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Chen Y, Huang D, Xie A, Shan Y, Zhao S, Gao C, Chen J, Shi H, Fang W, Peng J. Capn3b-deficient zebrafish model reveals a key role of autoimmune response in LGMDR1. J Genet Genomics 2024:S1673-8527(24)00249-2. [PMID: 39349278 DOI: 10.1016/j.jgg.2024.09.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2024] [Revised: 09/23/2024] [Accepted: 09/24/2024] [Indexed: 10/02/2024]
Abstract
Mutations in calcium-dependent papain-like protease CALPAIN3 (CAPN3) cause Limb-Girdle Muscular Dystrophy Recessive Type 1 (LGMDR1), the most common limb-girdle muscular dystrophy in humans. In addition to progressive muscle weakness, persistent inflammatory infiltration is also a feature of LGMDR1. Despite the underlying mechanism remaining poorly understood, we consider that it may relate to the newly defined role of CAPN3/Capn3b in the nucleolus. Here, we report that the loss-of-function of zebrafish capn3b, the counterpart of human CAPN3, induces autoimmune response akin to that in LGMDR1 patients. Mutant capn3b larvae are more susceptible to Listeria monocytogenes injection, characterized by recruiting more macrophages. Under germ-free conditions, transcriptome analysis of the capn3b mutant muscle reveals a significant upregulation of the chemokine-production-related genes. Coincidently, more neutrophils are recruited to the injury site imposed by either muscle stabbing or tail fin amputation. Nucleolar proteomic analysis and enzymatic assays reveal NKAP, an activating factor of the NF-κB pathway, to be a target of CAPN3. We conclude that the accumulation of Nkap and other factors in the capn3b mutant may be involved in the over-activation of innate immunity. Our studies indicate that the zebrafish capn3b mutant is a powerful model for studying the immunity-related progression of human LGMDR1.
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Affiliation(s)
- Yayue Chen
- MOE Key Laboratory for Molecular Animal Nutrition, College of Animal Sciences, Zhejiang University, Hangzhou, Zhejiang 310058, China
| | - Delai Huang
- MOE Key Laboratory for Molecular Animal Nutrition, College of Animal Sciences, Zhejiang University, Hangzhou, Zhejiang 310058, China
| | - Aixuan Xie
- MOE Key Laboratory for Molecular Animal Nutrition, College of Animal Sciences, Zhejiang University, Hangzhou, Zhejiang 310058, China
| | - Ying Shan
- MOE Key Laboratory for Molecular Animal Nutrition, College of Animal Sciences, Zhejiang University, Hangzhou, Zhejiang 310058, China
| | - Shuyi Zhao
- MOE Key Laboratory for Molecular Animal Nutrition, College of Animal Sciences, Zhejiang University, Hangzhou, Zhejiang 310058, China
| | - Ce Gao
- MOE Key Laboratory for Molecular Animal Nutrition, College of Animal Sciences, Zhejiang University, Hangzhou, Zhejiang 310058, China
| | - Jun Chen
- College of Animal Sciences, Zhejiang University, Hangzhou, Zhejiang 310058, China
| | - Hui Shi
- MOE Key Laboratory for Molecular Animal Nutrition, College of Animal Sciences, Zhejiang University, Hangzhou, Zhejiang 310058, China
| | - Weihuan Fang
- MOE Key Laboratory for Molecular Animal Nutrition, College of Animal Sciences, Zhejiang University, Hangzhou, Zhejiang 310058, China.
| | - Jinrong Peng
- MOE Key Laboratory for Molecular Animal Nutrition, College of Animal Sciences, Zhejiang University, Hangzhou, Zhejiang 310058, China.
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Villani KR, Zhong R, Henley-Beasley CS, Rastelli G, Harris E, Boncompagni S, Barton ER, Wei-LaPierre L. Loss of Calpain 3 dysregulates store-operated calcium entry and its exercise response in mice. FASEB J 2024; 38:e23825. [PMID: 39031532 PMCID: PMC11299996 DOI: 10.1096/fj.202400697r] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2024] [Revised: 06/18/2024] [Accepted: 07/08/2024] [Indexed: 07/22/2024]
Abstract
Limb-Girdle Muscular Dystrophy R1/2A (LGMD R1/2A) is caused by mutations in the CAPN3 gene encoding Calpain 3, a skeletal-muscle specific, Ca2+-dependent protease. Localization of Calpain 3 within the triad suggests it contributes to Ca2+ homeostasis. Through live-cell Ca2+ measurements, muscle mechanics, immunofluorescence, and electron microscopy (EM) in Capn3 deficient (C3KO) and wild-type (WT) mice, we determined whether loss of Calpain 3 altered Store-Operated Calcium Entry (SOCE) activity. Direct Ca2+ influx measurements revealed loss of Capn3 elicits elevated resting SOCE and increased resting cytosolic Ca2+, supported by high incidence of calcium entry units (CEUs) observed by EM. C3KO and WT mice were subjected to a single bout of treadmill running to elicit SOCE. Within 1HR post-treadmill running, C3KO mice exhibited diminished force production in extensor digitorum longus muscles and a greater decay of Ca2+ transients in flexor digitorum brevis muscle fibers during repetitive stimulation. Striking evidence for impaired exercise-induced SOCE activation in C3KO mice included poor colocalization of key SOCE proteins, stromal-interacting molecule 1 (STIM1) and ORAI1, combined with disappearance of CEUs in C3KO muscles. These results demonstrate that Calpain 3 is a key regulator of SOCE in skeletal muscle and identify SOCE dysregulation as a contributing factor to LGMD R1/2A pathology.
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Affiliation(s)
- Katelyn R. Villani
- Department of Applied Physiology and Kinesiology, College of Health and Human Performance, University of Florida, FL, USA
| | - Renjia Zhong
- Department of Applied Physiology and Kinesiology, College of Health and Human Performance, University of Florida, FL, USA
- Department of Emergency Medicine, the First Affiliated Hospital of China Medical University, Shenyang, Liaoning, China
| | - C. Spencer Henley-Beasley
- Department of Applied Physiology and Kinesiology, College of Health and Human Performance, University of Florida, FL, USA
- Myology Institute, University of Florida, FL, USA
| | - Giorgia Rastelli
- Center for Advanced Studies and Technology and Department of Neuroscience, Imaging and Clinical Sciences, University G. d’Annunzio of Chieti–Pescara, Chieti, Italy
| | - Erin Harris
- Department of Applied Physiology and Kinesiology, College of Health and Human Performance, University of Florida, FL, USA
| | - Simona Boncompagni
- Center for Advanced Studies and Technology and Department of Neuroscience, Imaging and Clinical Sciences, University G. d’Annunzio of Chieti–Pescara, Chieti, Italy
| | - Elisabeth R. Barton
- Department of Applied Physiology and Kinesiology, College of Health and Human Performance, University of Florida, FL, USA
- Myology Institute, University of Florida, FL, USA
| | - Lan Wei-LaPierre
- Department of Applied Physiology and Kinesiology, College of Health and Human Performance, University of Florida, FL, USA
- Myology Institute, University of Florida, FL, USA
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Forsting J, Wächter M, Froeling M, Rohm M, Güttsches AK, De Lorenzo A, Südkamp N, Kocabas A, Vorgerd M, Enax-Krumova E, Rehmann R, Schlaffke L. Quantitative muscle magnetic resonance imaging in limb-girdle muscular dystrophy type R1 (LGMDR1): A prospective longitudinal cohort study. NMR IN BIOMEDICINE 2024:e5172. [PMID: 38794994 DOI: 10.1002/nbm.5172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/03/2023] [Revised: 04/16/2024] [Accepted: 04/20/2024] [Indexed: 05/27/2024]
Abstract
Limb-girdle muscular dystrophy (LGMD) type R1 (LGMDR1) is the most common subtype of LGMD in Europe. Prospective longitudinal data, including clinical assessments and new biomarkers such as quantitative magnetic resonance imaging (qMRI), are needed to evaluate the natural course of the disease and therapeutic options. We evaluated eight thigh and seven leg muscles of 13 LGMDR1 patients (seven females, mean age 36.7 years, body mass index 23.9 kg/m2) and 13 healthy age- and gender-matched controls in a prospective longitudinal design over 1 year. Clinical assessment included testing for muscle strength with quick motor function measure (QMFM), gait analysis and patient questionnaires (neuromuscular symptom score, activity limitation [ACTIVLIM]). MRI scans were performed on a 3-T MRI scanner, including a Dixon-based sequence, T2 mapping and diffusion tensor imaging. The qMRI values of fat fraction (FF), water T2 relaxation time (T2), fractional anisotropy, mean diffusivity, axial diffusivity and radial diffusivity were analysed. Within the clinical outcome measures, significant deterioration between baseline and follow-up was found for ACTIVLIM (p = 0.029), QMFM (p = 0.012). Analysis of qMRI parameters of the patient group revealed differences between time points for both FF and T2 when analysing all muscles (FF: p < 0.001; T2: p = 0.016). The highest increase of fat replacement was found in muscles with an FF of between 10% and 50% at baseline. T2 in muscles with low-fat replacement increased significantly. No significant differences were found for the diffusion metrics. Significant correlations between qMRI metrics and clinical assessments were found at baseline and follow-up, while only T2 changes in thigh muscles correlated with changes in ACTIVLIM over time (ρ = -0.621, p < 0.05). Clinical assessments can show deterioration of the general condition of LGMDR1 patients. qMRI measures can give additional information about underlying pathophysiology. Further research is needed to establish qMRI outcome measures for clinical trials.
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Affiliation(s)
- Johannes Forsting
- Department of Neurology, BG-University Hospital Bergmannsheil, Ruhr-University Bochum, Bochum, Germany
| | - Marian Wächter
- Department of Neurology, BG-University Hospital Bergmannsheil, Ruhr-University Bochum, Bochum, Germany
| | - Martijn Froeling
- Department of Radiology, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - Marlena Rohm
- Department of Neurology, BG-University Hospital Bergmannsheil, Ruhr-University Bochum, Bochum, Germany
- Heimer Institute for Muscle Research, BG-University Hospital Bergmannsheil, Bochum, Germany
| | - Anne-Katrin Güttsches
- Department of Neurology, BG-University Hospital Bergmannsheil, Ruhr-University Bochum, Bochum, Germany
- Heimer Institute for Muscle Research, BG-University Hospital Bergmannsheil, Bochum, Germany
| | - Alice De Lorenzo
- Department of Neurology, BG-University Hospital Bergmannsheil, Ruhr-University Bochum, Bochum, Germany
| | - Nicolina Südkamp
- Department of Neurology, BG-University Hospital Bergmannsheil, Ruhr-University Bochum, Bochum, Germany
| | - Abdulhadi Kocabas
- Department of Neurology, BG-University Hospital Bergmannsheil, Ruhr-University Bochum, Bochum, Germany
| | - Matthias Vorgerd
- Department of Neurology, BG-University Hospital Bergmannsheil, Ruhr-University Bochum, Bochum, Germany
- Heimer Institute for Muscle Research, BG-University Hospital Bergmannsheil, Bochum, Germany
| | - Elena Enax-Krumova
- Department of Neurology, BG-University Hospital Bergmannsheil, Ruhr-University Bochum, Bochum, Germany
| | - Robert Rehmann
- Department of Neurology, BG-University Hospital Bergmannsheil, Ruhr-University Bochum, Bochum, Germany
- Department of Neurology, Klinikum Dortmund, University Witten-Herdecke, Dortmund, Germany
| | - Lara Schlaffke
- Department of Neurology, BG-University Hospital Bergmannsheil, Ruhr-University Bochum, Bochum, Germany
- Heimer Institute for Muscle Research, BG-University Hospital Bergmannsheil, Bochum, Germany
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4
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Politano L. Is Cardiac Transplantation Still a Contraindication in Patients with Muscular Dystrophy-Related End-Stage Dilated Cardiomyopathy? A Systematic Review. Int J Mol Sci 2024; 25:5289. [PMID: 38791328 PMCID: PMC11121328 DOI: 10.3390/ijms25105289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2024] [Revised: 05/05/2024] [Accepted: 05/08/2024] [Indexed: 05/26/2024] Open
Abstract
Inherited muscular diseases (MDs) are genetic degenerative disorders typically caused by mutations in a single gene that affect striated muscle and result in progressive weakness and wasting in affected individuals. Cardiac muscle can also be involved with some variability that depends on the genetic basis of the MD (Muscular Dystrophy) phenotype. Heart involvement can manifest with two main clinical pictures: left ventricular systolic dysfunction with evolution towards dilated cardiomyopathy and refractory heart failure, or the presence of conduction system defects and serious life-threatening ventricular arrhythmias. The two pictures can coexist. In these cases, heart transplantation (HTx) is considered the most appropriate option in patients who are not responders to the optimized standard therapeutic protocols. However, cardiac transplant is still considered a relative contraindication in patients with inherited muscle disorders and end-stage cardiomyopathies. High operative risk related to muscle impairment and potential graft involvement secondary to the underlying myopathy have been the two main reasons implicated in the generalized reluctance to consider cardiac transplant as a viable option. We report an overview of cardiac involvement in MDs and its possible association with the underlying molecular defect, as well as a systematic review of HTx outcomes in patients with MD-related end-stage dilated cardiomyopathy, published so far in the literature.
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Affiliation(s)
- Luisa Politano
- Cardiomyology and Medical Genetics, University of Campania Luigi Vanvitelli, 80138 Naples, Italy
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5
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Banerjee S, Radotra BD, Luthra-Guptasarma M, Goyal MK. Identification of novel pathogenic variants of Calpain-3 gene in limb girdle muscular dystrophy R1. Orphanet J Rare Dis 2024; 19:140. [PMID: 38561828 PMCID: PMC10983654 DOI: 10.1186/s13023-024-03158-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Accepted: 03/28/2024] [Indexed: 04/04/2024] Open
Abstract
BACKGROUND Limb Girdle Muscular Dystrophy R1 (LGMDR1) is an autosomal recessive neuromuscular disease caused by mutations in the calpain-3 (CAPN3) gene. As clinical and pathological features may overlap with other types of LGMD, therefore definite molecular diagnosis is required to understand the progression of this debilitating disease. This study aims to identify novel variants of CAPN3 gene in LGMDR1 patients. RESULTS Thirty-four patients with clinical and histopathological features suggestive of LGMD were studied. The muscle biopsy samples were evaluated using Enzyme histochemistry, Immunohistochemistry, followed by Western Blotting and Sanger sequencing. Out of 34 LGMD cases, 13 patients were diagnosed as LGMDR1 by immunoblot analysis, demonstrating reduced or absent calpain-3 protein as compared to controls. Variants of CAPN3 gene were also found and pathogenicity was predicted using in-silico prediction tools. The CAPN3 gene variants found in this study, included, two missense variants [CAPN3: c.1189T > C, CAPN3: c.2338G > C], one insertion-deletion [c.1688delinsTC], one splice site variant [c.2051-1G > T], and one nonsense variant [c.1939G > T; p.Glu647Ter]. CONCLUSIONS We confirmed 6 patients as LGMDR1 (with CAPN3 variants) from our cohort and calpain-3 protein expression was significantly reduced by immunoblot analysis as compared to control. Besides the previously known variants, our study found two novel variants in CAPN3 gene by Sanger sequencing-based approach indicating that genetic variants in LGMDR1 patients may help to understand the etiology of the disease and future prognostication.
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Affiliation(s)
- Sukanya Banerjee
- Department of Histopathology, Post Graduate Institute of Medical Education and Research, 160012, Chandigarh, India
| | - Bishan Dass Radotra
- Department of Histopathology, Post Graduate Institute of Medical Education and Research, 160012, Chandigarh, India.
| | - Manni Luthra-Guptasarma
- Department of Immunopathology, Post Graduate Institute of Medical Education and Research, 160012, Chandigarh, India
| | - Manoj K Goyal
- Department of Neurology, Post Graduate Institute of Medical Education and Research, 160012, Chandigarh, India
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6
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Doody A, Alfano L, Diaz-Manera J, Lowes L, Mozaffar T, Mathews KD, Weihl CC, Wicklund M, Hung M, Statland J, Johnson NE. Defining clinical endpoints in limb girdle muscular dystrophy: a GRASP-LGMD study. BMC Neurol 2024; 24:96. [PMID: 38491364 PMCID: PMC10941356 DOI: 10.1186/s12883-024-03588-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Accepted: 02/26/2024] [Indexed: 03/18/2024] Open
Abstract
BACKGROUND The Limb Girdle Muscular Dystrophies (LGMDs) are characterized by progressive weakness of the shoulder and hip girdle muscles as a result of over 30 different genetic mutations. This study is designed to develop clinical outcome assessments across the group of disorders. METHODS/DESIGN The primary goal of this study is to evaluate the utility of a set of outcome measures on a wide range of LGMD phenotypes and ability levels to determine if it would be possible to use similar outcomes between individuals with different phenotypes. We will perform a multi-center, 12-month study of 188 LGMD patients within the established Genetic Resolution and Assessments Solving Phenotypes in LGMD (GRASP-LGMD) Research Consortium, which is comprised of 11 sites in the United States and 2 sites in Europe. Enrolled patients will be clinically affected and have mutations in CAPN3 (LGMDR1), ANO5 (LGMDR12), DYSF (LGMDR2), DNAJB6 (LGMDD1), SGCA (LGMDR3), SGCB (LGMDR4), SGCD (LGMDR6), or SGCG (LGMDR5, or FKRP-related (LGMDR9). DISCUSSION To the best of our knowledge, this will be the largest consortium organized to prospectively validate clinical outcome assessments (COAs) in LGMD at its completion. These assessments will help clinical trial readiness by identifying reliable, valid, and responsive outcome measures as well as providing data driven clinical trial decision making for future clinical trials on therapeutic agents for LGMD. The results of this study will permit more efficient clinical trial design. All relevant data will be made available for investigators or companies involved in LGMD therapeutic development upon conclusion of this study as applicable. TRIAL REGISTRATION Clinicaltrials.gov NCT03981289; Date of registration: 6/10/2019.
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Affiliation(s)
- Amy Doody
- Virginia Commonwealth University, Richmond, VA, USA
| | | | | | - Linda Lowes
- Nationwide Children's Hospital, Columbus, OH, USA
| | | | | | | | | | - Man Hung
- Roseman University, Salt Lake City, UT, USA
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Azzag K, Gransee HM, Magli A, Yamashita AMS, Tungtur S, Ahlquist A, Zhan WZ, Onyebu C, Greising SM, Mantilla CB, Perlingeiro RCR. Enhanced Diaphragm Muscle Function upon Satellite Cell Transplantation in Dystrophic Mice. Int J Mol Sci 2024; 25:2503. [PMID: 38473751 PMCID: PMC10931593 DOI: 10.3390/ijms25052503] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Revised: 02/11/2024] [Accepted: 02/17/2024] [Indexed: 03/14/2024] Open
Abstract
The diaphragm muscle is essential for breathing, and its dysfunctions can be fatal. Many disorders affect the diaphragm, including muscular dystrophies. Despite the clinical relevance of targeting the diaphragm, there have been few studies evaluating diaphragm function following a given experimental treatment, with most of these involving anti-inflammatory drugs or gene therapy. Cell-based therapeutic approaches have shown success promoting muscle regeneration in several mouse models of muscular dystrophy, but these have focused mainly on limb muscles. Here we show that transplantation of as few as 5000 satellite cells directly into the diaphragm results in consistent and robust myofiber engraftment in dystrophin- and fukutin-related protein-mutant dystrophic mice. Transplanted cells also seed the stem cell reservoir, as shown by the presence of donor-derived satellite cells. Force measurements showed enhanced diaphragm strength in engrafted muscles. These findings demonstrate the feasibility of cell transplantation to target the diseased diaphragm and improve its contractility.
