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Peringeth G, Abbi B, Mahmood S. Treatment of myopathy and cutaneous ulcers in anti-MDA5-positive dermatomyositis with triple therapy. BMJ Case Rep 2024; 17:e253960. [PMID: 38514155 PMCID: PMC10961521 DOI: 10.1136/bcr-2022-253960] [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: 03/23/2024] Open
Abstract
Antimelanoma differentiation-associated protein 5 positive dermatomyositis (MDA5 DM) is a rare subtype of idiopathic inflammatory myopathy. There are limited data available regarding the cutaneous manifestations of MDA5 DM in the African American population. We presented the case of a male patient in his early 20s who presented with debilitating cutaneous ulceration and myopathy. Workup revealed interstitial lung disease (ILD) and positive MDA5 serology consistent with MDA5 DM. He made a remarkable recovery in terms of myopathy and cutaneous ulcerations with a multipronged regimen of prednisone, intravenous immunoglobulin and mycophenolate mofetil. However, there was a progression of ILD on this regimen which warranted use of rituximab.
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Affiliation(s)
- Gopisree Peringeth
- Department of Medicine, Albert Einstein College of Medicine, Bronx, New York, USA
| | - Bhavna Abbi
- Department of Medicine, Albert Einstein College of Medicine, Bronx, New York, USA
- Rheumatology, Lahey Hospital and Medical Center, Burlington, Massachusetts, USA
| | - Shereen Mahmood
- Department of Medicine, Albert Einstein College of Medicine, Bronx, New York, USA
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2
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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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3
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Paul A, Nair AV, Krupa J, Iyadurai R. Hoffman syndrome with the classic sign of myoedema and an unusual finding of systolic heart failure. BMJ Case Rep 2023; 16:e252795. [PMID: 37802588 PMCID: PMC10565170 DOI: 10.1136/bcr-2022-252795] [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: 10/10/2023] Open
Abstract
A man in his 20s presented with a 6-year history of calf muscle hypertrophy, proximal muscle weakness and muscle cramps. Along with this, he also had patchy hair loss, facial puffiness and slurring of speech. On examination, he had mild symmetrical proximal muscle weakness, a delayed relaxation phase of his deep tendon reflexes and a rare neurological sign of myoedema. His laboratory investigations revealed elevated thyroid-stimulating hormone levels with high creatine kinase levels, and an echocardiogram showed left ventricular systolic dysfunction. He was diagnosed with Hoffman syndrome, a rare pseudohypertrophic myopathy associated with severe and prolonged hypothyroidism. He had an excellent response to thyroid hormone replacement.
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Affiliation(s)
- Anna Paul
- General Medicine, Christian Medical College and Hospital Vellore, Vellore, Tamil Nadu, India
| | | | - Jesu Krupa
- Cardiology, Christian Medical College and Hospital Vellore, Vellore, Tamil Nadu, India
| | - Ramya Iyadurai
- General Medicine, Christian Medical College and Hospital Vellore, Vellore, Tamil Nadu, India
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Li A, Shami GJ, Griffiths L, Lal S, Irving H, Braet F. Giant mitochondria in cardiomyocytes: cellular architecture in health and disease. Basic Res Cardiol 2023; 118:39. [PMID: 37775647 PMCID: PMC10541842 DOI: 10.1007/s00395-023-01011-3] [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: 07/26/2023] [Revised: 08/29/2023] [Accepted: 09/15/2023] [Indexed: 10/01/2023]
Abstract
Giant mitochondria are frequently observed in different disease models within the brain, kidney, and liver. In cardiac muscle, these enlarged organelles are present across diverse physiological and pathophysiological conditions including in ageing and exercise, and clinically in alcohol-induced heart disease and various cardiomyopathies. This mitochondrial aberration is widely considered an early structural hallmark of disease leading to adverse organ function. In this thematic paper, we discuss the current state-of-knowledge on the presence, structure and functional implications of giant mitochondria in heart muscle. Despite its demonstrated reoccurrence in different heart diseases, the literature on this pathophysiological phenomenon remains relatively sparse since its initial observations in the early 60s. We review historical and contemporary investigations from cultured cardiomyocytes to human tissue samples to address the role of giant mitochondria in cardiac health and disease. Finally, we discuss their significance for the future development of novel mitochondria-targeted therapies to improve cardiac metabolism and functionality.
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Affiliation(s)
- Amy Li
- Department of Rural Clinical Sciences, La Trobe Rural Health School, La Trobe University, Bendigo, VIC, Australia.
- Centre for Healthy Futures, Torrens University Australia, Surry Hills, NSW, Australia.
- School of Medical Sciences, The University of Sydney, Camperdown, NSW, Australia.
| | - Gerald J Shami
- School of Medical Sciences (Molecular and Cellular Biomedicine), The University of Sydney, Camperdown, NSW, Australia
- Australian Centre for Microscopy and Microanalysis, The University of Sydney, Camperdown, NSW, Australia
| | - Lisa Griffiths
- Anatomical Pathology, PathWest, QEII Medical Centre, Nedlands, WA, Australia
| | - Sean Lal
- School of Medical Sciences, The University of Sydney, Camperdown, NSW, Australia
| | - Helen Irving
- Department of Rural Clinical Sciences, La Trobe Rural Health School, La Trobe University, Bendigo, VIC, Australia
| | - Filip Braet
- School of Medical Sciences (Molecular and Cellular Biomedicine), The University of Sydney, Camperdown, NSW, Australia.
- Australian Centre for Microscopy and Microanalysis, The University of Sydney, Camperdown, NSW, Australia.
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Fossmo HL, Ørstavik K, Frich JC, Robinson HS. Translation, reliability, and validity of the Norwegian version of the ABILHAND-NMD and the ACTIVLIM for Myotonic Dystrophy type 1. Disabil Rehabil 2023:1-9. [PMID: 37438996 DOI: 10.1080/09638288.2023.2231848] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/14/2023]
Abstract
PURPOSE To translate ABILHAND-NMD and ACTIVLIM into Norwegian and assess their psychometric properties in adults with Myotonic Dystrophy type 1(DM1). METHODS ABILHAND-NMD and ACTIVLIM were translated into Norwegian through a standardized translation process. Psychometric properties of the translated questionnaires were tested. Intraclass correlation coefficient (ICC3.1) was used to assess test-retest reliability and Cronbach's α for internal consistency. The validity of the questionnaires was also assessed. RESULTS A total of 39 adults with DM1 were included. We found excellent test-retest reliability on ABILHAND-NMD (ICC 0.91) and ACTIVLIM (ICC 0.93). We found a good internal consistency of ABILHAND-NMD with Cronbach's α (95%CI) of 0.80 (0.69-0.88) and ACTIVLIM with Cronbach's α (95%CI) of 0.88 (0.82-0.93) An expert group of healthcare professionals and a pilot group reported good face and content validity. We found a high correlation between ABILHAND-NMD and ACTIVLIM (r = 0.75), p < 0.001 implying good convergent validity. ABILHAND-NMD and ACTIVLIM showed no floor effect, but a potential for ceiling effect. CONCLUSION The Norwegian versions of ABILHAND-NMD and ACTIVLIM are reliable and valid patient reported outcome measures for Myotonic Dystrophy type 1. The questionnaires are easy to administer as they take a short time to answer, and the participants reported no problems understanding the questions.
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Affiliation(s)
- Hanne Ludt Fossmo
- Neurological Department, EMAN, Oslo University Hospital, Oslo, Norway
- Vikersund Kurbad AS, Vikersund Rehabilitation Centre, Vikersund, Norway
- Member of ERN EURO-NMD
| | - Kristin Ørstavik
- Neurological Department, EMAN, Oslo University Hospital, Oslo, Norway
- Member of ERN EURO-NMD
| | - Jan C Frich
- Department of Health Management and Health Economics, University of Oslo, Institute of Health and Society, Oslo, Norway
| | - Hilde Stendal Robinson
- Department of Interdisciplinary Health Sciences, University of Oslo, Institute of Health and Society, Oslo, Norway
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Nandy A, Tankisi H, Krøigård AB, Dalager MG, Hvidbjerg MS, Schrøder HD, Obál I. Sporadic late onset nemaline myopathy with concurrent dermatological symptoms responding to immunosuppressive treatment. BMC Neurol 2023; 23:233. [PMID: 37328820 DOI: 10.1186/s12883-023-03283-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Accepted: 06/09/2023] [Indexed: 06/18/2023] Open
Abstract
BACKGROUND Sporadic late onset nemaline myopathy is a rare, progressive muscle disease, presenting in adulthood, mainly affecting proximal limb and bulbar muscles. Muscle biopsies show characteristic nemaline rods. The putative mechanism is considered immune-related. Other manifestations aside from neuromuscular symptoms have not been described previously. CASE PRESENTATION We present a case with atypical sporadic late onset nemaline myopathy (SLONM) of a non-HIV, non-MGUS subtype, where skin manifestations preceded neuromuscular symptoms, and a residual thymus with the histology of thymic follicular hyperplasia was detected during the diagnostic workup. Thorough dermatological investigations could not explain the skin presentations. Muscle biopsy revealed variation in fiber diameter, ragged-red and COX-negative fibers associated with discrete fibrosis. Electron microscopy detected atrophic muscle fibres with disorganization of the myofibrils, nemaline rods and abnormal mitochondria. Single-fiber EMG suggested signs of a neuromuscular transmission defect, EMG showed signs of myopathy. Analyses of antibodies associated with myasthenia gravis were negative. The patient showed improvement after intravenous immunoglobulin treatment regarding both the skin and the muscle symptoms. CONCLUSIONS Our case highlights the heterogeneity of SLONM with its varied spectrum of presentation. A unique combination of dermatological symptoms and SLONM could be seen with skin lesions as primary presenting symptoms. An association can be considered between the different manifestations, presumably based on immune etiology, where immunosuppressive therapy has been beneficial.
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Affiliation(s)
- Anirban Nandy
- Department of Neurology, Aalborg University Hospital, Ladegaardsgade 5, Aalborg, 9000, Denmark
| | - Hatice Tankisi
- Department of Clinical Neurophysiology, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, Aarhus, 8200, Denmark
| | - Anne Bruun Krøigård
- Department of Pathology, Odense University Hospital, J. B. Winsløws Vej 4, Odense, 5000, Denmark
| | - Maiken Glud Dalager
- Department of Dermatology, Aalborg University Hospital, Hobrovej 18-22, Aalborg, 9000, Denmark
| | - Marie Skov Hvidbjerg
- Department of Clinical Genetics, Aalborg University Hospital, Ladegaardsgade 5, Aalborg, 9000, Denmark
| | - Henrik Daa Schrøder
- Department of Pathology, Odense University Hospital, J. B. Winsløws Vej 4, Odense, 5000, Denmark
| | - Izabella Obál
- Department of Neurology, Aalborg University Hospital, Ladegaardsgade 5, Aalborg, 9000, Denmark.
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Zhu XY, Tang XH, Yu H. Amiodarone-induced muscle tremor in an elderly patient: A case report. World J Clin Cases 2022; 10:12726-12733. [PMID: 36579101 PMCID: PMC9791518 DOI: 10.12998/wjcc.v10.i34.12726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Revised: 10/09/2022] [Accepted: 11/04/2022] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Amiodarone is a Class III antiarrhythmic drug, which has been adopted for the treatment of atrial fibrillation and ventricular arrhythmia. However, the use of amiodarone can cause lower limb muscle tremors, which is recognized as a rare side effect of this medication.
CASE SUMMARY An 84-year-old female was administrated with amiodarone for paroxysmal supraventricular tachycardia and frequent ventricular tachycardia. The patient developed a bilateral gastrocnemius tremor in the course of medication, and the strength of the patient’s bilateral knee flexor and extensor reached 4/5 and 3/5, respectively. After the use of amiodarone was stopped, and the patient was given a small dose of levetiracetam, the lower limb tremor symptoms were significantly mitigated, along with activity and function.
CONCLUSION Attention should be paid to the significance of the side effects of drugs in the elderly, which may be atypical in the elderly. The relevant side effects of drugs may not be as rare as reported due to individual differences and different pharmacokinetics. If the side effects are generated, the medication should be adjusted in time, and the progress of the side effects should be intervened.
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Affiliation(s)
- Xiao-Yong Zhu
- Department of Cardiology, Jiujiang University Affiliated Hospital, Jiujiang 332000, Jiangxi Province, China
| | - Xin-Hu Tang
- Department of Cardiology, Jiujiang University Affiliated Hospital, Jiujiang 332000, Jiangxi Province, China
| | - Hua Yu
- Department of Cardiology, Jiujiang University Affiliated Hospital, Jiujiang 332000, Jiangxi Province, China
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8
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Jimenez JC, Lucas CHG, LaHue SC, Sharpe BA. Giant cell myositis associated with metastatic thymoma and granulomatous hypercalcaemia. BMJ Case Rep 2022; 15:e246688. [PMID: 35667693 PMCID: PMC9171203 DOI: 10.1136/bcr-2021-246688] [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: 11/04/2022] Open
Abstract
Giant cell myositis (GCM) is a rare inflammatory myopathy associated with myasthenia gravis and thymoma. Here, we report on a woman in her late 50s with a history of myasthenia gravis, systemic lupus erythematosus and stage IV thymoma with pleural metastases, who presented with proximal weakness, neuromuscular respiratory failure and hypercalcaemia. She was diagnosed with GCM via muscle biopsy and screened for myocarditis but showed no evidence of myocardial involvement. Her hypercalcaemia was consistent with a granulomatous process, likely driven by her GCM. Her strength gradually improved, and her hypercalcaemia did not recur after treatment with high dose steroids, intravenous immune globulin and plasma exchange. Her course was complicated by several opportunistic infections in the setting of her immunosuppression. Despite the high morbidity associated with GCM, she demonstrated clinical improvement after initiating immunosuppressive therapy and continues to be managed in the outpatient setting.
