology Department, Biodonostia Health Research Institute, Donostia, Spain
| | - Elena Pegoraro
- Department of Neurosciences, University of Padova, Padua, Italy
| | - Maria Elena Farrugia
- Department of Neurology, Institute of Neurological Sciences, Queen Elizabeth University Hospital, Glasgow, Scotland, UK
| | - Mathias Vorgerd
- Heimer Institut for Muscle Research, Klinikum Bergmannsheil Ruhr, University Bochum, Bochum, Germany
| | | | - Jean Baptiste Chanson
- Centre de Référence des Maladies Neuromusculaires Nord/Est/Ile-de-France and ERN-EURO-NMD, Neurology Department, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - Aleksandra Nadaj-Pakleza
- Centre de Référence des Maladies Neuromusculaires Nord/Est/Ile-de-France and ERN-EURO-NMD, Neurology Department, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - Hakan Cetin
- Neurology Department, Medical University of Vienna, Vienna, Austria
| | | | | | - Jorge Bevilacqua
- Departamento de Neurología y Neurocirugía, Hospital Clínico Universidad de Chile, Santiago de Chile, Chile
| | - Nicholas Earle
- Departamento de Neurología y Neurocirugía, Hospital Clínico Universidad de Chile, Santiago de Chile, Chile
| | - Mario Campero
- Departamento de Neurología y Neurocirugía, Hospital Clínico Universidad de Chile, Santiago de Chile, Chile
| | - Jorge Díaz
- Departamento de Neurología y Neurocirugía, Hospital Clínico Universidad de Chile, Santiago de Chile, Chile
| | - Chiseko Ikenaga
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, USA
| | - Thomas E Lloyd
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, USA
| | - Ichizo Nishino
- Department of Neuromuscular Research, National Institute of Neuroscience, National Center of Neurology, Tokyo, Japan
| | - Yukako Nishimori
- Department of Neuromuscular Research, National Institute of Neuroscience, National Center of Neurology, Tokyo, Japan
| | - Yoshihiko Saito
- Department of Neuromuscular Research, National Institute of Neuroscience, National Center of Neurology, Tokyo, Japan
| | - Yasushi Oya
- Department of Neurology, National Center Hospital, NCNP, Tokyo, Japan
| | - Yoshiaki Takahashi
- Department of Neurology, Kagawa Prefectural Central Hospital, Kagawa, Japan
| | | | - Ryo Sasaki
- Department of Neurology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Japan
| | - Chiara Marini-Bettolo
- John Walton Muscular Dystrophy Research Centre, Newcastle University Translational and Clinical Research Institute and Newcastle Hospitals NHS Foundation Trust, Center for Life, Central Parkway, Newcastle Upon Tyne, NE13BZ, United Kingdom
| | - Michela Guglieri
- John Walton Muscular Dystrophy Research Centre, Newcastle University Translational and Clinical Research Institute and Newcastle Hospitals NHS Foundation Trust, Center for Life, Central Parkway, Newcastle Upon Tyne, NE13BZ, United Kingdom
| | - Volker Straub
- John Walton Muscular Dystrophy Research Centre, Newcastle University Translational and Clinical Research Institute and Newcastle Hospitals NHS Foundation Trust, Center for Life, Central Parkway, Newcastle Upon Tyne, NE13BZ, United Kingdom
| | - Tanya Stojkovic
- APHP, Centre de Référence des Maladies Neuromusculaires, Institut de Myologie, Centre de Recherche en Myologie, Sorbonne Université, APHP, Hôpital Pitié-Salpêtrière, Paris, France
| | - Robert Y Carlier
- Department of Radiology, Assistance Publique-Hôpitaux de Paris (AP-HP), DMU Start Imaging, Raymond Poincaré Teaching Hospital, Garches, France
| | - Jordi Díaz-Manera
- John Walton Muscular Dystrophy Research Centre, Newcastle University Translational and Clinical Research Institute and Newcastle Hospitals NHS Foundation Trust, Center for Life, Central Parkway, Newcastle Upon Tyne, NE13BZ, United Kingdom.
- Neuromuscular Diseases Unit, Neurology Department, Institut d'Investigació Biomèdica Sant Pau (IIB SANT PAU), Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.
- Center for Biomedical Network Research on Rare Diseases (CIBERER), Instituto de Salud Carlos III, Madrid, Spain.
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Cocchiararo I, Cattaneo O, Rajendran J, Chabry F, Cornut M, Soldati H, Bigot A, Mamchaoui K, Gibertini S, Bouche A, Ham DJ, Laumonier T, Prola A, Castets P. Identification of a muscle-specific isoform of VMA21 as a potent actor in X-linked myopathy with excessive autophagy pathogenesis. Hum Mol Genet 2023; 32:3374-3389. [PMID: 37756622 PMCID: PMC10695681 DOI: 10.1093/hmg/ddad164] [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: 06/08/2023] [Revised: 08/23/2023] [Accepted: 09/21/2023] [Indexed: 09/29/2023] Open
Abstract
Defective lysosomal acidification is responsible for a large range of multi-systemic disorders associated with impaired autophagy. Diseases caused by mutations in the VMA21 gene stand as exceptions, specifically affecting skeletal muscle (X-linked Myopathy with Excessive Autophagy, XMEA) or liver (Congenital Disorder of Glycosylation). VMA21 chaperones vacuolar (v-) ATPase assembly, which is ubiquitously required for proper lysosomal acidification. The reason VMA21 deficiencies affect specific, but divergent tissues remains unknown. Here, we show that VMA21 encodes a yet-unreported long protein isoform, in addition to the previously described short isoform, which we name VMA21-120 and VMA21-101, respectively. In contrast to the ubiquitous pattern of VMA21-101, VMA21-120 was predominantly expressed in skeletal muscle, and rapidly up-regulated upon differentiation of mouse and human muscle precursors. Accordingly, VMA21-120 accumulated during development, regeneration and denervation of mouse skeletal muscle. In contrast, neither induction nor blockade of autophagy, in vitro and in vivo, strongly affected VMA21 isoform expression. Interestingly, VMA21-101 and VMA21-120 both localized to the sarcoplasmic reticulum of muscle cells, and interacted with the v-ATPase. While VMA21 deficiency impairs autophagy, VMA21-101 or VMA21-120 overexpression had limited impact on autophagic flux in muscle cells. Importantly, XMEA-associated mutations lead to both VMA21-101 deficiency and loss of VMA21-120 expression. These results provide important insights into the clinical diversity of VMA21-related diseases and uncover a muscle-specific VMA21 isoform that potently contributes to XMEA pathogenesis.
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Affiliation(s)
- Ilaria Cocchiararo
- Department of Cell Physiology and Metabolism, Faculty of Medicine, University of Geneva, 1 rue Michel Servet, CH-1211 Geneva, Switzerland
| | - Olivia Cattaneo
- Department of Cell Physiology and Metabolism, Faculty of Medicine, University of Geneva, 1 rue Michel Servet, CH-1211 Geneva, Switzerland
| | - Jayasimman Rajendran
- Department of Cell Physiology and Metabolism, Faculty of Medicine, University of Geneva, 1 rue Michel Servet, CH-1211 Geneva, Switzerland
| | - Florent Chabry
- Department of Cell Physiology and Metabolism, Faculty of Medicine, University of Geneva, 1 rue Michel Servet, CH-1211 Geneva, Switzerland
| | - Mélanie Cornut
- Department of Cell Physiology and Metabolism, Faculty of Medicine, University of Geneva, 1 rue Michel Servet, CH-1211 Geneva, Switzerland
| | - Hadrien Soldati
- Department of Cell Physiology and Metabolism, Faculty of Medicine, University of Geneva, 1 rue Michel Servet, CH-1211 Geneva, Switzerland
| | - Anne Bigot
- Centre de Recherche en Myologie, Inserm, Institut de Myologie, Sorbonne Université, 47 Bd de l'Hôpital, 75013 Paris, France
| | - Kamel Mamchaoui
- Centre de Recherche en Myologie, Inserm, Institut de Myologie, Sorbonne Université, 47 Bd de l'Hôpital, 75013 Paris, France
| | - Sara Gibertini
- Neuromuscular Diseases and Neuroimmunology Unit, Muscle Cell Biology Lab, Fondazione IRCCS Istituto Neurologico “C. Besta”, Via Amadeo 42, 20133 Milano, Italy
| | - Axelle Bouche
- Department of Cell Physiology and Metabolism, Faculty of Medicine, University of Geneva, 1 rue Michel Servet, CH-1211 Geneva, Switzerland
- Department of Orthopaedic Surgery, Geneva University Hospitals and Faculty of Medicine, University Medical Center, 1 rue Michel Servet, 1211, Geneva, Switzerland
| | - Daniel J Ham
- Biozentrum, University of Basel, Spitalstrasse 41, 4056 Basel, Switzerland
| | - Thomas Laumonier
- Department of Cell Physiology and Metabolism, Faculty of Medicine, University of Geneva, 1 rue Michel Servet, CH-1211 Geneva, Switzerland
- Department of Orthopaedic Surgery, Geneva University Hospitals and Faculty of Medicine, University Medical Center, 1 rue Michel Servet, 1211, Geneva, Switzerland
| | - Alexandre Prola
- Department of Cell Physiology and Metabolism, Faculty of Medicine, University of Geneva, 1 rue Michel Servet, CH-1211 Geneva, Switzerland
| | - Perrine Castets
- Department of Cell Physiology and Metabolism, Faculty of Medicine, University of Geneva, 1 rue Michel Servet, CH-1211 Geneva, Switzerland
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26
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Carrington G, Hau A, Kosta S, Dugdale HF, Muntoni F, D’Amico A, Van den Bergh P, Romero NB, Malfatti E, Vilchez JJ, Oldfors A, Pajusalu S, Õunap K, Giralt-Pujol M, Zanoteli E, Campbell KS, Iwamoto H, Peckham M, Ochala J. Human skeletal myopathy myosin mutations disrupt myosin head sequestration. JCI Insight 2023; 8:e172322. [PMID: 37788100 PMCID: PMC10721271 DOI: 10.1172/jci.insight.172322] [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: 05/15/2023] [Accepted: 09/20/2023] [Indexed: 10/05/2023] Open
Abstract
Myosin heavy chains encoded by MYH7 and MYH2 are abundant in human skeletal muscle and important for muscle contraction. However, it is unclear how mutations in these genes disrupt myosin structure and function leading to skeletal muscle myopathies termed myosinopathies. Here, we used multiple approaches to analyze the effects of common MYH7 and MYH2 mutations in the light meromyosin (LMM) region of myosin. Analyses of expressed and purified MYH7 and MYH2 LMM mutant proteins combined with in silico modeling showed that myosin coiled coil structure and packing of filaments in vitro are commonly disrupted. Using muscle biopsies from patients and fluorescent ATP analog chase protocols to estimate the proportion of myosin heads that were super-relaxed, together with x-ray diffraction measurements to estimate myosin head order, we found that basal myosin ATP consumption was increased and the myosin super-relaxed state was decreased in vivo. In addition, myofiber mechanics experiments to investigate contractile function showed that myofiber contractility was not affected. These findings indicate that the structural remodeling associated with LMM mutations induces a pathogenic state in which formation of shutdown heads is impaired, thus increasing myosin head ATP demand in the filaments, rather than affecting contractility. These key findings will help design future therapies for myosinopathies.