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Affiliation(s)
- Karim Azzag
- Lillehei Heart Institute, Department of Medicine, University of Minnesota, Minneapolis, MN 55455, USA; (K.A.); (A.M.); (A.M.S.Y.); (S.T.); (A.A.); (C.O.)
| | - Heather M. Gransee
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, MN 55905, USA; (H.M.G.); (W.-Z.Z.); (C.B.M.)
| | - Alessandro Magli
- Lillehei Heart Institute, Department of Medicine, University of Minnesota, Minneapolis, MN 55455, USA; (K.A.); (A.M.); (A.M.S.Y.); (S.T.); (A.A.); (C.O.)
| | - Aline M. S. Yamashita
- Lillehei Heart Institute, Department of Medicine, University of Minnesota, Minneapolis, MN 55455, USA; (K.A.); (A.M.); (A.M.S.Y.); (S.T.); (A.A.); (C.O.)
| | - Sudheer Tungtur
- Lillehei Heart Institute, Department of Medicine, University of Minnesota, Minneapolis, MN 55455, USA; (K.A.); (A.M.); (A.M.S.Y.); (S.T.); (A.A.); (C.O.)
| | - Aaron Ahlquist
- Lillehei Heart Institute, Department of Medicine, University of Minnesota, Minneapolis, MN 55455, USA; (K.A.); (A.M.); (A.M.S.Y.); (S.T.); (A.A.); (C.O.)
| | - Wen-Zhi Zhan
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, MN 55905, USA; (H.M.G.); (W.-Z.Z.); (C.B.M.)
| | - Chiemelie Onyebu
- Lillehei Heart Institute, Department of Medicine, University of Minnesota, Minneapolis, MN 55455, USA; (K.A.); (A.M.); (A.M.S.Y.); (S.T.); (A.A.); (C.O.)
| | - Sarah M. Greising
- School of Kinesiology, University of Minnesota, Minneapolis, MN 55455, USA;
| | - Carlos B. Mantilla
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, MN 55905, USA; (H.M.G.); (W.-Z.Z.); (C.B.M.)
- Department of Physiology and Biomedical Engineering, Mayo Clinic, Rochester, MN 55905, USA
| | - Rita C. R. Perlingeiro
- Lillehei Heart Institute, Department of Medicine, University of Minnesota, Minneapolis, MN 55455, USA; (K.A.); (A.M.); (A.M.S.Y.); (S.T.); (A.A.); (C.O.)
- Stem Cell Institute, University of Minnesota, Minneapolis, MN 55455, USA
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8
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Villani KR, Zhong R, Henley-Beasley CS, Rastelli G, Boncompagni S, Barton ER, Wei-LaPierre L. Loss of calpain 3 dysregulates store-operated calcium entry and its exercise response in mice. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2024:2024.01.12.575391. [PMID: 38293127 PMCID: PMC10827051 DOI: 10.1101/2024.01.12.575391] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/01/2024]
Abstract
Limb-Girdle Muscular Dystrophy 2A (LGMD2A) is caused by mutations in the CAPN3 gene encoding Calpain 3, a skeletal-muscle specific, Ca2+-dependent protease. Localization of Calpain 3 within the triad suggests it contributes to Ca2+ homeostasis. Through live-cell Ca2+ measurements, muscle mechanics, immunofluorescence, and electron microscopy (EM) in Capn3 deficient (C3KO) and wildtype (WT) mice, we determined if loss of Calpain 3 altered Store-Operated Calcium Entry (SOCE) activity. Direct Ca2+ influx measurements revealed loss of Capn3 elicits elevated resting SOCE and increased resting cytosolic Ca2+, supported by high incidence of calcium entry units (CEUs) observed by EM. C3KO and WT mice were subjected to a single bout of treadmill running to elicit SOCE. Within 1HR post-treadmill running, C3KO mice exhibited diminished force production in extensor digitorum longus muscles and a greater decay of Ca2+ transients in flexor digitorum brevis muscle fibers during repetitive stimulation. Striking evidence for impaired exercise-induced SOCE activation in C3KO mice included poor colocalization of key SOCE proteins, stromal-interacting molecule 1 (STIM1) and ORAI1, combined with disappearance of CEUs in C3KO muscles. These results demonstrate that Calpain 3 is a key regulator of SOCE in skeletal muscle and identify SOCE dysregulation as a contributing factor to LGMD2A pathology.
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Affiliation(s)
- Katelyn R. Villani
- Department of Applied Physiology and Kinesiology, College of Health and Human Performance, University of Florida, FL, USA
| | - Renjia Zhong
- Department of Applied Physiology and Kinesiology, College of Health and Human Performance, University of Florida, FL, USA
- Department of Emergency Medicine, the First Affiliated Hospital of China Medical University, Shenyang, Liaoning, China
| | - C. Spencer Henley-Beasley
- Department of Applied Physiology and Kinesiology, College of Health and Human Performance, University of Florida, FL, USA
- Myology Institute, University of Florida, FL, USA
| | - Giorgia Rastelli
- Center for Advanced Studies and Technology and Department of Neuroscience, Imaging and Clinical Sciences, University G. d’Annunzio of Chieti–Pescara, Chieti, Italy
| | - Simona Boncompagni
- Center for Advanced Studies and Technology and Department of Neuroscience, Imaging and Clinical Sciences, University G. d’Annunzio of Chieti–Pescara, Chieti, Italy
| | - Elisabeth R. Barton
- Department of Applied Physiology and Kinesiology, College of Health and Human Performance, University of Florida, FL, USA
- Myology Institute, University of Florida, FL, USA
| | - Lan Wei-LaPierre
- Department of Applied Physiology and Kinesiology, College of Health and Human Performance, University of Florida, FL, USA
- Myology Institute, University of Florida, FL, USA
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9
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ŞAHİN İO, KARATAŞ E, DEMİR M, TAN B, PER H, ÖZKUL Y, DÜNDAR M. A retrospective study on the clinical and molecular outcomes of calpainopathy in a Turkish patient cohort. Turk J Med Sci 2023; 54:86-98. [PMID: 38812636 PMCID: PMC11031166 DOI: 10.55730/1300-0144.5769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Revised: 02/15/2024] [Accepted: 12/18/2023] [Indexed: 05/31/2024] Open
Abstract
Background and aim Calpainopathy, also known as limb-girdle muscular dystrophy recessive type 1, is a progressive muscle disorder that impacts the muscles around the hips and shoulders. The disease is caused by defects in the CAPN3 gene and can be inherited in both recessive and dominant forms. In this retrospective study, we aimed to evaluate the clinical and molecular results of our patients with calpainopathy and to examine the CAPN3 variants in Turkish and global populations. Materials and methods Molecular analyses were performed using the next-generation sequencing (NGS) method. CAPN3 variants were identified through the examination of various databases. Results In this retrospective study, the cohort consisted of seven patients exhibiting the CAPN3 (NM_000070.3) mutation and a phenotype compatible with calpainopathy at a single center in Türkiye. All patients displayed high CK levels and muscle weakness. We report a novel missense c.2437G>A variant that causes the autosomal dominant form of calpainopathy. Interestingly, the muscle biopsy report for the patient with the novel mutation indicated sarcoglycan deficiency. Molecular findings for the remaining individuals in the cohort included a compound heterozygous variant (frameshift and missense), one homozygous nonsense, one homozygous intronic deletion, and three homozygous missense variants. The most common variant in the Turkish population was c.550del. In both populations, pathogenic variants were most frequently located in exon 21, according to exon length. Variants were stochastically distributed based on consequences in CAPN3 domains. Conclusion Therefore, the NGS method proves highly effective in diagnosing rare diseases characterized by clinical heterogeneity. Assessing variants based on ethnicity holds significance in the development of precise therapies.
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Affiliation(s)
- İzem Olcay ŞAHİN
- Department of Medical Genetics, Faculty of Medicine, Erciyes University, Kayseri,
Turkiye
| | - Emine KARATAŞ
- Department of Medical Genetics, Faculty of Medicine, Erciyes University, Kayseri,
Turkiye
| | - Mikail DEMİR
- Department of Medical Genetics, Faculty of Medicine, Erciyes University, Kayseri,
Turkiye
| | - Büşra TAN
- Department of Medical Genetics, Faculty of Medicine, Erciyes University, Kayseri,
Turkiye
| | - Hüseyin PER
- Department of Pediatric Neurology, Faculty of Medicine, Children’s Hospital, Erciyes University, Kayseri,
Turkiye
| | - Yusuf ÖZKUL
- Department of Medical Genetics, Faculty of Medicine, Erciyes University, Kayseri,
Turkiye
| | - Munis DÜNDAR
- Department of Medical Genetics, Faculty of Medicine, Erciyes University, Kayseri,
Turkiye
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Nallamilli BRR, Pan Y, Sniderman King L, Jagannathan L, Ramachander V, Lucas A, Markind J, Colzani R, Hegde M. Combined sequence and copy number analysis improves diagnosis of limb girdle and other myopathies. Ann Clin Transl Neurol 2023; 10:2092-2104. [PMID: 37688281 PMCID: PMC10647006 DOI: 10.1002/acn3.51896] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Revised: 07/31/2023] [Accepted: 08/20/2023] [Indexed: 09/10/2023] Open
Abstract
OBJECTIVE Clinical and genetic heterogeneities make diagnosis of limb-girdle muscular dystrophy (LGMD) and other overlapping disorders of muscle weakness complicated and expensive. We aimed to develop a comprehensive next generation sequence-based multi-gene panel ("The Lantern Focused Neuromuscular Panel") to detect both sequence variants and copy number variants in one assay. METHODS Patients with clinical diagnosis of LGMD or other overlapping muscular dystrophies in the United States were tested by PerkinElmer Genomics in 2018-2021 via "The Lantern Project," a sponsored diagnostic testing program. Sixty-six genes related to LGMD subtypes- and other myopathies were investigated. Main outcomes were diagnostic yield, gene-variant spectrum, and LGMD subtypes' prevalence. RESULTS Molecular diagnosis was established in 19.6% (1266) of 6473 cases. Major genes contributing to LGMD were identified including CAPN3 (5.4%, 68), DYSF (4.0%, 51), GAA (3.7%, 47), ANO5 (3.6%, 45), and FKRP (2.7%, 34). Genes of other overlapping MD subtypes identified included PABPN1 (10.5%, 133), VCP (2.2%, 28), MYOT (1.2% 15), LDB3 (1.0%, 13), COL6A1 (1.5%, 19), FLNC (1.1%, 14), and DNAJB6 (0.8%, 10). Different sizes of copy number variants including single exon, multi-exon, and whole genes were identified in 7.5% (95) cases in genes including DMD, EMD, CAPN3, ANO5, SGCG, COL6A2, DOK7, and LAMA2. INTERPRETATION "The Lantern Focused Neuromuscular Panel" enables identification of LGMD subtypes and other myopathies with overlapping clinical features. Prevalence of some MD subtypes was higher than previously reported. Widespread deployment of this comprehensive NGS panel has the potential to ensure early, accurate diagnosis as well as re-define MD epidemiology.
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Tomforde M, Steinbach M, Haack TB, Kuhlenbäumer G. Family and literature analysis demonstrates phenotypic effect of two variants in the calpain-3 gene. Neurogenetics 2023; 24:273-278. [PMID: 37589857 PMCID: PMC10545561 DOI: 10.1007/s10048-023-00728-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Accepted: 08/02/2023] [Indexed: 08/18/2023]
Abstract
Both, recessive (LGMD R1) and dominant (LGMD D4) inheritance occur in calpain 3-related muscular dystrophy. We report a family with calpain-related muscular dystrophy caused by two known variants in the calpain 3 gene (CAPN3, NM_000070.3; (I) c.700G>A, p.Gly234Arg and (II) c.1746-20C>G, p.?). Three family members are compound heterozygous and exhibit a relatively homogeneous phenotype characterized by progressive proximal weakness starting in the third to fourth decade of life in the shoulder girdle and spreading to the legs. Two family members affected only by the p.Gly234Arg heterozygous missense variants show a different phenotype characterized by severe exertional myalgia without overt pareses. We conclude that in our family, the missense variant causes a severe myalgic phenotype without pareses that is aggravated by the second intronic variant and put these findings in the context of previous studies of the same variants.
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Affiliation(s)
- Maike Tomforde
- Department of Neurology, University Medical Center Schleswig-Holstein, Kiel, Germany
| | - Meike Steinbach
- Department of Neurology, University Medical Center Schleswig-Holstein, Kiel, Germany
| | - Tobias B Haack
- Institute of Medical Genetics and Applied Genomics, University of Tübingen, Tübingen, Germany
| | - Gregor Kuhlenbäumer
- Department of Neurology, University Medical Center Schleswig-Holstein, Kiel, Germany.
- Department of Neurology, Kiel University, Arnold-Heller Str. 3, D-24105, Kiel, Germany.
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Muni-Lofra R, Juanola-Mayos E, Schiava M, Moat D, Elseed M, Michel-Sodhi J, Harris E, McCallum M, Moore U, Richardson M, Trainor C, Wong K, Malinova M, Bolano-Diaz C, Keogh MJ, Ghimenton E, Verdu-Diaz J, Mayhew A, Guglieri M, Straub V, James MK, Marini-Bettolo C, Diaz-Manera J. Longitudinal Analysis of Respiratory Function of Different Types of Limb Girdle Muscular Dystrophies Reveals Independent Trajectories. Neurol Genet 2023; 9:e200084. [PMID: 37440793 PMCID: PMC10335843 DOI: 10.1212/nxg.0000000000200084] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Accepted: 05/24/2023] [Indexed: 07/15/2023]
Abstract
Background and Objectives The prevalence and progression of respiratory muscle dysfunction in patients with limb girdle muscular dystrophies (LGMDs) has been only partially described to date. Most reports include cross-sectional data on a limited number of patients making it difficult to gain a wider perspective on respiratory involvement throughout the course of the disease and to compare the most prevalent LGMD subtypes. Methods We reviewed the results of spirometry studies collected longitudinally in our cohort of patients in routine clinical visits from 2002 to 2020 along with additional clinical and genetic data. A linear mixed model was used to investigate the factors associated with the progression of respiratory dysfunction. Results We followed up 156 patients with 5 different forms of LGMDs for a median of 8 years (range 1-25 years). Of them, 53 patients had pathogenic variants in the Capn3 gene, 47 patients in the Dysf gene, 24 patients in the Fkrp gene, 19 in the Ano5 gene, and 13 in one of the sarcoglycan genes (SCG). At baseline, 58 patients (37.1%) had a forced vital capacity percentage predicted (FVCpp) below 80%, while 14 patients (8.9%) had peak cough flow (PCF) values below 270 L/min. As a subgroup, FKRP was the group with a higher number of patients having FVC <80% and/or PCF <270 L/min at initial assessment (66%). We observed a progressive decline in FVCpp and PCF measurements over time, being age, use of wheelchair, and LGMD subtype independent factors associated with this decline. Fkrp and sarcoglycan patients had a quicker decline in their FVC (Kaplan-Meier curve, F test, p < 0.001 and p = 0.02, respectively). Only 7 of the 58 patients with low FVCpp values reported symptoms of respiratory dysfunction, which are commonly reported by patients with FVCpp below 50%-60%. The number of patients ventilated increased from 2 to 8 during follow-up. Discussion Respiratory dysfunction is a frequent complication of patients with LGMDs that needs to be carefully studied and has direct implications in the care offered in daily clinics. Respiratory dysfunction is associated with disease progression because it is especially seen in patients who are full-time wheelchair users, being more frequent in patients with mutations in the Fkrp and sarcoglycan genes.