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Affiliation(s)
- Jessica C Jimenez
- Department of Neurology, University of California San Francisco School of Medicine, San Francisco, California, USA
| | - Calixto-Hope G Lucas
- Department of Pathology, University of California San Francisco, San Francisco, California, USA
| | - Sara C LaHue
- Department of Neurology, University of California San Francisco School of Medicine, San Francisco, California, USA
- Department of Neurology, University of California San Francisco Weill Institute for Neurosciences, San Francisco, California, USA
| | - Bradley A Sharpe
- Department of Medicine, University of California San Francisco, San Francisco, California, USA
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9
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Abstract
Hydroxyl-methyl-glutaryl-Co-A reductase (HMGCR) immune mediated necrotising myopathy (IMNM) is a rare autoimmune myositis that is thought to be triggered by statins and responds to immunomodulation. We report a case of a woman in her 30s with HMGCR IMNM without a history of statin exposure who had a clear flare of her myositis after beginning mushroom supplements. Mushrooms are natural HMGCR inhibitors, and this is the first case to demonstrate a flare triggered by mushrooms in a patient with known HMGCR IMNM. This case highlights the importance of reviewing diet and supplements in patients with IMNM. It also emphasises the importance of strict statin avoidance for patients with IMNM even when the myositis is under good control.
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Affiliation(s)
- Brittany Adler
- Rheumatology, Johns Hopkins University, Baltimore, MD, USA
| | | | - Eleni Tiniakou
- Rheumatology, Johns Hopkins University, Baltimore, MD, USA
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10
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Fermon C, Authier FJ, Gallay L. Idiopathic eosinophilic myositis: a systematic literature review. Neuromuscul Disord 2021; 32:116-124. [PMID: 34980535 DOI: 10.1016/j.nmd.2021.10.003] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2021] [Revised: 10/02/2021] [Accepted: 10/06/2021] [Indexed: 11/16/2022]
Abstract
Eosinophilic myositis belong to the idiopathic inflammatory myopathies and are defined by an inflammatory infiltrate composed of eosinophils within the muscle. To date, no consensus exists for diagnosis and care of such patients. The aim of this review was to describe clinical and histological presentation, treatment, and outcome of eosinophilic myositis based on a systematic review of all published histologically proven cases of eosinophilic myositis. A total of 453 records were identified in MEDLINE until November 2020. A total of 69 published cases were identified. The analysis of these allowed the distinction of the 3 previously described pathological subtypes: focal eosinophilic myositis (n = 17); diffuse eosinophilic myositis (n = 36); and eosinophilic perimyositis (n = 16). We propose a simple algorithm for diagnosis and treatment strategy for the care of patient with muscular symptoms and blood eosinophilia. This work also highlights eosinophilic myositis pathogenesis and the need for careful investigations in order to rule out differential diagnoses.
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Affiliation(s)
- Cécile Fermon
- Department of Internal Medicine, Edouard Herriot University Hospital, Hospices Civils de Lyon, University Claude Bernard, 5 Place d'Arsonval, F-69003, Lyon, France.
| | - François-Jérôme Authier
- University Paris Est-Créteil, INSERM, IMRB U955, Team Relaix, F-94010, Créteil, France; Reference Centre for Neuromuscular Diseases "Nord-Est-Ile de France", FILNEMUS, France; Department of Pathology, AP-HP, Henri Mondor University Hospital, F-94010, Créteil, France
| | - Laure Gallay
- Department of Internal Medicine, Edouard Herriot University Hospital, Hospices Civils de Lyon, University Claude Bernard, 5 Place d'Arsonval, F-69003, Lyon, France
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11
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Romani M, Auwerx J. Phalloidin Staining of Actin Filaments for Visualization of Muscle Fibers in Caenorhabditis elegans. Bio Protoc 2021; 11:e4183. [PMID: 34722829 PMCID: PMC8517648 DOI: 10.21769/bioprotoc.4183] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Revised: 06/25/2021] [Accepted: 07/07/2021] [Indexed: 01/09/2023] Open
Abstract
Advances in C. elegans research have allowed scientists to recapitulate different human disorders, from neurodegenerative diseases to muscle dysfunction, in these nematodes. Concomitantly, the interest in visualizing organs affected by these conditions has grown, leading to the establishment of different antibody- and dye-based staining protocols to verify tissue morphology. In particular, the quality of muscle tissue has been largely used in nematodes as a readout for fitness and healthspan. Phalloidin derivatives, which are commonly used to stain actin filaments in cells and tissues, have been implemented in the context of C. elegans research for visualization of muscle fibers. However, the majority of the phalloidin-based protocols depend on fixation steps using harmful compounds, preparation of specific buffers, and large amounts of worms. Herein, we implemented a safer and more flexible experimental procedure to stain actin filaments in C. elegans using phalloidin-based dyes. Lyophilization of the worms followed by their acetone permeabilization allows bypassing the fixation process while also providing the opportunity to suspend the experiment at different steps. Moreover, by using conventional buffers throughout our protocol, we avoid the additional preparation of solutions. Finally, our protocol requires a limited number of worms, making it suitable for slow-growing C. elegans strains. Overall, this protocol provides an efficient, fast, and safer method to stain actin filaments and visualize muscle fibers in C. elegans. Graphic abstract: Schematic overview of phalloidin staining in C. elegans for assessing muscle fiber morphology.
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Affiliation(s)
- Mario Romani
- Laboratory of Integrative Systems Physiology, École Polytechnique Fédérale de Lausanne, Lausanne, Switzerland
| | - Johan Auwerx
- Laboratory of Integrative Systems Physiology, École Polytechnique Fédérale de Lausanne, Lausanne, Switzerland
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Thebault S, Gibbs E, Bourque P, McKim D, Rakhra K, Breiner A, Frykman H, Warman-Chardon J. MuSK not MNGIE: Atypical MuSK-antibody myasthenia presenting as a genetic disorder. Neuromuscul Disord 2021; 31:1279-1281. [PMID: 34690051 DOI: 10.1016/j.nmd.2021.08.014] [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: 07/28/2021] [Revised: 08/25/2021] [Accepted: 08/31/2021] [Indexed: 11/19/2022]
Abstract
Myasthenia gravis is a treatable autoimmune disease caused by autoantibodies directed against membrane proteins at the neuromuscular junction. While acetylcholine receptor antibodies are most common, a minority of patients have antibodies directed against muscle-specific kinase (MuSK-antibody). Differentiating features often include subacute onset and rapid progression of bulbar, respiratory and neck extensor muscles, with sparing of distal appendicular muscles, most commonly in middle-aged females. Here we present an atypical presentation of MuSK-antibody myasthenic syndrome in a young male consisting of a gradual-onset, insidiously-progressive, non-fatigable and non-fluctuating ocular, bulbar and oesophageal weakness, with a normal frontalis single fibre EMG. This case clinically resembled a mitochondrial myopathy (Mitochondrial Neurogastrointestinal Encephalopathy-MNGIE) with a poor prognosis. Because of the atypical presentation, MuSK antibodies were identified very late in the disease course, at which point the patient responded very well to immunotherapy. We report an unusual presentation of an uncommon but treatable condition, illustrating significant phenotypic heterogeneity possible in MuSK-antibody myasthenic syndrome.
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Affiliation(s)
- Simon Thebault
- Department of Medicine, The Ottawa Hospital, Centre for Neuromuscular Disease and University of Ottawa, Canada.
| | - Ebrima Gibbs
- The University of British Columbia Neuroimmunology lab, Canada
| | - Pierre Bourque
- Department of Medicine, The Ottawa Hospital, Centre for Neuromuscular Disease and University of Ottawa, Canada
| | - Doug McKim
- Department of Medicine, The Ottawa Hospital, Centre for Neuromuscular Disease and University of Ottawa, Canada
| | - Kawan Rakhra
- Department of Diagnostic Imaging, The Ottawa Hospital and University of Ottawa, Canada
| | - Ari Breiner
- Department of Medicine, The Ottawa Hospital, Centre for Neuromuscular Disease and University of Ottawa, Canada
| | - Hans Frykman
- The University of British Columbia Neuroimmunology lab, Canada
| | - Jodi Warman-Chardon
- Department of Medicine, The Ottawa Hospital, Centre for Neuromuscular Disease and University of Ottawa, Canada; Department of Genetics, Children's Hospital of Eastern Ontario Research Institute.
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Polavarapu K, Mathur A, Joshi A, Nashi S, Preethish-Kumar V, Bardhan M, Sharma P, Parveen S, Seth M, Vengalil S, Chawla T, Shingavi L, Shamim U, Nayak S, Vivekanand A, Töpf A, Roos A, Horvath R, Lochmüller H, Nandeesh B, Arunachal G, Nalini A, Faruq M. A founder mutation in the GMPPB gene [c.1000G > A (p.Asp334Asn)] causes a mild form of limb-girdle muscular dystrophy/congenital myasthenic syndrome (LGMD/CMS) in South Indian patients. Neurogenetics 2021. [PMID: 34333724 DOI: 10.1007/s10048-021-00658-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Accepted: 07/08/2021] [Indexed: 10/20/2022]
Abstract
Twelve patients from seven unrelated South Indian families with a limb-girdle muscular dystrophy-congenital myasthenic syndrome (LGMD/CMS) phenotype and recessive inheritance underwent deep clinical phenotyping, electrophysiological evaluation, muscle histopathology, and next-generation sequencing/Sanger sequencing-based identification of the genetic defect. Homozygosity mapping was performed using high-throughput genome-wide genotyping for mapping the mutation and to evaluate the founder effect. The age of disease onset among patients ranged from childhood to 40 years of age. The key clinical manifestations observed were progressive fatigable limb-girdle weakness, muscle hypertrophy/atrophy, and preferential weakness in a dystrophic pattern. The ages at last follow-up ranged from 30 to 64 years; nine were independently ambulant, two required assistance, and one was wheelchair-bound. Lower limb muscle MRI showed varying degrees of fat replacement in the glutei, hamstrings, anterior leg muscles, and medial gastrocnemius. All patients showed significant decrement on repetitive nerve stimulation (RNS). Muscle biopsy in 7 patients revealed varying degrees of dystrophic and neurogenic changes. Treatment with pyridostigmine and/or salbutamol resulted in variable improvement in 10 patients. Genetic analysis showed an identical homozygous GMPPB mutation c.1000G > A (p.Asp334Asn) in all affected patients. A region of homozygosity (6Mbp) was observed flanking the c.1000G > A change in carrier chromosomes. This study identifies c.1000G > A in GMPPB as a common founder mutation in an ethnic community of South Indian descent with milder yet variable degree of clinical presentation of GMPPB-associated LGMD-CMS.
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Blokhuis AM, Deenen JCW, Voermans NC, van Engelen BGM, Kievit W, Groothuis JT. The socioeconomic burden of facioscapulohumeral muscular dystrophy. J Neurol 2021; 268:4778-4788. [PMID: 34043041 PMCID: PMC8563627 DOI: 10.1007/s00415-021-10591-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Revised: 03/19/2021] [Accepted: 05/03/2021] [Indexed: 12/23/2022]
Abstract
BACKGROUND Promising genetic therapies are being investigated in facioscapulohumeral muscular dystrophy (FSHD). However, the current cost of illness is largely unknown. OBJECTIVE This study aimed at determining the socioeconomic burden of FSHD. METHODS Adult patients with FSHD from the Dutch FSHD registry were invited to complete a questionnaire on medical consumption, work productivity and health-related quality of life (HR-QoL) using the EQ-5D-5L. Associated costs were calculated from a societal perspective. A generalized linear model was fitted to the data to investigate whether level of mobility was related to annual costs of illness. RESULTS 172 patients with FSHD completed the questionnaire (response rate 65%). The per-patient annual direct medical costs of FSHD were estimated at €12,077, direct non-medical costs at €9179 and indirect costs at €5066, adding up to a total cost of illness of €26,322 per patient per year. The direct costs of illness were €21,256, approximately five times higher than the mean per-capita health expenditures in the Netherlands. Major cost-driving factors were formal home care and informal care. A decreased level of mobility was associated with higher direct costs of illness. HR-QoL was significantly reduced in patients with FSHD with a median health utility value of 0.63. CONCLUSIONS We show that FSHD is associated with substantial direct and indirect socioeconomic costs as well as a reduction in HR-QoL. These findings are important for health care decision makers and aids in allocation of research funds and evaluation of the cost-effectiveness of novel therapies.
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Affiliation(s)
- Anna M Blokhuis
- Department of Rehabilitation, Sint Maartenskliniek, Nijmegen, The Netherlands. .,Donders Institute for Brain, Cognition and Behaviour, Department of Rehabilitation, Radboud university medical center, Nijmegen, The Netherlands.
| | - Johanna C W Deenen
- Donders Institute for Brain, Cognition and Behaviour, Department of Neurology, Radboud university medical center, Nijmegen, The Netherlands
| | - Nicol C Voermans
- Donders Institute for Brain, Cognition and Behaviour, Department of Neurology, Radboud university medical center, Nijmegen, The Netherlands
| | - Baziel G M van Engelen
- Donders Institute for Brain, Cognition and Behaviour, Department of Neurology, Radboud university medical center, Nijmegen, The Netherlands
| | - Wietske Kievit
- Department for Health Evidence, Radboud Institute for Health Sciences, Radboud university medical center, Nijmegen, The Netherlands
| | - Jan T Groothuis
- Donders Institute for Brain, Cognition and Behaviour, Department of Rehabilitation, Radboud university medical center, Nijmegen, The Netherlands
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Wang LH, Shaw DWW, Faino A, Budech CB, Lewis LM, Statland J, Eichinger K, Tapscott SJ, Tawil RN, Friedman SD. Longitudinal study of MRI and functional outcome measures in facioscapulohumeral muscular dystrophy. BMC Musculoskelet Disord 2021; 22:262. [PMID: 33691664 PMCID: PMC7948347 DOI: 10.1186/s12891-021-04134-7] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Accepted: 03/02/2021] [Indexed: 02/06/2023] Open
Abstract
Background Facioscapulohumeral muscular dystrophy (FSHD) is a patchy and slowly progressive disease of skeletal muscle. For MRI to be a useful biomarker in an FSHD clinical trial, it should reliably detect changes over relatively short time-intervals (~ 1 year). We hypothesized that fatty change over the study course would be most likely in muscles already demonstrating disease progression, and that the degree of MRI burden would be correlated with function. Methods We studied 36 patients with FSHD and lower-extremity weakness at baseline. Thirty-two patients returned in our 12-month longitudinal observational study. We analyzed DIXON MRI images of 16 lower-extremity muscles in each patient and compared them to quantitative strength measurement and ambulatory functional outcome measures. Results There was a small shift to higher fat fractions in the summed muscle data for each patient, however individual muscles demonstrated much larger magnitudes of change. The greatest increase in fat fraction was observed in muscles having an intermediate fat replacement at baseline, with minimally (baseline fat fraction < 0.10) or severely (> 0.70) affected muscles less likely to progress. Functional outcome measures did not demonstrate marked change over the interval; however, overall MRI disease burden was correlated with functional outcome measures. Direct comparison of the tibialis anterior (TA) fat fraction and quantitative strength measurement showed a sigmoidal relationship, with steepest drop being when the muscle gets more than ~ 20% fatty replaced. Conclusions Assessing MRI changes in 16 lower-extremity muscles across 1 year demonstrated that those muscles having an intermediate baseline fat fraction were more likely to progress. Ambulatory functional outcome measures are generally related to overall muscle MRI burden but remain unchanged in the short term. Quantitative strength measurement of the TA showed a steep loss of strength when more fatty infiltration is present suggesting that MRI may be preferable for following incremental change or modulation with drug therapy. Supplementary Information The online version contains supplementary material available at 10.1186/s12891-021-04134-7.