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Affiliation(s)
- Glenn Carrington
- The Astbury Centre for Structural and Molecular Biology and
- School of Molecular and Cellular Biology, Faculty of Biological Sciences, University of Leeds, Leeds, United Kingdom
| | - Abbi Hau
- Centre of Human and Applied Physiological Sciences and
- Randall Centre for Cell and Molecular Biophysics, School of Basic & Medical Biosciences, Faculty of Life Sciences & Medicine, King’s College London, United Kingdom
| | - Sarah Kosta
- Department of Physiology, University of Kentucky, Lexington, Kentucky, USA
| | - Hannah F. Dugdale
- Centre of Human and Applied Physiological Sciences and
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, United Kingdom
| | - Francesco Muntoni
- UCL Great Ormond Street Institute of Child Health, London, United Kingdom
- NIHR Biomedical Research Centre at Great Ormond Street Hospital, Great Ormond Street, London, United Kingdom
| | - Adele D’Amico
- Department of Neurosciences, Unit of Neuromuscular and Neurodegenerative Disorders, IRCCS Bambino Gesù Children’s Hospital, Rome, Italy
| | - Peter Van den Bergh
- Neuromuscular Reference Center, Neurology Department, University Hospital Saint-Luc, Brussels, Belgium
| | - Norma B. Romero
- Neuromuscular Morphology Unit, Institute of Myology, Myology Research Centre INSERM, Sorbonne University, Hôpital Pitié-Salpêtrière, Paris, France
| | - Edoardo Malfatti
- APHP, Centre de Référence de Pathologie Neuromusculaire Nord-Est-Ile-de-France, Henri Mondor Hospital, Inserm U955, Creteil, France
- U1179 UVSQ-INSERM Handicap Neuromuscular: Physiology, Biotherapy and Applied Pharmacology, UFR Simone Veil-Santé, Université Versailles Saint Quentin en Yvelines, Paris-Saclay, France
| | - Juan Jesus Vilchez
- Neuromuscular and Ataxias Research Group, Instituto de Investigación Sanitaria La Fe, Valencia, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER) Spain, Valencia, Spain
| | - Anders Oldfors
- Department of Laboratory Medicine, University of Gothenburg, Gothenburg, Sweden
| | - Sander Pajusalu
- Genetics and Personalized Medicine Clinic, Tartu University Hospital, Tartu, Estonia
- Department of Clinical Genetics, Institute of Clinical Medicine, University of Tartu, Tartu, Estonia
| | - Katrin Õunap
- Genetics and Personalized Medicine Clinic, Tartu University Hospital, Tartu, Estonia
- Department of Clinical Genetics, Institute of Clinical Medicine, University of Tartu, Tartu, Estonia
| | - Marta Giralt-Pujol
- The Astbury Centre for Structural and Molecular Biology and
- School of Molecular and Cellular Biology, Faculty of Biological Sciences, University of Leeds, Leeds, United Kingdom
| | - Edmar Zanoteli
- Universidade de São Paulo, Hospital das Clínicas, Faculty of Medicine, Department of Neurology, São Paulo SP, Brazil
- Universidade Federal de São Paulo, Escola Paulista de Medicina, Department of Neurology, São Paulo SP, Brazil
| | - Kenneth S. Campbell
- Department of Physiology, University of Kentucky, Lexington, Kentucky, USA
- Division of Cardiovascular Medicine, University of Kentucky, Lexington, Kentucky, USA
| | - Hiroyuki Iwamoto
- SPring-8, Japan Synchrotron Radiation Research Institute, Hyogo, Japan
| | - Michelle Peckham
- The Astbury Centre for Structural and Molecular Biology and
- School of Molecular and Cellular Biology, Faculty of Biological Sciences, University of Leeds, Leeds, United Kingdom
| | - Julien Ochala
- Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark
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27
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Long AM, Lee G, Demonbreun AR, McNally EM. Extracellular matrix contribution to disease progression and dysfunction in myopathy. Am J Physiol Cell Physiol 2023; 325:C1244-C1251. [PMID: 37746696 PMCID: PMC10855263 DOI: 10.1152/ajpcell.00182.2023] [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: 05/09/2023] [Revised: 08/27/2023] [Accepted: 09/13/2023] [Indexed: 09/26/2023]
Abstract
Myopathic processes affect skeletal muscle and heart. In the muscular dystrophies, which are a subset of myopathies, muscle cells are gradually replaced by fibrosis and fat, impairing muscle function as well as regeneration and repair. In addition to skeletal muscle, these genetic disorders often also affect the heart, where fibrofatty infiltration progressively accumulates in the myocardium, impairing heart function. Although considerable effort has focused on gene-corrective and gene-replacement approaches to stabilize myofibers and cardiomyocytes, the continual and ongoing deposition of extracellular matrix itself contributes to tissue and organ dysfunction. Transcriptomic and proteomic profiling, along with high-resolution imaging and biophysical measurements, have been applied to define extracellular matrix components and their role in contributing to cardiac and skeletal muscle weakness. More recently, decellularization methods have been adapted to an on-slide format to preserve the spatial geography of the extracellular matrix, allowing new insight into matrix remodeling and its direct role in suppressing regeneration in muscle. This review highlights recent literature with focus on the extracellular matrix and molecular mechanisms that contribute to muscle and heart fibrotic disorders. We will also compare how the myopathic matrix differs from healthy matrix, emphasizing how the pathological matrix contributes to disease.
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Affiliation(s)
- Ashlee M Long
- Center for Genetic Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, United States
| | - GaHyun Lee
- Center for Genetic Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, United States
| | - Alexis R Demonbreun
- Center for Genetic Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, United States
- Department of Pharmacology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, United States
| | - Elizabeth M McNally
- Center for Genetic Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, United States
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Strauss KA, Carson VJ, Bolettieri E, Everett M, Bollinger A, Bowser LE, Beiler K, Young M, Edvardson S, Fraenkel N, D'Amico A, Bertini E, Lingappa L, Chowdhury D, Lowes LP, Iammarino M, Alfano LN, Brigatti KW. WiTNNess: An international natural history study of infantile-onset TNNT1 myopathy. Ann Clin Transl Neurol 2023; 10:1972-1984. [PMID: 37632133 PMCID: PMC10647004 DOI: 10.1002/acn3.51884] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Revised: 07/10/2023] [Accepted: 08/02/2023] [Indexed: 08/27/2023] Open
Abstract
OBJECTIVE We created WiTNNess as a hybrid prospective/cross-sectional observational study to simulate a clinical trial for infantile-onset TNNT1 myopathy. Our aims were to identify populations for future trial enrollment, rehearse outcome assessments, specify endpoints, and refine trial logistics. METHODS Eligible participants had biallelic pathogenic variants of TNNT1 and infantile-onset proximal weakness without confounding conditions. The primary endpoint was ventilator-free survival. "Thriving" was a secondary endpoint defined as the ability to swallow and grow normally without non-oral feeding support. Endpoints of gross motor function included independent sitting and standing as defined by the Word Health Organization, a novel TNNT1 abbreviated motor score, and video mapping of limb movement. We recorded adverse events, concomitant medications, and indices of organ function to serve as comparators of safety in future trials. RESULTS Sixteen children were enrolled in the aggregate cohort (6 prospective, 10 cross-sectional; median census age 2.3 years, range 0.5-13.8). Median ventilator-free survival was 20.2 months and probability of death or permanent mechanical ventilation was 100% by age 60 months. All six children (100%) in the prospective arm failed to thrive by age 12 months. Only 2 of 16 (13%) children in the aggregate cohort sat independently and none stood alone. Novel exploratory motor assessments also proved informative. Laboratory and imaging data suggest that primary manifestations of TNNT1 deficiency are restricted to skeletal muscle. INTERPRETATION WiTNNess allowed us to streamline and economize the collection of historical control data without compromising scientific rigor, and thereby establish a sound operational framework for future clinical trials.
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Affiliation(s)
- Kevin A. Strauss
- Clinic for Special ChildrenStrasburgPennsylvaniaUSA
- Department of PediatricsPenn Medicine‐Lancaster General HospitalPennsylvaniaLancasterUSA
- Department of PediatricsUMass Chan Medical SchoolWorcesterMassachusettsUSA
- Department of Molecular, Cell & Cancer BiologyUMass Chan Medical SchoolWorcesterMassachusettsUSA
| | - Vincent J. Carson
- Clinic for Special ChildrenStrasburgPennsylvaniaUSA
- Department of PediatricsPenn Medicine‐Lancaster General HospitalPennsylvaniaLancasterUSA
| | | | | | | | | | | | - Millie Young
- Clinic for Special ChildrenStrasburgPennsylvaniaUSA
| | - Simon Edvardson
- ALYN Hospital Pediatric and Adolescent Rehabilitation CenterJerusalemIsrael
| | - Nitay Fraenkel
- ALYN Hospital Pediatric and Adolescent Rehabilitation CenterJerusalemIsrael
| | - Adele D'Amico
- Unit of Muscular and Neurodegenerative Disorders, Department of NeurosciencesIRCCS Bambino Gesù Children's HospitalRomeItaly
| | - Enrico Bertini
- Unit of Muscular and Neurodegenerative Disorders, Department of NeurosciencesIRCCS Bambino Gesù Children's HospitalRomeItaly
| | - Lokesh Lingappa
- Department of Pediatric NeurologyRainbow Children's HospitalHyderabadIndia
| | - Devyani Chowdhury
- Cardiology Care for ChildrenLancasterPennsylvaniaUSA
- Department of CardiologyNemours Children's HealthWilmingtonDelawareUSA
| | - Linda P. Lowes
- Center for Gene TherapyNationwide Children's HospitalColumbusOhioUSA
| | - Megan Iammarino
- Center for Gene TherapyNationwide Children's HospitalColumbusOhioUSA
| | - Lindsay N. Alfano
- Center for Gene TherapyNationwide Children's HospitalColumbusOhioUSA
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Padmanabha H, Arunachal G, Kishore P, Sharma PP, Mailankody P, Mahale RR, Nashi S, Mathuranath PS, Chandra SR. Collagen XII-Related Myopathy: An Emerging Spectrum of Extracellular Matrix-Related Myopathy. Neurol India 2023; 71:1257-1259. [PMID: 38174471 DOI: 10.4103/0028-3886.391402] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2024]
Abstract
Collagen XII, a member of a protein family called fibril associated collagen with interrupted triple helices (FACIT), is an important component of extracellular matrix and is essential for bridging the neighbouring fibrils. Mutations in collagen XII have been recently described to cause a rare extracellular matrix-related myopathy in those whose phenotype resembles collagen VI-related dystrophies and were negative for pathogenic variants in COL6A genes. The authors report a 4-year old girl presented with a phenotype mimicking Ullrich congenital muscular dystrophy and genetically confirmed to have pathogenic variants in COL12A1 gene thus, expanding the phenotypic spectrum of COL12A1-related myopathy.
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Affiliation(s)
- Hansashree Padmanabha
- Department of Neurology, National Institute of Mental Health and Neurosciences, Near Diary Circle, Hosur Road, Bengaluru, Karnataka, India
| | - Gautham Arunachal
- Department of Human Genetics, National Institute of Mental Health and Neurosciences, Near Diary Circle, Hosur Road, Bengaluru, Karnataka, India
| | - Pratik Kishore
- Department of Neurology, National Institute of Mental Health and Neurosciences, Near Diary Circle, Hosur Road, Bengaluru, Karnataka, India
| | - P Praveen Sharma
- Department of Neurology, National Institute of Mental Health and Neurosciences, Near Diary Circle, Hosur Road, Bengaluru, Karnataka, India
| | - Pooja Mailankody
- Department of Neurology, National Institute of Mental Health and Neurosciences, Near Diary Circle, Hosur Road, Bengaluru, Karnataka, India
| | - Rohan R Mahale
- Department of Neurology, National Institute of Mental Health and Neurosciences, Near Diary Circle, Hosur Road, Bengaluru, Karnataka, India
| | - Saraswati Nashi
- Department of Neurology, National Institute of Mental Health and Neurosciences, Near Diary Circle, Hosur Road, Bengaluru, Karnataka, India
| | - P S Mathuranath
- Department of Neurology, National Institute of Mental Health and Neurosciences, Near Diary Circle, Hosur Road, Bengaluru, Karnataka, India
| | - Sadanandavalli R Chandra
- Department of Neurology, National Institute of Mental Health and Neurosciences, Near Diary Circle, Hosur Road, Bengaluru, Karnataka, India
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30
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Kim SR, Lee EI, Kim Y, Cho SW, Hong N, Rhee Y, Park JW. Preclinical assessment of rodent jumping power with a novel electrical stimulation-assisted device. Sci Rep 2023; 13:17371. [PMID: 37833409 PMCID: PMC10575903 DOI: 10.1038/s41598-023-44748-6] [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: 05/27/2023] [Accepted: 10/11/2023] [Indexed: 10/15/2023] Open
Abstract
Sarcopenia is a progressive loss of muscle mass and strength that is associated with increasing the risk of falls, musculoskeletal diseases, and chronic metabolic diseases. However, the animal models adopted to study sarcopenia face limitations since the functional tests conducted on human cannot be directly adapted to animals because the animals do not follow instructions. Moreover, current preclinical research tools for muscle function assessment, such as the rotarod, grip strength, and treadmill, have limitations, including low-intensity simple movements, evaluator subjectivity, and limited power indicators. Hence, in this study, we present a new jumping-power assessment tool in a preclinical rodent model to demonstrate muscle functions. To overcome the light weight and command issues in the rodent model, we developed an electrical stimulation-assisted jump power assessment device. Precisely, the device utilizes a load cell with a 0.1 g resolution and a 50 points/s data acquisition rate to capture the short period of the mouse jump. Additionally, interdigitated electrodes are used to electrically stimulate the mice and make them jump. While our primary focus in this article is the validation of the newly developed jump power assessment device, it is worth noting that this tool has several potential utilities. These include the phenotypic comparison of sarcopenia models, the exploration of muscle function reduction mechanisms, muscle function-related blood biomarkers, and the evaluation of drug intervention effects.