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Affiliation(s)
- Robert Muni-Lofra
- From the John Walton Muscular Dystrophy Research Centre (R.M.-L., M.S., D.M., M.E., J.M.-S., E.H., M. McCallum, U.M., M.R., C.T., K.W., M. Malinova, C.B.-D., M.J.K., E.G., J.V.-D., A.M., M.G., V.S., M.K.J., C.M.-B., J.D.-M.), Translational and Clinical Research Institute, Newcastle University, UK; Highly Specialized Service for Rare Neuromuscular Disorders (R.M.-L., M.S., D.M., M.E., J.M.-S., E.H., M. McCallum, U.M., M.R., C.T., K.W., M. Malinova, C.B.-D., M.J.K., E.G., J.V.-D., A.M., M.G., V.S., M.K.J., C.M.-B., J.D.-M.), Limb Girdle Muscular Dystrophies, Genetics Department, Integrated Laboratory Medicine, Newcastle Upon Tyne Hospitals NHS Foundation Trust, United Kingdom; and Neuromuscular Diseases Unit, Neurology Department, Hospital Germans Tries I Pujol (E.J.-M.), Badalona, Spain
| | - Eduard Juanola-Mayos
- From the John Walton Muscular Dystrophy Research Centre (R.M.-L., M.S., D.M., M.E., J.M.-S., E.H., M. McCallum, U.M., M.R., C.T., K.W., M. Malinova, C.B.-D., M.J.K., E.G., J.V.-D., A.M., M.G., V.S., M.K.J., C.M.-B., J.D.-M.), Translational and Clinical Research Institute, Newcastle University, UK; Highly Specialized Service for Rare Neuromuscular Disorders (R.M.-L., M.S., D.M., M.E., J.M.-S., E.H., M. McCallum, U.M., M.R., C.T., K.W., M. Malinova, C.B.-D., M.J.K., E.G., J.V.-D., A.M., M.G., V.S., M.K.J., C.M.-B., J.D.-M.), Limb Girdle Muscular Dystrophies, Genetics Department, Integrated Laboratory Medicine, Newcastle Upon Tyne Hospitals NHS Foundation Trust, United Kingdom; and Neuromuscular Diseases Unit, Neurology Department, Hospital Germans Tries I Pujol (E.J.-M.), Badalona, Spain
| | - Marianela Schiava
- From the John Walton Muscular Dystrophy Research Centre (R.M.-L., M.S., D.M., M.E., J.M.-S., E.H., M. McCallum, U.M., M.R., C.T., K.W., M. Malinova, C.B.-D., M.J.K., E.G., J.V.-D., A.M., M.G., V.S., M.K.J., C.M.-B., J.D.-M.), Translational and Clinical Research Institute, Newcastle University, UK; Highly Specialized Service for Rare Neuromuscular Disorders (R.M.-L., M.S., D.M., M.E., J.M.-S., E.H., M. McCallum, U.M., M.R., C.T., K.W., M. Malinova, C.B.-D., M.J.K., E.G., J.V.-D., A.M., M.G., V.S., M.K.J., C.M.-B., J.D.-M.), Limb Girdle Muscular Dystrophies, Genetics Department, Integrated Laboratory Medicine, Newcastle Upon Tyne Hospitals NHS Foundation Trust, United Kingdom; and Neuromuscular Diseases Unit, Neurology Department, Hospital Germans Tries I Pujol (E.J.-M.), Badalona, Spain
| | - Dionne Moat
- From the John Walton Muscular Dystrophy Research Centre (R.M.-L., M.S., D.M., M.E., J.M.-S., E.H., M. McCallum, U.M., M.R., C.T., K.W., M. Malinova, C.B.-D., M.J.K., E.G., J.V.-D., A.M., M.G., V.S., M.K.J., C.M.-B., J.D.-M.), Translational and Clinical Research Institute, Newcastle University, UK; Highly Specialized Service for Rare Neuromuscular Disorders (R.M.-L., M.S., D.M., M.E., J.M.-S., E.H., M. McCallum, U.M., M.R., C.T., K.W., M. Malinova, C.B.-D., M.J.K., E.G., J.V.-D., A.M., M.G., V.S., M.K.J., C.M.-B., J.D.-M.), Limb Girdle Muscular Dystrophies, Genetics Department, Integrated Laboratory Medicine, Newcastle Upon Tyne Hospitals NHS Foundation Trust, United Kingdom; and Neuromuscular Diseases Unit, Neurology Department, Hospital Germans Tries I Pujol (E.J.-M.), Badalona, Spain
| | - Maha Elseed
- From the John Walton Muscular Dystrophy Research Centre (R.M.-L., M.S., D.M., M.E., J.M.-S., E.H., M. McCallum, U.M., M.R., C.T., K.W., M. Malinova, C.B.-D., M.J.K., E.G., J.V.-D., A.M., M.G., V.S., M.K.J., C.M.-B., J.D.-M.), Translational and Clinical Research Institute, Newcastle University, UK; Highly Specialized Service for Rare Neuromuscular Disorders (R.M.-L., M.S., D.M., M.E., J.M.-S., E.H., M. McCallum, U.M., M.R., C.T., K.W., M. Malinova, C.B.-D., M.J.K., E.G., J.V.-D., A.M., M.G., V.S., M.K.J., C.M.-B., J.D.-M.), Limb Girdle Muscular Dystrophies, Genetics Department, Integrated Laboratory Medicine, Newcastle Upon Tyne Hospitals NHS Foundation Trust, United Kingdom; and Neuromuscular Diseases Unit, Neurology Department, Hospital Germans Tries I Pujol (E.J.-M.), Badalona, Spain
| | - Jassi Michel-Sodhi
- From the John Walton Muscular Dystrophy Research Centre (R.M.-L., M.S., D.M., M.E., J.M.-S., E.H., M. McCallum, U.M., M.R., C.T., K.W., M. Malinova, C.B.-D., M.J.K., E.G., J.V.-D., A.M., M.G., V.S., M.K.J., C.M.-B., J.D.-M.), Translational and Clinical Research Institute, Newcastle University, UK; Highly Specialized Service for Rare Neuromuscular Disorders (R.M.-L., M.S., D.M., M.E., J.M.-S., E.H., M. McCallum, U.M., M.R., C.T., K.W., M. Malinova, C.B.-D., M.J.K., E.G., J.V.-D., A.M., M.G., V.S., M.K.J., C.M.-B., J.D.-M.), Limb Girdle Muscular Dystrophies, Genetics Department, Integrated Laboratory Medicine, Newcastle Upon Tyne Hospitals NHS Foundation Trust, United Kingdom; and Neuromuscular Diseases Unit, Neurology Department, Hospital Germans Tries I Pujol (E.J.-M.), Badalona, Spain
| | - Elizabeth Harris
- From the John Walton Muscular Dystrophy Research Centre (R.M.-L., M.S., D.M., M.E., J.M.-S., E.H., M. McCallum, U.M., M.R., C.T., K.W., M. Malinova, C.B.-D., M.J.K., E.G., J.V.-D., A.M., M.G., V.S., M.K.J., C.M.-B., J.D.-M.), Translational and Clinical Research Institute, Newcastle University, UK; Highly Specialized Service for Rare Neuromuscular Disorders (R.M.-L., M.S., D.M., M.E., J.M.-S., E.H., M. McCallum, U.M., M.R., C.T., K.W., M. Malinova, C.B.-D., M.J.K., E.G., J.V.-D., A.M., M.G., V.S., M.K.J., C.M.-B., J.D.-M.), Limb Girdle Muscular Dystrophies, Genetics Department, Integrated Laboratory Medicine, Newcastle Upon Tyne Hospitals NHS Foundation Trust, United Kingdom; and Neuromuscular Diseases Unit, Neurology Department, Hospital Germans Tries I Pujol (E.J.-M.), Badalona, Spain
| | - Michelle McCallum
- From the John Walton Muscular Dystrophy Research Centre (R.M.-L., M.S., D.M., M.E., J.M.-S., E.H., M. McCallum, U.M., M.R., C.T., K.W., M. Malinova, C.B.-D., M.J.K., E.G., J.V.-D., A.M., M.G., V.S., M.K.J., C.M.-B., J.D.-M.), Translational and Clinical Research Institute, Newcastle University, UK; Highly Specialized Service for Rare Neuromuscular Disorders (R.M.-L., M.S., D.M., M.E., J.M.-S., E.H., M. McCallum, U.M., M.R., C.T., K.W., M. Malinova, C.B.-D., M.J.K., E.G., J.V.-D., A.M., M.G., V.S., M.K.J., C.M.-B., J.D.-M.), Limb Girdle Muscular Dystrophies, Genetics Department, Integrated Laboratory Medicine, Newcastle Upon Tyne Hospitals NHS Foundation Trust, United Kingdom; and Neuromuscular Diseases Unit, Neurology Department, Hospital Germans Tries I Pujol (E.J.-M.), Badalona, Spain
| | - Ursula Moore
- From the John Walton Muscular Dystrophy Research Centre (R.M.-L., M.S., D.M., M.E., J.M.-S., E.H., M. McCallum, U.M., M.R., C.T., K.W., M. Malinova, C.B.-D., M.J.K., E.G., J.V.-D., A.M., M.G., V.S., M.K.J., C.M.-B., J.D.-M.), Translational and Clinical Research Institute, Newcastle University, UK; Highly Specialized Service for Rare Neuromuscular Disorders (R.M.-L., M.S., D.M., M.E., J.M.-S., E.H., M. McCallum, U.M., M.R., C.T., K.W., M. Malinova, C.B.-D., M.J.K., E.G., J.V.-D., A.M., M.G., V.S., M.K.J., C.M.-B., J.D.-M.), Limb Girdle Muscular Dystrophies, Genetics Department, Integrated Laboratory Medicine, Newcastle Upon Tyne Hospitals NHS Foundation Trust, United Kingdom; and Neuromuscular Diseases Unit, Neurology Department, Hospital Germans Tries I Pujol (E.J.-M.), Badalona, Spain
| | - Mark Richardson
- From the John Walton Muscular Dystrophy Research Centre (R.M.-L., M.S., D.M., M.E., J.M.-S., E.H., M. McCallum, U.M., M.R., C.T., K.W., M. Malinova, C.B.-D., M.J.K., E.G., J.V.-D., A.M., M.G., V.S., M.K.J., C.M.-B., J.D.-M.), Translational and Clinical Research Institute, Newcastle University, UK; Highly Specialized Service for Rare Neuromuscular Disorders (R.M.-L., M.S., D.M., M.E., J.M.-S., E.H., M. McCallum, U.M., M.R., C.T., K.W., M. Malinova, C.B.-D., M.J.K., E.G., J.V.-D., A.M., M.G., V.S., M.K.J., C.M.-B., J.D.-M.), Limb Girdle Muscular Dystrophies, Genetics Department, Integrated Laboratory Medicine, Newcastle Upon Tyne Hospitals NHS Foundation Trust, United Kingdom; and Neuromuscular Diseases Unit, Neurology Department, Hospital Germans Tries I Pujol (E.J.-M.), Badalona, Spain
| | - Christina Trainor
- From the John Walton Muscular Dystrophy Research Centre (R.M.-L., M.S., D.M., M.E., J.M.-S., E.H., M. McCallum, U.M., M.R., C.T., K.W., M. Malinova, C.B.-D., M.J.K., E.G., J.V.-D., A.M., M.G., V.S., M.K.J., C.M.-B., J.D.-M.), Translational and Clinical Research Institute, Newcastle University, UK; Highly Specialized Service for Rare Neuromuscular Disorders (R.M.-L., M.S., D.M., M.E., J.M.-S., E.H., M. McCallum, U.M., M.R., C.T., K.W., M. Malinova, C.B.-D., M.J.K., E.G., J.V.-D., A.M., M.G., V.S., M.K.J., C.M.-B., J.D.-M.), Limb Girdle Muscular Dystrophies, Genetics Department, Integrated Laboratory Medicine, Newcastle Upon Tyne Hospitals NHS Foundation Trust, United Kingdom; and Neuromuscular Diseases Unit, Neurology Department, Hospital Germans Tries I Pujol (E.J.-M.), Badalona, Spain
| | - Karen Wong
- From the John Walton Muscular Dystrophy Research Centre (R.M.-L., M.S., D.M., M.E., J.M.-S., E.H., M. McCallum, U.M., M.R., C.T., K.W., M. Malinova, C.B.-D., M.J.K., E.G., J.V.-D., A.M., M.G., V.S., M.K.J., C.M.-B., J.D.-M.), Translational and Clinical Research Institute, Newcastle University, UK; Highly Specialized Service for Rare Neuromuscular Disorders (R.M.-L., M.S., D.M., M.E., J.M.-S., E.H., M. McCallum, U.M., M.R., C.T., K.W., M. Malinova, C.B.-D., M.J.K., E.G., J.V.-D., A.M., M.G., V.S., M.K.J., C.M.-B., J.D.-M.), Limb Girdle Muscular Dystrophies, Genetics Department, Integrated Laboratory Medicine, Newcastle Upon Tyne Hospitals NHS Foundation Trust, United Kingdom; and Neuromuscular Diseases Unit, Neurology Department, Hospital Germans Tries I Pujol (E.J.-M.), Badalona, Spain
| | - Monika Malinova
- From the John Walton Muscular Dystrophy Research Centre (R.M.-L., M.S., D.M., M.E., J.M.-S., E.H., M. McCallum, U.M., M.R., C.T., K.W., M. Malinova, C.B.-D., M.J.K., E.G., J.V.-D., A.M., M.G., V.S., M.K.J., C.M.-B., J.D.-M.), Translational and Clinical Research Institute, Newcastle University, UK; Highly Specialized Service for Rare Neuromuscular Disorders (R.M.-L., M.S., D.M., M.E., J.M.-S., E.H., M. McCallum, U.M., M.R., C.T., K.W., M. Malinova, C.B.-D., M.J.K., E.G., J.V.-D., A.M., M.G., V.S., M.K.J., C.M.-B., J.D.-M.), Limb Girdle Muscular Dystrophies, Genetics Department, Integrated Laboratory Medicine, Newcastle Upon Tyne Hospitals NHS Foundation Trust, United Kingdom; and Neuromuscular Diseases Unit, Neurology Department, Hospital Germans Tries I Pujol (E.J.-M.), Badalona, Spain
| | - Carla Bolano-Diaz
- From the John Walton Muscular Dystrophy Research Centre (R.M.-L., M.S., D.M., M.E., J.M.-S., E.H., M. McCallum, U.M., M.R., C.T., K.W., M. Malinova, C.B.-D., M.J.K., E.G., J.V.-D., A.M., M.G., V.S., M.K.J., C.M.-B., J.D.-M.), Translational and Clinical Research Institute, Newcastle University, UK; Highly Specialized Service for Rare Neuromuscular Disorders (R.M.-L., M.S., D.M., M.E., J.M.-S., E.H., M. McCallum, U.M., M.R., C.T., K.W., M. Malinova, C.B.-D., M.J.K., E.G., J.V.-D., A.M., M.G., V.S., M.K.J., C.M.-B., J.D.-M.), Limb Girdle Muscular Dystrophies, Genetics Department, Integrated Laboratory Medicine, Newcastle Upon Tyne Hospitals NHS Foundation Trust, United Kingdom; and Neuromuscular Diseases Unit, Neurology Department, Hospital Germans Tries I Pujol (E.J.-M.), Badalona, Spain
| | - Michael John Keogh
- From the John Walton Muscular Dystrophy Research Centre (R.M.-L., M.S., D.M., M.E., J.M.-S., E.H., M. McCallum, U.M., M.R., C.T., K.W., M. Malinova, C.B.-D., M.J.K., E.G., J.V.-D., A.M., M.G., V.S., M.K.J., C.M.-B., J.D.-M.), Translational and Clinical Research Institute, Newcastle University, UK; Highly Specialized Service for Rare Neuromuscular Disorders (R.M.-L., M.S., D.M., M.E., J.M.-S., E.H., M. McCallum, U.M., M.R., C.T., K.W., M. Malinova, C.B.-D., M.J.K., E.G., J.V.-D., A.M., M.G., V.S., M.K.J., C.M.-B., J.D.-M.), Limb Girdle Muscular Dystrophies, Genetics Department, Integrated Laboratory Medicine, Newcastle Upon Tyne Hospitals NHS Foundation Trust, United Kingdom; and Neuromuscular Diseases Unit, Neurology Department, Hospital Germans Tries I Pujol (E.J.-M.), Badalona, Spain
| | - Elisabetta Ghimenton
- From the John Walton Muscular Dystrophy Research Centre (R.M.-L., M.S., D.M., M.E., J.M.-S., E.H., M. McCallum, U.M., M.R., C.T., K.W., M. Malinova, C.B.-D., M.J.K., E.G., J.V.-D., A.M., M.G., V.S., M.K.J., C.M.-B., J.D.-M.), Translational and Clinical Research Institute, Newcastle University, UK; Highly Specialized Service for Rare Neuromuscular Disorders (R.M.-L., M.S., D.M., M.E., J.M.-S., E.H., M. McCallum, U.M., M.R., C.T., K.W., M. Malinova, C.B.-D., M.J.K., E.G., J.V.-D., A.M., M.G., V.S., M.K.J., C.M.-B., J.D.-M.), Limb Girdle Muscular Dystrophies, Genetics Department, Integrated Laboratory Medicine, Newcastle Upon Tyne Hospitals NHS Foundation Trust, United Kingdom; and Neuromuscular Diseases Unit, Neurology Department, Hospital Germans Tries I Pujol (E.J.-M.), Badalona, Spain
| | - Jose Verdu-Diaz
- From the John Walton Muscular Dystrophy Research Centre (R.M.-L., M.S., D.M., M.E., J.M.-S., E.H., M. McCallum, U.M., M.R., C.T., K.W., M. Malinova, C.B.-D., M.J.K., E.G., J.V.-D., A.M., M.G., V.S., M.K.J., C.M.-B., J.D.-M.), Translational and Clinical Research Institute, Newcastle University, UK; Highly Specialized Service for Rare Neuromuscular Disorders (R.M.-L., M.S., D.M., M.E., J.M.-S., E.H., M. McCallum, U.M., M.R., C.T., K.W., M. Malinova, C.B.-D., M.J.K., E.G., J.V.-D., A.M., M.G., V.S., M.K.J., C.M.-B., J.D.-M.), Limb Girdle Muscular Dystrophies, Genetics Department, Integrated Laboratory Medicine, Newcastle Upon Tyne Hospitals NHS Foundation Trust, United Kingdom; and Neuromuscular Diseases Unit, Neurology Department, Hospital Germans Tries I Pujol (E.J.-M.), Badalona, Spain
| | - Anna Mayhew
- From the John Walton Muscular Dystrophy Research Centre (R.M.-L., M.S., D.M., M.E., J.M.-S., E.H., M. McCallum, U.M., M.R., C.T., K.W., M. Malinova, C.B.-D., M.J.K., E.G., J.V.-D., A.M., M.G., V.S., M.K.J., C.M.-B., J.D.-M.), Translational and Clinical Research Institute, Newcastle University, UK; Highly Specialized Service for Rare Neuromuscular Disorders (R.M.-L., M.S., D.M., M.E., J.M.-S., E.H., M. McCallum, U.M., M.R., C.T., K.W., M. Malinova, C.B.-D., M.J.K., E.G., J.V.-D., A.M., M.G., V.S., M.K.J., C.M.-B., J.D.-M.), Limb Girdle Muscular Dystrophies, Genetics Department, Integrated Laboratory Medicine, Newcastle Upon Tyne Hospitals NHS Foundation Trust, United Kingdom; and Neuromuscular Diseases Unit, Neurology Department, Hospital Germans Tries I Pujol (E.J.-M.), Badalona, Spain
| | - Michela Guglieri
- From the John Walton Muscular Dystrophy Research Centre (R.M.-L., M.S., D.M., M.E., J.M.-S., E.H., M. McCallum, U.M., M.R., C.T., K.W., M. Malinova, C.B.-D., M.J.K., E.G., J.V.-D., A.M., M.G., V.S., M.K.J., C.M.-B., J.D.-M.), Translational and Clinical Research Institute, Newcastle University, UK; Highly Specialized Service for Rare Neuromuscular Disorders (R.M.-L., M.S., D.M., M.E., J.M.-S., E.H., M. McCallum, U.M., M.R., C.T., K.W., M. Malinova, C.B.-D., M.J.K., E.G., J.V.-D., A.M., M.G., V.S., M.K.J., C.M.-B., J.D.-M.), Limb Girdle Muscular Dystrophies, Genetics Department, Integrated Laboratory Medicine, Newcastle Upon Tyne Hospitals NHS Foundation Trust, United Kingdom; and Neuromuscular Diseases Unit, Neurology Department, Hospital Germans Tries I Pujol (E.J.-M.), Badalona, Spain
| | - Volker Straub
- From the John Walton Muscular Dystrophy Research Centre (R.M.-L., M.S., D.M., M.E., J.M.-S., E.H., M. McCallum, U.M., M.R., C.T., K.W., M. Malinova, C.B.-D., M.J.K., E.G., J.V.-D., A.M., M.G., V.S., M.K.J., C.M.-B., J.D.-M.), Translational and Clinical Research Institute, Newcastle University, UK; Highly Specialized Service for Rare Neuromuscular Disorders (R.M.-L., M.S., D.M., M.E., J.M.-S., E.H., M. McCallum, U.M., M.R., C.T., K.W., M. Malinova, C.B.-D., M.J.K., E.G., J.V.-D., A.M., M.G., V.S., M.K.J., C.M.-B., J.D.-M.), Limb Girdle Muscular Dystrophies, Genetics Department, Integrated Laboratory Medicine, Newcastle Upon Tyne Hospitals NHS Foundation Trust, United Kingdom; and Neuromuscular Diseases Unit, Neurology Department, Hospital Germans Tries I Pujol (E.J.-M.), Badalona, Spain
| | - Meredith K James
- From the John Walton Muscular Dystrophy Research Centre (R.M.-L., M.S., D.M., M.E., J.M.-S., E.H., M. McCallum, U.M., M.R., C.T., K.W., M. Malinova, C.B.-D., M.J.K., E.G., J.V.-D., A.M., M.G., V.S., M.K.J., C.M.-B., J.D.-M.), Translational and Clinical Research Institute, Newcastle University, UK; Highly Specialized Service for Rare Neuromuscular Disorders (R.M.-L., M.S., D.M., M.E., J.M.-S., E.H., M. McCallum, U.M., M.R., C.T., K.W., M. Malinova, C.B.-D., M.J.K., E.G., J.V.-D., A.M., M.G., V.S., M.K.J., C.M.-B., J.D.-M.), Limb Girdle Muscular Dystrophies, Genetics Department, Integrated Laboratory Medicine, Newcastle Upon Tyne Hospitals NHS Foundation Trust, United Kingdom; and Neuromuscular Diseases Unit, Neurology Department, Hospital Germans Tries I Pujol (E.J.-M.), Badalona, Spain
| | - Chiara Marini-Bettolo
- From the John Walton Muscular Dystrophy Research Centre (R.M.-L., M.S., D.M., M.E., J.M.-S., E.H., M. McCallum, U.M., M.R., C.T., K.W., M. Malinova, C.B.-D., M.J.K., E.G., J.V.-D., A.M., M.G., V.S., M.K.J., C.M.-B., J.D.-M.), Translational and Clinical Research Institute, Newcastle University, UK; Highly Specialized Service for Rare Neuromuscular Disorders (R.M.-L., M.S., D.M., M.E., J.M.-S., E.H., M. McCallum, U.M., M.R., C.T., K.W., M. Malinova, C.B.-D., M.J.K., E.G., J.V.-D., A.M., M.G., V.S., M.K.J., C.M.-B., J.D.-M.), Limb Girdle Muscular Dystrophies, Genetics Department, Integrated Laboratory Medicine, Newcastle Upon Tyne Hospitals NHS Foundation Trust, United Kingdom; and Neuromuscular Diseases Unit, Neurology Department, Hospital Germans Tries I Pujol (E.J.-M.), Badalona, Spain