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Affiliation(s)
- Leo H Wang
- Department of Neurology, University of Washington, Seattle, Washington, USA.
| | - Dennis W W Shaw
- Department of Radiology, University of Washington, Seattle, Washington, USA
| | - Anna Faino
- Children's Core for Biomedical Statistics, Seattle Children's Research Institute, Seattle, Washington, USA
| | | | - Leann M Lewis
- Department of Neurology, University of Rochester, Rochester, New York, USA
| | - Jeffrey Statland
- Department of Neurology, Kansas University Medical Center, Fairway, KS, USA
| | - Katy Eichinger
- Department of Neurology, University of Rochester, Rochester, New York, USA
| | - Stephen J Tapscott
- Human Biology Division, Fred Hutchinson Research Center, Seattle, Washington, USA
| | - Rabi N Tawil
- Department of Neurology, University of Rochester, Rochester, New York, USA
| | - Seth D Friedman
- Department of Radiology, University of Washington, Seattle, Washington, USA
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16
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Wang LH, Johnstone LM, Bindschadler M, Tapscott SJ, Friedman SD. Adapting MRI as a clinical outcome measure for a facioscapulohumeral muscular dystrophy trial of prednisone and tacrolimus: case report. BMC Musculoskelet Disord 2021; 22:56. [PMID: 33422031 PMCID: PMC7797109 DOI: 10.1186/s12891-020-03910-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Accepted: 12/23/2020] [Indexed: 08/30/2023] Open
Abstract
Background Facioscapulohumeral muscular dystrophy (FSHD) is a patchy and slowly progressive disease of skeletal muscle. MRI short tau inversion recovery (STIR) sequences of patient muscles often show increased hyperintensity that is hypothesized to be associated with inflammation. This is supported by the presence of inflammatory changes on biopsies of STIR-positive muscles. We hypothesized that the STIR positivity would normalize with targeted immunosuppressive therapy. Case presentation 45-year-old male with FSHD type 1 was treated with 12 weeks of immunosuppressive therapy, tacrolimus and prednisone. Tacrolimus was treated to a goal serum trough of > 5 ng/mL and prednisone was tapered every month. Quantitative strength exam, functional outcome measures, and muscle MRI were performed at baseline, week 6, and week 12. The patient reported subjective worsening as reflected in quantitative strength exam. The MRI STIR signal was slightly increased from 0.02 to 0.03 of total muscle; while the T1 fat fraction was stable. Functional outcome measures also were stable. Conclusions Immunosuppressive therapy in refractive autoimmune myopathy in other contexts has been shown to reverse STIR signal hyperintensity, however this treatment did not reverse STIR signal in this patient with FSHD. In fact, STIR signal slightly increased throughout the treatment period. This is the first study of using MRI STIR and T1 fat fraction to follow treatment effect in FSHD. We find that STIR might not be a dynamic marker for suppressing inflammation in FSHD.
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Affiliation(s)
- Leo H Wang
- Department of Neurology, University of Washington, Seattle, Washington, USA. .,University of Washington Medical Center, Box 356465, 1959 NE Pacific Street, Seattle, WA, USA.
| | - Laura M Johnstone
- Department of Rehabilitative Medicine, University of Washington, Seattle, Washington, USA
| | - Michael Bindschadler
- Radiology Clinical Research Imaging Core/Neurology, Seattle Children's Hospital, Seattle, Washington, USA
| | - Stephen J Tapscott
- Human Biology Division, Fred Hutchinson Research Center, Seattle, Washington, USA
| | - Seth D Friedman
- Radiology Clinical Research Imaging Core/Improvement and Innovation, Seattle Children's Hospital, Seattle, Washington, USA
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17
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Gonzalez A, Iles TL, Iaizzo PA, Bandschapp O. Impact of statin intake on malignant hyperthermia: an in vitro and in vivo swine study. BMC Anesthesiol 2020; 20:270. [PMID: 33096987 PMCID: PMC7585199 DOI: 10.1186/s12871-020-01186-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2020] [Accepted: 10/13/2020] [Indexed: 01/24/2023] Open
Abstract
Background Statin intake is associated with muscular side effects, among which the unmasking of latent myopathies and of malignant hyperthermia (MH) susceptibility have been reported. These findings, together with experimental data in small animals, prompt speculation that statin therapy may compromise the performance of skeletal muscle during diagnostic in vitro contracture tests (IVCT). In addition, statins might reduce triggering thresholds in susceptible individuals (MHS), or exacerbate MH progression. We sought to obtain empirical data to address these questions. Methods We compared the responses of 3 different muscles from untreated or simvastatin treated MHS and non-susceptible (MHN) pigs. MHS animals were also invasively monitored for signs of impending MH during sevoflurane anesthesia. Results Muscles from statin treated MHS pigs responded with enhanced in vitro contractures to halothane, while responses to caffeine were unaltered by the treatment. Neither agent elicited contractures in muscles from statin treated MHN pigs. In vivo, end- tide pCO2, hemodynamic evolution, plasma pH, potassium and lactate concentrations consistently pointed to mild acceleration of MH development in statin-treated pigs, whereas masseter spasm and rigor faded compared to untreated MHS animals. Conclusions The diagnostic sensitivity and specificity of the IVCT remains unchanged by a short-term simvastatin treatment in MHS swine. Evidence of modest enhancement in cardiovascular and metabolic signs of MH, as well as masked pathognomonic muscle rigor observed under simvastatin therapy suggest a potentially misleading influence on the clinical presentation of MH. The findings deserve further study to include other statins and therapeutic regimes.
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Affiliation(s)
- Asensio Gonzalez
- Department for Anesthesia, Interdisciplinary Intermediate Care, Prehospital Emergency Medicine and Pain Therapy, University Hospital Basel, Spitalstrasse 21, CH-4031, Basel, Switzerland
| | - Tinen L Iles
- Department of Surgery and Integrative Biology and Physiology, Institute for Engineering in Medicine, University of Minnesota, Minneapolis, USA
| | - Paul A Iaizzo
- Department of Surgery and Integrative Biology and Physiology, Institute for Engineering in Medicine, University of Minnesota, Minneapolis, USA
| | - Oliver Bandschapp
- Department for Anesthesia, Interdisciplinary Intermediate Care, Prehospital Emergency Medicine and Pain Therapy, University Hospital Basel, Spitalstrasse 21, CH-4031, Basel, Switzerland.
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18
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Biere J, Okkersen K, van Alfen N, Kessels RPC, Gouw AA, van Dorst M, van Engelen B, Stam CJ, Raaphorst J. Characterization of EEG-based functional brain networks in myotonic dystrophy type 1. Clin Neurophysiol 2020; 131:1886-1895. [PMID: 32590320 DOI: 10.1016/j.clinph.2020.05.014] [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: 05/28/2019] [Revised: 05/20/2020] [Accepted: 05/22/2020] [Indexed: 11/19/2022]
Abstract
OBJECTIVE In the autosomal dominant, multisystem, chronic progressive disease myotonic dystrophy type 1 (DM1), cognitive deficits may originate from disrupted functional brain networks. We aimed to use network analysis of resting-state electro-encephalography (EEG) recordings of patients with DM1 and matched unaffected controls to investigate changes in network organization in large-scale functional brain networks and correlations with cognitive deficits. METHODS In this cross-sectional study, 28 adult patients with genetically confirmed DM1 and 26 age-, sex- and education-matched unaffected controls underwent resting-state EEG and neuropsychological assessment. We calculated the Phase Lag Index (PLI) to determine EEG frequency-dependent functional connectivity between brain regions. Functional brain networks were characterized by applying concepts from graph theory and compared between-groups. Network topology was evaluated using the minimum spanning tree (MST). We evaluated correlations between network metrics and neuropsychological tests that showed statistically significant between-group differences. RESULTS Functional connectivity estimated as whole-brain median PLI for DM1 patients versus healthy controls was higher in theta band (0.141 [0.050] versus 0.125 [0.018], p = 0.029), and lower in the upper alpha band (0.154 [0.048] versus 0.182 [0.073], p = 0.038), respectively. Functional MST-constructed networks in DM1 patients were significantly dissimilar from healthy controls in the delta, (p = 0.009); theta, (p = 0.009); lower alpha, (p = 0.036); and upper alpha, (p = 0.008) bands. In evaluation of local MST network measures, trends toward networks with higher global integration in the theta band and lower global integration in the upper alpha band were observed. Compared to unaffected controls, DM1 patients performed worse on tests of attention, motor function, executive function and visuospatial memory. Visuospatial memory correlated with the global median PLI in the upper alpha band; the Stroop interference test correlated with betweenness centrality in this band. CONCLUSION This study supports the hypothesis that brain changes in DM1 give rise to disrupted functional network organization, as modelled with EEG-based networks. Further study may help unravel the relations with clinical brain-related DM1 symptoms. SIGNIFICANCE EEG network analysis has potential to help understand brain related DM1 phenotypes. FUNDING This work was supported by the European Community's Seventh Framework Programme (FP7/2007-2013) under grant agreement n° 305697 (OPTIMISTIC) and the Marigold Foundation.
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Affiliation(s)
- Joost Biere
- Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, the Netherlands.
| | - Kees Okkersen
- Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, the Netherlands.
| | - Nens van Alfen
- Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, the Netherlands.
| | - Roy P C Kessels
- Department of Neuropsychology and Rehabilitation Psychology, Radboud University Medical Center, Nijmegen, the Netherlands; Center for Cognition, Donders Institute for Brain, Cognition and Behaviour, Radboud University, Kapittelweg 29, 6525 EN Nijmegen, the Netherlands; Vincent van Gogh Institute for Psychiatry, Venray, the Netherlands.
| | - Alida A Gouw
- Department of Neurology and Clinical Neurophysiology, Amsterdam University Medical Center, Amsterdam, the Netherlands.
| | - Maud van Dorst
- Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, the Netherlands; Vincent van Gogh Institute for Psychiatry, Venray, the Netherlands.
| | - Baziel van Engelen
- Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, the Netherlands.
| | - Cornelis J Stam
- Department of Neurology and Clinical Neurophysiology, Amsterdam University Medical Center, Amsterdam, the Netherlands.
| | - Joost Raaphorst
- Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, the Netherlands; Department of Neurology, Academic University Medical Center, Amsterdam, the Netherlands.
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19
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Scaber J, Molyneux AJ, Buckley C, Webb AJS. Two case reports of distal upper limb weakness following influenza-like illness: an emerging pattern of para-infectious myositis in adults. BMC Neurol 2020; 20:237. [PMID: 32522188 PMCID: PMC7285489 DOI: 10.1186/s12883-020-01821-1] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2020] [Accepted: 06/04/2020] [Indexed: 11/10/2022] Open
Abstract
Background Myositis is a recognised complication of numerous systemic viral infections including influenza. In adults the typical pattern is characterised by myalgia and marked proximal muscle weakness in upper and lower limbs and resolves slowly over weeks rather than days. Case presentation Here, we describe two male patients with myositis with an unusual distribution of weakness in the distal upper limbs, which both followed a flu-like illness and resolved spontaneously. Both patients had moderate elevations in creatine kinase, extensive negative serological investigations, normal nerve conduction studies and myopathic changes on electromyography. Conclusions In the para-infectious context, myositis is an important differential of acute distal upper limb weakness. This unusual pattern of acute muscle weakness should be recognised to avoid unnecessary in treatments. Similar cases in the recent literature in male patients between the ages of 25 to 55 are reviewed and suggest an emerging pattern of para-infectious myositis.
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Affiliation(s)
- Jakub Scaber
- Nuffield Department of Clinical Neurosciences, University of Oxford, West Wing Level 6, John Radcliffe Hospital, Headley Way, Oxford, OX3 9DU, UK
| | - Adam J Molyneux
- Department of Clinical Neurophysiology, Oxford University Hospitals, Foundation Trust, Oxford, UK
| | - Camilla Buckley
- Nuffield Department of Clinical Neurosciences, University of Oxford, West Wing Level 6, John Radcliffe Hospital, Headley Way, Oxford, OX3 9DU, UK
| | - Alastair J S Webb
- Nuffield Department of Clinical Neurosciences, University of Oxford, West Wing Level 6, John Radcliffe Hospital, Headley Way, Oxford, OX3 9DU, UK.
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Abstract
Sarcopenia – the accelerated age-related loss of muscle mass and function – is an under-diagnosed condition, and is central to deteriorating mobility, disability and frailty in older age. There is a lack of treatment options for older adults at risk of sarcopenia. Although sarcopenia's pathogenesis is multifactorial, its major phenotypes – muscle mass and muscle strength – are highly heritable. Several genome-wide association studies of muscle-related traits were published recently, providing dozens of candidate genes, many with unknown function. Therefore, animal models are required not only to identify causal mechanisms, but also to clarify the underlying biology and translate this knowledge into new interventions. Over the past several decades, small teleost fishes had emerged as powerful systems for modeling the genetics of human diseases. Owing to their amenability to rapid genetic intervention and the large number of conserved genetic and physiological features, small teleosts – such as zebrafish, medaka and killifish – have become indispensable for skeletal muscle genomic studies. The goal of this Review is to summarize evidence supporting the utility of small fish models for accelerating our understanding of human skeletal muscle in health and disease. We do this by providing a basic foundation of the (zebra)fish skeletal muscle morphology and physiology, and evidence of muscle-related gene homology. We also outline challenges in interpreting zebrafish mutant phenotypes and in translating them to human disease. Finally, we conclude with recommendations on future directions to leverage the large body of tools developed in small fish for the needs of genomic exploration in sarcopenia. Summary: Zebrafish and other small fish have become powerful disease models. Here, we summarize the evidence for the utility of small teleost models for genetic research in sarcopenia – the age-related loss of muscle mass and function.