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Affiliation(s)
- Seung-Rok Kim
- Department of Materials Science and Engineering, Yonsei University, 50 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Korea
| | - Ey-In Lee
- Department of Materials Science and Engineering, Yonsei University, 50 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Korea
| | - Yongnyun Kim
- Yonsei University Health System, Seoul, 03722, Korea
| | - Sang Wouk Cho
- Department of Integrative Medicine, Yonsei University College of Medicine, Seoul, Korea
- Institue for Innovation in Digital Healthcare (IIDH), Severance Hospital, Seoul, Korea
| | - Namki Hong
- Institue for Innovation in Digital Healthcare (IIDH), Severance Hospital, Seoul, Korea.
- Department of Internal Medicine, Severance Hospital, Endocrine Research Institute, Yonsei University College of Medicine, Seoul, 03722, Korea.
| | - Yumie Rhee
- Department of Internal Medicine, Severance Hospital, Endocrine Research Institute, Yonsei University College of Medicine, Seoul, 03722, Korea.
| | - Jin-Woo Park
- Department of Materials Science and Engineering, Yonsei University, 50 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Korea.
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31
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Sonne A, Antonovic AK, Melhedegaard E, Akter F, Andersen JL, Jungbluth H, Witting N, Vissing J, Zanoteli E, Fornili A, Ochala J. Abnormal myosin post-translational modifications and ATP turnover time associated with human congenital myopathy-related RYR1 mutations. Acta Physiol (Oxf) 2023; 239:e14035. [PMID: 37602753 PMCID: PMC10909445 DOI: 10.1111/apha.14035] [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: 05/30/2023] [Revised: 08/07/2023] [Accepted: 08/08/2023] [Indexed: 08/22/2023]
Abstract
AIM Conditions related to mutations in the gene encoding the skeletal muscle ryanodine receptor 1 (RYR1) are genetic muscle disorders and include congenital myopathies with permanent weakness, as well as episodic phenotypes such as rhabdomyolysis/myalgia. Although RYR1 dysfunction is the primary mechanism in RYR1-related disorders, other downstream pathogenic events are less well understood and may include a secondary remodeling of major contractile proteins. Hence, in the present study, we aimed to investigate whether congenital myopathy-related RYR1 mutations alter the regulation of the most abundant contractile protein, myosin. METHODS We used skeletal muscle tissues from five patients with RYR1-related congenital myopathy and compared those with five controls and five patients with RYR1-related rhabdomyolysis/myalgia. We then defined post-translational modifications on myosin heavy chains (MyHCs) using LC/MS. In parallel, we determined myosin relaxed states using Mant-ATP chase experiments and performed molecular dynamics (MD) simulations. RESULTS LC/MS revealed two additional phosphorylations (Thr1309-P and Ser1362-P) and one acetylation (Lys1410-Ac) on the β/slow MyHC of patients with congenital myopathy. This method also identified six acetylations that were lacking on MyHC type IIa of these patients (Lys35-Ac, Lys663-Ac, Lys763-Ac, Lys1171-Ac, Lys1360-Ac, and Lys1733-Ac). MD simulations suggest that modifying myosin Ser1362 impacts the protein structure and dynamics. Finally, Mant-ATP chase experiments showed a faster ATP turnover time of myosin heads in the disordered-relaxed conformation. CONCLUSIONS Altogether, our results suggest that RYR1 mutations have secondary negative consequences on myosin structure and function, likely contributing to the congenital myopathic phenotype.
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Affiliation(s)
- Alexander Sonne
- Department of Biomedical Sciences, Faculty of Health and Medical SciencesUniversity of CopenhagenCopenhagenDenmark
| | - Anna Katarina Antonovic
- Department of Chemistry, School of Physical and Chemical SciencesQueen Mary University of LondonLondonUK
| | - Elise Melhedegaard
- Department of Biomedical Sciences, Faculty of Health and Medical SciencesUniversity of CopenhagenCopenhagenDenmark
| | - Fariha Akter
- Department of Chemistry, School of Physical and Chemical SciencesQueen Mary University of LondonLondonUK
| | - Jesper L. Andersen
- Department of Orthopaedic Surgery, Institute of Sports Medicine CopenhagenCopenhagen University Hospital, Bispebjerg and FrederiksbergCopenhagenDenmark
- Center for Healthy Aging, Department of Clinical MedicineUniversity of CopenhagenCopenhagenDenmark
| | - Heinz Jungbluth
- Department of Paediatric NeurologyEvelina London Children's HospitalLondonUK
- Randall Centre for Cell and Molecular Biophysics, Muscle Signalling Section, Faculty of Life Sciences and MedicineKing's College LondonLondonUK
| | - Nanna Witting
- Copenhagen Neuromuscular Center, Department of NeurologyUniversity of CopenhagenCopenhagenDenmark
| | - John Vissing
- Copenhagen Neuromuscular Center, Department of NeurologyUniversity of CopenhagenCopenhagenDenmark
| | - Edmar Zanoteli
- Departamento de Neurologia, Faculdade de Medicina, Hospital das ClínicasUniversidade de São PauloSão PauloBrazil
| | - Arianna Fornili
- Department of Chemistry, School of Physical and Chemical SciencesQueen Mary University of LondonLondonUK
| | - Julien Ochala
- Department of Biomedical Sciences, Faculty of Health and Medical SciencesUniversity of CopenhagenCopenhagenDenmark
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32
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Fletcher E, Miserlis D, Sorokolet K, Wilburn D, Bradley C, Papoutsi E, Wilkinson T, Ring A, Ferrer L, Haynatzki G, Smith RS, Bohannon WT, Koutakis P. Diet-induced obesity augments ischemic myopathy and functional decline in a murine model of peripheral artery disease. Transl Res 2023; 260:17-31. [PMID: 37220835 DOI: 10.1016/j.trsl.2023.05.002] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Revised: 05/10/2023] [Accepted: 05/15/2023] [Indexed: 05/25/2023]
Abstract
Peripheral artery disease (PAD) causes an ischemic myopathy contributing to patient disability and mortality. Most preclinical models to date use young, healthy rodents with limited translatability to human disease. Although PAD incidence increases with age, and obesity is a common comorbidity, the pathophysiologic association between these risk factors and PAD myopathy is unknown. Using our murine model of PAD, we sought to elucidate the combined effect of age, diet-induced obesity and chronic hindlimb ischemia (HLI) on (1) mobility, (2) muscle contractility, and markers of muscle (3) mitochondrial content and function, (4) oxidative stress and inflammation, (5) proteolysis, and (6) cytoskeletal damage and fibrosis. Following 16-weeks of high-fat, high-sucrose, or low-fat, low-sucrose feeding, HLI was induced in 18-month-old C57BL/6J mice via the surgical ligation of the left femoral artery at 2 locations. Animals were euthanized 4-weeks post-ligation. Results indicate mice with and without obesity shared certain myopathic changes in response to chronic HLI, including impaired muscle contractility, altered mitochondrial electron transport chain complex content and function, and compromised antioxidant defense mechanisms. However, the extent of mitochondrial dysfunction and oxidative stress was significantly greater in obese ischemic muscle compared to non-obese ischemic muscle. Moreover, functional impediments, such as delayed post-surgical recovery of limb function and reduced 6-minute walking distance, as well as accelerated intramuscular protein breakdown, inflammation, cytoskeletal damage, and fibrosis were only evident in mice with obesity. As these features are consistent with human PAD myopathy, our model could be a valuable tool to test new therapeutics.
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Affiliation(s)
- Emma Fletcher
- Department of Biology, Baylor University, Waco, Texas
| | - Dimitrios Miserlis
- Department of Surgery, University of Texas at Austin Dell Medical School, Austin, Texas
| | | | - Dylan Wilburn
- Department of Health, Human Performance and Recreation, Baylor University, Waco, Texas
| | | | | | | | - Andrew Ring
- Department of Biology, Baylor University, Waco, Texas
| | - Lucas Ferrer
- Department of Surgery, University of Texas at Austin Dell Medical School, Austin, Texas
| | - Gleb Haynatzki
- Department of Biostatistics, University of Nebraska Medical Center, Omaha, Nebraska
| | - Robert S Smith
- Department of Surgery, Baylor Scott & White Medical Center, Temple, Texas
| | - William T Bohannon
- Department of Surgery, Baylor Scott & White Medical Center, Temple, Texas
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33
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Boeing A, Mavrommatis L, Daya NM, Zhuge H, Volke L, Kocabas A, Kneifel M, Athamneh M, Krause K, Südkamp N, Döring K, Theiss C, Roos A, Zaehres H, Güttsches AK, Vorgerd M. Generation of two human iPSC lines (HIMRi002-A and HIMRi003-A) derived from Caveolinopathy patients with rippling muscle disease. Stem Cell Res 2023; 72:103220. [PMID: 37839261 DOI: 10.1016/j.scr.2023.103220] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Revised: 09/28/2023] [Accepted: 10/02/2023] [Indexed: 10/17/2023] Open
Abstract
Here we introduce the human induced pluripotent stem cell lines (hiPSCs), HIMRi002-A and HIMRi003-A, generated from cultured dermal fibroblasts of 61-year-old (HIMRi002-A) and 38-year-old (HIMRi003-A) female patients, carrying a known heterozygous pathogenic variant (p.A46T) in the Caveolin 3 (CAV3) gene, via lentiviral expression of OCT4, SOX2, KLF4 and c-MYC. HIMRi002-A and HIMRi003-A display typical embryonic stem cell-like morphology, carry the p.A46T CAV3 gene mutation, express several pluripotent stem cell markers, retain normal karyotype (46, XX) and can differentiate in all three germ layers. We postulate that the HIMRi002-A and HIMRi003-A iPSC lines can be used for the characterization of CAV3-associated pathomechanisms and for developing new therapeutic options.
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Affiliation(s)
- A Boeing
- Department of Neurology, Heimer Institute for Muscle Research, BG-University Hospital Bergmannsheil, Ruhr-University Bochum, 44789 Bochum, Germany
| | - L Mavrommatis
- Department of Neurology, Heimer Institute for Muscle Research, BG-University Hospital Bergmannsheil, Ruhr-University Bochum, 44789 Bochum, Germany
| | - N M Daya
- Department of Neurology, Heimer Institute for Muscle Research, BG-University Hospital Bergmannsheil, Ruhr-University Bochum, 44789 Bochum, Germany
| | - H Zhuge
- Department of Neurology, Heimer Institute for Muscle Research, BG-University Hospital Bergmannsheil, Ruhr-University Bochum, 44789 Bochum, Germany
| | - L Volke
- Department of Neurology, Heimer Institute for Muscle Research, BG-University Hospital Bergmannsheil, Ruhr-University Bochum, 44789 Bochum, Germany
| | - A Kocabas
- Department of Neurology, Heimer Institute for Muscle Research, BG-University Hospital Bergmannsheil, Ruhr-University Bochum, 44789 Bochum, Germany
| | - M Kneifel
- Department of Neurology, Heimer Institute for Muscle Research, BG-University Hospital Bergmannsheil, Ruhr-University Bochum, 44789 Bochum, Germany
| | - M Athamneh
- Department of Neurology, Heimer Institute for Muscle Research, BG-University Hospital Bergmannsheil, Ruhr-University Bochum, 44789 Bochum, Germany
| | - K Krause
- Department of Neurology, Heimer Institute for Muscle Research, BG-University Hospital Bergmannsheil, Ruhr-University Bochum, 44789 Bochum, Germany
| | - N Südkamp
- Department of Neurology, Heimer Institute for Muscle Research, BG-University Hospital Bergmannsheil, Ruhr-University Bochum, 44789 Bochum, Germany
| | - K Döring
- Department of Human Genetics, Ruhr-University Bochum, 44801 Bochum, Germany
| | - C Theiss
- Department of Cytology, Ruhr-University Bochum, 44801 Bochum, Germany
| | - A Roos
- Department of Neurology, Heimer Institute for Muscle Research, BG-University Hospital Bergmannsheil, Ruhr-University Bochum, 44789 Bochum, Germany
| | - H Zaehres
- Department of Anatomy and Molecular Embryology, Institute of Anatomy, Ruhr-University Bochum, 44801 Bochum, Germany
| | - A K Güttsches
- Department of Neurology, Heimer Institute for Muscle Research, BG-University Hospital Bergmannsheil, Ruhr-University Bochum, 44789 Bochum, Germany
| | - M Vorgerd
- Department of Neurology, Heimer Institute for Muscle Research, BG-University Hospital Bergmannsheil, Ruhr-University Bochum, 44789 Bochum, Germany.