| | - Jordi Diaz-Manera
- From the John Walton Muscular Dystrophy Research Centre (R.M.-L., M.S., D.M., M.E., J.M.-S., E.H., M. McCallum, U.M., M.R., C.T., K.W., M. Malinova, C.B.-D., M.J.K., E.G., J.V.-D., A.M., M.G., V.S., M.K.J., C.M.-B., J.D.-M.), Translational and Clinical Research Institute, Newcastle University, UK; Highly Specialized Service for Rare Neuromuscular Disorders (R.M.-L., M.S., D.M., M.E., J.M.-S., E.H., M. McCallum, U.M., M.R., C.T., K.W., M. Malinova, C.B.-D., M.J.K., E.G., J.V.-D., A.M., M.G., V.S., M.K.J., C.M.-B., J.D.-M.), Limb Girdle Muscular Dystrophies, Genetics Department, Integrated Laboratory Medicine, Newcastle Upon Tyne Hospitals NHS Foundation Trust, United Kingdom; and Neuromuscular Diseases Unit, Neurology Department, Hospital Germans Tries I Pujol (E.J.-M.), Badalona, Spain
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Manjunath V, Thenral SG, Lakshmi BR, Nalini A, Bassi A, Karthikeyan KP, Piyusha K, Menon R, Malhotra A, Praveena LS, Anjanappa RM, Murugan SMS, Polavarapu K, Bardhan M, Preethish-Kumar V, Vengalil S, Nashi S, Sanga S, Acharya M, Raju R, Pai VR, Ramprasad VL, Gupta R. Large Region of Homozygous (ROH) Identified in Indian Patients with Autosomal Recessive Limb-Girdle Muscular Dystrophy with p.Thr182Pro Variant in SGCB Gene. Hum Mutat 2023. [DOI: 10.1155/2023/4362273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/30/2023]
Abstract
The sarcoglycanopathies are autosomal recessive limb-girdle muscular dystrophies (LGMDs) caused by the mutations in genes encoding the α, β, γ, and δ proteins which stabilizes the sarcolemma of muscle cells. The clinical phenotype is characterized by progressive proximal muscle weakness with childhood onset. Muscle biopsy findings are diagnostic in confirming dystrophic changes and deficiency of one or more sarcoglycan proteins. In this study, we summarized 1,046 LGMD patients for which a precise diagnosis was identified using targeted sequencing. The most frequent phenotypes identified in the patients are LGMDR1 (19.7%), LGMDR4 (19.0%), LGMDR2 (17.5%), and MMD1 (14.5%). Among the reported genes, each of CAPN3, SGCB, and DYSF variants was reported in more than 10% of our study cohort. The most common variant SGCB p.Thr182Pro was identified in 146 (12.5%) of the LGMD patients, and in 97.9% of these patients, the variant was found to be homozygous. To understand the genetic structure of the patients carrying SGCB p.Thr182Pro, we genotyped 68 LGMD patients using a whole genome microarray. Analysis of the array data identified a large ~1 Mb region of homozygosity (ROH) (chr4:51817441-528499552) suggestive of a shared genomic region overlapping the recurrent missense variant and shared across all 68 patients. Haplotype analysis identified 133 marker haplotypes that were present in ~85.3% of the probands as a double allele and absent in all random controls. We also identified 5 markers (rs1910739, rs6852236, rs13122418, rs13353646, and rs6554360) which were present in a significantly higher proportion in the patients compared to random control set (
) and the population database. Of note, admixture analysis was suggestive of greater proportion of West Eurasian/European ancestry as compared to random controls. Haplotype analysis and frequency in the population database indicate a probable event of founder effect. Further systematic study is needed to identify the communities and regions where the SGCB p.Thr182Pro variant is observed in higher proportions. After identifying these communities and//or region, a screening program is needed to identify carriers and provide them counselling.
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Diella E, LoMauro A, Delle Fave M, Cima R, D'Angelo MG. The Performance of Upper Limb (PUL) module in limb-girdle muscular dystrophy. ACTA MYOLOGICA : MYOPATHIES AND CARDIOMYOPATHIES : OFFICIAL JOURNAL OF THE MEDITERRANEAN SOCIETY OF MYOLOGY 2023; 41:207-211. [PMID: 36793650 PMCID: PMC9896594 DOI: 10.36185/2532-1900-084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Accepted: 12/21/2022] [Indexed: 02/17/2023]
Abstract
Limb-girdle muscular dystrophy (LGMD) is a genetic muscle disorder causing weakness and wasting of the proximal limb musculature. When ambulation is lost, the attention must be shifted to the upper limb muscles' function. We studied the upper limb muscle strength and the corresponding function in 15 LGMDR1/LGMD2A and 13 LGMDR2/LGMD2B, through the Performance of Upper Limb scale and the MRC score of upper limbs. The proximal item K and the distal items N and R were lower in LGMD2B/R2. The mean MRC score of all the muscles involved linearly correlated (r2 = 0.922) for item K in LGMD2B/R2. The functional worsening paralleled the muscles weakness in LGMD2B/R2. By contrast, at proximal level the function of LGMD2A/R1 was preserved despite muscle weakness was present, presumably due to compensatory strategies. Sometimes the combination of parameters might be more informative than considering them separately. PUL scale and MRC might be interesting outcome measures in non-ambulant patients.
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Affiliation(s)
- Eleonora Diella
- Neuro Rehabilitation of Rare Diseases of Central and Pheripheral Nervous System Unit Scientific Institute IRCCS E. Medea, Bosisio Parini (LC), Italy
| | - Antonella LoMauro
- Dipartimento di Elettronica, Informazione e Bioingegneria, Politecnico di Milano, Milan, Italy
| | - Morena Delle Fave
- Neuro Rehabilitation of Rare Diseases of Central and Pheripheral Nervous System Unit Scientific Institute IRCCS E. Medea, Bosisio Parini (LC), Italy
| | - Rossella Cima
- Neuro Rehabilitation of Rare Diseases of Central and Pheripheral Nervous System Unit Scientific Institute IRCCS E. Medea, Bosisio Parini (LC), Italy
| | - Maria Grazie D'Angelo
- Neuro Rehabilitation of Rare Diseases of Central and Pheripheral Nervous System Unit Scientific Institute IRCCS E. Medea, Bosisio Parini (LC), Italy
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15
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Jensen SM, Müller KI, Mellgren SI, Bindoff LA, Rasmussen M, Ørstavik K, Jonsrud C, Tveten K, Nilssen Ø, Van Ghelue M, Arntzen KA. Epidemiology and natural history in 101 subjects with FKRP-related limb-girdle muscular dystrophy R9. The Norwegian LGMDR9 cohort study (2020). Neuromuscul Disord 2023; 33:119-132. [PMID: 36522254 DOI: 10.1016/j.nmd.2022.11.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Revised: 09/08/2022] [Accepted: 11/21/2022] [Indexed: 11/27/2022]
Abstract
We aimed to investigate the epidemiology and natural history of FKRP-related limb-girdle muscular dystrophy R9 (LGMDR9) in Norway. We identified 153 genetically confirmed subjects making the overall prevalence 2.84/100,000, the highest reported figure worldwide. Of the 153 subjects, 134 (88 %) were homozygous for FKRP c.826C>A giving a carrier frequency for this variant of 1/101 in Norway. Clinical questionnaires and patient notes from 101 subjects, including 88 c.826C>A homozygotes, were reviewed, and 43/101 subjects examined clinically. Age of onset in c.826C>A homozygotes demonstrated a bimodal distribution. Female subjects showed an increased cumulative probability of wheelchair dependency and need for ventilatory support. Across the cohort, the need for ventilatory support preceded wheelchair dependency in one third of the cases, usually due to sleep apnea. In c.826C>A homozygotes, occurrence of cardiomyopathy correlated positively with male gender but not with age or disease stage. This study highlights novel gender differences in both loss of ambulation, need for ventilatory support and the development of cardiomyopathy. Our results confirm the need for vigilance in order to detect respiratory insufficiency and cardiac involvement, but indicate that these events affect males and females differently.
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Affiliation(s)
- Synnøve M Jensen
- National Neuromuscular Centre Norway and Department of Neurology, University Hospital of North Norway HF, Tromsø, PO Box 100, N-9038, Tromsø, Norway; Department of Clinical Medicine, University of Tromsø - The Artic University of Norway, PO Box 6050 Langnes, N-9037, Tromsø, Norway.
| | - Kai Ivar Müller
- National Neuromuscular Centre Norway and Department of Neurology, University Hospital of North Norway HF, Tromsø, PO Box 100, N-9038, Tromsø, Norway; Department of Clinical Medicine, University of Tromsø - The Artic University of Norway, PO Box 6050 Langnes, N-9037, Tromsø, Norway; Department of Neurology, Hospital of Southern Norway, PO box 416 Lundsiden, 4604, Kristiansand S, Norway
| | - Svein Ivar Mellgren
- National Neuromuscular Centre Norway and Department of Neurology, University Hospital of North Norway HF, Tromsø, PO Box 100, N-9038, Tromsø, Norway; Department of Clinical Medicine, University of Tromsø - The Artic University of Norway, PO Box 6050 Langnes, N-9037, Tromsø, Norway
| | - Laurence A Bindoff
- Department of Clinical Medicine (K1), University of Bergen, N-5021, Bergen, Norway; Department of Neurology, Haukeland University Hospital, PO Box 1400, N-5021, Bergen, Norway; National Unit of Newborn Screening and Advanced Laboratory Diagnostics, Oslo University Hospital, PO Box 4950 Nydalen, N-0424, Oslo, Norway
| | - Magnhild Rasmussen
- Department of Clinical Neurosciences for Children, Oslo University Hospital, PO Box 4950 Nydalen, N-0424, Oslo, Norway; Unit for Congenital and Hereditary Neuromuscular Conditions (EMAN), Department of Neurology, Oslo University Hospital, PO Box 4950 Nydalen, N-0424, Oslo, Norway
| | - Kristin Ørstavik
- Unit for Congenital and Hereditary Neuromuscular Conditions (EMAN), Department of Neurology, Oslo University Hospital, PO Box 4950 Nydalen, N-0424, Oslo, Norway
| | - Christoffer Jonsrud
- Department of Medical Genetics, Division of Child and Adolescent Health, University Hospital of North Norway HF, PO Box 55, N-9038, Tromsø, Norway
| | - Kristian Tveten
- Department of Medical Genetics, Telemark Hospital Trust, PO Box 2900 Kjørbekk, N-3710, Skien, Norway
| | - Øivind Nilssen
- Department of Clinical Medicine, University of Tromsø - The Artic University of Norway, PO Box 6050 Langnes, N-9037, Tromsø, Norway; Department of Medical Genetics, Division of Child and Adolescent Health, University Hospital of North Norway HF, PO Box 55, N-9038, Tromsø, Norway
| | - Marijke Van Ghelue
- Department of Clinical Medicine, University of Tromsø - The Artic University of Norway, PO Box 6050 Langnes, N-9037, Tromsø, Norway; Department of Medical Genetics, Division of Child and Adolescent Health, University Hospital of North Norway HF, PO Box 55, N-9038, Tromsø, Norway
| | - Kjell Arne Arntzen
- National Neuromuscular Centre Norway and Department of Neurology, University Hospital of North Norway HF, Tromsø, PO Box 100, N-9038, Tromsø, Norway; Department of Clinical Medicine, University of Tromsø - The Artic University of Norway, PO Box 6050 Langnes, N-9037, Tromsø, Norway
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16
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Ribault S, Rippert P, Jain M, Le Goff L, Genod DV, Barriere A, Berruyer A, Garde C, Tinat M, Pons C, Vuillerot C. Psychometric Characteristics of the Motor Function Measure in Neuromuscular Diseases: A Systematic Review1. J Neuromuscul Dis 2023; 10:301-314. [PMID: 37125561 PMCID: PMC10408216 DOI: 10.3233/jnd-230001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
Abstract
BACKGROUND Recent pharmaceutical breakthroughs in neuromuscular diseases may considerably change the prognosis and natural history these diseases. The ability to measure clinically relevant outcomes such as motor function is critical for the assessment of therapeutics and the follow up of individuals. The Motor Function Measure (MFM) is a quantitative scale designed to measure motor function in adult and children with neuromuscular disease (NMD). OBJECTIVE The objective of this study is to assess the quality and level of evidence of the MFM's published measurement properties by completing a systematic review of the validation and responsiveness studies of the MFM20 (a 20-item version of MFM adapted for children 2 to 6 years of age) and the MFM32 (the original 32 item version), in all NMDs and in specific diseases. METHODS A search for MFM responsiveness and MFM validation studies was completed in February 2023 in EMBASE, MEDLINE, SCOPUS and Web of Science databases. The PRISMA guidelines and the COSMIN manual for systematic reviews were followed for databases searches, articles screening and selection, study quality and measurement properties evaluation. RESULTS 49 studies were included in analysis. In studies including individuals with all NMDs, MFM's internal consistency, reliability, convergent validity, construct validity and responsiveness were rated as sufficient with a high quality of evidence. Structural validity was rated sufficient with a moderate quality of evidence In SMA in particular, MFM's reliability, internal consistency, convergent validity, discriminant validity and responsiveness are sufficient with a high quality of evidence. More studies would be required to assess specific measurement properties in different diseases. MFM32's minimal clinically relevant difference has been defined between 2 and 6%. CONCLUSION MFM's structural validity, internal consistency, reliability, construct validity, convergent validity and responsiveness have been verified with moderate to high level of evidence.
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Affiliation(s)
- Shams Ribault
- Hospices Civils de Lyon, Hôpital Femme Mère Enfant, Service de médecine physique et réadaptation pédiatrique, Bron cedex F-69677
- Pathophysiology and Genetics of Neuron and Muscle, CNRS UMR 5261, INSERM U1315, Université Lyon1, Faculté de Médecine Lyon Est, Lyon, France
| | - Pascal Rippert
- Hospices Civils de Lyon, Hôpital Femme Mère Enfant, Service de médecine physique et réadaptation pédiatrique, Bron cedex F-69677
- Hospices Civils de Lyon, Pôle Santé Publique, Service Recherche et Epidémiologie Clinique, Lyon F-69003
| | - Minal Jain
- Rehabilitation Medicine Department, National Institutes of Health, Bethesda, MD, US
| | - Laure Le Goff
- Hospices Civils de Lyon, Hôpital Femme Mère Enfant, Service de médecine physique et réadaptation pédiatrique, Bron cedex F-69677
| | - Dominique Vincent Genod
- Hospices Civils de Lyon, Hôpital Femme Mère Enfant, Service de médecine physique et réadaptation pédiatrique, Bron cedex F-69677
| | - Aurélie Barriere
- Hospices Civils de Lyon, Hôpital Femme Mère Enfant, Service de médecine physique et réadaptation pédiatrique, Bron cedex F-69677
| | - Anne Berruyer
- Hospices Civils de Lyon, Hôpital Femme Mère Enfant, Service de médecine physique et réadaptation pédiatrique, Bron cedex F-69677
| | - Camille Garde
- Hospices Civils de Lyon, Hôpital Femme Mère Enfant, Service de médecine physique et réadaptation pédiatrique, Bron cedex F-69677
| | - Marie Tinat
- Hospices Civils de Lyon, Hôpital Femme Mère Enfant, Service de médecine physique et réadaptation pédiatrique, Bron cedex F-69677
| | - Christelle Pons
- SSR pédiatrique, fondation Ildys, rue Alain-Colas, 29200 Brest, France; Service de médecine physique et de réadaptation, CHRU de Brest, Brest, France; Laboratoire de traitement de l’information médicale (LaTIM), inserm U1101, université Bretagne Occidentale, France
| | - Carole Vuillerot
- Hospices Civils de Lyon, Hôpital Femme Mère Enfant, Service de médecine physique et réadaptation pédiatrique, Bron cedex F-69677
- Pathophysiology and Genetics of Neuron and Muscle, CNRS UMR 5261, INSERM U1315, Université Lyon1, Faculté de Médecine Lyon Est, Lyon, France
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17
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Forsting J, Rohm M, Froeling M, Güttsches AK, Südkamp N, Roos A, Vorgerd M, Schlaffke L, Rehmann R. Quantitative muscle MRI captures early muscle degeneration in calpainopathy. Sci Rep 2022; 12:19676. [PMID: 36385624 PMCID: PMC9669006 DOI: 10.1038/s41598-022-23972-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2022] [Accepted: 11/08/2022] [Indexed: 11/17/2022] Open
Abstract
To evaluate differences in qMRI parameters of muscle diffusion tensor imaging (mDTI), fat-fraction (FF) and water T2 time in leg muscles of calpainopathy patients (LGMD R1/D4) compared to healthy controls, to correlate those findings to clinical parameters and to evaluate if qMRI parameters show muscle degeneration in not-yet fatty infiltrated muscles. We evaluated eight thigh and seven calf muscles of 19 calpainopathy patients and 19 healthy matched controls. MRI scans were performed on a 3T MRI including a mDTI, T2 mapping and mDixonquant sequence. Clinical assessment was done with manual muscle testing, patient questionnaires (ACTIVLIM, NSS) as well as gait analysis. Average FF was significantly different in all muscles compared to controls (p < 0.001). In muscles with less than 8% FF a significant increase of FA (p < 0.005) and decrease of RD (p < 0.004) was found in high-risk muscles of calpainopathy patients. Water T2 times were increased within the low- and intermediate-risk muscles (p ≤ 0.045) but not in high-risk muscles (p = 0.062). Clinical assessments correlated significantly with qMRI values: QMFM vs. FF: r = - 0.881, p < 0.001; QMFM versus FA: r = - 0.747, p < 0.001; QMFM versus MD: r = 0.942, p < 0.001. A good correlation of FF and diffusion metrics to clinical assessments was found. Diffusion metrics and T2 values are promising candidates to serve as sensitive early and non-invasive methods to capture early muscle degeneration in non-fat-infiltrated muscles in calpainopathies.