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Affiliation(s)
- Alon Daya
- The Faculty of Marine Sciences, Ruppin Academic Center, Michmoret 40297, Israel
| | - Rajashekar Donaka
- The Musculoskeletal Genetics Laboratory, The Azrieli Faculty of Medicine, Bar-Ilan University, Safed 130010, Israel
| | - David Karasik
- The Musculoskeletal Genetics Laboratory, The Azrieli Faculty of Medicine, Bar-Ilan University, Safed 130010, Israel .,Hebrew SeniorLife, Hinda and Arthur Marcus Institute for Aging Research, Boston, MA 02131, USA
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21
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Arbeeva L, Yau M, Mitchell BD, Jackson RD, Ryan K, Golightly YM, Hannan MT, Nelson A, Jordan JM, Hochberg MC. Genome-wide meta-analysis identified novel variant associated with hallux valgus in Caucasians. J Foot Ankle Res 2020; 13:11. [PMID: 32131869 PMCID: PMC7057609 DOI: 10.1186/s13047-020-0379-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2019] [Accepted: 02/20/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Hallux valgus, one of the most common structural foot deformities, is highly heritable. However, previous efforts to elucidate the genetic underpinnings of hallux valgus through a genome-wide association study (GWAS) conducted in 4409 Caucasians did not identify genome-wide significant associations with hallux valgus in both gender-specific and sex-combined GWAS meta-analyses. In this analysis, we add newly available data and more densely imputed genotypes to identify novel genetic variants associated with hallux valgus. METHODS A total of 5925 individuals of European Ancestry were categorized into two groups: 'hallux valgus present' (n = 2314) or 'no deformity' (n = 3611) as determined by trained examiners or using the Manchester grading scale. Genotyping was performed using commercially available arrays followed by imputation to the Haplotype Reference Consortium (HRC) reference panel version 1.1. We conducted both sex-specific and sex-combined association analyses using logistic regression and generalized estimating equations as appropriate in each cohort. Results were then combined in a fixed-effects inverse-variance meta-analyses. Functional Mapping and Annotation web-based platform (FUMA) was used for positional mapping, gene and gene-set analyses. RESULTS We identified a novel locus in the intronic region of CLCA2 on chromosome 1, rs55807512 (OR = 0.48, p = 2.96E-09), an expression quantitative trait locus for COL24A1, a member of the collagen gene family. CONCLUSION In this report of the largest GWAS of hallux valgus to date, we identified a novel genome-wide significant locus for hallux valgus. Additional replication and functional follow-up will be needed to determine the functional role of this locus in hallux valgus biology.
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Affiliation(s)
- Liubov Arbeeva
- Thurston Arthritis Research Center, University of North Carolina, Thurston Arthritis Research Center, 3300 Thurston Building, Campus Box #7280, Chapel Hill, NC, 27599-7280, USA.
| | - Michelle Yau
- Hebrew SeniorLife Marcus Institute for Aging Research and Harvard Medical School, Boston, MA, USA
| | - Braxton D Mitchell
- University of Maryland School of Medicine, Baltimore, MD, USA
- Geriatrics Research and Education Clinical Center, Baltimore Veterans Administration Medical Center, Baltimore, MD, USA
| | - Rebecca D Jackson
- Department of Internal Medicine, Division of Endocrinology, Diabetes and Metabolism, The Ohio State University, Columbus, OH, USA
| | - Kathleen Ryan
- University of Maryland School of Medicine, Baltimore, MD, USA
| | - Yvonne M Golightly
- Thurston Arthritis Research Center, University of North Carolina, Thurston Arthritis Research Center, 3300 Thurston Building, Campus Box #7280, Chapel Hill, NC, 27599-7280, USA
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
- Injury Prevention Research Center, University of North Carolina, Chapel Hill, North Carolina, USA
- Division of Physical Therapy, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Marian T Hannan
- Hebrew SeniorLife Marcus Institute for Aging Research and Harvard Medical School, Boston, MA, USA
| | - Amanda Nelson
- Thurston Arthritis Research Center, University of North Carolina, Thurston Arthritis Research Center, 3300 Thurston Building, Campus Box #7280, Chapel Hill, NC, 27599-7280, USA
- Department of Medicine, University of North Carolina, Chapel Hill, NC, USA
| | - Joanne M Jordan
- Thurston Arthritis Research Center, University of North Carolina, Thurston Arthritis Research Center, 3300 Thurston Building, Campus Box #7280, Chapel Hill, NC, 27599-7280, USA
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
- Department of Medicine, University of North Carolina, Chapel Hill, NC, USA
- Department of Orthopedics, University of North Carolina, Chapel Hill, NC, USA
| | - Marc C Hochberg
- University of Maryland School of Medicine, Baltimore, MD, USA
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22
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Husebye SA, Rebne CB, Stokland AE, Sanaker PS, Bindoff LA. A hospital based epidemiological study of genetically determined muscle disease in south western Norway. Neuromuscul Disord 2020; 30:181-185. [PMID: 32146000 DOI: 10.1016/j.nmd.2020.01.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2019] [Revised: 01/22/2020] [Accepted: 01/29/2020] [Indexed: 12/17/2022]
Abstract
We determined the prevalence of genetically determined neuromuscular diseases in adult Norwegian patients from Hordaland County. We identified patients using International Classification of Disease codes registered in our hospital database and reviewed patient notes to ensure diagnostic accuracy. To ensure maximal ascertainment, we screened both inpatient and outpatient contacts from two 5-year periods 01.01.2005 to 31.12.2009 and 01.01.2008 to 01.01.2013, and used the second data set to define prevalence. Myotonic dystrophy was the commonest adult muscle disorder with a minimum prevalence of 11.84/100,000 followed by facioscapulohumeral muscular dystrophy at 6.42/100,000. Genetically confirmed limb-girdle muscular dystrophies had a prevalence of 4.2/100,000 with CAPN3 mutations being the commonest followed by mutations in ANO5 and FKRP. Becker muscular dystrophy was rare (0.4/100,000). For the purposes of comparison, we also ascertained adults with spinal muscular atrophy (SMA) and found a prevalence of 4.42/100,000. The impact of neuromuscular disease is enormous both for the patient and for society. Progressive weakness and increasing dependency together with pulmonary and cardiac complications require specialised, multidisciplinary follow up. The provision of such care places substantial demands on health service resources. Thus, precise understanding of both type of neuromuscular disease and numbers of patients is essential in order to manage individuals appropriately and plan future health service needs.
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Affiliation(s)
| | | | | | | | - Laurence A Bindoff
- Department of Clinical Medicine, University of Bergen, Norway; Department of Neurology, Haukeland University Hospital, Bergen, Norway.
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Pinal-Fernandez I, Pak K, Casal-Dominguez M, Hosono Y, Mecoli C, Christopher-Stine L, Mammen AL. Validation of anti-Mi2 autoantibody testing by line blot. Autoimmun Rev 2019; 19:102425. [PMID: 31734399 DOI: 10.1016/j.autrev.2019.102425] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2019] [Accepted: 07/31/2019] [Indexed: 11/26/2022]
Affiliation(s)
- Iago Pinal-Fernandez
- Muscle Disease Unit, Laboratory of Muscle Stem Cells and Gene Regulation, National Institute of Arthritis and Musculoskeletal and Skin Diseases, National Institutes of Health, Bethesda, Maryland, United States of America; Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States of America; Faculty of Health Sciences, Universitat Oberta de Catalunya, Barcelona, Spain.
| | - Katherine Pak
- Muscle Disease Unit, Laboratory of Muscle Stem Cells and Gene Regulation, National Institute of Arthritis and Musculoskeletal and Skin Diseases, National Institutes of Health, Bethesda, Maryland, United States of America
| | - Maria Casal-Dominguez
- Muscle Disease Unit, Laboratory of Muscle Stem Cells and Gene Regulation, National Institute of Arthritis and Musculoskeletal and Skin Diseases, National Institutes of Health, Bethesda, Maryland, United States of America; Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States of America
| | - Yuji Hosono
- Muscle Disease Unit, Laboratory of Muscle Stem Cells and Gene Regulation, National Institute of Arthritis and Musculoskeletal and Skin Diseases, National Institutes of Health, Bethesda, Maryland, United States of America
| | - Christopher Mecoli
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States of America
| | - Lisa Christopher-Stine
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States of America; Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States of America
| | - Andrew L Mammen
- Muscle Disease Unit, Laboratory of Muscle Stem Cells and Gene Regulation, National Institute of Arthritis and Musculoskeletal and Skin Diseases, National Institutes of Health, Bethesda, Maryland, United States of America; Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States of America; Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States of America.
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24
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Abstract
We describe the case of a 76-year-old man who presented with bilateral lower limb weakness associated with decreased urine output. His initial blood results showed acute kidney injury (AKI) stage 3 with substantially raised serum creatine kinase concentration of 37 950 IU/L (normal range <171 U/L). He had been on high-dose rosuvastatin for 4 years with a recent brand change occurring 1 week prior to onset of symptoms. There was no history of pre-existing neuromuscular disease. Statin-related rhabdomyolysis was suspected and rosuvastatin was withheld. His muscle strength gradually improved. He required haemodialysis for 10 weeks. He was discharged home after a complicated course of hospitalisation. His renal function improved and he became dialysis-independent; however, he was left with residual chronic kidney disease.
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Affiliation(s)
- Kosar Hussain
- General Medicine, Goulburn Valley Health, Shepparton, Victoria, Australia
| | - Anil Xavier
- Nephrology and General Medicine, Goulburn Valley Health, Shepparton, Victoria, Australia
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Brisset M, Béhin A, Pottier C, Jardel C, Sharshar T, Mochel F, Mallard F, Slama A, Lombès A, Eymard B, Laforêt P. Life-threatening lactic acidosis occurring in adults with mitochondrial disorders. Rev Neurol (Paris) 2019; 175:564-7. [PMID: 31053354 DOI: 10.1016/j.neurol.2018.12.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2018] [Revised: 12/02/2018] [Accepted: 12/07/2018] [Indexed: 11/20/2022]
Abstract
Although relatively common in children, severe acute lactic acidosis is rare in adults with mitochondrial myopathies. We report here three cases, aged 27, 32 and 32 years, who developed life-threatening metabolic crisis with severe lactic acidosis, requiring hospitalisation in intensive care unit. Plasma lactates were elevated 10 to 15 fold normal values, necessitating extra-renal dialysis. By contrast CK levels were moderately increased (3 to 5N). No triggering factor was identified, but retrospectively all patients reported long-lasting mild muscle fatigability and weakness before their acute metabolic crisis. All of them recovered after prolonged intensive care but resting lactate levels remained elevated. Muscle biopsy showed ragged-red and COX-negative fibers in two patients and mild lipidosis in the third one. Heteroplasmic pathogenic point mutations were detected in MT-TL1 (m.3280G>A;m.3258C>T) and MT-TK (m.8363A>G). Life-threatening lactic acidosis may thus be a major inaugural clinical manifestation in adults with mitochondrial myopathies. Prolonged intensive care may lead to a dramatic and sustained improvement and is mandatory in such cases.
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Abstract
The electrodiagnostic tests performed in a patient with suspected muscle disease should provide reliable answers to the addressed questions: (1) differentiate a myopathic disorder from a neuropathic one and (2) precise the nature and cause of the myopathy. Answer to the first question mainly requires needle electromyography (EMG) of 4-6 muscles. Recordings may include extraction and measurements of motor unit potentials (MUPs). Reduced MUP spike duration indicates a lack of active muscle fibers within the motor units, and is the most reliable sign of myopathy. Needle EMG will also guide toward the etiology of the myopathy through the topographical distribution (proximal, distal, etc.) of abnormal EMG tracings and the identification of electrical activity at rest, especially fibrillation and myotonic discharges which guide toward evolutive myopathies and myotonic syndromes, respectively. The study of sensory nerve conduction should involve two to three nerves in order to disclose the coexistence of a sensory neuropathy (particularly in mitochondrial myopathies). If the diagnosis remains uncertain, functional provocative tests should be performed: 3Hz repetitive nerve stimulation to search for a myasthenic syndrome, repeated short exercise (combined with cooling if necessary) in the case of myotonic syndrome; long exercise test if periodic paralysis is suspected.