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Sayegh Y, Tang V, Khzam RA, Rosenberg AE, Blessing N, Dubovy S. Presentation of a Smooth Muscle Hamartoma in the Bulbar Conjunctiva of an Adolescent Boy: A Case Report and Review of Literature. Cornea 2023; 42:1176-1178. [PMID: 37267468 PMCID: PMC10524459 DOI: 10.1097/ico.0000000000003314] [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: 11/18/2022] [Accepted: 04/14/2023] [Indexed: 06/04/2023]
Abstract
PURPOSE The aim of this study was to describe a novel presentation of conjunctival smooth muscle hamartoma and review the histopathologic findings of this entity. METHODS A 17-year-old African American adolescent boy presented with a pink, nontender lesion of the right bulbar conjunctiva that did not improve with medical management. He had no previous medical or ocular history. The lesion was excised. RESULTS Histopathologic examination disclosed morphologically benign smooth muscle bundles within the substantia propria that stained positively for smooth muscle actin, vimentin, and desmin consistent with the diagnosis of a smooth muscle hamartoma. CONCLUSIONS Although congenital smooth muscle hamartomas of the conjunctiva have been rarely reported in the literature, this is the first described case of a smooth muscle hamartoma presenting in adolescence in the bulbar conjunctiva. This lesion should be considered in the differential diagnosis for adolescents with similar appearing lesions.
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Affiliation(s)
- Yoseph Sayegh
- Florida Lions Ocular Pathology Laboratory, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL
| | - Vincent Tang
- Florida Lions Ocular Pathology Laboratory, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL
| | - Rayan Abou Khzam
- Florida Lions Ocular Pathology Laboratory, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL
| | - Andrew E Rosenberg
- Department of Pathology, University of Miami Miller School of Medicine, Miami, FL
| | - Nathan Blessing
- Oculofacial Plastic & Reconstructive Surgery, Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL; and
| | - Sander Dubovy
- Florida Lions Ocular Pathology Laboratory, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL
- Department of Pathology, University of Miami Miller School of Medicine, Miami, FL
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35
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Milisenda JC, Pinal-Fernandez I, Lloyd TE, Grau-Junyent JM, Christopher-Stine L, Corse AM, Mammen AL. The pattern of MHC class I expression in muscle biopsies from patients with myositis and other neuromuscular disorders. Rheumatology (Oxford) 2023; 62:3156-3160. [PMID: 36707996 PMCID: PMC10473215 DOI: 10.1093/rheumatology/kead052] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [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: 10/07/2022] [Revised: 12/28/2022] [Accepted: 01/23/2023] [Indexed: 01/29/2023] Open
Abstract
OBJECTIVE Diagnostic muscle biopsies are routinely immunostained for major histocompatibility complex class I (MHC-I) protein. In this study we analysed the prevalence and patterns of MHC-I immunostaining in biopsies from patients with different types of myopathies and neurogenic disorders. METHODS All 357 diagnostic muscle biopsies processed at the Johns Hopkins Neuromuscular Pathology Laboratory from August 2013 to January 2017 were immunostained for MHC-I. The prevalence and patterns of MHC-I immunostaining were compared between patients with histologically normal muscle biopsies (n = 31), idiopathic inflammatory myopathies (IIMs; n = 170), non-inflammatory myopathies (n = 60) and neurogenic disorders (n = 96). RESULTS MHC-I immunostaining was abnormal in most patients with DM (98%), sporadic IBM (sIBM; 100%), immune-mediated necrotizing myopathy (IMNM; 100%) and polymyositis (77%). In contrast, MHC-I immunostaining was less frequently present in non-inflammatory myopathies (32%) or neurogenic disorders (30%). Overall, abnormal MHC-I immunostaining had a sensitivity of 0.95 and a specificity of 0.82 for diagnosing IIMs. A focal MHC-I staining pattern was associated with IMNM, whereas a global pattern was more prevalent in sIBM and a perifascicular pattern was significantly more common in dermatomyositis. Among 18 DM biopsies without perifascicular atrophy, 50% had a perifascicular MHC-I staining pattern. Sarcoplasmic upregulation staining was more common than sarcolemmal staining across all groups. CONCLUSION MHC-I immunostaining was useful to distinguish IIMs from non-inflammatory myopathies or neurogenic disorders. Of note, a perifascicular MHC-I staining pattern was present only in those with DM, including half of those without perifascicular atrophy; many of these biopsies may not otherwise have been diagnostic for DM.
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Affiliation(s)
- José C Milisenda
- Muscle Research Unit, Internal Medicine Service, Hospital Clínic de Barcelona, Universidad de Barcelona and CIBERER, Barcelona, Spain
- Muscle Disease Unit, Laboratory of Muscle Stem Cells and Gene Regulations, National Institute of Arthritis and Musculoskeletal and Skin Diseases, National Institutes of Health, Bethesda, Maryland, USA
| | - Iago Pinal-Fernandez
- Muscle Disease Unit, Laboratory of Muscle Stem Cells and Gene Regulations, National Institute of Arthritis and Musculoskeletal and Skin Diseases, National Institutes of Health, Bethesda, Maryland, USA
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Thomas E Lloyd
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Josep Maria Grau-Junyent
- Muscle Research Unit, Internal Medicine Service, Hospital Clínic de Barcelona, Universidad de Barcelona and CIBERER, Barcelona, Spain
| | | | - Andrea M Corse
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Andrew L Mammen
- Muscle Disease Unit, Laboratory of Muscle Stem Cells and Gene Regulations, National Institute of Arthritis and Musculoskeletal and Skin Diseases, National Institutes of Health, Bethesda, Maryland, USA
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
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36
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de Bruyn A, Montagnese F, Holm-Yildiz S, Scharff Poulsen N, Stojkovic T, Behin A, Palmio J, Jokela M, De Bleecker JL, de Visser M, van der Kooi AJ, Ten Dam L, Domínguez González C, Maggi L, Gallone A, Kostera-Pruszczyk A, Macias A, Łusakowska A, Nedkova V, Olive M, Álvarez-Velasco R, Wanschitz J, Paradas C, Mavillard F, Querin G, Fernández-Eulate G, Quinlivan R, Walter MC, Depuydt CE, Udd B, Vissing J, Schoser B, Claeys KG. Anoctamin-5 related muscle disease: clinical and genetic findings in a large European cohort. Brain 2023; 146:3800-3815. [PMID: 36913258 DOI: 10.1093/brain/awad088] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2022] [Revised: 02/06/2023] [Accepted: 02/25/2023] [Indexed: 03/14/2023] Open
Abstract
Anoctamin-5 related muscle disease is caused by biallelic pathogenic variants in the anoctamin-5 gene (ANO5) and shows variable clinical phenotypes: limb-girdle muscular dystrophy type 12 (LGMD-R12), distal muscular dystrophy type 3 (MMD3), pseudometabolic myopathy or asymptomatic hyperCKaemia. In this retrospective, observational, multicentre study we gathered a large European cohort of patients with ANO5-related muscle disease to study the clinical and genetic spectrum and genotype-phenotype correlations. We included 234 patients from 212 different families, contributed by 15 centres from 11 European countries. The largest subgroup was LGMD-R12 (52.6%), followed by pseudometabolic myopathy (20.5%), asymptomatic hyperCKaemia (13.7%) and MMD3 (13.2%). In all subgroups, there was a male predominance, except for pseudometabolic myopathy. Median age at symptom onset of all patients was 33 years (range 23-45 years). The most frequent symptoms at onset were myalgia (35.3%) and exercise intolerance (34.1%), while at last clinical evaluation most frequent symptoms and signs were proximal lower limb weakness (56.9%) and atrophy (38.1%), myalgia (45.1%) and atrophy of the medial gastrocnemius muscle (38.4%). Most patients remained ambulatory (79.4%). At last evaluation, 45.9% of patients with LGMD-R12 additionally had distal weakness in the lower limbs and 48.4% of patients with MMD3 also showed proximal lower limb weakness. Age at symptom onset did not differ significantly between males and females. However, males had a higher risk of using walking aids earlier (P = 0.035). No significant association was identified between sportive versus non-sportive lifestyle before symptom onset and age at symptom onset nor any of the motor outcomes. Cardiac and respiratory involvement that would require treatment occurred very rarely. Ninety-nine different pathogenic variants were identified in ANO5 of which 25 were novel. The most frequent variants were c.191dupA (p.Asn64Lysfs*15) (57.7%) and c.2272C>T (p.Arg758Cys) (11.1%). Patients with two loss-of function variants used walking aids at a significantly earlier age (P = 0.037). Patients homozygous for the c.2272C>T variant showed a later use of walking aids compared to patients with other variants (P = 0.043). We conclude that there was no correlation of the clinical phenotype with the specific genetic variants, and that LGMD-R12 and MMD3 predominantly affect males who have a significantly worse motor outcome. Our study provides useful information for clinical follow up of the patients and for the design of clinical trials with novel therapeutic agents.