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Affiliation(s)
- Johannes Forsting
- Department of Neurology, BG-University Hospital Bergmannsheil, Ruhr-University Bochum, Bürkle-de-la-Camp-Platz 1, 44789, Bochum, Germany
| | - Marlena Rohm
- Department of Neurology, BG-University Hospital Bergmannsheil, Ruhr-University Bochum, Bürkle-de-la-Camp-Platz 1, 44789, Bochum, Germany
- Heimer Institute for Muscle Research, BG-University Hospital Bergmannsheil, Bochum, Germany
| | - Martijn Froeling
- Department of Radiology, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - Anne-Katrin Güttsches
- Department of Neurology, BG-University Hospital Bergmannsheil, Ruhr-University Bochum, Bürkle-de-la-Camp-Platz 1, 44789, Bochum, Germany
- Heimer Institute for Muscle Research, BG-University Hospital Bergmannsheil, Bochum, Germany
| | - Nicolina Südkamp
- Department of Neurology, BG-University Hospital Bergmannsheil, Ruhr-University Bochum, Bürkle-de-la-Camp-Platz 1, 44789, Bochum, Germany
- Heimer Institute for Muscle Research, BG-University Hospital Bergmannsheil, Bochum, Germany
| | - Andreas Roos
- Department of Neurology, BG-University Hospital Bergmannsheil, Ruhr-University Bochum, Bürkle-de-la-Camp-Platz 1, 44789, Bochum, Germany
- Heimer Institute for Muscle Research, BG-University Hospital Bergmannsheil, Bochum, Germany
- Department of Neuropediatrics, University Hospital Essen, Duisburg-Essen University, Essen, Germany
| | - Matthias Vorgerd
- Department of Neurology, BG-University Hospital Bergmannsheil, Ruhr-University Bochum, Bürkle-de-la-Camp-Platz 1, 44789, Bochum, Germany
- Heimer Institute for Muscle Research, BG-University Hospital Bergmannsheil, Bochum, Germany
| | - Lara Schlaffke
- Department of Neurology, BG-University Hospital Bergmannsheil, Ruhr-University Bochum, Bürkle-de-la-Camp-Platz 1, 44789, Bochum, Germany
- Heimer Institute for Muscle Research, BG-University Hospital Bergmannsheil, Bochum, Germany
| | - Robert Rehmann
- Department of Neurology, BG-University Hospital Bergmannsheil, Ruhr-University Bochum, Bürkle-de-la-Camp-Platz 1, 44789, Bochum, Germany.
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18
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Aivazoglou LU, Guimarães JB, Costa MAF, Aihara AY, Cardoso FN, Pinto WBVDR, de Souza PVS, da Silva AMS, Zanoteli E, Oliveira ASB, Carvalho AAS, Fernandes ADRC. Whole-body magnetic resonance imaging in limb girdle muscular dystrophy type R1/2A: correlation with clinical scores. Muscle Nerve 2022; 66:471-478. [PMID: 35894554 DOI: 10.1002/mus.27686] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2021] [Revised: 07/19/2022] [Accepted: 07/24/2022] [Indexed: 11/05/2022]
Abstract
INTRODUCTION/AIM The most common limb girdle muscular dystrophy (LGMD) worldwide is LGMD type R1 (LGMDR1). The aim of this study was to correlate the magnetic resonance imaging (MRI) findings with functional scores and to describe the whole-body MRI (WBMRI) pattern in a LGMDR1 Brazilian cohort. METHODS LGMDR1 patients under follow-up in three centers were referred for the study. Clinical data were collected and a functional evaluation was performed, consisting of Gardner-Medwin and Walton (GMW) and Brooke scales. All patients underwent a WBMRI study (1.5T) with axial T1 and STIR images. Fifty-one muscles were semiquantitatively assessed regarding fatty infiltration and muscle edema. RESULTS The study group consisted of 18 patients. The highest fatty infiltration scores involved the serratus anterior, biceps femoris long head, adductor magnus and lumbar erector spinae. There was a latero-medial and caudo-cranial descending gradient of involvement of the paravertebral muscles, with erector spinae being significantly more affected than the transversospinalis muscles (p<0.05). A striped appearance that has been dubbed the "pseudocollagen sign" was present in 72% of the patients. There was a positive correlation between the MRI score and GMW (Rho:0.83) and Brooke (Rho:0.53) scores. DISCUSSION WBMRI in LGMDR1 allows a global patient evaluation including involvement of the paraspinal muscles, usually an underestimated feature in the clinical and imaging study of myopathies. Knowledge of the WBMRI pattern of LGMDR1 involvement can be useful in the diagnostic approach and in future studies to identify the best target muscles to serve as outcome measures in clinical trials.
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Affiliation(s)
- Laís U Aivazoglou
- Department of Radiology and Diagnostic Imaging, Universidade Federal de São Paulo (UNIFESP), Rua Napoleão de Barros, 800. Zip Code: 04024-002, São Paulo, SP, Brazil.,Division of Musculoskeletal Imaging, Laboratório Delboni Auriemo / DASA (Diagnósticos da América SA), Av Juruá, 434. Zip Code: 06455-010, Barueri, SP, Brazil
| | - Julio B Guimarães
- Department of Radiology and Diagnostic Imaging, Universidade Federal de São Paulo (UNIFESP), Rua Napoleão de Barros, 800. Zip Code: 04024-002, São Paulo, SP, Brazil
| | - Maria Alice F Costa
- Department of Radiology and Diagnostic Imaging, Universidade Federal de São Paulo (UNIFESP), Rua Napoleão de Barros, 800. Zip Code: 04024-002, São Paulo, SP, Brazil.,Division of Musculoskeletal Imaging, Laboratório Delboni Auriemo / DASA (Diagnósticos da América SA), Av Juruá, 434. Zip Code: 06455-010, Barueri, SP, Brazil
| | - André Yui Aihara
- Department of Radiology and Diagnostic Imaging, Universidade Federal de São Paulo (UNIFESP), Rua Napoleão de Barros, 800. Zip Code: 04024-002, São Paulo, SP, Brazil.,Division of Musculoskeletal Imaging, Laboratório Delboni Auriemo / DASA (Diagnósticos da América SA), Av Juruá, 434. Zip Code: 06455-010, Barueri, SP, Brazil
| | - Fabiano N Cardoso
- Department of Radiology and Diagnostic Imaging, Universidade Federal de São Paulo (UNIFESP), Rua Napoleão de Barros, 800. Zip Code: 04024-002, São Paulo, SP, Brazil
| | - Wladimir B V de R Pinto
- Division of Neuromuscular Diseases, Department of Neurology and Neurosurgery - Universidade Federal de São Paulo (UNIFESP), Rua Embaú, 67. Zip Code: 04039-060, São Paulo, SP, Brazil
| | - Paulo Victor S de Souza
- Division of Neuromuscular Diseases, Department of Neurology and Neurosurgery - Universidade Federal de São Paulo (UNIFESP), Rua Embaú, 67. Zip Code: 04039-060, São Paulo, SP, Brazil
| | - André M S da Silva
- Departamento de Neurologia, Faculdade de Medicina, Universidade de São Paulo, Av. Dr. Enéas de Carvalho Aguiar, 255 - Sala 5083. Zip code: 05402-000, São Paulo, SP, Brazil
| | - Edmar Zanoteli
- Departamento de Neurologia, Faculdade de Medicina, Universidade de São Paulo, Av. Dr. Enéas de Carvalho Aguiar, 255 - Sala 5083. Zip code: 05402-000, São Paulo, SP, Brazil
| | - Acary S B Oliveira
- Division of Neuromuscular Diseases, Department of Neurology and Neurosurgery - Universidade Federal de São Paulo (UNIFESP), Rua Embaú, 67. Zip Code: 04039-060, São Paulo, SP, Brazil
| | - Alzira A S Carvalho
- Laboratório de Doenças Neuromusculares da Faculdade de Medicina do ABC - Departamento de Neurociênciasm, Av. Lauro Gomes, 2000. Zip Code: 09060-870, Santo André, SP, Brazil
| | - Artur da R C Fernandes
- Department of Radiology and Diagnostic Imaging, Universidade Federal de São Paulo (UNIFESP), Rua Napoleão de Barros, 800. Zip Code: 04024-002, São Paulo, SP, Brazil
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19
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Ozyilmaz B, Kirbiyik O, Ozdemir TR, Ozer OK, Kutbay YB, Erdogan KM, Guvenc MS, Arıkan Ş, Turk TS, Kale MY, Uludag IF, Baydan F, Sertpoyraz F, Gencpinar P, Diniz G. Experiences in the molecular genetic and histopathological evaluation of calpainopathies. Neurogenetics 2022; 23:103-114. [DOI: 10.1007/s10048-022-00687-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Accepted: 02/09/2022] [Indexed: 11/29/2022]
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20
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Lasa-Elgarresta J, Mosqueira-Martín L, González-Imaz K, Marco-Moreno P, Gerenu G, Mamchaoui K, Mouly V, López de Munain A, Vallejo-Illarramendi A. Targeting the Ubiquitin-Proteasome System in Limb-Girdle Muscular Dystrophy With CAPN3 Mutations. Front Cell Dev Biol 2022; 10:822563. [PMID: 35309930 PMCID: PMC8924035 DOI: 10.3389/fcell.2022.822563] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Accepted: 02/03/2022] [Indexed: 12/26/2022] Open
Abstract
LGMDR1 is caused by mutations in the CAPN3 gene that encodes calpain 3 (CAPN3), a non-lysosomal cysteine protease necessary for proper muscle function. Our previous findings show that CAPN3 deficiency leads to reduced SERCA levels through increased protein degradation. This work investigates the potential contribution of the ubiquitin-proteasome pathway to increased SERCA degradation in LGMDR1. Consistent with our previous results, we observed that CAPN3-deficient human myotubes exhibit reduced SERCA protein levels and high cytosolic calcium concentration. Treatment with the proteasome inhibitor bortezomib (Velcade) increased SERCA2 protein levels and normalized intracellular calcium levels in CAPN3-deficient myotubes. Moreover, bortezomib was able to recover mutated CAPN3 protein in a patient carrying R289W and R546L missense mutations. We found that CAPN3 knockout mice (C3KO) presented SERCA deficits in skeletal muscle in the early stages of the disease, prior to the manifestation of muscle deficits. However, treatment with bortezomib (0.8 mg/kg every 72 h) for 3 weeks did not rescue SERCA levels. No change in muscle proteasome activity was observed in bortezomib-treated animals, suggesting that higher bortezomib doses are needed to rescue SERCA levels in this model. Overall, our results lay the foundation for exploring inhibition of the ubiquitin-proteasome as a new therapeutic target to treat LGMDR1 patients. Moreover, patients carrying missense mutations in CAPN3 and presumably other genes may benefit from proteasome inhibition by rescuing mutant protein levels. Further studies in suitable models will be necessary to demonstrate the therapeutic efficacy of proteasome inhibition for different missense mutations.
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Affiliation(s)
- Jaione Lasa-Elgarresta
- Group of Neuroscience, Departments of Pediatrics and Neuroscience, Faculty of Medicine and Nursing, Hospital Donostia, UPV/EHU, San Sebastian, Spain.,IIS Biodonostia, Neurosciences Area, Group of Neuromuscular Diseases, San Sebastian, Spain
| | - Laura Mosqueira-Martín
- Group of Neuroscience, Departments of Pediatrics and Neuroscience, Faculty of Medicine and Nursing, Hospital Donostia, UPV/EHU, San Sebastian, Spain.,IIS Biodonostia, Neurosciences Area, Group of Neuromuscular Diseases, San Sebastian, Spain
| | - Klaudia González-Imaz
- IIS Biodonostia, Neurosciences Area, Group of Neuromuscular Diseases, San Sebastian, Spain
| | - Pablo Marco-Moreno
- IIS Biodonostia, Neurosciences Area, Group of Neuromuscular Diseases, San Sebastian, Spain
| | - Gorka Gerenu
- IIS Biodonostia, Neurosciences Area, Group of Neuromuscular Diseases, San Sebastian, Spain.,CIBERNED, Instituto de Salud Carlos III, Ministry of Economy and Competitiveness, Madrid, Spain.,Department of Physiology, Faculty of Medicine and Nursing, UPV/EHU, Leioa, Spain
| | - Kamel Mamchaoui
- Sorbonne Université, Inserm, Institut de Myologie, Centre de Recherche en Myologie, Paris, France
| | - Vincent Mouly
- Sorbonne Université, Inserm, Institut de Myologie, Centre de Recherche en Myologie, Paris, France
| | - Adolfo López de Munain
- Group of Neuroscience, Departments of Pediatrics and Neuroscience, Faculty of Medicine and Nursing, Hospital Donostia, UPV/EHU, San Sebastian, Spain.,IIS Biodonostia, Neurosciences Area, Group of Neuromuscular Diseases, San Sebastian, Spain.,CIBERNED, Instituto de Salud Carlos III, Ministry of Economy and Competitiveness, Madrid, Spain
| | - Ainara Vallejo-Illarramendi
- Group of Neuroscience, Departments of Pediatrics and Neuroscience, Faculty of Medicine and Nursing, Hospital Donostia, UPV/EHU, San Sebastian, Spain.,IIS Biodonostia, Neurosciences Area, Group of Neuromuscular Diseases, San Sebastian, Spain.,CIBERNED, Instituto de Salud Carlos III, Ministry of Economy and Competitiveness, Madrid, Spain
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21
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Ganassi M, Muntoni F, Zammit PS. Defining and identifying satellite cell-opathies within muscular dystrophies and myopathies. Exp Cell Res 2022; 411:112906. [PMID: 34740639 PMCID: PMC8784828 DOI: 10.1016/j.yexcr.2021.112906] [Citation(s) in RCA: 28] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Revised: 10/12/2021] [Accepted: 10/29/2021] [Indexed: 12/19/2022]
Abstract
Muscular dystrophies and congenital myopathies arise from specific genetic mutations causing skeletal muscle weakness that reduces quality of life. Muscle health relies on resident muscle stem cells called satellite cells, which enable life-course muscle growth, maintenance, repair and regeneration. Such tuned plasticity gradually diminishes in muscle diseases, suggesting compromised satellite cell function. A central issue however, is whether the pathogenic mutation perturbs satellite cell function directly and/or indirectly via an increasingly hostile microenvironment as disease progresses. Here, we explore the effects on satellite cell function of pathogenic mutations in genes (myopathogenes) that associate with muscle disorders, to evaluate clinical and muscle pathological hallmarks that define dysfunctional satellite cells. We deploy transcriptomic analysis and comparison between muscular dystrophies and myopathies to determine the contribution of satellite cell dysfunction using literature, expression dynamics of myopathogenes and their response to the satellite cell regulator PAX7. Our multimodal approach extends current pathological classifications to define Satellite Cell-opathies: muscle disorders in which satellite cell dysfunction contributes to pathology. Primary Satellite Cell-opathies are conditions where mutations in a myopathogene directly affect satellite cell function, such as in Progressive Congenital Myopathy with Scoliosis (MYOSCO) and Carey-Fineman-Ziter Syndrome (CFZS). Primary satellite cell-opathies are generally characterised as being congenital with general hypotonia, and specific involvement of respiratory, trunk and facial muscles, although serum CK levels are usually within the normal range. Secondary Satellite Cell-opathies have mutations in myopathogenes that affect both satellite cells and muscle fibres. Such classification aids diagnosis and predicting probable disease course, as well as informing on treatment and therapeutic development.
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Affiliation(s)
- Massimo Ganassi
- Randall Centre for Cell and Molecular Biophysics, King's College London, London, SE1 1UL, UK.
| | - Francesco Muntoni
- Dubowitz Neuromuscular Centre, UCL Great Ormond Street Institute of Child Health, 30 Guilford Street, London, WC1N 1EH, United Kingdom; NIHR Great Ormond Street Hospital Biomedical Research Centre, UCL Great Ormond Street Institute of Child Health, 30 Guilford Street, London, WC1N 1EH, United Kingdom
| | - Peter S Zammit
- Randall Centre for Cell and Molecular Biophysics, King's College London, London, SE1 1UL, UK.
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22
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Ganaraja VH, Polavarapu K, Bardhan M, Preethish-Kumar V, Leena S, Anjanappa RM, Vengalil S, Nashi S, Arunachal G, Gunasekaran S, Mohan D, Raju S, Unnikrishnan G, Huddar A, Ravi-Kiran V, Thomas PT, Nalini A. Disease Progression and Mutation Pattern in a Large Cohort of LGMD R1/LGMD 2A Patients from India. Glob Med Genet 2021; 9:34-41. [PMID: 35169782 PMCID: PMC8837411 DOI: 10.1055/s-0041-1736567] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Accepted: 09/18/2021] [Indexed: 10/31/2022] Open
Abstract
AbstractCalpainopathy is caused by mutations in the CAPN3. There is only one clinical and genetic study of CAPN3 from India and none from South India. A total of 72 (male[M]:female [F] = 34:38) genetically confirmed probands from 72 independent families are included in this study. Consanguinity was present in 54.2%. The mean age of onset and duration of symptoms are 13.5 ± 6.4 and 6.3 ± 4.7 years, respectively. Positive family history occurred in 23.3%. The predominant initial symptoms were proximal lower limb weakness (52.1%) and toe walking (20.5%). At presentation, 97.2% had hip girdle weakness, 69.4% had scapular winging, and 58.3% had contractures. Follow-up was available in 76.4%, and 92.7% were ambulant at a mean age of 23.7 ± 7.6 years and duration of 4.5 years, remaining 7.3% became wheelchair-bound at 25.5 ± 5.7 years of age (mean duration = 13.5 ± 4.6), 4.1% were aged more than 40 years (duration range = 5–20). The majority remained ambulant 10 years after disease onset. Next-generation sequencing (NGS) detected 47 unique CAPN3 variants in 72 patients, out of which 19 are novel. Missense variants were most common occurring in 59.7% (homozygous = 29; Compound heterozygous = 14). In the remaining 29 patients (40.3%), at least one suspected loss of function variant was present. Common recurrent variants were c.2051–1G > T and c.2338G > C in 9.7%, c.1343G > A, c.802–9G > A, and c.1319G > A in 6.9% and c.1963delC in 5.5% of population. Large deletions were observed in 4.2%. Exon 10 mutations accounted for 12 patients (16.7%). Our study highlights the efficiency of NGS technology in screening and molecular diagnosis of limb-girdle muscular dystrophy with recessive form (LGMDR1) patients in India.