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Affiliation(s)
- Emmanuel Fournier
- Department of Physiology, Pitié-Salpêtrière Faculty of Medicine, Sorbonne University, Paris, France.
| | - Nacira Tabti
- Department of Physiology, Pitié-Salpêtrière Faculty of Medicine, Sorbonne University, Paris, France
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27
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Yiş U, Becker K, Yılmaz Ş, Çırak S. Acanthocytosis and HyperCKemia. Turk J Haematol 2018; 35:296-297. [PMID: 28515033 PMCID: PMC6256827 DOI: 10.4274/tjh.2017.0142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Affiliation(s)
- Uluç Yiş
- Dokuz Eylül University Faculty of Medicine, Department of Pediatrics, Division of Pediatric Neurology, İzmir, Turkey
| | - Kerstin Becker
- University Hospital Cologne, Department of Pediatrics, Cologne, Germany,University of Cologne, Center for Molecular Medicine Cologne, Cologne, Germany
| | - Şebnem Yılmaz
- Dokuz Eylül University Faculty of Medicine, Department of Pediatrics, Division of Pediatric Hematology, İzmir, Turkey
| | - Sebahattin Çırak
- University Hospital Cologne, Department of Pediatrics, Cologne, Germany,University of Cologne, Center for Molecular Medicine Cologne, Cologne, Germany
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Ridley WE, Xiang H, Han J, Ridley LJ. Feather pattern: Muscle disease. J Med Imaging Radiat Oncol 2018; 62 Suppl 1:133-134. [PMID: 30309111 DOI: 10.1111/1754-9485.12_12786] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
| | - Hao Xiang
- Department of Radiology, Concord Repatriation General Hospital, Concord, New South Wales, Australia
| | - Jason Han
- Department of Radiology, Concord Repatriation General Hospital, Concord, New South Wales, Australia
| | - Lloyd J Ridley
- Department of Radiology, Concord Repatriation General Hospital, Concord, New South Wales, Australia.,Discipline of Medical Imaging, University of Sydney, Sydney, New South Wales, Australia
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Scheidegger O, Leupold D, Sauter R, Findling O, Rösler KM, Hundsberger T. 36-Months follow-up assessment after cessation and resuming of enzyme replacement therapy in late onset Pompe disease: data from the Swiss Pompe Registry. J Neurol 2018; 265:2783-8. [PMID: 30232608 DOI: 10.1007/s00415-018-9065-7] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2018] [Revised: 09/14/2018] [Accepted: 09/16/2018] [Indexed: 01/14/2023]
Abstract
INTRODUCTION Although not curative, enzyme replacement therapy (ERT) with recombinant human acid alpha-glucosidase enzyme has shown to be effective in the treatment of late-onset Pompe disease (LOPD). For this potentially life-long treatment, little is known on the clinical effect of cessation and resuming ERT. Due to a Swiss supreme court decision on ERT reimbursement, a temporary stop of ERT occurred in our study population. The aim of this study was to report the 36-months follow-up assessments after resuming ERT. METHODS After resuming ERT, seven patients suffering from genetically and enzymatically confirmed LOPD had periodic, mandatory, prospective assessments of pulmonary function tests, muscle strength summary scores, distances walked in timed walking tests, and patient-reported questionnaires. Data were statistically analyzed for significant differences between time points at ERT cessation, at ERT resuming, and 36 months thereafter. RESULTS After resuming ERT forced vital capacity (p = 0.007) and distance walked in the 6 min walk test (6-MWT, p = 0.011) significantly increased at 36 months. Compared to before ERT cessation, distance walked in 6-MWT at 36 months still remained significantly lower (p = 0.005). Self-reported scores in the fatigue severity scale significantly declined at 36 months after resuming ERT (p = 0.019). No other functional or reported parameter significantly changed at 36 months after resuming ERT. CONCLUSIONS Our data suggests that long-term interruption of ERT in LOPD may lead to deterioration of clinical meaningful parameters and quality of life. In addition, a clinical restoration after ERT cessation is possible for most of the LOPD patients within a 36 months follow-up.
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Pappa E, Papadopoulos C, Grimbert P, Laforêt P, Bassez G. Renal artery fibromuscular dysplasia in Pompe disease: A case report. Mol Genet Metab Rep 2018; 16:64-65. [PMID: 30090700 PMCID: PMC6078050 DOI: 10.1016/j.ymgmr.2018.07.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2018] [Revised: 07/10/2018] [Accepted: 07/10/2018] [Indexed: 12/03/2022] Open
Abstract
Vascular involvement in Late Onset Pompe Disease, glycogen storage disease type II characterized by limb-girdle muscle and diaphragmatic weakness, is well documented. Abnormalities of posterior cerebral circulation have mostly been reported, whereas there are also cases of associated extracerebral arteriopathy. We report the case of a 42-year-old man diagnosed with LOPD a year after renal infarct due to renal artery fibromuscular dysplasia. We propose that the association of LOPD and arteriopathy should always be considered in clinical practice.
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Affiliation(s)
- Evangelia Pappa
- Centre de Référence Neuromusculaire Nord/Est/Ile de France, AP-HP, Institut de Myologie, GH Pitié-Salpêtrière, 47-83 Boulevard de l'Hôpital, 75013 Paris, France
| | - Constantinos Papadopoulos
- Centre de Référence Neuromusculaire Nord/Est/Ile de France, AP-HP, Institut de Myologie, GH Pitié-Salpêtrière, 47-83 Boulevard de l'Hôpital, 75013 Paris, France
| | - Philippe Grimbert
- Service de Néphrologie et Transplantation, Hôpital Henri-Mondor, AP-HP, 51, avenue Maréchal-de-Lattre-de-Tassigny, 94010 Créteil, France
| | - Pascal Laforêt
- Centre de Référence Neuromusculaire Nord/Est/Ile de France, Service de Neurologie, Hôpital Raymond-Poincaré, AP-HP, 104 Boulevard Raymond Poincaré, 92380 Garches, France
| | - Guillaume Bassez
- Centre de Référence Neuromusculaire Nord/Est/Ile de France, AP-HP, Institut de Myologie, GH Pitié-Salpêtrière, 47-83 Boulevard de l'Hôpital, 75013 Paris, France
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31
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Scott D, de Courten B, Ebeling PR. Sarcopenia: a potential cause and consequence of type 2 diabetes in Australia's ageing population? Med J Aust 2018; 207:89. [PMID: 28701132 DOI: 10.5694/mja16.01243] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2016] [Accepted: 11/02/2016] [Indexed: 01/25/2023]
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Saury C, Lardenois A, Schleder C, Leroux I, Lieubeau B, David L, Charrier M, Guével L, Viau S, Delorme B, Rouger K. Human serum and platelet lysate are appropriate xeno-free alternatives for clinical-grade production of human MuStem cell batches. Stem Cell Res Ther 2018; 9:128. [PMID: 29720259 PMCID: PMC5932844 DOI: 10.1186/s13287-018-0852-y] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2017] [Revised: 02/16/2018] [Accepted: 03/20/2018] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Canine MuStem cells have demonstrated regenerative efficacy in a dog model of muscular dystrophy, and the recent characterization of human counterparts (hMuStem) has highlighted the therapeutic potential of this muscle-derived stem cell population. To date, these cells have only been generated in research-grade conditions. However, evaluation of the clinical efficacy of any such therapy will require the production of hMuStem cells in compliance with good manufacturing practices (GMPs). Because the current use of fetal bovine serum (FBS) to isolate and expand hMuStem cells raises several ethical, safety, and supply concerns, we assessed the use of two alternative xeno-free blood derivatives: human serum (HS) and a human platelet lysate (hPL). METHODS hMuStem cells were isolated and expanded in vitro in either HS-supplemented or hPL-supplemented media and the proliferation rate, clonogenicity, myogenic commitment potential, and oligopotency compared with that observed in FBS-supplemented medium. Flow cytometry and high-throughput 3'-digital gene expression RNA sequencing were used to characterize the phenotype and global gene expression pattern of hMuStem cells cultured with HS or hPL. RESULTS HS-supplemented and hPL-supplemented media both supported the isolation and long-term proliferation of hMuStem cells. Compared with FBS-based medium, both supplements enhanced clonogenicity and allowed for a reduction in growth factor supplementation. Neither supplement altered the cell lineage pattern of hMuStem cells. In vitro differentiation assays revealed a decrease in myogenic commitment and in the fusion ability of hMuStem cells when cultured with hPL. In return, this reduction of myogenic potential in hPL-supplemented cultures was rapidly reversed by substitution of hPL with HS or fibrinogen-depleted hPL. Moreover, culture of hMuStem cells in hPL hydrogel and fibrinogen-depleted hPL demonstrated that myogenic differentiation potential is maintained in heparin-free hPL derivatives. CONCLUSIONS Our findings indicate that HS and hPL are efficient and viable alternatives to FBS for the preparation of hMuStem cell batches in compliance with GMPs.
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Affiliation(s)
- Charlotte Saury
- Macopharma, Biotherapy Division, F-59420, Mouvaux, France.,PAnTher, INRA, École Nationale Vétérinaire, Agro-alimentaire et de l'alimentation Nantes-Atlantique (Oniris), Université Bretagne Loire (UBL), F-44307, Nantes, France
| | - Aurélie Lardenois
- PAnTher, INRA, École Nationale Vétérinaire, Agro-alimentaire et de l'alimentation Nantes-Atlantique (Oniris), Université Bretagne Loire (UBL), F-44307, Nantes, France
| | - Cindy Schleder
- PAnTher, INRA, École Nationale Vétérinaire, Agro-alimentaire et de l'alimentation Nantes-Atlantique (Oniris), Université Bretagne Loire (UBL), F-44307, Nantes, France
| | - Isabelle Leroux
- PAnTher, INRA, École Nationale Vétérinaire, Agro-alimentaire et de l'alimentation Nantes-Atlantique (Oniris), Université Bretagne Loire (UBL), F-44307, Nantes, France
| | | | - Laurent David
- Centre de Recherche en Transplantation et Immunologie UMR1064, INSERM, UBL, F-44093, Nantes, France.,Institut de Transplantation Urologie Néphrologie (ITUN), CHU Nantes, F-44093, Nantes, France.,Inserm UMS016, SFR François Bonamy, iPSC Core Facility, Nantes, France.,CNRS UMS 3556, Nantes, France.,Université de Nantes, Nantes, France.,CHU Nantes, Nantes, France
| | - Marine Charrier
- PAnTher, INRA, École Nationale Vétérinaire, Agro-alimentaire et de l'alimentation Nantes-Atlantique (Oniris), Université Bretagne Loire (UBL), F-44307, Nantes, France.,Institut du thorax, INSERM, CNRS, Université de Nantes, Nantes, France.,Université de Nantes, F-44000, Nantes, France
| | - Laëtitia Guével
- PAnTher, INRA, École Nationale Vétérinaire, Agro-alimentaire et de l'alimentation Nantes-Atlantique (Oniris), Université Bretagne Loire (UBL), F-44307, Nantes, France.,Université de Nantes, F-44000, Nantes, France
| | - Sabrina Viau
- Macopharma, Biotherapy Division, F-59420, Mouvaux, France
| | - Bruno Delorme
- Macopharma, Biotherapy Division, F-59420, Mouvaux, France
| | - Karl Rouger
- PAnTher, INRA, École Nationale Vétérinaire, Agro-alimentaire et de l'alimentation Nantes-Atlantique (Oniris), Université Bretagne Loire (UBL), F-44307, Nantes, France. .,INRA, UMR 703, École Nationale Vétérinaire, Agroalimentaire et de l'Alimentation Nantes-Atlantique (Oniris), Route de Gachet, CS. 40706, F-44307, Nantes, France.
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Abstract
Duchenne Muscular Dystrophy (DMD) is an X-linked recessive disorder caused by a deficient or defective synthesis of dystrophin protein. DMD is the most common form of muscular dystrophy with an incidence of about 1 in 5000 live boys. Though primarily resulting in progressive muscle weakness, it affects various other organs as well. Heart, brain and smooth muscles are commonly involved, because of expression of dystrophin in these organs. The management of DMD requires a multidisciplinary liaison, anticipatory management and prevention of the complications. Consensus based international recommendation for management of DMD have been published in the year 2010, recognizing DMD as a multi-systemic and progressive disease. The proper management of a boy with DMD can improve ambulation, independence, quality of life and delay disease - related complications. A lot can be done to comfort affected children and their care givers even in a resource limited setting. This review discusses these options and also the current understanding of the disease.
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Alamo L, Pinto A, Sulbarán G, Mavárez J, Padrón R. Lessons from a tarantula: new insights into myosin interacting-heads motif evolution and its implications on disease. Biophys Rev 2017; 10:1465-1477. [PMID: 28871552 DOI: 10.1007/s12551-017-0292-4] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2017] [Accepted: 07/27/2017] [Indexed: 12/18/2022] Open
Abstract
Tarantula's leg muscle thick filament is the ideal model for the study of the structure and function of skeletal muscle thick filaments. Its analysis has given rise to a series of structural and functional studies, leading, among other things, to the discovery of the myosin interacting-heads motif (IHM). Further electron microscopy (EM) studies have shown the presence of IHM in frozen-hydrated and negatively stained thick filaments of striated, cardiac, and smooth muscle of bilaterians, most showing the IHM parallel to the filament axis. EM studies on negatively stained heavy meromyosin of different species have shown the presence of IHM on sponges, animals that lack muscle, extending the presence of IHM to metazoans. The IHM evolved about 800 MY ago in the ancestor of Metazoa, and independently with functional differences in the lineage leading to the slime mold Dictyostelium discoideum (Mycetozoa). This motif conveys important functional advantages, such as Ca2+ regulation and ATP energy-saving mechanisms. Recent interest has focused on human IHM structure in order to understand the structural basis underlying various conditions and situations of scientific and medical interest: the hypertrophic and dilated cardiomyopathies, overfeeding control, aging and hormone deprival muscle weakness, drug design for schistosomiasis control, and conditioning exercise physiology for the training of power athletes.
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Affiliation(s)
- Lorenzo Alamo
- Centro de Biología Estructural "Humberto Fernández-Morán", Instituto Venezolano de Investigaciones Científicas (IVIC), Apdo. 20632, Caracas, 1020A, Venezuela
| | - Antonio Pinto
- Centro de Biología Estructural "Humberto Fernández-Morán", Instituto Venezolano de Investigaciones Científicas (IVIC), Apdo. 20632, Caracas, 1020A, Venezuela
| | - Guidenn Sulbarán
- Centro de Biología Estructural "Humberto Fernández-Morán", Instituto Venezolano de Investigaciones Científicas (IVIC), Apdo. 20632, Caracas, 1020A, Venezuela.,Institut de Biologie Structurale (IBS), CEA-CNRS Université Grenoble Alpes, Grenoble, France
| | - Jesús Mavárez
- Laboratoire d'Ecologie Alpine, UMR 5553 CNRS-Université Grenoble Alpes, 2233 Rue de la Piscine, 38041, Grenoble, France
| | - Raúl Padrón
- Centro de Biología Estructural "Humberto Fernández-Morán", Instituto Venezolano de Investigaciones Científicas (IVIC), Apdo. 20632, Caracas, 1020A, Venezuela.