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Affiliation(s)
- Alexander de Bruyn
- Department of Neurology, University Hospitals Leuven, 3000 Leuven, Belgium
| | - Federica Montagnese
- Friedrich-Baur-Institute, Department of Neurology, Ludwig-Maximilians-University of Munich, 80336 Munich, Germany
| | - Sonja Holm-Yildiz
- Copenhagen Neuromuscular Center (CNMC), Rigshospitalet, University of Copenhagen, 2100 Copenhagen, Denmark
| | - Nanna Scharff Poulsen
- Copenhagen Neuromuscular Center (CNMC), Rigshospitalet, University of Copenhagen, 2100 Copenhagen, Denmark
| | - Tanya Stojkovic
- Reference Center for Neuromuscular Disorders Nord/Est/Île-de-France, Sorbonne Université, AP-HP, Hôpital Pitié-Salpêtrière, 75013 Paris, France
| | - Anthony Behin
- Reference Center for Neuromuscular Disorders Nord/Est/Île-de-France, Sorbonne Université, AP-HP, Hôpital Pitié-Salpêtrière, 75013 Paris, France
| | - Johanna Palmio
- Neuromuscular Center, Department of Neurology, Tampere University Hospital, 33520 Tampere, Finland
| | - Manu Jokela
- Neuromuscular Center, Department of Neurology, Tampere University Hospital, 33520 Tampere, Finland
- Neurocenter, Department of Neurology, Clinical Neurosciences, Turku University Hospital and University of Turku, 20014 Turku, Finland
| | - Jan L De Bleecker
- Department of Neurology, University Hospital Gent, 9000 Gent, Belgium
| | - Marianne de Visser
- Department of Neurology, Amsterdam University Medical Centers, Location AMC, Neuroscience Institute, University of Amsterdam, 1107 AZ Amsterdam, The Netherlands
| | - Anneke J van der Kooi
- Department of Neurology, Amsterdam University Medical Centers, Location AMC, Neuroscience Institute, University of Amsterdam, 1107 AZ Amsterdam, The Netherlands
| | - Leroy Ten Dam
- Department of Neurology, Amsterdam University Medical Centers, Location AMC, Neuroscience Institute, University of Amsterdam, 1107 AZ Amsterdam, The Netherlands
| | - Cristina Domínguez González
- Reference Center for Rare Neuromuscular Disorders, imas12 Research Institute, Hospital Universitario 12 de Octubre, Biomedical Network Research Center on Rare Diseases (CIBERER), Instituto de Salud Carlos III, 28041 Madrid, Spain
| | - Lorenzo Maggi
- Neuroimmunology and Neuromuscular Diseases Unit, Fondazione IRCCS Istituto Neurologico "Carlo Besta", 20133 Milan, Italy
| | - Annamaria Gallone
- Neuroimmunology and Neuromuscular Diseases Unit, Fondazione IRCCS Istituto Neurologico "Carlo Besta", 20133 Milan, Italy
| | | | - Anna Macias
- Department of Neurology, Medical University of Warsaw, 02-091 Warsaw, Poland
| | - Anna Łusakowska
- Department of Neurology, Medical University of Warsaw, 02-091 Warsaw, Poland
| | - Velina Nedkova
- Department of Neurology, Bellvitge Hospital, 08041 Barcelona, Spain
| | - Montse Olive
- Neuromuscular Disorders Unit, Department of Neurology, Hospital de la Santa Creu i Sant Pau and Biomedical Research Institute Sant Pau (IIB Sat Pau), 08041 Barcelona, Spain
- Center for Biomedical Network Research on Rare Diseases (CIBERER), Instituto de Salud Carlos III, 28001 Madrid, Spain
| | - Rodrigo Álvarez-Velasco
- Neuromuscular Disorders Unit, Department of Neurology, Hospital de la Santa Creu i Sant Pau and Biomedical Research Institute Sant Pau (IIB Sat Pau), 08041 Barcelona, Spain
- Center for Biomedical Network Research on Rare Diseases (CIBERER), Instituto de Salud Carlos III, 28001 Madrid, Spain
| | - Julia Wanschitz
- Department of Neurology, Medical University of Innsbruck, 6020 Innsbruck, Austria
| | - Carmen Paradas
- Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, 41013 Sevilla, Spain
- Centro Investigacion Biomedica en Red Enfermedades Neurodegenerativas (CIBERNED), Instituto de Salud Carlos III, 41013 Sevilla, Spain
| | - Fabiola Mavillard
- Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, 41013 Sevilla, Spain
- Centro Investigacion Biomedica en Red Enfermedades Neurodegenerativas (CIBERNED), Instituto de Salud Carlos III, 41013 Sevilla, Spain
| | - Giorgia Querin
- Institut de Myologie, I-Motion Adult ClinicalTrials Platform, Hôpital Pitié-Salpêtrière, 75013 Paris, France
| | - Gorka Fernández-Eulate
- Reference Center for Neuromuscular Disorders Nord/Est/Île-de-France, Sorbonne Université, AP-HP, Hôpital Pitié-Salpêtrière, 75013 Paris, France
| | - Ros Quinlivan
- Department of Neuromuscular Diseases, UCL Queen Square Institute of Neurology, WC1N 3BG London, UK
| | - Maggie C Walter
- Friedrich-Baur-Institute, Department of Neurology, Ludwig-Maximilians-University of Munich, 80336 Munich, Germany
| | - Christophe E Depuydt
- Laboratory for Muscle Diseases and Neuropathies, Department of Neurosciences, KU Leuven, and Leuven Brain Institute (LBI), 3000 Leuven, Belgium
| | - Bjarne Udd
- Neuromuscular Center, Department of Neurology, Tampere University Hospital, 33520 Tampere, Finland
| | - John Vissing
- Copenhagen Neuromuscular Center (CNMC), Rigshospitalet, University of Copenhagen, 2100 Copenhagen, Denmark
| | - Benedikt Schoser
- Friedrich-Baur-Institute, Department of Neurology, Ludwig-Maximilians-University of Munich, 80336 Munich, Germany
| | - Kristl G Claeys
- Department of Neurology, University Hospitals Leuven, 3000 Leuven, Belgium
- Laboratory for Muscle Diseases and Neuropathies, Department of Neurosciences, KU Leuven, and Leuven Brain Institute (LBI), 3000 Leuven, Belgium
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37
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Maggi L, Gibertini S, Iannibelli E, Gallone A, Bonanno S, Cazzato D, Gerevini S, Moscatelli M, Blasevich F, Riolo G, Mantegazza R, Ruggieri A. PLIN4-related myopathy: clinical, histological and imaging data in a large cohort of patients. J Neurol 2023; 270:4538-4543. [PMID: 37145156 PMCID: PMC10421775 DOI: 10.1007/s00415-023-11729-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 04/13/2023] [Accepted: 04/13/2023] [Indexed: 05/06/2023]
Affiliation(s)
- Lorenzo Maggi
- Neuroimmunology and Neuromuscular Disease Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Sara Gibertini
- Neuroimmunology and Neuromuscular Disease Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Eliana Iannibelli
- Neuroimmunology and Neuromuscular Disease Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Annamaria Gallone
- Neuroimmunology and Neuromuscular Disease Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Silvia Bonanno
- Neuroimmunology and Neuromuscular Disease Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Daniele Cazzato
- Neurophysiology Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | | | - Marco Moscatelli
- Neuroradiology, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - Flavia Blasevich
- Neuroimmunology and Neuromuscular Disease Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Giorgia Riolo
- Neuroimmunology and Neuromuscular Disease Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Renato Mantegazza
- Neuroimmunology and Neuromuscular Disease Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Alessandra Ruggieri
- Neuroimmunology and Neuromuscular Disease Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy.
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38
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Luu Y, Pithadia DJ, Teng J, Khuu P. Ichthyosis, cataracts, and motor delay in an infant: A case of Chanarin-Dorfman syndrome. Pediatr Dermatol 2023; 40:879-881. [PMID: 36709747 DOI: 10.1111/pde.15258] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Accepted: 01/03/2023] [Indexed: 01/30/2023]
Abstract
Chanarin-Dorfman syndrome (CDS) is a rare, autosomal recessive disorder of impaired triacylglycerol catabolism leading to cytoplasmic deposition of triglycerides in various cell types. We describe the case of an 8-month-old boy with cataracts, strabismus, motor delays, and an ichthyosiform rash since birth. Genetic testing revealed a pathogenic variant of the ABHD5 gene, suggestive of CDS, and further workup demonstrated hepatic steatosis and myopathy. His ichthyosis improved with initiation of a diet low in very long-chain fatty acids and medium-chain fatty acid supplementation.
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Affiliation(s)
- Yen Luu
- University of Missouri-Kansas City School of Medicine, Kansas City, Missouri, USA
| | - Deeti J Pithadia
- Division of Pediatric Dermatology, Department of Dermatology, Lucile Packard Children's Hospital, Stanford University School of Medicine, Stanford, California, USA
| | - Joyce Teng
- Division of Pediatric Dermatology, Department of Dermatology, Lucile Packard Children's Hospital, Stanford University School of Medicine, Stanford, California, USA
| | - Phuong Khuu
- Division of Pediatric Dermatology, Department of Dermatology, Lucile Packard Children's Hospital, Stanford University School of Medicine, Stanford, California, USA
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39
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Zhu C, Karvar M, Koh DJ, Sklyar K, Endo Y, Quint J, Samandari M, Tamayol A, Sinha I. Acellular collagen-glycosaminoglycan matrix promotes functional recovery in a rat model of volumetric muscle loss. Regen Med 2023; 18:623-633. [PMID: 37491948 DOI: 10.2217/rme-2023-0060] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/27/2023] Open
Abstract
Aim: Volumetric muscle loss (VML) is a composite loss of skeletal muscle, which heals with fibrosis, minimal muscle regeneration, and incomplete functional recovery. This study investigated whether collagen-glycosaminoglycan scaffolds (CGS) improve functional recovery following VML. Methods: 15 Sprague-Dawley rats underwent either sham injury or bilateral tibialis anterior (TA) VML injury, with or without CGS implantation. Results: In rats with VML injuries treated with CGS, the TA exhibited greater in vivo tetanic forces and in situ twitch and tetanic dorsiflexion forces compared with those in the non-CGS group at 4- and 6-weeks following injury, respectively. Histologically, the VML with CGS group demonstrated reduced fibrosis and increased muscle regeneration. Conclusion: Taken together, CGS implantation has potential augment muscle recovery following VML.
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Affiliation(s)
- Christina Zhu
- Division of Plastic Surgery, Brigham & Women's Hospital, Harvard Medical School, Boston, MA 02115, USA
- Texas Tech University Health Sciences Center School of Medicine, Lubbock, TX 79430, USA
| | - Mehran Karvar
- Division of Plastic Surgery, Brigham & Women's Hospital, Harvard Medical School, Boston, MA 02115, USA
| | - Daniel J Koh
- Division of Plastic Surgery, Brigham & Women's Hospital, Harvard Medical School, Boston, MA 02115, USA
- Boston University Chobanian & Avedisian School of Medicine, Boston, MA 02118, USA
| | - Karina Sklyar
- Division of Plastic Surgery, Brigham & Women's Hospital, Harvard Medical School, Boston, MA 02115, USA
| | - Yori Endo
- Division of Plastic Surgery, Brigham & Women's Hospital, Harvard Medical School, Boston, MA 02115, USA
| | - Jacob Quint
- Department of Biomedical Engineering, University of Connecticut, Farmington, CT 06269, USA
| | - Mohamadmahdi Samandari
- Department of Biomedical Engineering, University of Connecticut, Farmington, CT 06269, USA
| | - Ali Tamayol
- Department of Biomedical Engineering, University of Connecticut, Farmington, CT 06269, USA
| | - Indranil Sinha
- Division of Plastic Surgery, Brigham & Women's Hospital, Harvard Medical School, Boston, MA 02115, USA
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40
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De Paolis F, Testa S, Guarnaccia G, Reggio A, Fornetti E, Cicciarelli F, Deodati R, Bernardini S, Peluso D, Baldi J, Biagini R, Bellisari FC, Izzo A, Sgalambro F, Arrigoni F, Rizzo F, Cannata S, Sciarra T, Fuoco C, Gargioli C. Long-term longitudinal study on swine VML model. Biol Direct 2023; 18:42. [PMID: 37518063 PMCID: PMC10388508 DOI: 10.1186/s13062-023-00399-1] [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: 06/14/2023] [Accepted: 07/24/2023] [Indexed: 08/01/2023] Open
Abstract
BACKGROUND Volumetric Muscle Loss (VML), resulting from severe trauma or surgical ablation, is a pathological condition preventing myofibers regeneration, since skeletal muscle owns the remarkable ability to restore tissue damage, but only when limited in size. The current surgical therapies employed in the treatment of this pathology, which particularly affects military personnel, do not yet provide satisfactory results. For this reason, more innovative approaches must be sought, specifically skeletal muscle tissue engineering seems to highlight promising results obtained from preclinical studies in VML mouse model. Despite the great results obtained in rodents, translation into human needs a comparable animal model in terms of size, in order to validate the efficacy of the tissue engineering approach reconstructing larger muscle mass (human-like). In this work we aim to demonstrate the validity of a porcine model, that has underwent a surgical ablation of a large muscle area, as a VML damage model. RESULTS For this purpose, morphological, ultrasound, histological and fluorescence analyses were carried out on the scar tissue formed following the surgical ablation of the peroneus tertius muscle of Sus scrofa domesticus commonly called mini-pig. In particular, the replenishment of the damaged area, the macrophage infiltration and the vascularization at different time-points were evaluated up to the harvesting of the scar upon six months. CONCLUSION Here we demonstrated that following VML damage, there is an extremely poor regenerative process in the swine muscle tissue, while the formation of fibrotic, scar tissue occurs. The analyses performed up to 180 days after the injury revealed the development of a stable, structured and cellularized tissue, provided with vessels and extracellular matrix acquiring the status of granulation tissue like in human.