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Affiliation(s)
- Valakunja H. Ganaraja
- Department of Neurology, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Kiran Polavarapu
- Department of Neurology, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
- Division of Neurology, Department of Medicine, Children's Hospital of Eastern Ontario Research Institute, University of Ottawa, The Ottawa Hospital, Ottawa, Canada
| | - Mainak Bardhan
- Department of Neurology, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Veeramani Preethish-Kumar
- Department of Neurology, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Shingavi Leena
- Department of Neurology, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Ram M. Anjanappa
- Department of Neurology, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
- Division of Neurology, Department of Medicine, Children's Hospital of Eastern Ontario Research Institute, University of Ottawa, The Ottawa Hospital, Ottawa, Canada
| | - Seena Vengalil
- Department of Neurology, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Saraswati Nashi
- Department of Neurology, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Gautham Arunachal
- Department of Human Genetics, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Swetha Gunasekaran
- Department of Human Genetics, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Dhaarini Mohan
- Department of Neurology, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Sanita Raju
- Department of Neurology, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Gopikrishnan Unnikrishnan
- Department of Neurology, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Akshata Huddar
- Department of Neurology, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Valasani Ravi-Kiran
- Department of Neurology, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Priya T. Thomas
- Department of Psychiatric Social Work, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Atchayaram Nalini
- Department of Neurology, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
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23
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Molecular and cellular basis of genetically inherited skeletal muscle disorders. Nat Rev Mol Cell Biol 2021; 22:713-732. [PMID: 34257452 PMCID: PMC9686310 DOI: 10.1038/s41580-021-00389-z] [Citation(s) in RCA: 44] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/04/2021] [Indexed: 02/06/2023]
Abstract
Neuromuscular disorders comprise a diverse group of human inborn diseases that arise from defects in the structure and/or function of the muscle tissue - encompassing the muscle cells (myofibres) themselves and their extracellular matrix - or muscle fibre innervation. Since the identification in 1987 of the first genetic lesion associated with a neuromuscular disorder - mutations in dystrophin as an underlying cause of Duchenne muscular dystrophy - the field has made tremendous progress in understanding the genetic basis of these diseases, with pathogenic variants in more than 500 genes now identified as underlying causes of neuromuscular disorders. The subset of neuromuscular disorders that affect skeletal muscle are referred to as myopathies or muscular dystrophies, and are due to variants in genes encoding muscle proteins. Many of these proteins provide structural stability to the myofibres or function in regulating sarcolemmal integrity, whereas others are involved in protein turnover, intracellular trafficking, calcium handling and electrical excitability - processes that ensure myofibre resistance to stress and their primary activity in muscle contraction. In this Review, we discuss how defects in muscle proteins give rise to muscle dysfunction, and ultimately to disease, with a focus on pathologies that are most common, best understood and that provide the most insight into muscle biology.
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24
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Guglieri M, Díaz-Manera J, Straub V. TREAT-NMD stakeholder meeting for natural history studies in limb girdle muscular dystrophy 18th June 2019, Amsterdam, The Netherlands. Neuromuscul Disord 2021; 31:899-906. [PMID: 34426054 DOI: 10.1016/j.nmd.2021.06.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Revised: 06/15/2021] [Accepted: 06/23/2021] [Indexed: 11/18/2022]
Affiliation(s)
- Michela Guglieri
- The John Walton Muscular Dystrophy Research Center, Newcastle University and Newcastle Hospitals NHS Foundation Trust, The International Centre for Life, Central Parkway, Newcastle upon Tyne NE1 3BZ, UK
| | - Jordi Díaz-Manera
- The John Walton Muscular Dystrophy Research Center, Newcastle University and Newcastle Hospitals NHS Foundation Trust, The International Centre for Life, Central Parkway, Newcastle upon Tyne NE1 3BZ, UK; Neuromuscular Disorders Unit, Neurology Department, Hospital de la Santa Creu I Sant Pau, de Barcelona, Spain
| | - Volker Straub
- The John Walton Muscular Dystrophy Research Center, Newcastle University and Newcastle Hospitals NHS Foundation Trust, The International Centre for Life, Central Parkway, Newcastle upon Tyne NE1 3BZ, UK.
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25
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Abstract
The limb-girdle muscular dystrophies (LGMD) are a collection of genetic diseases united in their phenotypical expression of pelvic and shoulder area weakness and wasting. More than 30 subtypes have been identified, five dominant and 26 recessive. The increase in the characterization of new genotypes in the family of LGMDs further adds to the heterogeneity of the disease. Meanwhile, better understanding of the phenotype led to the reconsideration of the disease definition, which resulted in eight old subtypes to be no longer recognized officially as LGMD and five new diseases to be added to the LGMD family. The unique variabilities of LGMD stem from genetic mutations, which then lead to protein and ultimately muscle dysfunction. Herein, we review the LGMD pathway, starting with the genetic mutations that encode proteins involved in muscle maintenance and repair, and including the genotype–phenotype relationship of the disease, the epidemiology, disease progression, burden of illness, and emerging treatments.
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26
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Current and Future Therapeutic Strategies for Limb Girdle Muscular Dystrophy Type R1: Clinical and Experimental Approaches. PATHOPHYSIOLOGY 2021; 28:238-249. [PMID: 35366260 PMCID: PMC8830477 DOI: 10.3390/pathophysiology28020016] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Revised: 05/15/2021] [Accepted: 05/17/2021] [Indexed: 11/16/2022] Open
Abstract
Limb girdle muscular dystrophy type R1 disease is a progressive disease that is caused by mutations in the CAPN3 gene and involves the extremity muscles of the hip and shoulder girdle. The CAPN3 protein has proteolytic and non-proteolytic properties. The functions of the CAPN3 protein that have been determined so far can be listed as remodeling and combining contractile proteins in the sarcomere with the substrates with which it interacts, controlling the Ca2+ flow in and out through the sarcoplasmic reticulum, and regulation of membrane repair and muscle regeneration. Even though there are several gene therapies, cellular therapies, and drug therapies, such as glucocorticoid treatment, AAV- mediated therapy, CRISPR-Cas9, induced pluripotent stem cells, MYO-029, and AMBMP, which are either in preclinical or clinical phases, or have been completed, there is no final cure. Inhibitors and small molecules (tauroursodeoxycholic acid, salubrinal, rapamycin, CDN1163, dwarf open reading frame) targeting ER stress factors that are thought to be effective in muscle loss can be considered potential therapy strategies. At present, little can be done to treat the progressive muscle wasting, loss of function, and premature mortality of patients with LGMDR1, and there is a pressing need for more research to develop potential therapies.
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27
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Zhang C, Zheng X, Lu D, Xu L, Che F, Liu S. Compound heterozygous CAPN3 variants identified in a family with limb-girdle muscular dystrophy recessive 1. Mol Med Rep 2021; 23:480. [PMID: 33899113 PMCID: PMC8097764 DOI: 10.3892/mmr.2021.12119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Accepted: 04/12/2021] [Indexed: 11/05/2022] Open
Abstract
Limb-girdle muscular dystrophy recessive 1 (LGMDR1), a rare subtype of muscular dystrophy, is characterized by progressive muscle weakness and degeneration with a predominant presentation on the shoulder, pelvic and proximal limb muscles. Variants in calcium-activated neutral proteinase 3 (CAPN3), which encodes an enzyme, calpain 3, are considered the major cause of LGMDR1. The present study was conducted to identify the variants responsible for clinical symptoms in a Chinese patient with limb-girdle muscular dystrophies (LGMDs) and explore its genotype-phenotype associations. A series of clinical examinations were conducted, including blood tests and magnetic resonance imaging scans of the lower legs, electromyography and muscle biopsy on the proband diagnosed with muscular dystrophies. Genomic DNA was extracted from the peripheral blood of a three-person family with LGMDs and pathogenic variants detected by whole-exome sequencing (WES) were verified by Sanger sequencing. The WES of this patient revealed compound heterozygous variants in CAPN3, c.2120A>G/p.(Asp707Gly) in exon 20 and c.2201_2202delAT/p.(Tyr734*) in exon 21, which were inherited from his parents and absent from 200 control individuals of similar ethnic origin, indicating that these variants are the pathogenic triggers of the LGMDR1 phenotype. Notably, these CAPN3 sequence variants were related to LGMDR1 pathogenesis in this three-person family. The newly discovered c.2201_2202delAT/p.(Tyr734*) expands the current CAPN3 variant spectrum, improving the understanding of the conditions required to develop molecular diagnostic tools and for genetic counseling, particularly for families with a history of autosomal recessive LGMDs.
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Affiliation(s)
- Cheng Zhang
- Medical Genetic Department, The Affiliated Hospital of Qingdao University, Qingdao, Shandong 266003, P.R. China
| | - Xueping Zheng
- Department of Geriatric Medicine, The Affiliated Hospital of Qingdao University, Qingdao, Shandong 266003, P.R. China
| | - Deguo Lu
- Department of Neurology, The Eleventh Clinical Medical College of Qingdao University, Linyi People's Hospital, Linyi, Shandong 276000, P.R. China
| | - Lulu Xu
- Department of Geriatric Medicine, The Affiliated Hospital of Qingdao University, Qingdao, Shandong 266003, P.R. China
| | - Fengyuan Che
- Department of Neurology, The Eleventh Clinical Medical College of Qingdao University, Linyi People's Hospital, Linyi, Shandong 276000, P.R. China
| | - Shiguo Liu
- Medical Genetic Department, The Affiliated Hospital of Qingdao University, Qingdao, Shandong 266003, P.R. China
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28
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LoMauro A, Gandossini S, Russo A, Diella E, Pistininzi C, Marchi E, Pascuzzo R, Vantini S, Aliverti A, D'Angelo MG. Over three decades of natural history of limb girdle muscular dystrophy type R1/2A and R2/2B: Mathematical modelling of a multifactorial study. Neuromuscul Disord 2021; 31:489-497. [PMID: 33836912 DOI: 10.1016/j.nmd.2021.02.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Revised: 02/11/2021] [Accepted: 02/23/2021] [Indexed: 11/15/2022]
Abstract
We aimed to describe the natural history of Limb Girdle Muscular Dystrophy type 2A and 2B over more than three decades by considering muscular strength, motor, cardiac and respiratory function. 428 visits of nineteen 2A and twenty 2B patients were retrospectively analysed through a regression model to create the curves of evolution with disease duration of muscle strength (through Medical Research Council grading), motor function measure scale (D1, D2 and D3 domains) and cardio-pulmonary function tests. Clinically relevant muscular and motor function alterations occurred after the first decade of disease, while mild respiratory function alterations started after the second, with preserved cardiac function. Although type 2A showed relatively stronger distal lower limb muscles, while type 2B started with relatively stronger upper limb muscles, the corresponding motor functions were similar, becoming severely compromised after 25 years of disease. This was the longest retrospective study in types 2A and 2B. It defined curves of disease evolution not only from a neuromuscular, but also from functional, cardiac, and respiratory points of view, to be used to evaluate how the natural progression is changed by therapies. Due to slow disease progression, it was not possible to identify time sensitive endpoints.
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Affiliation(s)
- Antonella LoMauro
- Dipartimento di Elettronica, Informazione e Bioingegneria, Politecnico di Milano, Milano, Italy.
| | - Sandra Gandossini
- Scientific Institute IRCCS E. Medea, NeuroMuscular Unit, Bosisio Parini, LC, Italy
| | - Annamaria Russo
- Scientific Institute IRCCS E. Medea, NeuroMuscular Unit, Bosisio Parini, LC, Italy
| | - Eleonora Diella
- Scientific Institute IRCCS E. Medea, NeuroMuscular Unit, Bosisio Parini, LC, Italy
| | - Cristina Pistininzi
- Scientific Institute IRCCS E. Medea, NeuroMuscular Unit, Bosisio Parini, LC, Italy
| | - Eraldo Marchi
- Scientific Institute IRCCS E. Medea, NeuroMuscular Unit, Bosisio Parini, LC, Italy
| | - Riccardo Pascuzzo
- Neuroradiology Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milano, Italy
| | - Simone Vantini
- MOX-Department of Mathematics, Politecnico di Milano, Milano, Italy
| | - Andrea Aliverti
- Dipartimento di Elettronica, Informazione e Bioingegneria, Politecnico di Milano, Milano, Italy
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29
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Spinozzi S, Albini S, Best H, Richard I. Calpains for dummies: What you need to know about the calpain family. BIOCHIMICA ET BIOPHYSICA ACTA-PROTEINS AND PROTEOMICS 2021; 1869:140616. [PMID: 33545367 DOI: 10.1016/j.bbapap.2021.140616] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Revised: 01/29/2021] [Accepted: 01/30/2021] [Indexed: 12/17/2022]
Abstract
This review was written in memory of our late friend, Dr. Hiroyuki Sorimachi, who, following the steps of his mentor Koichi Suzuki, a pioneer in calpain research, has made tremendous contributions to the field. During his career, Hiro also wrote several reviews on calpain, the last of which, published in 2016, was comprehensive. In this manuscript, we decided to put together a review with the basic information a novice may need to know about calpains. We also tried to avoid similarities with previous reviews and reported the most significant new findings, at the same time highlighting Hiro's contributions to the field. The review will cover a short history of calpain discovery, the presentation of the family, the life of calpain from transcription to activity, human diseases caused by calpain mutations and therapeutic perspectives.
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Affiliation(s)
- Simone Spinozzi
- Genethon, 1 bis, Rue de l'Internationale - 91000 Evry, France; Université Paris-Saclay, Univ Evry, Inserm, Genethon, Integrare Research Unit UMR_S951, 91000, Evry, France
| | - Sonia Albini
- Genethon, 1 bis, Rue de l'Internationale - 91000 Evry, France; Université Paris-Saclay, Univ Evry, Inserm, Genethon, Integrare Research Unit UMR_S951, 91000, Evry, France
| | - Heather Best
- Genethon, 1 bis, Rue de l'Internationale - 91000 Evry, France; Université Paris-Saclay, Univ Evry, Inserm, Genethon, Integrare Research Unit UMR_S951, 91000, Evry, France
| | - Isabelle Richard
- Genethon, 1 bis, Rue de l'Internationale - 91000 Evry, France; Université Paris-Saclay, Univ Evry, Inserm, Genethon, Integrare Research Unit UMR_S951, 91000, Evry, France.
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30
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Malfatti E, Richard I. [Calpainopathies: state of the art and therapeutic perspectives]. Med Sci (Paris) 2021; 36 Hors série n° 2:17-21. [PMID: 33427631 DOI: 10.1051/medsci/2020244] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Calpainopathies are inherited limb-girdle muscular dystrophies, most often following an autosomal recessive (AR) transmission. Autosomal dominant (AD) forms with less severe presentation are increasingly reported. Calpainopathies with autosomal recessive (AR) mutations of the calpain3 gene (CAPN3) are associated with limb girdle muscular dystrophy type R1 (LGMD-R1, OMIM 253600) also referred to as LGMD-2A according to the old nomenclature. LGMD-R1 is the commonest form of all LGMDs, with an estimated prevalence of 10 to 70 cases per million inhabitants, that is a cohort of between 670 and 4,200 patients in France theoritically. Patients present a symmetrical proximal axial myopathy manifesting itself between the first and second decade. The clinical course is variable. The level of Creatine- Kinase (CK) is usually high and there is no cardiac involvement. From a therapeutic perspective, the autosomal recessive form of calpainopathy is quite suitable to gene replacement strategies; the viability of recombinant AAV-mediated calpain 3 transfer has been demonstrated in animal models and clinical trials are expected in the coming years. Meanwhile, natural history studies are needed to prepare for future clinical trials.
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Affiliation(s)
- Edoardo Malfatti
- Centre Expert de Pathologie Neuromusculaire, Hôpital Henri Mondor, Créteil, France et Centre de Référence de Pathologie Neuromusculaire Nord/Est/Île-de-France
| | - Isabelle Richard
- Généthon, 91000, Évry, France. - Université Paris-Saclay, Université Évry, Inserm, Généthon, Unité de Recherche Integrare, UMR_S951, 91000, Évry, France
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31
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Jahnke VE, Peterson JM, Van Der Meulen JH, Boehler J, Uaesoontrachoon K, Johnston HK, Defour A, Phadke A, Yu Q, Jaiswal JK, Nagaraju K. Mitochondrial dysfunction and consequences in calpain-3-deficient muscle. Skelet Muscle 2020; 10:37. [PMID: 33308300 PMCID: PMC7730798 DOI: 10.1186/s13395-020-00254-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2020] [Accepted: 11/16/2020] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Nonsense or loss-of-function mutations in the non-lysosomal cysteine protease calpain-3 result in limb-girdle muscular dystrophy type 2A (LGMD2A). While calpain-3 is implicated in muscle cell differentiation, sarcomere formation, and muscle cytoskeletal remodeling, the physiological basis for LGMD2A has remained elusive. METHODS Cell growth, gene expression profiling, and mitochondrial content and function were analyzed using muscle and muscle cell cultures established from healthy and calpain-3-deficient mice. Calpain-3-deficient mice were also treated with PPAR-delta agonist (GW501516) to assess mitochondrial function and membrane repair. The unpaired t test was used to assess the significance of the differences observed between the two groups or treatments. ANOVAs were used to assess significance over time. RESULTS We find that calpain-3 deficiency causes mitochondrial dysfunction in the muscles and myoblasts. Calpain-3-deficient myoblasts showed increased proliferation, and their gene expression profile showed aberrant mitochondrial biogenesis. Myotube gene expression analysis further revealed altered lipid metabolism in calpain-3-deficient muscle. Mitochondrial defects were validated in vitro and in vivo. We used GW501516 to improve mitochondrial biogenesis in vivo in 7-month-old calpain-3-deficient mice. This treatment improved satellite cell activity as indicated by increased MyoD and Pax7 mRNA expression. It also decreased muscle fatigability and reduced serum creatine kinase levels. The decreased mitochondrial function also impaired sarcolemmal repair in the calpain-3-deficient skeletal muscle. Improving mitochondrial activity by acute pyruvate treatment improved sarcolemmal repair. CONCLUSION Our results provide evidence that calpain-3 deficiency in the skeletal muscle is associated with poor mitochondrial biogenesis and function resulting in poor sarcolemmal repair. Addressing this deficit by drugs that improve mitochondrial activity offers new therapeutic avenues for LGMD2A.