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Auranen M, Paetau A, Piirilä P, Pohju A, Salmi T, Lamminen A, Löfberg M, Mosegaard S, Olsen RK, Tyni T. Patient with multiple acyl-CoA dehydrogenation deficiency disease and FLAD1 mutations benefits from riboflavin therapy. Neuromuscul Disord 2017; 27:581-584. [PMID: 28433476 DOI: 10.1016/j.nmd.2017.03.003] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2016] [Revised: 01/30/2017] [Accepted: 03/07/2017] [Indexed: 10/20/2022]
Abstract
Multiple acyl-CoA dehydrogenation deficiency is genetically heterogenous metabolic disease with mutations in genes involved in electron transfer to the mitochondrial respiratory chain. Disease symptoms vary from severe neonatal form to late-onset presentation with metabolic acidosis, lethargy, vomiting, muscle pain and weakness. Riboflavin therapy has been shown to ameliorate diseases symptoms in some of these patients. Recently, mutations in FAD synthase have been described to cause multiple acyl-CoA dehydrogenation deficiency. We describe here the effect of riboflavin supplementation therapy in a previously reported adult patient with multiple acyl-CoA dehydrogenation deficiency having compound heterozygous gene variations in FLAD1 (MIM: 610595) encoding FAD synthase. We present thorough clinical history including laboratory investigations, muscle MRI, muscle biopsy and spiroergometric analyses comprising of a follow-up of 20 years. Our data suggest that patients with adult-onset multiple acyl-CoA dehydrogenation deficiency with FLAD1 gene mutations also benefit from long-term riboflavin therapy.
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Affiliation(s)
- M Auranen
- Research Programs Unit, Molecular Neurology, Biomedicum Helsinki, University of Helsinki, Helsinki, Finland; Clinical Neurosciences, Neurology, University of Helsinki and Helsinki University Hospital, Finland.
| | - A Paetau
- Department of Pathology, HUSLAB, University of Helsinki and Helsinki University Hospital, Finland
| | - P Piirilä
- Unit of Clinical Physiology, HUS Medical Imaging Center, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - A Pohju
- Clinical Nutrition Unit, Helsinki University Hospital, Finland
| | - T Salmi
- Department of Clinical Neurophysiology, Medical Imaging Center, Helsinki University Hospital, Finland
| | - A Lamminen
- Department of Radiology, Medical Imaging Center, Helsinki University Hospital, Finland
| | - M Löfberg
- Clinical Neurosciences, Neurology, University of Helsinki and Helsinki University Hospital, Finland
| | - S Mosegaard
- Research Unit for Molecular Medicine, Department of Clinical Medicine, Health, Aarhus University Hospital and Aarhus University, Denmark
| | - R K Olsen
- Research Unit for Molecular Medicine, Department of Clinical Medicine, Health, Aarhus University Hospital and Aarhus University, Denmark
| | - T Tyni
- Research Programs Unit, Molecular Neurology, Biomedicum Helsinki, University of Helsinki, Helsinki, Finland; Department of Pediatric Neurology, Hospital for Children and Adolescence, Helsinki University Central Hospital, Helsinki, Finland
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Suzuki N, Mori-Yoshimura M, Yamashita S, Nakano S, Murata KY, Inamori Y, Matsui N, Kimura E, Kusaka H, Kondo T, Higuchi I, Kaji R, Tateyama M, Izumi R, Ono H, Kato M, Warita H, Takahashi T, Nishino I, Aoki M. Multicenter questionnaire survey for sporadic inclusion body myositis in Japan. Orphanet J Rare Dis 2016; 11:146. [PMID: 27821140 PMCID: PMC5100251 DOI: 10.1186/s13023-016-0524-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2016] [Accepted: 10/11/2016] [Indexed: 11/20/2022] Open
Abstract
Background Sporadic inclusion body myositis (sIBM) is the most prevalent acquired muscle disease in the elderly. sIBM is an intractable and progressive disease of unknown cause and without effective treatment. The etiology of sIBM is still unknown; however, genetic factors, aging, lifestyles, and environmental factors may be involved. The purpose of this study is to elucidate the cross-sectional profile of patients affected by sIBM in Japan. Methods We surveyed patient data for 146 cases diagnosed at a number of centers across Japan. We also issued a questionnaire for 67 patients and direct caregivers to further elucidate the natural history of the disease. Results The mean age at the onset was 63.4 ± 9.2 years. The mean length of time from the onset to diagnosis was 55.52 ± 49.72 months, suggesting that there is a difficulty in diagnosing this disease with long-term consequences because of late treatment. 73 % described the psychological/mental aspect of the disease. The most popular primary caregiver was the patient’s spouse and 57 % patients mentioned that they were having problems managing the finances. Conclusions Through these surveys, we described the cross-sectional profiles of sIBM in Japan. Many patients described psychological/mental and financial anxiety because of the aged profile of sIBM patients. The profiles of sIBM patients are similar to those in Western countries.
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Affiliation(s)
- Naoki Suzuki
- Department of Neurology, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai, 980-8574, Japan
| | - Madoka Mori-Yoshimura
- Department of Neurology, National Center Hospital, National Center of Neurology and Psychiatry (NCNP), Tokyo, Japan
| | - Satoshi Yamashita
- Department of Neurology, Graduate School of Medical Sciences, Kumamoto University, 1-1-1 Honjo, Chuo-ku, Kumamoto, Japan
| | - Satoshi Nakano
- Department of Neurology, Osaka City General Hospital, 2-13-22 Miyakojima hondoori, Miyakojima-ku, Osaka, Japan
| | - Ken-Ya Murata
- Department of Neurology, Wakayama Medical University, Wakayama, Japan
| | - Yukie Inamori
- Department of Neurology and Geriatrics, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Naoko Matsui
- Department of Clinical Neuroscience, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan
| | - En Kimura
- Department of Neurology, Graduate School of Medical Sciences, Kumamoto University, 1-1-1 Honjo, Chuo-ku, Kumamoto, Japan
| | - Hirofumi Kusaka
- Department of Neurology, Kansai Medical University, 2-5-1, Shin-machi, Hirakata, Osaka, Japan
| | - Tomoyoshi Kondo
- Department of Neurology, Wakayama Medical University, Wakayama, Japan
| | - Itsuro Higuchi
- Department of Neurology and Geriatrics, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Ryuji Kaji
- Department of Clinical Neuroscience, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan
| | - Maki Tateyama
- Department of Neurology, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai, 980-8574, Japan
| | - Rumiko Izumi
- Department of Neurology, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai, 980-8574, Japan
| | - Hiroya Ono
- Department of Neurology, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai, 980-8574, Japan
| | - Masaaki Kato
- Department of Neurology, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai, 980-8574, Japan
| | - Hitoshi Warita
- Department of Neurology, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai, 980-8574, Japan
| | - Toshiaki Takahashi
- Department of Neurology, National Hospital Organization Sendai-Nishitaga National Hospital, Sendai, Japan
| | - Ichizo Nishino
- Department of Neuromuscular Research, National Institute of Neuroscience, Tokyo, Japan.,Department of Genome Medicine Development, Medical Genome Center, National Center of Neurology and Psychiatry (NCNP), Tokyo, Japan
| | - Masashi Aoki
- Department of Neurology, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai, 980-8574, Japan.
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Abstract
The dysfunction in a number of inherited cardiac and skeletal myopathies is primarily due to an altered ability of myofilaments to generate force and motion. Despite this crucial knowledge, there are, currently, no effective therapeutic interventions for these diseases. In this short review, we discuss recent findings giving strong evidence that genetically or pharmacologically modulating one of the myofilament proteins, myosin, could alleviate the muscle pathology. This should constitute a research and clinical priority.
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Affiliation(s)
- Julien Ochala
- Centre of Human and Aerospace Physiological Sciences, King's College London, London, UK
| | - Yin-Biao Sun
- Randall Division of Cell and Molecular Biophysics, British Heart Foundation Centre of Research Excellence, King's College London, London, UK
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Abstract
AIM To evaluate the economic burden of spinal muscular atrophy (SMA). MATERIALS AND METHODS This study used Department of Defense Military Healthcare System (MHS) data from 2003-2012. Healthcare costs were determined for patients with at least one inpatient or three outpatient claims with a diagnosis of SMA before 18 years of age and who had ≥ 6 months of data after first SMA diagnosis or expired within 6 months of initial diagnosis. A comparator cohort was selected using a 3:1 match based on age and gender. RESULTS A total of 239 individuals with SMA diagnosis met the inclusion criteria along with 717 matched comparator patients. More patients with SMA had hospitalizations (69.5%) compared to the comparator cohort (17.2%, p < 0.001). Median total expenditures across all years of data for patients with SMA were $83 652 (25-75th percentile = $29 620-228 754) vs the comparator group of $4329 (25-75(th) percentile = $1229-10 062 (p < 0.001)) over an average (SD) of 6.9 ± 3.6 years. The annualized mean costs of total healthcare expenditures were significantly higher for the SMA cases than the comparison cohort, $47 862 ± 88 607 compared to $1861 ± 6374, respectively (p < 0.001). The sub-group of patients with early diagnosis (n = 45) had 4.3 ± 2.9 years of observation with a median cost of $167 921 ($53 349-678 412). Mean age (SD) at first observed SMA diagnosis was 7.5 ± 6.4 years. Mean (SD) duration of follow-up after initial SMA diagnosis was 4.8 ± 3.3 years, with a median post-diagnosis cost of $60 213 ($18 229-192 559). The major costs for all patients were outpatient visits [median = $53 152 ($23 902-136 150)], followed by inpatient costs [median = $11 258 ($0-51 987)] and total prescription costs [median = $3167 ($943-13 283)]. LIMITATIONS The analysis is limited to the data available and may under-estimate the total cost of SMA. CONCLUSIONS Individuals with SMA have a high degree of morbidity, particularly those diagnosed during infancy. SMA patients have significant medical expenditures and high utilization of healthcare services.
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Affiliation(s)
- Edward P Armstrong
- a Strategic Therapeutics , Oro Valley , AZ , USA
- b College of Pharmacy , University of Arizona , Tucson , AZ , USA
| | - Daniel C Malone
- a Strategic Therapeutics , Oro Valley , AZ , USA
- b College of Pharmacy , University of Arizona , Tucson , AZ , USA
| | | | | | - Rees L Lee
- e Naval Medical Research Unit , Dayton , OH , USA
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Galbo H, Kall L. Circadian variations in clinical symptoms and concentrations of inflammatory cytokines, melatonin, and cortisol in polymyalgia rheumatica before and during prednisolone treatment: a controlled, observational, clinical experimental study. Arthritis Res Ther 2016; 18:174. [PMID: 27455959 PMCID: PMC4960703 DOI: 10.1186/s13075-016-1072-4] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2016] [Accepted: 07/06/2016] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND In contrast to rheumatoid arthritis (RA), no systematic investigation of diurnal variation has been carried out in polymyalgia rheumatica (PMR). The aim of the study was to provide the often-requested documentation of the 24-h time course of clinical symptoms in PMR and relate them to concentrations during the day of melatonin, inflammatory cytokines, and cortisol. Furthermore, the effects of 14 days of prednisolone treatment were studied. METHODS Ten glucocorticoid-naive patients newly diagnosed with PMR and seven non-PMR control subjects were studied for 24 h before treatment and during the 14th day of treatment with 20 mg/day of prednisolone. Global pain and generalized muscle stiffness were monitored by using visual analogue scales, and blood was drawn repeatedly. RESULTS In untreated patients, pain and stiffness peaked in the early morning, showing a plateau between 04:00 and 08:00, and then declined to a nadir at 16:00 (2P < 0.05). Plasma concentrations of interleukin (IL)-6, IL-8, tumor necrosis factor (TNF)-α, IL-1β, and IL-4 varied with time in both groups (2P < 0.05) and peaked between 04:00 and 08:00. Furthermore, except for IL-1β, concentrations of these cytokines and of IL-10 were higher throughout the 24-h observation period in patients than in control subjects (2P < 0.05). Also, melatonin and cortisol were consistently higher in patients (2P < 0.05) and varied with time (2P < 0.05), peaking around 02:00 and 08:00, respectively. In patients, prednisolone abolished symptoms, normalized C-reactive protein, and reduced melatonin, IL-6, IL-8, and TNF-α concentrations (2P < 0.05), while IL-10 increased between 10:00 and 14:00. CONCLUSIONS In PMR, key symptoms show diurnal variation. Furthermore, in PMR, concentrations of melatonin, several pro- and anti-inflammatory cytokines, and cortisol are increased throughout the day and show diurnal variation, as also seen in healthy subjects. The time courses and the inhibitory effects of prednisolone indicate that in PMR, as proposed for RA, melatonin stimulates cytokine production, which in turn accounts at least partly for the symptoms. Furthermore, overall, cortisol may downregulate cytokine production and symptoms. Stimulation of IL-10 secretion may participate in the anti-inflammatory effects of prednisolone. These findings support use of chronotherapy in PMR and encourage study of circadian variations in other inflammatory autoimmune diseases.
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Affiliation(s)
- Henrik Galbo
- Institute for Inflammation Research, Department of Rheumatology, Rigshospitalet, Copenhagen University Hospital, Blegdamsvej 9, Copenhagen, DK-2100, Denmark.
| | - Lisbeth Kall
- Institute for Inflammation Research, Department of Rheumatology, Rigshospitalet, Copenhagen University Hospital, Blegdamsvej 9, Copenhagen, DK-2100, Denmark
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Braczynski AK, Harter PN, Zeiner PS, Drott U, Tews DS, Preusse C, Penski C, Dunst M, Weis J, Stenzel W, Mittelbronn M. C5b-9 deposits on endomysial capillaries in non-dermatomyositis cases. Neuromuscul Disord 2016; 26:283-91. [PMID: 27020463 DOI: 10.1016/j.nmd.2016.02.014] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2015] [Revised: 02/22/2016] [Accepted: 02/26/2016] [Indexed: 11/28/2022]
Abstract
Deposits of the terminal-membrane-attack-complex (MAC) C5b-9 on perfascicular endomysial capillaries are generally regarded as diagnostic hallmark of dermatomyositis (DM). Although the pathophysiology is not clear, C5b-9 deposits on capillaries seem to be associated with microinfarctions and vascular damage. Here, we report on a series of 19 patients presenting with C5b-9 accumulation on endomysial capillaries in the absence of features for DM. To decipher differences in the capillary C5b-9 accumulation pattern between DM and non-DM cases, we assessed the extent of endomysial capillary C5b-9 deposits related to capillary density and extent of myofiber necrosis by immunohistochemistry in 12 DM and 8 control patients. We found similar numbers of C5b-9-positive myofibers in both DM and non-DM C5b-9(+) cases. The distribution pattern differed as DM cases showed significantly more perifascicular capillary C5b-9 deposits as compared to non-DM cases, which presented stronger endomysial capillary C5b-9 deposits in a diffuse pattern. While total capillary density was not differing, DM patients displayed significantly more C5b-9(+) necrotic fibers as compared to non-DM C5b-9(+). In summary, endomysial capillary C5b-9 deposits are present in a variety of non-DM cases, however with differing distribution pattern. In conclusion, capillary C5b-9(+) deposits should be assessed critically, taking into consideration the distribution pattern.