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Affiliation(s)
- Francesca De Paolis
- Department of Biology, University of Rome "Tor Vergata", Rome, 00133, Italy
- PhD Program in Cellular and Molecular Biology, Department of Biology, University of Rome "Tor Vergata", Rome, Italy
| | - Stefano Testa
- Marseille Medical Genetics, Aix-Marseille University, INSERM, Marseille, MMG, France
| | | | - Alessio Reggio
- Department of Biology, University of Rome "Tor Vergata", Rome, 00133, Italy
| | - Ersilia Fornetti
- Department of Biology, University of Rome "Tor Vergata", Rome, 00133, Italy
| | - Felice Cicciarelli
- Department of Biology, University of Rome "Tor Vergata", Rome, 00133, Italy
| | - Rebecca Deodati
- Department of Biology, University of Rome "Tor Vergata", Rome, 00133, Italy
| | - Sergio Bernardini
- Department of Biology, University of Rome "Tor Vergata", Rome, 00133, Italy
| | - Daniele Peluso
- Department of Biology, University of Rome "Tor Vergata", Rome, 00133, Italy
| | - Jacopo Baldi
- IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | | | | | - Antonio Izzo
- Department of Clinical Sciences and Applied Biotechnologies (DISCAB), Aquila, Italy
| | - Ferruccio Sgalambro
- Department of Clinical Sciences and Applied Biotechnologies (DISCAB), Aquila, Italy
| | - Francesco Arrigoni
- Department of Clinical Sciences and Applied Biotechnologies (DISCAB), Aquila, Italy
| | - Francesco Rizzo
- Joint Veteran Center, Scientific Department, Army Medical Center, Rome, Italy
| | - Stefano Cannata
- Department of Biology, University of Rome "Tor Vergata", Rome, 00133, Italy
| | - Tommaso Sciarra
- Joint Veteran Center, Scientific Department, Army Medical Center, Rome, Italy
| | - Claudia Fuoco
- Department of Biology, University of Rome "Tor Vergata", Rome, 00133, Italy.
| | - Cesare Gargioli
- Department of Biology, University of Rome "Tor Vergata", Rome, 00133, Italy.
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41
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Hymel LA, Anderson SE, Turner TC, York WY, Zhang H, Liversage AR, Lim HS, Qiu P, Mortensen LJ, Jang YC, Willett NJ, Botchwey EA. Identifying dysregulated immune cell subsets following volumetric muscle loss with pseudo-time trajectories. Commun Biol 2023; 6:749. [PMID: 37468760 PMCID: PMC10356763 DOI: 10.1038/s42003-023-04790-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [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: 12/16/2021] [Accepted: 03/31/2023] [Indexed: 07/21/2023] Open
Abstract
Volumetric muscle loss (VML) results in permanent functional deficits and remains a substantial regenerative medicine challenge. A coordinated immune response is crucial for timely myofiber regeneration, however the immune response following VML has yet to be fully characterized. Here, we leveraged dimensionality reduction and pseudo-time analysis techniques to elucidate the cellular players underlying a functional or pathological outcome as a result of subcritical injury or critical VML in the murine quadriceps, respectively. We found that critical VML resulted in a sustained presence of M2-like and CD206hiLy6Chi 'hybrid' macrophages whereas subcritical defects resolved these populations. Notably, the retained M2-like macrophages from critical VML injuries presented with aberrant cytokine production which may contribute to fibrogenesis, as indicated by their co-localization with fibroadipogenic progenitors (FAPs) in areas of collagen deposition within the defect. Furthermore, several T cell subpopulations were significantly elevated in critical VML compared to subcritical injuries. These results demonstrate a dysregulated immune response in critical VML that is unable to fully resolve the chronic inflammatory state and transition to a pro-regenerative microenvironment within the first week after injury. These data provide important insights into potential therapeutic strategies which could reduce the immune cell burden and pro-fibrotic signaling characteristic of VML.
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Affiliation(s)
- Lauren A Hymel
- Department of Biomedical Engineering, Georgia Institute of Technology, Atlanta, GA, USA
- Petit Institute for Bioengineering and Bioscience, Georgia Institute of Technology, Atlanta, GA, USA
| | - Shannon E Anderson
- Department of Biomedical Engineering, Georgia Institute of Technology, Atlanta, GA, USA
- Petit Institute for Bioengineering and Bioscience, Georgia Institute of Technology, Atlanta, GA, USA
| | - Thomas C Turner
- Department of Biomedical Engineering, Georgia Institute of Technology, Atlanta, GA, USA
- Petit Institute for Bioengineering and Bioscience, Georgia Institute of Technology, Atlanta, GA, USA
| | - William Y York
- Department of Biomedical Engineering, Georgia Institute of Technology, Atlanta, GA, USA
| | - Hongmanlin Zhang
- Petit Institute for Bioengineering and Bioscience, Georgia Institute of Technology, Atlanta, GA, USA
- School of Materials Science and Engineering, Georgia Institute of Technology, Atlanta, GA, USA
| | - Adrian R Liversage
- School of Chemical, Materials, and Biomedical Engineering, University of Georgia, Athens, GA, USA
- Regenerative Bioscience Center, Rhodes Center for ADS, University of Georgia, Athens, GA, USA
| | - Hong Seo Lim
- Department of Biomedical Engineering, Georgia Institute of Technology, Atlanta, GA, USA
- Petit Institute for Bioengineering and Bioscience, Georgia Institute of Technology, Atlanta, GA, USA
| | - Peng Qiu
- Department of Biomedical Engineering, Georgia Institute of Technology, Atlanta, GA, USA
- Petit Institute for Bioengineering and Bioscience, Georgia Institute of Technology, Atlanta, GA, USA
| | - Luke J Mortensen
- School of Chemical, Materials, and Biomedical Engineering, University of Georgia, Athens, GA, USA
- Regenerative Bioscience Center, Rhodes Center for ADS, University of Georgia, Athens, GA, USA
| | - Young C Jang
- Department of Biomedical Engineering, Georgia Institute of Technology, Atlanta, GA, USA.
- Department of Orthopaedics, Emory University, Atlanta, GA, USA.
| | - Nick J Willett
- Petit Institute for Bioengineering and Bioscience, Georgia Institute of Technology, Atlanta, GA, USA.
- Department of Orthopaedics, Emory University, Atlanta, GA, USA.
- Atlanta Veterans Affairs Medical Center, Decatur, GA, USA.
- Phil and Penny Knight Campus for Accelerating Scientific Impact, University of Oregon, Eugene, OR, USA.
- The Veterans Affairs Portland Health Care System, Portland, OR, USA.
| | - Edward A Botchwey
- Department of Biomedical Engineering, Georgia Institute of Technology, Atlanta, GA, USA.
- Petit Institute for Bioengineering and Bioscience, Georgia Institute of Technology, Atlanta, GA, USA.
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42
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Alawneh I, Yuki KE, Amburgey K, Yoon G, Dowling JJ, Hazrati LN, Gonorazky H. Titin related myopathy with ophthalmoplegia. A novel phenotype. Neuromuscul Disord 2023; 33:605-609. [PMID: 37393749 DOI: 10.1016/j.nmd.2023.05.003] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Revised: 05/01/2023] [Accepted: 05/11/2023] [Indexed: 07/04/2023]
Abstract
Titin-related myopathy is an emerging genetic neuromuscular disorder with a wide spectrum of clinical phenotypes. To date, there have not been reports of patients with this disease that presented with extraocular muscle involvement. Here we discuss a 19-year-old male with congenital weakness, complete ophthalmoplegia, thoracolumbar scoliosis, and obstructive sleep apnea. Muscle magnetic resonance imaging revealed severe involvement of the gluteal and anterior compartment muscles, and clear adductor sparing, while muscle biopsy of the right vastus lateralis showed distinctive cap-like structures. Trio Whole Exome Sequencing (WES) showed compound heterozygous likely pathologic variants in the TTN gene. (c.82541_82544dup (p.Arg27515Serfs*2) in exon 327 (NM_001267550.2) and c.31846+1G>A (p.?) in exon 123 (NM_001267550.2). To our knowledge, this is the first report of a TTN-related disorder associated with ophthalmoplegia.
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Affiliation(s)
- Issa Alawneh
- Division of Neurology, The Hospital for Sick Children, University of Toronto, Toronto, Canada
| | - Kyoko E Yuki
- Division of Genome Diagnostics, The Hospital for Sick Children, University of Toronto, Toronto, Canada
| | - Kimberly Amburgey
- Division of Neurology, The Hospital for Sick Children, University of Toronto, Toronto, Canada; Division of Genome Diagnostics, The Hospital for Sick Children, University of Toronto, Toronto, Canada
| | - Grace Yoon
- Division of Neurology, The Hospital for Sick Children, University of Toronto, Toronto, Canada; Division of Genetic, The Hospital for Sick Children, University of Toronto, Toronto, Canada
| | - James J Dowling
- Division of Neurology, The Hospital for Sick Children, University of Toronto, Toronto, Canada; Division of Genetic, The Hospital for Sick Children, University of Toronto, Toronto, Canada; Program of Genetic and Genome Biology, The Hospital for Sick Children, University of Toronto, Toronto, Canada
| | - Lili-Naz Hazrati
- Division of Pathology, The Hospital for Sick Children, University of Toronto, Toronto, Canada
| | - Hernan Gonorazky
- Division of Neurology, The Hospital for Sick Children, University of Toronto, Toronto, Canada; Program of Genetic and Genome Biology, The Hospital for Sick Children, University of Toronto, Toronto, Canada.
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43
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Duvvuri B, Pachman LM, Hermanson P, Wang T, Moore R, Ding-Hwa Wang D, Long A, Morgan GA, Doty S, Tian R, Sancak Y, Lood C. Role of mitochondria in the myopathy of juvenile dermatomyositis and implications for skeletal muscle calcinosis. J Autoimmun 2023; 138:103061. [PMID: 37244073 PMCID: PMC10330803 DOI: 10.1016/j.jaut.2023.103061] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [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: 03/05/2023] [Revised: 04/21/2023] [Accepted: 05/08/2023] [Indexed: 05/29/2023]
Abstract
OBJECTIVES To elucidate mechanisms contributing to skeletal muscle calcinosis in patients with juvenile dermatomyositis. METHODS A well-characterized cohorts of JDM (n = 68), disease controls (polymyositis, n = 7; juvenile SLE, n = 10, and RNP + overlap syndrome, n = 12), and age-matched health controls (n = 17) were analyzed for circulating levels of mitochondrial (mt) markers including mtDNA, mt-nd6, and anti-mitochondrial antibodies (AMAs) using standard qPCR, ELISA, and novel-in-house assays, respectively. Mitochondrial calcification of affected tissue biopsies was confirmed using electron microscopy and energy dispersive X-ray analysis. A human skeletal muscle cell line, RH30, was used to generate an in vitro calcification model. Intracellular calcification is measured by flow cytometry and microscopy. Mitochondria were assessed for mtROS production and membrane potential by flow cytometry and real-time oxygen consumption rate by Seahorse bioanalyzer. Inflammation (interferon-stimulated genes) was measured by qPCR. RESULTS In the current study, patients with JDM exhibited elevated levels of mitochondrial markers associated with muscle damage and calcinosis. Of particular interest are AMAs predictive of calcinosis. Human skeletal muscle cells undergo time- and dose-dependent accumulation of calcium phosphate salts with preferential localization to mitochondria. Calcification renders skeletal muscle cells mitochondria stressed, dysfunctional, destabilized, and interferogenic. Further, we report that inflammation induced by interferon-alpha amplifies mitochondrial calcification of human skeletal muscle cells via the generation of mitochondrial reactive oxygen species (mtROS). CONCLUSIONS Overall, our study demonstrates the mitochondrial involvement in the skeletal muscle pathology and calcinosis of JDM and mtROS as a central player in the calcification of human skeletal muscle cells. Therapeutic targeting of mtROS and/or upstream inducers, such as inflammation, may alleviate mitochondrial dysfunction, leading to calcinosis. AMAs can potentially identify patients with JDM at risk for developing calcinosis.