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Affiliation(s)
- Vanessa E Jahnke
- Center for Genetic Medicine Research, Children's National Research Institute, Children's National Hospital, Washington, D.C., USA
| | - Jennifer M Peterson
- School of Exercise and Rehabilitation Sciences, The University of Toledo, Toledo, OH, USA
| | - Jack H Van Der Meulen
- Center for Genetic Medicine Research, Children's National Research Institute, Children's National Hospital, Washington, D.C., USA
| | - Jessica Boehler
- Center for Genetic Medicine Research, Children's National Research Institute, Children's National Hospital, Washington, D.C., USA
| | - Kitipong Uaesoontrachoon
- Center for Genetic Medicine Research, Children's National Research Institute, Children's National Hospital, Washington, D.C., USA
| | - Helen K Johnston
- Center for Genetic Medicine Research, Children's National Research Institute, Children's National Hospital, Washington, D.C., USA
- Department of Genomics and Precision Medicine, George Washington University School of Medicine and Health Sciences, Washington, D.C., USA
| | - Aurelia Defour
- Center for Genetic Medicine Research, Children's National Research Institute, Children's National Hospital, Washington, D.C., USA
| | - Aditi Phadke
- Center for Genetic Medicine Research, Children's National Research Institute, Children's National Hospital, Washington, D.C., USA
| | - Qing Yu
- Center for Genetic Medicine Research, Children's National Research Institute, Children's National Hospital, Washington, D.C., USA
| | - Jyoti K Jaiswal
- Center for Genetic Medicine Research, Children's National Research Institute, Children's National Hospital, Washington, D.C., USA
- Department of Genomics and Precision Medicine, George Washington University School of Medicine and Health Sciences, Washington, D.C., USA
| | - Kanneboyina Nagaraju
- Center for Genetic Medicine Research, Children's National Research Institute, Children's National Hospital, Washington, D.C., USA.
- Department of Genomics and Precision Medicine, George Washington University School of Medicine and Health Sciences, Washington, D.C., USA.
- School of Pharmacy and Pharmaceutical Sciences, SUNY Binghamton University, PO Box 6000, Binghamton, NY, 13902, USA.
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32
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Zheng J, Xu X, Zhang X, Wang X, Shu J, Cai C. Variants of CAPN3 cause limb-girdle muscular dystrophy type 2A in two Chinese families. Exp Ther Med 2020; 21:104. [PMID: 33335567 PMCID: PMC7739812 DOI: 10.3892/etm.2020.9536] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2020] [Accepted: 10/26/2020] [Indexed: 11/11/2022] Open
Abstract
Limb-girdle muscular dystrophies (LGMDs) are a group of neuromuscular diseases that are characterized by progressive muscle weakness. LGMD type 2A (LGMD2A), caused by variants in the calpain-3 (CAPN3) gene, is the most prevalent type. The present study aimed to analyze pathogenic CAPN3 gene variants in two pedigrees affected by LGMD2A. Each family contains three patients who are siblings and sought genetic counseling. Genomic DNA was extracted from the peripheral blood samples collected from the probands and family members and whole-exome sequencing (WES) was used to detect the pathogenic genes in the probands. Suspected variants were subsequently validated by Sanger sequencing. In family 1, WES revealed that the proband carried the compound heterogeneous variants c.1194-9A>G and c.1437C>T (p.Ser479=) in CAPN3 (NM_000070.2). In family 2, WES identified that the proband carried the compound heterogeneous variants c.632+4A>G and c.1468C>T (p.Arg490Trp) in CAPN3 (NM_000070.2). In conclusion, the present study indicated that the compound heterogeneous variants of the CAPN3 gene were most likely responsible for LGMD2A in the two Chinese families.
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Affiliation(s)
- Jie Zheng
- Graduate College, Tianjin Medical University, Tianjin 300070, P.R. China
| | - Xiaowei Xu
- Tianjin Pediatric Research Institute, Tianjin Children's Hospital (Children's Hospital of Tianjin University), Tianjin 300134, P.R. China.,Tianjin Key Laboratory of Birth Defects for Prevention and Treatment, Tianjin 300134, P.R. China
| | - Xinjie Zhang
- Tianjin Pediatric Research Institute, Tianjin Children's Hospital (Children's Hospital of Tianjin University), Tianjin 300134, P.R. China.,Tianjin Key Laboratory of Birth Defects for Prevention and Treatment, Tianjin 300134, P.R. China
| | - Xuetao Wang
- Tianjin Pediatric Research Institute, Tianjin Children's Hospital (Children's Hospital of Tianjin University), Tianjin 300134, P.R. China.,Tianjin Key Laboratory of Birth Defects for Prevention and Treatment, Tianjin 300134, P.R. China
| | - Jianbo Shu
- Tianjin Pediatric Research Institute, Tianjin Children's Hospital (Children's Hospital of Tianjin University), Tianjin 300134, P.R. China.,Tianjin Key Laboratory of Birth Defects for Prevention and Treatment, Tianjin 300134, P.R. China
| | - Chunquan Cai
- Tianjin Pediatric Research Institute, Tianjin Children's Hospital (Children's Hospital of Tianjin University), Tianjin 300134, P.R. China.,Tianjin Key Laboratory of Birth Defects for Prevention and Treatment, Tianjin 300134, P.R. China.,Department of Neurosurgery, Tianjin Children's Hospital, Tianjin 300134, P.R. China
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33
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McGovern VL, Kray KM, Arnold WD, Duque SI, Iyer CC, Massoni-Laporte A, Workman E, Patel A, Battle DJ, Burghes AHM. Intragenic complementation of amino and carboxy terminal SMN missense mutations can rescue Smn null mice. Hum Mol Genet 2020; 29:3493-3503. [PMID: 33084884 PMCID: PMC7788290 DOI: 10.1093/hmg/ddaa235] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Revised: 09/18/2020] [Accepted: 10/15/2020] [Indexed: 01/15/2023] Open
Abstract
Spinal muscular atrophy is caused by reduced levels of SMN resulting from the loss of SMN1 and reliance on SMN2 for the production of SMN. Loss of SMN entirely is embryonic lethal in mammals. There are several SMN missense mutations found in humans. These alleles do not show partial function in the absence of wild-type SMN and cannot rescue a null Smn allele in mice. However, these human SMN missense allele transgenes can rescue a null Smn allele when SMN2 is present. We find that the N- and C-terminal regions constitute two independent domains of SMN that can be separated genetically and undergo intragenic complementation. These SMN protein heteromers restore snRNP assembly of Sm proteins onto snRNA and completely rescue both survival of Smn null mice and motor neuron electrophysiology demonstrating that the essential functional unit of SMN is the oligomer.
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Affiliation(s)
- Vicki L McGovern
- Department of Biological Chemistry and Pharmacology, The Ohio State University, Columbus, OH 43210, USA
| | - Kaitlyn M Kray
- Department of Biological Chemistry and Pharmacology, The Ohio State University, Columbus, OH 43210, USA
| | - W David Arnold
- Department of Neurology, The Ohio State University, Columbus, OH 43210, USA
| | - Sandra I Duque
- Department of Biological Chemistry and Pharmacology, The Ohio State University, Columbus, OH 43210, USA
| | - Chitra C Iyer
- Department of Biological Chemistry and Pharmacology, The Ohio State University, Columbus, OH 43210, USA
| | - Aurélie Massoni-Laporte
- Department of Biological Chemistry and Pharmacology, The Ohio State University, Columbus, OH 43210, USA
| | - Eileen Workman
- Department of Biological Chemistry and Pharmacology, The Ohio State University, Columbus, OH 43210, USA
| | - Aalapi Patel
- Department of Biological Chemistry and Pharmacology, The Ohio State University, Columbus, OH 43210, USA
| | - Daniel J Battle
- Department of Biological Chemistry, The Ohio State University, Columbus, OH 43210, USA
| | - Arthur H M Burghes
- Department of Biological Chemistry and Pharmacology, The Ohio State University, Columbus, OH 43210, USA
- Department of Neurology, The Ohio State University, Columbus, OH 43210, USA
- Department of Molecular Genetics, The Ohio State University, Columbus, OH 43210, USA
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34
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Liu J, Campagna J, John V, Damoiseaux R, Mokhonova E, Becerra D, Meng H, McNally EM, Pyle AD, Kramerova I, Spencer MJ. A Small-Molecule Approach to Restore a Slow-Oxidative Phenotype and Defective CaMKIIβ Signaling in Limb Girdle Muscular Dystrophy. Cell Rep Med 2020; 1:100122. [PMID: 33205074 PMCID: PMC7659555 DOI: 10.1016/j.xcrm.2020.100122] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2019] [Revised: 08/07/2020] [Accepted: 09/21/2020] [Indexed: 12/21/2022]
Abstract
Mutations in CAPN3 cause limb girdle muscular dystrophy R1 (LGMDR1, formerly LGMD2A) and lead to progressive and debilitating muscle wasting. Calpain 3 deficiency is associated with impaired CaMKIIβ signaling and blunted transcriptional programs that encode the slow-oxidative muscle phenotype. We conducted a high-throughput screen on a target of CaMKII (Myl2) to identify compounds to override this signaling defect; 4 were tested in vivo in the Capn3 knockout (C3KO) model of LGMDR1. The leading compound, AMBMP, showed good exposure and was able to reverse the LGMDR1 phenotype in vivo, including improved oxidative properties, increased slow fiber size, and enhanced exercise performance. AMBMP also activated CaMKIIβ signaling, but it did not alter other pathways known to be associated with muscle growth. Thus, AMBMP treatment activates CaMKII and metabolically reprograms skeletal muscle toward a slow muscle phenotype. These proof-of-concept studies lend support for an approach to the development of therapeutics for LGMDR1.
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MESH Headings
- Acyltransferases/genetics
- Acyltransferases/metabolism
- Animals
- Calcium-Calmodulin-Dependent Protein Kinase Type 2/genetics
- Calcium-Calmodulin-Dependent Protein Kinase Type 2/metabolism
- Calpain/deficiency
- Calpain/genetics
- Cardiac Myosins/genetics
- Cardiac Myosins/metabolism
- Cell Line
- Creatine Kinase, Mitochondrial Form/genetics
- Creatine Kinase, Mitochondrial Form/metabolism
- Female
- Gene Expression Regulation
- Male
- Mice
- Mice, Inbred C57BL
- Mice, Knockout
- Muscle Proteins/deficiency
- Muscle Proteins/genetics
- Muscle, Skeletal/drug effects
- Muscle, Skeletal/metabolism
- Muscle, Skeletal/pathology
- Muscular Dystrophies, Limb-Girdle/drug therapy
- Muscular Dystrophies, Limb-Girdle/genetics
- Muscular Dystrophies, Limb-Girdle/metabolism
- Muscular Dystrophies, Limb-Girdle/pathology
- Myoblasts/drug effects
- Myoblasts/metabolism
- Myoblasts/pathology
- Myosin Light Chains/genetics
- Myosin Light Chains/metabolism
- Oxidative Stress
- Phenotype
- Physical Conditioning, Animal
- Protein Isoforms/genetics
- Protein Isoforms/metabolism
- Pyrimidines/pharmacology
- Signal Transduction
- Small Molecule Libraries/pharmacology
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Affiliation(s)
- Jian Liu
- Department of Neurology, David Geffen School of Medicine at University of California, Los Angeles, Los Angeles, CA, USA
| | - Jesus Campagna
- Department of Neurology, David Geffen School of Medicine at University of California, Los Angeles, Los Angeles, CA, USA
| | - Varghese John
- Department of Neurology, David Geffen School of Medicine at University of California, Los Angeles, Los Angeles, CA, USA
| | - Robert Damoiseaux
- Department of Pharmacology, David Geffen School of Medicine and Molecular Screening Shared Resource, Crump Imaging Institute, University of California, Los Angeles, Los Angeles, CA, USA
| | - Ekaterina Mokhonova
- Department of Neurology, David Geffen School of Medicine at University of California, Los Angeles, Los Angeles, CA, USA
| | - Diana Becerra
- Department of Neurology, David Geffen School of Medicine at University of California, Los Angeles, Los Angeles, CA, USA
| | - Huan Meng
- Department of Medicine, David Geffen School of Medicine and California Nanosystems Institute, University of California, Los Angeles, Los Angeles, CA, USA
| | - Elizabeth M. McNally
- Center for Genetic Medicine, Northwestern University, Feinberg School of Medicine, Chicago, IL, USA
| | - April D. Pyle
- Department of Microbiology, Immunology and Medical Genetics, David Geffen School of Medicine at University of California, Los Angeles, Los Angeles, CA, USA
- Eli and Edythe Broad Center of Regenerative Medicine and Stem Cell Research, University of California, Los Angeles, Los Angeles, CA, USA
| | - Irina Kramerova
- Department of Neurology, David Geffen School of Medicine at University of California, Los Angeles, Los Angeles, CA, USA
| | - Melissa J. Spencer
- Department of Neurology, David Geffen School of Medicine at University of California, Los Angeles, Los Angeles, CA, USA
- Eli and Edythe Broad Center of Regenerative Medicine and Stem Cell Research, University of California, Los Angeles, Los Angeles, CA, USA
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35
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Zhong H, Zheng Y, Zhao Z, Lin P, Xi J, Zhu W, Lin J, Lu J, Yu M, Zhang W, Lv H, Yan C, Hu J, Wang Z, Lu J, Zhao C, Yuan Y, Luo S. Molecular landscape of CAPN3 mutations in limb-girdle muscular dystrophy type R1: from a Chinese multicentre analysis to a worldwide perspective. J Med Genet 2020; 58:729-736. [PMID: 32994280 DOI: 10.1136/jmedgenet-2020-107159] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Revised: 07/31/2020] [Accepted: 08/14/2020] [Indexed: 01/29/2023]
Abstract
BACKGROUND Limb-girdle muscular dystrophy type R1 (LGMDR1) can be caused by recessive CAPN3 mutations accounting for the majority of LGMD. To date, no systemic evaluation has been performed to analyse the detrimental and normal mutations on CAPN3 and its hotspots. METHODS CAPN3 variants (n=112) from a total of 124 patients with LGMDR1 recruited in four centres in China were retrospectively analysed. Then external CAPN3 variants (n=2031) from online databases were integrated with our Chinese cohort data to achieve a worldwide perspective on CAPN3 mutations. According to their related phenotypes (LGMDR1 or normal), we analysed consequence, distribution, ethnicity and severity scores of CAPN3 mutations. RESULTS Two hotspot mutations were identified including c.2120A>G in Chinese population and c.550del in Europe. According to the integrated dataset, 521 mutations were classified as LGMDR1-related and converged on exons 1, 10, 5, 22 and 13 of CAPN3. The remaining 1585 variants were classified as normal-population related. The deleterious ratio of LGMDR1-relevant variants to total variants in each population was 0.26 on average with a maximum of 0.35 in Finns and a minimum of 0.21 in South Asians. Severity evaluation showed that Chinese LGMDR1-related variants exhibited a higher risk (Combined Annotation Dependent Depletion score +1.10) than that from database patients (p<0.001). CONCLUSIONS This study confirmed two hotspots and LGMDR1-related CAPN3 variants, highlighting the advantages in using a data-based comprehensive analysis to achieve a genetic landscape for patients with LGMDR1.
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Affiliation(s)
- Huahua Zhong
- Department of Neurology, Huashan Hospital Fudan University, Shanghai, China
| | - Yiming Zheng
- Department of Neurology, Peking University First Hospital, Beijing, China
| | - Zhe Zhao
- Department of Neuromuscular Disorders, Hebei Medical University Third Affiliated Hospital, Shijiazhuang, China
| | - Pengfei Lin
- Department of Neurology, Shandong University Qilu Hospital, Jinan, China
| | - Jianying Xi
- Department of Neurology, Huashan Hospital Fudan University, Shanghai, China
| | - Wenhua Zhu
- Department of Neurology, Huashan Hospital Fudan University, Shanghai, China
| | - Jie Lin
- Department of Neurology, Huashan Hospital Fudan University, Shanghai, China
| | - Jun Lu
- Department of Neurology, Huashan Hospital Fudan University, Shanghai, China
| | - Meng Yu
- Department of Neurology, Peking University First Hospital, Beijing, China
| | - Wei Zhang
- Department of Neurology, Peking University First Hospital, Beijing, China
| | - He Lv
- Department of Neurology, Peking University First Hospital, Beijing, China
| | - Chuanzhu Yan
- Department of Neurology, Shandong University Qilu Hospital, Jinan, China
| | - Jing Hu
- Department of Neuromuscular Disorders, Hebei Medical University Third Affiliated Hospital, Shijiazhuang, China
| | - Zhaoxia Wang
- Department of Neurology, Peking University First Hospital, Beijing, China
| | - Jiahong Lu
- Department of Neurology, Huashan Hospital Fudan University, Shanghai, China
| | - Chongbo Zhao
- Department of Neurology, Huashan Hospital Fudan University, Shanghai, China
| | - Yun Yuan
- Department of Neurology, Peking University First Hospital, Beijing, China
| | - Sushan Luo
- Department of Neurology, Huashan Hospital Fudan University, Shanghai, China
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36
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Lostal W, Roudaut C, Faivre M, Charton K, Suel L, Bourg N, Best H, Smith JE, Gohlke J, Corre G, Li X, Elbeck Z, Knöll R, Deschamps JY, Granzier H, Richard I. Titin splicing regulates cardiotoxicity associated with calpain 3 gene therapy for limb-girdle muscular dystrophy type 2A. Sci Transl Med 2020; 11:11/520/eaat6072. [PMID: 31776291 DOI: 10.1126/scitranslmed.aat6072] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2019] [Accepted: 10/31/2019] [Indexed: 01/31/2023]
Abstract
Limb-girdle muscular dystrophy type 2A (LGMD2A or LGMDR1) is a neuromuscular disorder caused by mutations in the calpain 3 gene (CAPN3). Previous experiments using adeno-associated viral (AAV) vector-mediated calpain 3 gene transfer in mice indicated cardiac toxicity associated with the ectopic expression of the calpain 3 transgene. Here, we performed a preliminary dose study in a severe double-knockout mouse model deficient in calpain 3 and dysferlin. We evaluated safety and biodistribution of AAV9-desmin-hCAPN3 vector administration to nonhuman primates (NHPs) with a dose of 3 × 1013 viral genomes/kg. Vector administration did not lead to observable adverse effects or to detectable toxicity in NHP. Of note, the transgene expression did not produce any abnormal changes in cardiac morphology or function of injected animals while reaching therapeutic expression in skeletal muscle. Additional investigation on the underlying causes of cardiac toxicity observed after gene transfer in mice and the role of titin in this phenomenon suggest species-specific titin splicing. Mice have a reduced capacity for buffering calpain 3 activity compared to NHPs and humans. Our studies highlight a complex interplay between calpain 3 and titin binding sites and demonstrate an effective and safe profile for systemic calpain 3 vector delivery in NHP, providing critical support for the clinical potential of calpain 3 gene therapy in humans.