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Affiliation(s)
- Anne K Braczynski
- Edinger Institute, Institute of Neurology, University of Frankfurt am Main, Germany
| | - Patrick N Harter
- Edinger Institute, Institute of Neurology, University of Frankfurt am Main, Germany
| | - Pia S Zeiner
- Edinger Institute, Institute of Neurology, University of Frankfurt am Main, Germany
| | - Ulrich Drott
- Edinger Institute, Institute of Neurology, University of Frankfurt am Main, Germany
| | | | | | - Cornelia Penski
- Edinger Institute, Institute of Neurology, University of Frankfurt am Main, Germany
| | - Maika Dunst
- Edinger Institute, Institute of Neurology, University of Frankfurt am Main, Germany
| | - Joachim Weis
- Institute of Neuropathology, RWTH, Aachen, Germany
| | | | - Michel Mittelbronn
- Edinger Institute, Institute of Neurology, University of Frankfurt am Main, Germany.
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Abstract
Duchenne muscular dystrophy (DMD) and Becker muscular dystrophy are caused by mutations in the dystrophin-encoding DMD gene. Large deletions and duplications are most common, but small mutations have been found as well. Having a correct diagnosis is important for family planning and providing proper care to patients according to published guidelines. With mutation-specific therapies under development for DMD, a correct diagnosis is now also important for assessing whether patients are eligible for treatments. This review discusses different mutations causing DMD, diagnostic techniques available for making a genetic diagnosis for children suspected of DMD and the importance of having a specific genetic diagnosis in the context of emerging genetic therapies for DMD.
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Affiliation(s)
- Annemieke Aartsma-Rus
- Department of Human Genetics, Leiden University Medical Center, Leiden, The Netherlands,John Walton Muscular Dystrophy Research Centre and MRC Centre for Neuromuscular diseases, Institute of Genetic Medicine, Newcastle University, Newcastle, UK
| | - Ieke B Ginjaar
- Laboratory for Diagnostics Genome Analysis, Leiden University Medical Center, Leiden, The Netherlands
| | - Kate Bushby
- John Walton Muscular Dystrophy Research Centre and MRC Centre for Neuromuscular diseases, Institute of Genetic Medicine, Newcastle University, Newcastle, UK
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Calandra P, Cascino I, Lemmers RJLF, Galluzzi G, Teveroni E, Monforte M, Tasca G, Ricci E, Moretti F, van der Maarel SM, Deidda G. Allele-specific DNA hypomethylation characterises FSHD1 and FSHD2. J Med Genet 2016; 53:348-55. [PMID: 26831754 DOI: 10.1136/jmedgenet-2015-103436] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2015] [Accepted: 12/28/2015] [Indexed: 01/07/2023]
Abstract
BACKGROUND Facioscapulohumeral muscular dystrophy (FSHD) is associated with an epigenetic defect on 4qter. Two clinically indistinguishable forms of FSHD are known, FSHD1 and FSHD2. FSHD1 is caused by contraction of the highly polymorphic D4Z4 macrosatellite repeat array on chromosome 4q35. FSHD2 is caused by pathogenic mutations of the SMCHD1 gene.Both genetic defects lead to D4Z4 DNA hypomethylation. In the presence of a polymorphic polyadenylation signal (PAS), DNA hypomethylation leads to inappropriate expression of the D4Z4-encoded DUX4 transcription factor in skeletal muscle. Currently, hypomethylation is not diagnostic per se because of the interference of non-pathogenic arrays and the lack of information about the presence of DUX4-PAS. METHODS We investigated, by bisulfite sequencing, the DNA methylation levels of the region distal to the D4Z4 array selectively in PAS-positive alleles. RESULTS Comparison of FSHD1, FSHD2 and Control subjects showed a highly significant difference of methylation levels in all CpGs tested. Importantly, using a cohort of 112 samples, one of these CpGs (CpG6) is able to discriminate the affected individuals with a sensitivity of 0.95 supporting this assay potential for FSHD diagnosis. Moreover, our study showed a relationship between PAS-specific methylation and severity of the disease. CONCLUSIONS These data point to the CpGs distal to the D4Z4 array as a critical region reflecting multiple factors affecting the epigenetics of FSHD. Additionally, methylation analysis of this region allows the establishment of a rapid and sensitive tool for FSHD diagnosis.
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Affiliation(s)
- Patrizia Calandra
- Institute of Cell Biology and Neurobiology, National Research Council of Italy, Monterotondo (Rome), Italy
| | - Isabella Cascino
- Institute of Cell Biology and Neurobiology, National Research Council of Italy, Monterotondo (Rome), Italy
| | - Richard J L F Lemmers
- Department of Human Genetics, Leiden University Medical Center, Leiden, The Netherlands
| | - Giuliana Galluzzi
- Institute of Cell Biology and Neurobiology, National Research Council of Italy, Monterotondo (Rome), Italy
| | - Emanuela Teveroni
- Institute of Cell Biology and Neurobiology, National Research Council of Italy, Monterotondo (Rome), Italy Institute of Pathology, Catholic University School of Medicine, Rome, Italy
| | - Mauro Monforte
- Institute of Neurology, Catholic University School of Medicine, Rome, Italy
| | | | - Enzo Ricci
- Institute of Neurology, Catholic University School of Medicine, Rome, Italy
| | - Fabiola Moretti
- Institute of Cell Biology and Neurobiology, National Research Council of Italy, Monterotondo (Rome), Italy
| | | | - Giancarlo Deidda
- Institute of Cell Biology and Neurobiology, National Research Council of Italy, Monterotondo (Rome), Italy
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43
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Abstract
Duchenne muscular dystrophy (DMD) and Becker muscular dystrophy are caused by mutations in the dystrophin-encoding DMD gene. Large deletions and duplications are most common, but small mutations have been found as well. Having a correct diagnosis is important for family planning and providing proper care to patients according to published guidelines. With mutation-specific therapies under development for DMD, a correct diagnosis is now also important for assessing whether patients are eligible for treatments. This review discusses different mutations causing DMD, diagnostic techniques available for making a genetic diagnosis for children suspected of DMD and the importance of having a specific genetic diagnosis in the context of emerging genetic therapies for DMD.
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Affiliation(s)
- Annemieke Aartsma-Rus
- Department of Human Genetics, Leiden University Medical Center, Leiden, The Netherlands John Walton Muscular Dystrophy Research Centre and MRC Centre for Neuromuscular diseases, Institute of Genetic Medicine, Newcastle University, Newcastle, UK
| | - Ieke B Ginjaar
- Laboratory for Diagnostics Genome Analysis, Leiden University Medical Center, Leiden, The Netherlands
| | - Kate Bushby
- John Walton Muscular Dystrophy Research Centre and MRC Centre for Neuromuscular diseases, Institute of Genetic Medicine, Newcastle University, Newcastle, UK
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Cordero MD, Alcocer-Gómez E, Marín-Aguilar F, Rybkina T, Cotán D, Pérez-Pulido A, Alvarez-Suarez JM, Battino M, Sánchez-Alcazar JA, Carrión AM, Culic O, Navarro-Pando JM, Bullón P. Mutation in cytochrome b gene of mitochondrial DNA in a family with fibromyalgia is associated with NLRP3-inflammasome activation. J Med Genet 2015; 53:113-22. [PMID: 26566881 DOI: 10.1136/jmedgenet-2015-103392] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2015] [Accepted: 10/08/2015] [Indexed: 01/24/2023]
Abstract
BACKGROUND Fibromyalgia (FM) is a worldwide diffuse musculoskeletal chronic pain condition that affects up to 5% of the general population. Many symptoms associated with mitochondrial diseases are reported in patients with FM such as exercise intolerance, fatigue, myopathy and mitochondrial dysfunction. In this study, we report a mutation in cytochrome b gene of mitochondrial DNA (mtDNA) in a family with FM with inflammasome complex activation. METHODS mtDNA from blood cells of five patients with FM were sequenced. We clinically and genetically characterised a patient with FM and family with a new mutation in mtCYB. Mitochondrial mutation phenotypes were determined in skin fibroblasts and transmitochondrial cybrids. RESULTS After mtDNA sequence in patients with FM, we found a mitochondrial homoplasmic mutation m.15804T>C in the mtCYB gene in a patient and family, which was maternally transmitted. Mutation was observed in several tissues and skin fibroblasts showed a very significant mitochondrial dysfunction and oxidative stress. Increased NLRP3-inflammasome complex activation was observed in blood cells from patient and family. CONCLUSIONS We propose further studies on mtDNA sequence analysis in patients with FM with evidences for maternal inheritance. The presence of similar symptoms in mitochondrial myopathies could unmask mitochondrial diseases among patients with FM. On the other hand, the inflammasome complex activation by mitochondrial dysfunction could be implicated in the pathophysiology of mitochondrial diseases.
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Affiliation(s)
- Mario D Cordero
- IBiS Institute of Biomedicine of Seville, University Hospital Virgen del Rocío-CSIC-University of Seville, Sevilla, Spain Research Laboratory, Oral Medicine Department, University of Sevilla, Sevilla, Spain
| | - Elísabet Alcocer-Gómez
- Centro Andaluz de Biología del Desarrollo (CABD), Universidad Pablo de Olavide-CSIC-Junta de Andalucía, Sevilla, Spain Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), ISCIII, Sevilla, Spain
| | - Fabiola Marín-Aguilar
- IBiS Institute of Biomedicine of Seville, University Hospital Virgen del Rocío-CSIC-University of Seville, Sevilla, Spain
| | - Tatyana Rybkina
- División de Neurociencias, Universidad Pablo de Olavide de Sevilla, Sevilla, Spain
| | - David Cotán
- Centro Andaluz de Biología del Desarrollo (CABD), Universidad Pablo de Olavide-CSIC-Junta de Andalucía, Sevilla, Spain Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), ISCIII, Sevilla, Spain
| | - Antonio Pérez-Pulido
- Centro Andaluz de Biología del Desarrollo (CABD), Universidad Pablo de Olavide-CSIC-Junta de Andalucía, Sevilla, Spain
| | - José Miguel Alvarez-Suarez
- Escuela de Medicina Veterinaria y Zootecnia, Facultad de Ciencias de la Salud, Universidad de Las Américas, Quito, Ecuador
| | - Maurizio Battino
- Dipartimento di Scienze Cliniche Specialistiche ed Odontostomatologiche-Sez. Biochimica, Università Politecnica delle Marche, Ancona, Italy
| | - José Antonio Sánchez-Alcazar
- Centro Andaluz de Biología del Desarrollo (CABD), Universidad Pablo de Olavide-CSIC-Junta de Andalucía, Sevilla, Spain Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), ISCIII, Sevilla, Spain
| | - Angel M Carrión
- División de Neurociencias, Universidad Pablo de Olavide de Sevilla, Sevilla, Spain
| | - Ognjen Culic
- Faculty of Pharmacy and Biochemistry, University of Zagreb, Zagreb, Croatia
| | - José M Navarro-Pando
- Unidad de Reproducción Humana y Cirugía Endoscópica, Instituto para el Estudio de la Biología de la Reproducción Humana (INEBIR), Sevilla, Spain
| | - Pedro Bullón
- IBiS Institute of Biomedicine of Seville, University Hospital Virgen del Rocío-CSIC-University of Seville, Sevilla, Spain Research Laboratory, Oral Medicine Department, University of Sevilla, Sevilla, Spain
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Guan X, Goddard MA, Mack DL, Childers MK. Gene therapy in monogenic congenital myopathies. Methods 2016; 99:91-8. [PMID: 26454198 DOI: 10.1016/j.ymeth.2015.10.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2015] [Revised: 09/10/2015] [Accepted: 10/07/2015] [Indexed: 12/19/2022] Open
Abstract
Current treatment options for patients with monogenetic congenital myopathies (MCM) ameliorate the symptoms of the disorder without resolving the underlying cause. However, gene therapies are being developed where the mutated or deficient gene target is replaced. Preclinical findings in animal models appear promising, as illustrated by gene replacement for X-linked myotubular myopathy (XLMTM) in canine and murine models. Prospective applications and approaches to gene replacement therapy, using these disorders as examples, are discussed in this review.
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Ochala J, Ravenscroft G, McNamara E, Nowak KJ, Iwamoto H. X-ray recordings reveal how a human disease-linked skeletal muscle α-actin mutation leads to contractile dysfunction. J Struct Biol 2015; 192:331-335. [PMID: 26407659 DOI: 10.1016/j.jsb.2015.09.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2015] [Revised: 08/13/2015] [Accepted: 09/22/2015] [Indexed: 10/23/2022]
Abstract
In humans, mutant skeletal muscle α-actin proteins are associated with contractile dysfunction, skeletal muscle weakness and a wide range of primarily skeletal muscle diseases. Despite this knowledge, the exact molecular mechanisms triggering the contractile dysfunction remain unknown. Here, we aimed to unravel these. Hence, we used a transgenic mouse model expressing a well-described D286G mutant skeletal muscle α-actin protein and recapitulating the human condition of contractile deregulation and severe skeletal muscle weakness. We then recorded and analyzed the small-angle X-ray diffraction patterns of isolated membrane-permeabilized myofibers. Results showed that upon addition of Ca(2+), the intensity changes of the second (1/19 nm(-1)) and sixth (1/5.9 nm(-1)) actin layer lines and of the first myosin meridional reflection (1/14.3 nm(-1)) were disrupted when the thin-thick filament overlap was optimal (sarcomere length of 2.5-2.6 μm). However these reflections were normal when the thin and thick filaments were not interacting (sarcomere length>3.6 μm). These findings demonstrate, for the first time, that the replacement of just one amino acid in the skeletal muscle α-actin protein partly prevents actin conformational changes during activation, disrupting the strong binding of myosin molecules. This leads to a limited myosin-related tropomyosin movement over the thin filaments, further affecting the amount of cross-bridges, explaining the contractile dysfunction.