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Affiliation(s)
- Bhargavi Duvvuri
- Division of Rheumatology, University of Washington, Seattle, WA, USA.
| | - Lauren M Pachman
- Division of Pediatric Rheumatology, Department of Pediatrics, Ann & Robert H. Lurie Children's Hospital of Chicago, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA; CureJM Center of Excellence, Ann & Robert H. Lurie Children's Hospital of Chicago and the Stanley Manne Simpson-Quarrey Research Institute, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Payton Hermanson
- Division of Rheumatology, University of Washington, Seattle, WA, USA
| | - Ting Wang
- Division of Rheumatology, University of Washington, Seattle, WA, USA
| | - Richard Moore
- Cedars Sinai Med Ctr, Division of Rheumatology, Los Angeles, CA, USA
| | | | - Aaron Long
- Department of Pharmacology, University of Washington, Seattle, WA, USA
| | - Gabrielle A Morgan
- Division of Pediatric Rheumatology, Department of Pediatrics, Ann & Robert H. Lurie Children's Hospital of Chicago, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA; CureJM Center of Excellence, Ann & Robert H. Lurie Children's Hospital of Chicago and the Stanley Manne Simpson-Quarrey Research Institute, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | | | - Rong Tian
- Mitochondria and Metabolism Center, University of Washington School of Medicine, Seattle, WA, USA
| | - Yasemin Sancak
- Department of Pharmacology, University of Washington, Seattle, WA, USA
| | - Christian Lood
- Division of Rheumatology, University of Washington, Seattle, WA, USA.
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Parson JC, Biltz NK, Meyer GA. Decellularization-Based Quantification of Skeletal Muscle Fatty Infiltration. J Vis Exp 2023. [PMID: 37358301 PMCID: PMC10837739 DOI: 10.3791/65461] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/27/2023] Open
Abstract
Fatty infiltration is the accumulation of adipocytes between myofibers in skeletal muscle and is a prominent feature of many myopathies, metabolic disorders, and dystrophies. Clinically in human populations, fatty infiltration is assessed using noninvasive methods, including computed tomography (CT), magnetic resonance imaging (MRI), and ultrasound (US). Although some studies have used CT or MRI to quantify fatty infiltration in mouse muscle, costs and insufficient spatial resolution remain challenging. Other small animal methods utilize histology to visualize individual adipocytes; however, this methodology suffers from sampling bias in heterogeneous pathology. This protocol describes the methodology to qualitatively view and quantitatively measure fatty infiltration comprehensively throughout intact mouse muscle and at the level of individual adipocytes using decellularization. The protocol is not limited to specific muscles or specific species and can be extended to human biopsy. Additionally, gross qualitative and quantitative assessments can be made with standard laboratory equipment for little cost, making this procedure more accessible across research laboratories.
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Affiliation(s)
- Jacob C Parson
- Program in Physical Therapy, Washington University in St. Louis
| | - Nicole K Biltz
- Program in Physical Therapy, Washington University in St. Louis
| | - Gretchen A Meyer
- Program in Physical Therapy, Washington University in St. Louis; Departments of Neurology, Orthopaedic Surgery and Biomedical Engineering, Washington University in St. Louis;
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45
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Di Martino A, Cescon M, D’Agostino C, Schilardi F, Sabatelli P, Merlini L, Faldini C. Collagen VI in the Musculoskeletal System. Int J Mol Sci 2023; 24:5095. [PMID: 36982167 PMCID: PMC10049728 DOI: 10.3390/ijms24065095] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [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: 02/02/2023] [Revised: 02/26/2023] [Accepted: 03/01/2023] [Indexed: 03/10/2023] Open
Abstract
Collagen VI exerts several functions in the tissues in which it is expressed, including mechanical roles, cytoprotective functions with the inhibition of apoptosis and oxidative damage, and the promotion of tumor growth and progression by the regulation of cell differentiation and autophagic mechanisms. Mutations in the genes encoding collagen VI main chains, COL6A1, COL6A2 and COL6A3, are responsible for a spectrum of congenital muscular disorders, namely Ullrich congenital muscular dystrophy (UCMD), Bethlem myopathy (BM) and myosclerosis myopathy (MM), which show a variable combination of muscle wasting and weakness, joint contractures, distal laxity, and respiratory compromise. No effective therapeutic strategy is available so far for these diseases; moreover, the effects of collagen VI mutations on other tissues is poorly investigated. The aim of this review is to outline the role of collagen VI in the musculoskeletal system and to give an update about the tissue-specific functions revealed by studies on animal models and from patients' derived samples in order to fill the knowledge gap between scientists and the clinicians who daily manage patients affected by collagen VI-related myopathies.
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Affiliation(s)
- Alberto Di Martino
- I Orthopedic and Traumatology Department, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy
- Department of Biomedical and Neuromotor Science, DIBINEM, University of Bologna, 40136 Bologna, Italy
| | - Matilde Cescon
- Department of Molecular Medicine, University of Padova, 35131 Padova, Italy
| | - Claudio D’Agostino
- I Orthopedic and Traumatology Department, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy
- Department of Biomedical and Neuromotor Science, DIBINEM, University of Bologna, 40136 Bologna, Italy
| | - Francesco Schilardi
- I Orthopedic and Traumatology Department, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy
- Department of Biomedical and Neuromotor Science, DIBINEM, University of Bologna, 40136 Bologna, Italy
| | - Patrizia Sabatelli
- Unit of Bologna, CNR-Institute of Molecular Genetics “Luigi Luca Cavalli-Sforza”, 40136 Bologna, Italy
- IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy
| | - Luciano Merlini
- Department of Biomedical and Neuromotor Science, DIBINEM, University of Bologna, 40136 Bologna, Italy
| | - Cesare Faldini
- I Orthopedic and Traumatology Department, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy
- Department of Biomedical and Neuromotor Science, DIBINEM, University of Bologna, 40136 Bologna, Italy
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46
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Natera‐de Benito D, Olival J, Garcia‐Cabau C, Jou C, Roldan M, Codina A, Expósito‐Escudero J, Batlle C, Carrera‐García L, Ortez C, Salvatella X, Palau F, Nascimento A, Hoenicka J. Common pathophysiology for ANXA11 disorders caused by aspartate 40 variants. Ann Clin Transl Neurol 2023; 10:408-425. [PMID: 36651622 PMCID: PMC10014011 DOI: 10.1002/acn3.51731] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Revised: 01/02/2023] [Accepted: 01/05/2023] [Indexed: 01/19/2023] Open
Abstract
OBJECTIVE Mutations in ANXA11 cause amyotrophic lateral sclerosis (ALS) and have recently been identified as a cause of multisystem proteinopathy and adult-onset muscular dystrophy. These conditions are adult-onset diseases and result from the substitution of Aspartate 40 (Asp40) for an apolar residue in the intrinsically disordered domain (IDD) of ANXA11. Some ALS-related variants are known to affect ANXA11 IDD; however, the mechanism by which the myopathy occurs is unknown. METHODS Genetic analysis was performed using WES-trio. For the study of variant pathogenicity, we used recombinant proteins, muscle biopsy, and fibroblasts. RESULTS Here we describe an individual with severe and rapidly progressive childhood-onset oculopharyngeal muscular dystrophy who carries a new ANXA11 variant at position Asp40 (p.Asp40Ile; c.118_119delGAinsAT). p.Asp40Ile is predicted to enhance the aggregation propensity of ANXA11 to a greater extent than other changes affecting this residue. In vitro studies using recombinant ANXA11p.Asp40Ile showed abnormal phase separation and confirmed this variant is more aggregation-prone than the ALS-associated variant ANXA11p.Asp40Gly . The study of the patient's fibroblasts revealed defects in stress granules dynamics and clearance, and muscle histopathology showed a myopathic pattern with ANXA11 protein aggregates. Super-resolution imaging showed aggregates expressed as pearl strips or large complex structures in the sarcoplasm, and as layered subsarcolemmal chains probably reflecting ANXA11 multifunctionality. INTERPRETATION We demonstrate common pathophysiology for disorders associated with ANXA11 Asp40 allelic variants. Clinical phenotypes may result from different deleterious impacts of variants upon ANXA11 stability against aggregation, and differential muscle or motor neuron dysfunction expressed as a temporal and tissue-specific continuum.
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Affiliation(s)
- Daniel Natera‐de Benito
- Neuromuscular Unit, Department of NeurologyHospital Sant Joan de DéuBarcelona08950Spain
- Applied Research in Neuromuscular DiseasesInstitut de Recerca Sant Joan de DéuBarcelona08950Spain
| | - Jonathan Olival
- Laboratory of Neurogenetics and Molecular Medicine – IPERInstitut de Recerca Sant Joan de Déu08950BarcelonaSpain
| | - Carla Garcia‐Cabau
- Institute for Research in Biomedicine (IRB Barcelona)The Barcelona Institute of Science and TechnologyBarcelona08029Spain
| | - Cristina Jou
- Applied Research in Neuromuscular DiseasesInstitut de Recerca Sant Joan de DéuBarcelona08950Spain
- Department of PathologyHospital Sant Joan de DéuBarcelona08950Spain
| | - Mònica Roldan
- Confocal Microscopy and Cellular Imaging UnitInstitut de Recerca Sant Joan de DéuBarcelona08950Spain
- Department of Genetics and Developmental Medicine – IPERHospital Sant Joan de DéuBarcelona08950Spain
| | - Anna Codina
- Applied Research in Neuromuscular DiseasesInstitut de Recerca Sant Joan de DéuBarcelona08950Spain
| | - Jessica Expósito‐Escudero
- Neuromuscular Unit, Department of NeurologyHospital Sant Joan de DéuBarcelona08950Spain
- Applied Research in Neuromuscular DiseasesInstitut de Recerca Sant Joan de DéuBarcelona08950Spain
| | - Cristina Batlle
- Laboratory of Neurogenetics and Molecular Medicine – IPERInstitut de Recerca Sant Joan de Déu08950BarcelonaSpain
| | - Laura Carrera‐García
- Neuromuscular Unit, Department of NeurologyHospital Sant Joan de DéuBarcelona08950Spain
- Applied Research in Neuromuscular DiseasesInstitut de Recerca Sant Joan de DéuBarcelona08950Spain
| | - Carlos Ortez
- Neuromuscular Unit, Department of NeurologyHospital Sant Joan de DéuBarcelona08950Spain
- Applied Research in Neuromuscular DiseasesInstitut de Recerca Sant Joan de DéuBarcelona08950Spain
- Center for Biomedical Research Network on Rare Diseases (CIBERER)ISCIIIBarcelonaSpain
| | - Xavier Salvatella
- Institute for Research in Biomedicine (IRB Barcelona)The Barcelona Institute of Science and TechnologyBarcelona08029Spain
- ICREABarcelona08010Spain
| | - Francesc Palau
- Laboratory of Neurogenetics and Molecular Medicine – IPERInstitut de Recerca Sant Joan de Déu08950BarcelonaSpain
- Department of Genetics and Developmental Medicine – IPERHospital Sant Joan de DéuBarcelona08950Spain
- Center for Biomedical Research Network on Rare Diseases (CIBERER)ISCIIIBarcelonaSpain
- Division of Pediatrics, Faculty of Medicine and Health SciencesUniversity of BarcelonaBarcelona08007Spain
- ERN ITHACABarcelona08950Spain
| | - Andrés Nascimento
- Neuromuscular Unit, Department of NeurologyHospital Sant Joan de DéuBarcelona08950Spain
- Applied Research in Neuromuscular DiseasesInstitut de Recerca Sant Joan de DéuBarcelona08950Spain
- Center for Biomedical Research Network on Rare Diseases (CIBERER)ISCIIIBarcelonaSpain
| | - Janet Hoenicka
- Laboratory of Neurogenetics and Molecular Medicine – IPERInstitut de Recerca Sant Joan de Déu08950BarcelonaSpain
- Center for Biomedical Research Network on Rare Diseases (CIBERER)ISCIIIBarcelonaSpain
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47
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Pedersen JJ, Stemmerik MG, Jacobsen LN, Skriver SV, Wilms GR, Duno M, Vissing J. Muscle fat replacement and contractility in patients with skeletal muscle sodium channel disorders. Sci Rep 2023; 13:2538. [PMID: 36782059 PMCID: PMC9925746 DOI: 10.1038/s41598-023-29759-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Accepted: 02/09/2023] [Indexed: 02/15/2023] Open
Abstract
Skeletal muscle sodium channel disorders give rise to episodic symptoms such as myotonia and/or periodic paralysis. Chronic symptoms with permanent weakness are not considered characteristic of the phenotypes. Muscle fat replacement represents irreversible damage that inevitably will impact on muscle strength. This study investigates muscle fat replacement and contractility in patients with pathogenic SCN4A variants compared to healthy controls. T1-weighted and 2-point Dixon MRI of the legs were conducted to assess fat replacement. Stationary dynamometry was used to assess muscle strength. Contractility was determined by maximal muscle contraction divided by cross-sectional muscle area. The average cross-sectional intramuscular fat fraction was greater in patients compared with controls by 2.5% in the calves (95% CI 0.74-4.29%, p = 0.007) and by 2.0% in the thighs (95% CI 0.75-3.2%, p = 0.003). Muscle contractility was less in patients vs. controls by 14-27% (p < 0.05). Despite greater fat fraction and less contractility, absolute strength was not significantly less. This study quantitatively documents greater fat fraction and additionally describes difference in muscle contractility in a large cohort of patients with skeletal muscle sodium channel disorders. The clinical impact of these abnormal findings is likely limited as muscle hypertrophy in the patients served to preserve absolute muscle strength. Subgroup analysis indicated significant difference in phenotype by genotype, however these findings lack statistical significance and serve as inspiration for future researchers to probe into the geno- phenotype relationship in these disorders.Trial registration: The study was registered at http://clinicaltrials.gov (identifier: NCT04808388).