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Affiliation(s)
- Julien Ochala
- Centre of Human and Aerospace Physiological Sciences, School of Biomedical Sciences, King's College London, London, United Kingdom.
| | - Gianina Ravenscroft
- Harry Perkins Institute of Medical Research, The University of Western Australia, Nedlands, Australia
| | - Elyshia McNamara
- Harry Perkins Institute of Medical Research, The University of Western Australia, Nedlands, Australia
| | - Kristen J Nowak
- Harry Perkins Institute of Medical Research, The University of Western Australia, Nedlands, Australia
| | - Hiroyuki Iwamoto
- Japan Synchrotron Radiation Research Institute, SPring8, Hyogo, Japan
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Hernández-Laín A, Guerrero AM, Domínguez-González C, Fernández-Vázquez I, Maya DG, Delmiro A, Arenas J, Morales JR, Blázquez A, Moran M, Martín MA. A novel RRM2B gene variant associated with Telbivudine-induced mitochondrial myopathy. J Neurol Sci 2015; 358:481-3. [PMID: 26359855 DOI: 10.1016/j.jns.2015.08.1550] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2015] [Revised: 08/29/2015] [Accepted: 08/31/2015] [Indexed: 11/26/2022]
Affiliation(s)
- Aurelio Hernández-Laín
- Department of Pathology (Neuropathology), Hospital Universitario 12 de Octubre, Madrid Research Institute, Spain.
| | | | - Cristina Domínguez-González
- Department of Neurology (Neuromuscular Unit), Hospital Universitario 12 de Octubre, Madrid, Spain; Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), U723 Madrid, Spain.
| | | | - David Gata Maya
- Department of Neurology, Hospital Universitario 12 de Octubre, Madrid, Spain.
| | - Aitor Delmiro
- Mitochondrial Diseases Laboratory, Hospital Universitario 12 de Octubre Research Institute, Madrid 28041, Spain; Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), U723 Madrid, Spain.
| | - Joaquín Arenas
- Mitochondrial Diseases Laboratory, Hospital Universitario 12 de Octubre Research Institute, Madrid 28041, Spain; Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), U723 Madrid, Spain.
| | - Juan Ruiz Morales
- Department of Neurology, Hospital Universitario 12 de Octubre, Madrid, Spain.
| | - Alberto Blázquez
- Mitochondrial Diseases Laboratory, Hospital Universitario 12 de Octubre Research Institute, Madrid 28041, Spain; Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), U723 Madrid, Spain.
| | - María Moran
- Mitochondrial Diseases Laboratory, Hospital Universitario 12 de Octubre Research Institute, Madrid 28041, Spain; Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), U723 Madrid, Spain.
| | - Miguel A Martín
- Mitochondrial Diseases Laboratory, Hospital Universitario 12 de Octubre Research Institute, Madrid 28041, Spain; Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), U723 Madrid, Spain.
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Li K, Dortch RD, Kroop SF, Huston JW, Gochberg DF, Park JH, Damon BM. A rapid approach for quantitative magnetization transfer imaging in thigh muscles using the pulsed saturation method. Magn Reson Imaging 2015; 33:709-17. [PMID: 25839394 DOI: 10.1016/j.mri.2015.03.003] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2014] [Revised: 03/08/2015] [Accepted: 03/30/2015] [Indexed: 11/27/2022]
Abstract
Quantitative magnetization transfer (qMT) imaging in skeletal muscle may be confounded by intramuscular adipose components, low signal-to-noise ratios (SNRs), and voluntary and involuntary motion artifacts. Collectively, these issues could create bias and error in parameter fitting. In this study, technical considerations related to these factors were systematically investigated, and solutions were proposed. First, numerical simulations indicate that the presence of an additional fat component significantly underestimates the pool size ratio (F). Therefore, fat-signal suppression (or water-selective excitation) is recommended for qMT imaging of skeletal muscle. Second, to minimize the effect of motion and muscle contraction artifacts in datasets collected with a conventional 14-point sampling scheme, a rapid two-parameter model was adapted from previous studies in the brain and spinal cord. The consecutive pair of sampling points with highest accuracy and precision for estimating F was determined with numerical simulations. Its performance with respect to SNR and incorrect parameter assumptions was systematically evaluated. QMT data fitting was performed in healthy control subjects and polymyositis patients, using both the two- and five-parameter models. The experimental results were consistent with the predictions from the numerical simulations. These data support the use of the two-parameter modeling approach for qMT imaging of skeletal muscle as a means to reduce total imaging time and/or permit additional signal averaging.
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Affiliation(s)
- Ke Li
- Institute of Imaging Science, Vanderbilt University, Nashville, TN 37232, USA; Department of Radiology and Radiological Sciences, Vanderbilt University, Nashville, TN 37232, USA.
| | - Richard D Dortch
- Institute of Imaging Science, Vanderbilt University, Nashville, TN 37232, USA; Department of Radiology and Radiological Sciences, Vanderbilt University, Nashville, TN 37232, USA; Department of Biomedical Engineering, Vanderbilt University, Nashville, TN 37232, USA
| | - Susan F Kroop
- Department of Rheumatology, Vanderbilt University, Nashville, TN 37232, USA
| | - Joseph W Huston
- Department of Rheumatology, Vanderbilt University, Nashville, TN 37232, USA
| | - Daniel F Gochberg
- Institute of Imaging Science, Vanderbilt University, Nashville, TN 37232, USA; Department of Radiology and Radiological Sciences, Vanderbilt University, Nashville, TN 37232, USA; Department of Physics and Astronomy, Vanderbilt University, Nashville, TN 37232, USA
| | - Jane H Park
- Institute of Imaging Science, Vanderbilt University, Nashville, TN 37232, USA; Department of Radiology and Radiological Sciences, Vanderbilt University, Nashville, TN 37232, USA; Department of Molecular Physiology and Biophysics, Vanderbilt University, Nashville, TN 37232, USA
| | - Bruce M Damon
- Institute of Imaging Science, Vanderbilt University, Nashville, TN 37232, USA; Department of Radiology and Radiological Sciences, Vanderbilt University, Nashville, TN 37232, USA; Department of Biomedical Engineering, Vanderbilt University, Nashville, TN 37232, USA; Department of Molecular Physiology and Biophysics, Vanderbilt University, Nashville, TN 37232, USA
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Böhm J, Chevessier F, Koch C, Peche GA, Mora M, Morandi L, Pasanisi B, Moroni I, Tasca G, Fattori F, Ricci E, Pénisson-Besnier I, Nadaj-Pakleza A, Fardeau M, Joshi PR, Deschauer M, Romero NB, Eymard B, Laporte J. Clinical, histological and genetic characterisation of patients with tubular aggregate myopathy caused by mutations in STIM1. J Med Genet 2014; 51:824-33. [PMID: 25326555 DOI: 10.1136/jmedgenet-2014-102623] [Citation(s) in RCA: 60] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
BACKGROUND Tubular aggregate myopathies (TAMs) are muscle disorders characterised by abnormal accumulations of densely packed single-walled or double-walled membrane tubules in muscle fibres. Recently, STIM1, encoding a major calcium sensor of the endoplasmic reticulum, was identified as a TAM gene. METHODS The present study aims to define the clinical, histological and ultrastructural phenotype of tubular aggregate myopathy and to assess the STIM1 mutation spectrum. RESULTS We describe six new TAM families harbouring one known and four novel STIM1 mutations. All identified mutations are heterozygous missense mutations affecting highly conserved amino acids in the calcium-binding EF-hand domains, demonstrating the presence of a mutation hot spot for TAM. We show that the mutations induce constitutive STIM1 clustering, strongly suggesting that calcium sensing and consequently calcium homoeostasis is impaired. Histological and ultrastructural analyses define a common picture with tubular aggregates labelled with Gomori trichrome and Nicotinamide adenine dinucleotide (NADH) tetrazolium reductase, substantiating their endoplasmic reticulum origin. The aggregates were observed in both fibre types and were often accompanied by nuclear internalisation and fibre size variability. The phenotypical spectrum ranged from childhood onset progressive muscle weakness and elevated creatine kinase levels to adult-onset myalgia without muscle weakness and normal CK levels. CONCLUSIONS The present study expands the phenotypical spectrum of STIM1-related tubular aggregate myopathy. STIM1 should therefore be considered for patients with tubular aggregate myopathies involving either muscle weakness or myalgia as the first and predominant clinical sign.
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Affiliation(s)
- Johann Böhm
- Department of Translational Medicine and Neurogenetics, IGBMC (Institut de Génétique et de Biologie Moléculaire et Cellulaire), Illkirch, France Inserm, U964, Illkirch, France CNRS, UMR7104, Illkirch, France University of Strasbourg, Illkirch, France Collège de France, Chaire de Génétique Humaine, Illkirch, France
| | - Frédéric Chevessier
- Department of Neuropathology, University Hospital Erlangen, Erlangen, Germany
| | - Catherine Koch
- Department of Translational Medicine and Neurogenetics, IGBMC (Institut de Génétique et de Biologie Moléculaire et Cellulaire), Illkirch, France Inserm, U964, Illkirch, France CNRS, UMR7104, Illkirch, France University of Strasbourg, Illkirch, France Collège de France, Chaire de Génétique Humaine, Illkirch, France
| | - G Arielle Peche
- Department of Translational Medicine and Neurogenetics, IGBMC (Institut de Génétique et de Biologie Moléculaire et Cellulaire), Illkirch, France Inserm, U964, Illkirch, France CNRS, UMR7104, Illkirch, France University of Strasbourg, Illkirch, France Collège de France, Chaire de Génétique Humaine, Illkirch, France
| | - Marina Mora
- Neuromuscular Diseases and Neuroimmunology Unit, Fondazione IRCCS Istituto Neurologico C. Besta, Milano, Italy Muscle Cell Biology Lab, Fondazione IRCCS Istituto Neurologico C. Besta, Milano, Italy
| | - Lucia Morandi
- Neuromuscular Diseases and Neuroimmunology Unit, Fondazione IRCCS Istituto Neurologico C. Besta, Milano, Italy
| | - Barbara Pasanisi
- Neuromuscular Diseases and Neuroimmunology Unit, Fondazione IRCCS Istituto Neurologico C. Besta, Milano, Italy
| | - Isabella Moroni
- Child Neurology Department, Fondazione IRCCS Istituto Neurologico C. Besta, Milano, Italy
| | - Giorgio Tasca
- Unit for Neuromuscular and Neurodegenerative Disorders, Laboratory of Molecular Medicine, Bambino Gesù Children's Hospital, Rome, Italy
| | - Fabiana Fattori
- Unit for Neuromuscular and Neurodegenerative Disorders, Laboratory of Molecular Medicine, Bambino Gesù Children's Hospital, Rome, Italy
| | - Enzo Ricci
- Institute of Neurology, Catholic University School of Medicine, Rome, Italy
| | - Isabelle Pénisson-Besnier
- Neurology Department, Centre de Référence des Maladies Neuromusculaires, Centre Hospitalier Universitaire d'Angers, Angers, France
| | - Aleksandra Nadaj-Pakleza
- Neurology Department, Centre de Référence des Maladies Neuromusculaires, Centre Hospitalier Universitaire d'Angers, Angers, France
| | - Michel Fardeau
- Centre de Référence de Pathologie Neuromusculaire Paris-Est, Groupe Hospitalier Pitié-Salpêtrière, Paris, France Institut de Myologie, GHU La Pitié-Salpêtrière, Paris, France
| | - Pushpa Raj Joshi
- Department of Neurology, Martin-Luther-University Halle-Wittenberg, Halle (Saale), Germany
| | - Marcus Deschauer
- Department of Neurology, Martin-Luther-University Halle-Wittenberg, Halle (Saale), Germany
| | - Norma Beatriz Romero
- Centre de Référence de Pathologie Neuromusculaire Paris-Est, Groupe Hospitalier Pitié-Salpêtrière, Paris, France Institut de Myologie, GHU La Pitié-Salpêtrière, Paris, France
| | - Bruno Eymard
- Centre de Référence de Pathologie Neuromusculaire Paris-Est, Groupe Hospitalier Pitié-Salpêtrière, Paris, France
| | - Jocelyn Laporte
- Department of Translational Medicine and Neurogenetics, IGBMC (Institut de Génétique et de Biologie Moléculaire et Cellulaire), Illkirch, France Inserm, U964, Illkirch, France CNRS, UMR7104, Illkirch, France University of Strasbourg, Illkirch, France Collège de France, Chaire de Génétique Humaine, Illkirch, France
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von Renesse A, Petkova MV, Lützkendorf S, Heinemeyer J, Gill E, Hübner C, von Moers A, Stenzel W, Schuelke M. POMK mutation in a family with congenital muscular dystrophy with merosin deficiency, hypomyelination, mild hearing deficit and intellectual disability. J Med Genet 2014; 51:275-82. [PMID: 24556084 DOI: 10.1136/jmedgenet-2013-102236] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
BACKGROUND Congenital muscular dystrophies (CMD) with hypoglycosylation of α-dystroglycan are clinically and genetically heterogeneous disorders that are often associated with brain malformations and eye defects. Presently, 16 proteins are known whose dysfunction impedes glycosylation of α-dystroglycan and leads to secondary dystroglycanopathy. OBJECTIVE To identify the cause of CMD with secondary merosin deficiency, hypomyelination and intellectual disability in two siblings from a consanguineous family. METHODS Autozygosity mapping followed by whole exome sequencing and immunochemistry were used to discover and verify a new genetic defect in two siblings with CMD. RESULTS We identified a homozygous missense mutation (c.325C>T, p.Q109*) in protein O-mannosyl kinase (POMK) that encodes a glycosylation-specific kinase (SGK196) required for function of the dystroglycan complex. The protein was absent from skeletal muscle and skin fibroblasts of the patients. In patient muscle, β-dystroglycan was normally expressed at the sarcolemma, while α-dystroglycan failed to do so. Further, we detected co-localisation of POMK with desmin at the costameres in healthy muscle, and a substantial loss of desmin from the patient muscle. CONCLUSIONS Homozygous truncating mutations in POMK lead to CMD with secondary merosin deficiency, hypomyelination and intellectual disability. Loss of desmin suggests that failure of proper α-dystroglycan glycosylation impedes the binding to extracellular matrix proteins and also affects the cytoskeleton.
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Affiliation(s)
- Anja von Renesse
- Department of Neuropediatrics, Charité-Universitätsmedizin Berlin, Berlin, Germany
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