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Affiliation(s)
- Jonas Jalili Pedersen
- Copenhagen Neuromuscular Center, Department of Neurology, Rigshospitalet, University of Copenhagen, Inge Lehmanns Vej 7-9, 2100, Copenhagen, Denmark.
| | - Mads Godtfeldt Stemmerik
- Copenhagen Neuromuscular Center, Department of Neurology, Rigshospitalet, University of Copenhagen, Inge Lehmanns Vej 7-9, 2100, Copenhagen, Denmark
| | - Laura Nørager Jacobsen
- Copenhagen Neuromuscular Center, Department of Neurology, Rigshospitalet, University of Copenhagen, Inge Lehmanns Vej 7-9, 2100, Copenhagen, Denmark
| | - Sofie Vinther Skriver
- Copenhagen Neuromuscular Center, Department of Neurology, Rigshospitalet, University of Copenhagen, Inge Lehmanns Vej 7-9, 2100, Copenhagen, Denmark
| | - Gustav Rhode Wilms
- Copenhagen Neuromuscular Center, Department of Neurology, Rigshospitalet, University of Copenhagen, Inge Lehmanns Vej 7-9, 2100, Copenhagen, Denmark
| | - Morten Duno
- Clinical Genetic Laboratory, Department of Biochemical Genetics, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - John Vissing
- Copenhagen Neuromuscular Center, Department of Neurology, Rigshospitalet, University of Copenhagen, Inge Lehmanns Vej 7-9, 2100, Copenhagen, Denmark
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48
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Motherwell JM, Dolan CP, Kanovka SS, Edwards JB, Franco SR, Janakiram NB, Valerio MS, Goldman SM, Dearth CL. Effects of Adjunct Antifibrotic Treatment within a Regenerative Rehabilitation Paradigm for Volumetric Muscle Loss. Int J Mol Sci 2023; 24:3564. [PMID: 36834976 PMCID: PMC9964131 DOI: 10.3390/ijms24043564] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 02/03/2023] [Accepted: 02/07/2023] [Indexed: 02/12/2023] Open
Abstract
The use of a rehabilitation approach that promotes regeneration has the potential to improve the efficacy of pro-regenerative therapies and maximize functional outcomes in the treatment of volumetric muscle loss (VML). An adjunct antifibrotic treatment could further enhance functional gains by reducing fibrotic scarring. This study aimed to evaluate the potential synergistic effects of losartan, an antifibrotic pharmaceutical, paired with a voluntary wheel running rehabilitation strategy to enhance a minced muscle graft (MMG) pro-regenerative therapy in a rodent model of VML. The animals were randomly assigned into four groups: (1) antifibrotic with rehabilitation, (2) antifibrotic without rehabilitation, (3) vehicle treatment with rehabilitation, and (4) vehicle treatment without rehabilitation. At 56 days, the neuromuscular function was assessed, and muscles were collected for histological and molecular analysis. Surprisingly, we found that the losartan treatment decreased muscle function in MMG-treated VML injuries by 56 days, while the voluntary wheel running elicited no effect. Histologic and molecular analysis revealed that losartan treatment did not reduce fibrosis. These findings suggest that losartan treatment as an adjunct therapy to a regenerative rehabilitation strategy negatively impacts muscular function and fails to promote myogenesis following VML injury. There still remains a clinical need to develop a regenerative rehabilitation treatment strategy for traumatic skeletal muscle injuries. Future studies should consider optimizing the timing and duration of adjunct antifibrotic treatments to maximize functional outcomes in VML injuries.
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Affiliation(s)
- Jessica M. Motherwell
- DoD-VA Extremity Trauma and Amputation Center of Excellence, Montgomery, MD 20815, USA
- Department of Surgery, Walter Reed National Military Medical Center, Uniformed Services University of the Health Sciences, Montgomery, MD 20815, USA
| | - Connor P. Dolan
- DoD-VA Extremity Trauma and Amputation Center of Excellence, Montgomery, MD 20815, USA
- Department of Surgery, Walter Reed National Military Medical Center, Uniformed Services University of the Health Sciences, Montgomery, MD 20815, USA
| | - Sergey S. Kanovka
- DoD-VA Extremity Trauma and Amputation Center of Excellence, Montgomery, MD 20815, USA
- Department of Surgery, Walter Reed National Military Medical Center, Uniformed Services University of the Health Sciences, Montgomery, MD 20815, USA
- The Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Montgomery, MD 20817, USA
| | - Jorge B. Edwards
- DoD-VA Extremity Trauma and Amputation Center of Excellence, Montgomery, MD 20815, USA
- Department of Surgery, Walter Reed National Military Medical Center, Uniformed Services University of the Health Sciences, Montgomery, MD 20815, USA
- The Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Montgomery, MD 20817, USA
| | - Sarah R. Franco
- DoD-VA Extremity Trauma and Amputation Center of Excellence, Montgomery, MD 20815, USA
- Department of Surgery, Walter Reed National Military Medical Center, Uniformed Services University of the Health Sciences, Montgomery, MD 20815, USA
| | - Naveena B. Janakiram
- DoD-VA Extremity Trauma and Amputation Center of Excellence, Montgomery, MD 20815, USA
- Department of Surgery, Walter Reed National Military Medical Center, Uniformed Services University of the Health Sciences, Montgomery, MD 20815, USA
| | - Michael S. Valerio
- DoD-VA Extremity Trauma and Amputation Center of Excellence, Montgomery, MD 20815, USA
- Department of Surgery, Walter Reed National Military Medical Center, Uniformed Services University of the Health Sciences, Montgomery, MD 20815, USA
| | - Stephen M. Goldman
- DoD-VA Extremity Trauma and Amputation Center of Excellence, Montgomery, MD 20815, USA
- Department of Surgery, Walter Reed National Military Medical Center, Uniformed Services University of the Health Sciences, Montgomery, MD 20815, USA
| | - Christopher L. Dearth
- DoD-VA Extremity Trauma and Amputation Center of Excellence, Montgomery, MD 20815, USA
- Department of Surgery, Walter Reed National Military Medical Center, Uniformed Services University of the Health Sciences, Montgomery, MD 20815, USA
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49
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Granger A, Beecher G, Liewluck T, Nicolau S, Flanigan KM, Laughlin RS, Milone M. Inherited myopathy plus: Double-trouble from rare neuromuscular disorders. Neuromuscul Disord 2023; 33:153-160. [PMID: 36628841 DOI: 10.1016/j.nmd.2022.12.009] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2022] [Revised: 11/21/2022] [Accepted: 12/14/2022] [Indexed: 12/23/2022]
Abstract
A rare disorder in the USA is one that affects <200,000 people, making inherited myopathies rare diseases. Increasing access to genetic testing has been instrumental for the diagnosis of inherited myopathies. Genetic findings, however, require clinical correlation due to variable phenotype, polygenic etiology of certain inherited disorders, and possible co-existing independent neuromuscular disorders. We searched the Mayo Clinic Rochester medical record (2004-2020) to identify adult patients carrying pathogenic variants or likely pathogenic variants in genes causative of myopathies and having a coexisting independent neuromuscular disorder classified as rare at https://rarediseases.info.nih.gov/. One additional patient was identified at Nationwide Children's hospital. Clinical and laboratory findings were reviewed. We identified 14 patients from 13 families fulfilling search criteria. Seven patients had a "double-trouble" inherited myopathy; two had an inherited myopathy with coexistent idiopathic myositis; three had an inherited myopathy with coexisting rare neuromuscular disorder of neurogenic type; a female DMD carrier had co-existing distal spinal muscular atrophy, which was featuring the clinical phenotype; and a patient with a MYH7 pathogenic variant had Sandhoff disease causing motor neuron disease. These cases highlight the relevance of correlating genetic findings, even when diagnostic, with clinical features, to allow precise diagnosis, optimal care, and accurate prognosis.
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Affiliation(s)
- Andre Granger
- Department of Neurology, Mayo Clinic, Rochester, MN, USA
| | | | | | - Stefan Nicolau
- Center for Gene Therapy, Nationwide Children's Hospital, Columbus, OH, USA
| | - Kevin M Flanigan
- Center for Gene Therapy, Nationwide Children's Hospital, Columbus, OH, USA
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50
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Ross L, McKelvie P, Reardon K, Wong H, Wicks I, Day J. Muscle biopsy practices in the evaluation of neuromuscular disease: A systematic literature review. Neuropathol Appl Neurobiol 2023; 49:e12888. [PMID: 36734037 PMCID: PMC10946625 DOI: 10.1111/nan.12888] [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: 09/23/2022] [Revised: 01/26/2023] [Accepted: 01/28/2023] [Indexed: 02/04/2023]
Abstract
AIMS Muscle biopsy techniques range from needle muscle biopsy (NMB) and conchotome biopsy to open surgical biopsy. It is unknown whether specific biopsy techniques offer superior diagnostic yield or differ in procedural complication rates. Therefore, we aimed to compare the diagnostic utility of NMB, conchotome and open muscle biopsies in the assessment of neuromuscular disorders. METHODS A systematic literature review of the EMBASE and Medline (Ovid) databases was performed to identify original, full-length research articles that described the muscle biopsy technique used to diagnose neuromuscular disease in both adult and paediatric patient populations. Studies of any design, excluding case reports, were eligible for inclusion. Data pertaining to biopsy technique, biopsy yield and procedural complications were extracted. RESULTS Sixty-four studies reporting the yield of a specific muscle biopsy technique and, or procedural complications were identified. Open surgical biopsies provided a larger tissue sample than any type of percutaneous muscle biopsy. Where anaesthetic details were reported, general anaesthesia was required in 60% of studies that reported open surgical biopsies. Percutaneous biopsies were most commonly performed under local anaesthesia and despite the smaller tissue yield, moderate- to large-gauge needle and conchotome muscle biopsies had an equivalent diagnostic utility to that of open surgical muscle biopsy. All types of muscle biopsy procedures were well tolerated with few adverse events and no scarring complications were reported with percutaneous sampling. CONCLUSIONS When a histological diagnosis of myopathy is required, moderate- to large-gauge NMB and the conchotome technique appear to have an equivalent diagnostic yield to that of an open surgical biopsy.
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Affiliation(s)
- Laura Ross
- Department of RheumatologySt Vincent's Hospital MelbourneFitzroyVictoriaAustralia
- Department of MedicineThe University of Melbourne at St Vincent's HospitalFitzroyVictoriaAustralia
| | - Penny McKelvie
- Department of Anatomical PathologySt Vincent's Hospital MelbourneFitzroyVictoriaAustralia
| | - Katrina Reardon
- Department of NeurologySt Vincent's Hospital MelbourneFitzroyVictoriaAustralia
| | - Huon Wong
- Inflammation DivisionWalter and Eliza Hall Institute of Medical ResearchParkvilleVictoriaAustralia
| | - Ian Wicks
- Inflammation DivisionWalter and Eliza Hall Institute of Medical ResearchParkvilleVictoriaAustralia
- Department of RheumatologyRoyal Melbourne HospitalParkvilleVictoriaAustralia
- Department of Medical BiologyUniversity of MelbourneParkvilleVictoriaAustralia
| | - Jessica Day
- Inflammation DivisionWalter and Eliza Hall Institute of Medical ResearchParkvilleVictoriaAustralia
- Department of RheumatologyRoyal Melbourne HospitalParkvilleVictoriaAustralia
- Department of Medical BiologyUniversity of MelbourneParkvilleVictoriaAustralia
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