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Affiliation(s)
- William Lostal
- Généthon INSERM, U951, INTEGRARE Research Unit, Evry F-91002, France
| | - Carinne Roudaut
- Généthon INSERM, U951, INTEGRARE Research Unit, Evry F-91002, France
| | - Marine Faivre
- Généthon INSERM, U951, INTEGRARE Research Unit, Evry F-91002, France
| | - Karine Charton
- Généthon INSERM, U951, INTEGRARE Research Unit, Evry F-91002, France
| | - Laurence Suel
- Généthon INSERM, U951, INTEGRARE Research Unit, Evry F-91002, France
| | - Nathalie Bourg
- Généthon INSERM, U951, INTEGRARE Research Unit, Evry F-91002, France
| | - Heather Best
- Généthon INSERM, U951, INTEGRARE Research Unit, Evry F-91002, France
| | | | | | - Guillaume Corre
- Généthon INSERM, U951, INTEGRARE Research Unit, Evry F-91002, France
| | - Xidan Li
- Department of Medicine, Karolinska Institute, Stockholm SE-171 77, Sweden
| | - Zaher Elbeck
- Department of Medicine, Karolinska Institute, Stockholm SE-171 77, Sweden
| | - Ralph Knöll
- Department of Medicine, Karolinska Institute, Stockholm SE-171 77, Sweden.,AstraZeneca, R&D, Innovative Medicines & Early Development, Cardiovascular, Renal and Metabolic Diseases (CVRM), Pepparedsleden 1, SE-431 83 Mölndal, Sweden
| | - Jack-Yves Deschamps
- Emergency and Critical Care Unit, ONIRIS, School of Veterinary Medicine, La Chantrerie, 44307 Nantes Cedex 03, France
| | | | - Isabelle Richard
- Généthon INSERM, U951, INTEGRARE Research Unit, Evry F-91002, France.
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37
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Kramerova I, Marinov M, Owens J, Lee SJ, Becerra D, Spencer MJ. Myostatin inhibition promotes fast fibre hypertrophy but causes loss of AMP-activated protein kinase signalling and poor exercise tolerance in a model of limb-girdle muscular dystrophy R1/2A. J Physiol 2020; 598:3927-3939. [PMID: 33460149 DOI: 10.1113/jp279943] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Accepted: 07/08/2020] [Indexed: 05/31/2024] Open
Abstract
KEY POINTS Limb-girdle muscular dystrophy R1 (LGMD R1) is caused by mutations in the CAPN3 gene and is characterized by progressive muscle loss, impaired mitochondrial function and reductions in the slow oxidative gene expression programme. Myostatin is a negative regulator of muscle growth, and its inhibition improves the phenotype in several muscle wasting disorders. The effect of genetic and pharmacological inhibition of myostatin signalling on the disease phenotype in a mouse model of LGMD R1 (CAPN3 knockout mouse-C3KO) was studied. Inhibition of myostatin signalling in C3KO muscles resulted in significant muscle hypertrophy; however, there were no improvements in muscle strength and exacerbation of exercise intolerance concomitant with further reduction of muscle oxidative capacity was observed. Inhibition of myostatin signalling is unlikely to be a valid therapeutic strategy for LGMD R1. ABSTRACT Limb-girdle muscular dystrophy R1 (LGMD R1) is caused by mutations in the CAPN3 gene and is characterized by progressive muscle loss, impaired mitochondrial function and reductions in the slow oxidative gene expression programme. There are currently no therapies available to patients. We sought to determine if induction of muscle growth, through myostatin inhibition, represents a viable therapeutic strategy for this disease. Myostatin is a negative regulator of muscle growth, and its inhibition improves the phenotype in several muscle wasting disorders. However, the effect of myostatin depends on the genetic and pathophysiological context and may not be efficacious in all contexts. We found that genetic inhibition of myostatin through overexpression of follistatin (an endogenous inhibitor of myostatin) in our LGMD R1 model (C3KO) resulted in 1.5- to 2-fold increase of muscle mass for the majority of limb muscles. However, muscle strength was not improved and exercise intolerance was exacerbated. Pharmacological inhibition of myostatin, using an anti-myostatin antibody, resulted in statistically significant increases in muscle mass; however, functional testing did not reveal changes in muscle strength nor endurance in treated C3KO mice. Histochemical and biochemical evaluation of follistatin overexpressing mice revealed a reduction in the percentage of oxidative fibres and decreased activation of AMP-activated protein kinase signalling in transgenics compared to C3KO muscles. Our data suggest that muscle hypertrophy, induced by myostatin inhibition, leads to loss of oxidative capacity, which further compromises metabolically impaired C3KO muscles and thus is unlikely to be a valid strategy for treatment of LGMD R1.
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Affiliation(s)
- Irina Kramerova
- Department of Neurology, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | - Masha Marinov
- Department of Neurology, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | | | - Se-Jin Lee
- The Jackson Laboratory and University of Connecticut School of Medicine, Farmington, CT, USA
| | - Diana Becerra
- Department of Neurology, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | - Melissa J Spencer
- Department of Neurology, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
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Strafella C, Caputo V, Campoli G, Galota RM, Mela J, Zampatti S, Minozzi G, Sancricca C, Servidei S, Giardina E, Cascella R. Genetic Counseling and NGS Screening for Recessive LGMD2A Families. High Throughput 2020; 9:ht9020013. [PMID: 32397577 PMCID: PMC7349198 DOI: 10.3390/ht9020013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Revised: 03/18/2020] [Accepted: 05/06/2020] [Indexed: 12/20/2022] Open
Abstract
Genetic counseling applied to limb–girdle muscular dystrophies (LGMDs) can be very challenging due to their clinical and genetic heterogeneity and the availability of different molecular assays. Genetic counseling should therefore be addressed to select the most suitable approach to increase the diagnostic rate and provide an accurate estimation of recurrence risk. This is particularly true for families with a positive history for recessive LGMD, in which the presence of a known pathogenetic mutation segregating within the family may not be enough to exclude the risk of having affected children without exploring the genetic background of phenotypically unaffected partners. In this work, we presented a family with a positive history for LGMD2A (OMIM #253600, also known as calpainopathy) characterized by compound heterozygosity for two CAPN3 mutations. The genetic specialist suggested the segregation analysis of both mutations within the family as a first-level analysis. Sequentially, next-generation sequencing (NGS) analysis was performed in the partners of healthy carriers to provide an accurate recurrence/reproductive risk estimation considering the genetic background of the couple. Finally, this work highlighted the importance of providing a genetic counseling/testing service even in unaffected individuals with a carrier partner. This approach can support genetic counselors in estimating the reproductive/recurrence risk and eventually, suggesting prenatal testing, early diagnosis or other medical surveillance strategies.
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Affiliation(s)
- Claudia Strafella
- Genomic Medicine Laboratory UILDM, Santa Lucia Foundation, 00179 Rome, Italy; (V.C.); (G.C.); (R.M.G.); (J.M.); (S.Z.); (E.G.); (R.C.)
- Department of Biomedicine and Prevention, Tor Vergata University, 00133 Rome, Italy
- Correspondence:
| | - Valerio Caputo
- Genomic Medicine Laboratory UILDM, Santa Lucia Foundation, 00179 Rome, Italy; (V.C.); (G.C.); (R.M.G.); (J.M.); (S.Z.); (E.G.); (R.C.)
- Department of Biomedicine and Prevention, Tor Vergata University, 00133 Rome, Italy
| | - Giulia Campoli
- Genomic Medicine Laboratory UILDM, Santa Lucia Foundation, 00179 Rome, Italy; (V.C.); (G.C.); (R.M.G.); (J.M.); (S.Z.); (E.G.); (R.C.)
| | - Rosaria Maria Galota
- Genomic Medicine Laboratory UILDM, Santa Lucia Foundation, 00179 Rome, Italy; (V.C.); (G.C.); (R.M.G.); (J.M.); (S.Z.); (E.G.); (R.C.)
| | - Julia Mela
- Genomic Medicine Laboratory UILDM, Santa Lucia Foundation, 00179 Rome, Italy; (V.C.); (G.C.); (R.M.G.); (J.M.); (S.Z.); (E.G.); (R.C.)
| | - Stefania Zampatti
- Genomic Medicine Laboratory UILDM, Santa Lucia Foundation, 00179 Rome, Italy; (V.C.); (G.C.); (R.M.G.); (J.M.); (S.Z.); (E.G.); (R.C.)
| | - Giulietta Minozzi
- Department of Veterinary Medicine, University of Milan, 20133 Milan, Italy;
| | - Cristina Sancricca
- Fondazione Policlinico Universitario A. Gemelli IRCCS, UOC Neurofisiopatologia, 00168 Rome, Italy; (C.S.); (S.S.)
- Unione Italiana Lotta Distrofia Muscolare (UILDM), Sezione Laziale, 00167 Rome, Italy
| | - Serenella Servidei
- Fondazione Policlinico Universitario A. Gemelli IRCCS, UOC Neurofisiopatologia, 00168 Rome, Italy; (C.S.); (S.S.)
| | - Emiliano Giardina
- Genomic Medicine Laboratory UILDM, Santa Lucia Foundation, 00179 Rome, Italy; (V.C.); (G.C.); (R.M.G.); (J.M.); (S.Z.); (E.G.); (R.C.)
- Department of Biomedicine and Prevention, Tor Vergata University, 00133 Rome, Italy
| | - Raffaella Cascella
- Genomic Medicine Laboratory UILDM, Santa Lucia Foundation, 00179 Rome, Italy; (V.C.); (G.C.); (R.M.G.); (J.M.); (S.Z.); (E.G.); (R.C.)
- Department of Biomedical Sciences, Catholic University Our Lady of Good Counsel, 1000 Tirana, Albania
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Abstract
PURPOSE OF REVIEW As a group, the limb-girdle muscular dystrophies (LGMDs) are the fourth most prevalent genetic muscle disease, yet they are still not well known or understood. This article defines and describes LGMDs, delineates a diagnostic strategy, and discusses treatment of the LGMDs. RECENT FINDINGS In 2018, the definition of the LGMDs was further refined, and a new nomenclature was proposed. Diagnosis of the LGMDs was long guided by the distinctive clinical characteristics of each particular subtype but now integrates use of genetics-with next-generation sequencing panels, exomes, and full genome analysis-early in the diagnostic assessment. Appreciation of the phenotypic diversity of each LGMD subtype continues to expand. This emphasizes the need for precision genetic diagnostics to better understand each subtype and formulate appropriate management for individual patients. Of significant relevance, the explosion of research into therapeutic options accentuates the need for accurate diagnosis, comprehensive disease characterization, and description of the natural histories of the LGMDs to move the field forward and to mitigate disease impact on patients with LGMD. SUMMARY The LGMDs are genetic muscle diseases that superficially appear similar to one another but have important differences in rates of progression and concomitant comorbidities. Definitive diagnoses are crucial to guide management and treatment now and in the future. As targeted treatments emerge, it will be important for clinicians to understand the nomenclature, diagnosis, clinical manifestations, and treatments of the LGMDs.
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Hamaguchi M, Fujita H, Suzuki K, Nakamura T, Nishino I, Hirata K. [A male patient with adult-onset sporadic calpainopathy presenting with hypertrophy of the upper extremities]. Rinsho Shinkeigaku 2019; 59:740-745. [PMID: 31656265 DOI: 10.5692/clinicalneurol.cn-001330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
A 33-year-old man presented with slowly progressive weakness in the lower extremities over 8 years. At the age of 16 years, the elevation of serum creatine kinase level was detected. Physical examination revealed scapular winging, exaggerated lumbar lordosis and tendoachilles contracture. Gowers sign was positive and proximal dominant limb weakness was noted. Hypertrophy was observed in the upper limbs such as the biceps brachii and forearm flexor muscles. Muscle biopsy showed distinct differences in size of muscle fibers and regenerating and necrotic muscle fibers. A histological study revealed decreased calpain3 expression. Gene analysis of CAPN3 revealed two known gene mutations, leading to a diagnosis of calpainopathy (limb girdle muscular dystrophy 2A; LGMD2A). We here report our patient to discuss findings of upper limb hypertrophy, which are frequently missed compared to the lower limb, but important clinical findings.
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Affiliation(s)
| | | | | | | | - Ichizo Nishino
- Department of Neuromuscular Research, National Institute of Neurology, National Center of Neurology and Psychiatry.,Department of Clinical Genome Analysis, Medical Genome Center, National Center of Neurology and Psychiatry
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European muscle MRI study in limb girdle muscular dystrophy type R1/2A (LGMDR1/LGMD2A). J Neurol 2019; 267:45-56. [PMID: 31555977 DOI: 10.1007/s00415-019-09539-y] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2019] [Revised: 09/09/2019] [Accepted: 09/10/2019] [Indexed: 02/07/2023]
Abstract
BACKGROUND Limb girdle muscular dystrophy type R1/2A (LGMDR1/LGMD2A) is a progressive myopathy caused by deficiency of calpain 3, a calcium-dependent cysteine protease of skeletal muscle, and it represents the most frequent type of LGMD worldwide. In the last few years, muscle magnetic resonance imaging (MRI) has been proposed as a tool for identifying patterns of muscular involvement in genetic disorders and as a biomarker of disease progression in muscle diseases. In this study, 57 molecularly confirmed LGMDR1 patients from a European cohort (age range 7-78 years) underwent muscle MRI and a global evaluation of functional status (Gardner-Medwin and Walton score and ability to raise the arms). RESULTS We confirmed a specific pattern of fatty substitution involving predominantly the hip adductors and hamstrings in lower limbs. Spine extensors were more severely affected than spine rotators, in agreement with higher incidence of lordosis than scoliosis in LGMDR1. Hierarchical clustering of lower limb MRI scores showed that involvement of anterior thigh muscles discriminates between classes of disease progression. Severity of muscle fatty substitution was significantly correlated with CAPN3 mutations: in particular, patients with no or one "null" alleles showed a milder involvement, compared to patients with two null alleles (i.e., predicting absence of calpain-3 protein). Expectedly, fat infiltration scores strongly correlated with functional measures. The "pseudocollagen" sign (central areas of sparing in some muscle) was associated with longer and more severe disease course. CONCLUSIONS We conclude that skeletal muscle MRI represents a useful tool in the diagnostic workup and clinical management of LGMDR1.
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Lasa-Elgarresta J, Mosqueira-Martín L, Naldaiz-Gastesi N, Sáenz A, López de Munain A, Vallejo-Illarramendi A. Calcium Mechanisms in Limb-Girdle Muscular Dystrophy with CAPN3 Mutations. Int J Mol Sci 2019; 20:E4548. [PMID: 31540302 PMCID: PMC6770289 DOI: 10.3390/ijms20184548] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2019] [Revised: 09/10/2019] [Accepted: 09/11/2019] [Indexed: 12/22/2022] Open
Abstract
Limb-girdle muscular dystrophy recessive 1 (LGMDR1), previously known as LGMD2A, is a rare disease caused by mutations in the CAPN3 gene. It is characterized by progressive weakness of shoulder, pelvic, and proximal limb muscles that usually appears in children and young adults and results in loss of ambulation within 20 years after disease onset in most patients. The pathophysiological mechanisms involved in LGMDR1 remain mostly unknown, and to date, there is no effective treatment for this disease. Here, we review clinical and experimental evidence suggesting that dysregulation of Ca2+ homeostasis in the skeletal muscle is a significant underlying event in this muscular dystrophy. We also review and discuss specific clinical features of LGMDR1, CAPN3 functions, novel putative targets for therapeutic strategies, and current approaches aiming to treat LGMDR1. These novel approaches may be clinically relevant not only for LGMDR1 but also for other muscular dystrophies with secondary calpainopathy or with abnormal Ca2+ homeostasis, such as LGMD2B/LGMDR2 or sporadic inclusion body myositis.
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Affiliation(s)
- Jaione Lasa-Elgarresta
- Biodonostia, Neurosciences Area, Group of Neuromuscular Diseases, 20014 San Sebastian, Spain.
- CIBERNED, Instituto de Salud Carlos III, Ministry of Science, Innovation and Universities, 28031 Madrid, Spain.
| | - Laura Mosqueira-Martín
- Biodonostia, Neurosciences Area, Group of Neuromuscular Diseases, 20014 San Sebastian, Spain.
- CIBERNED, Instituto de Salud Carlos III, Ministry of Science, Innovation and Universities, 28031 Madrid, Spain.
| | - Neia Naldaiz-Gastesi
- Biodonostia, Neurosciences Area, Group of Neuromuscular Diseases, 20014 San Sebastian, Spain.
- CIBERNED, Instituto de Salud Carlos III, Ministry of Science, Innovation and Universities, 28031 Madrid, Spain.
| | - Amets Sáenz
- Biodonostia, Neurosciences Area, Group of Neuromuscular Diseases, 20014 San Sebastian, Spain.
- CIBERNED, Instituto de Salud Carlos III, Ministry of Science, Innovation and Universities, 28031 Madrid, Spain.
| | - Adolfo López de Munain
- Biodonostia, Neurosciences Area, Group of Neuromuscular Diseases, 20014 San Sebastian, Spain.
- CIBERNED, Instituto de Salud Carlos III, Ministry of Science, Innovation and Universities, 28031 Madrid, Spain.
- Departmento de Neurosciencias, Universidad del País Vasco UPV/EHU, 20014 San Sebastian, Spain.
- Osakidetza Basque Health Service, Donostialdea Integrated Health Organisation, Neurology Department, 20014 San Sebastian, Spain.
| | - Ainara Vallejo-Illarramendi
- Biodonostia, Neurosciences Area, Group of Neuromuscular Diseases, 20014 San Sebastian, Spain.
- CIBERNED, Instituto de Salud Carlos III, Ministry of Science, Innovation and Universities, 28031 Madrid, Spain.
- Grupo Neurociencias, Departmento de Pediatría, Hospital Universitario Donostia, UPV/EHU, 20014 San Sebastian, Spain.
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Strafella C, Campoli G, Galota RM, Caputo V, Pagliaroli G, Carboni S, Zampatti S, Peconi C, Mela J, Sancricca C, Primiano G, Minozzi G, Servidei S, Cascella R, Giardina E. Limb-Girdle Muscular Dystrophies (LGMDs): The Clinical Application of NGS Analysis, a Family Case Report. Front Neurol 2019; 10:619. [PMID: 31263448 PMCID: PMC6585112 DOI: 10.3389/fneur.2019.00619] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2019] [Accepted: 05/28/2019] [Indexed: 12/12/2022] Open
Abstract
The diagnosis of LGMD2A (calpainopathy) can be challenging due to genetic heterogeneity and to high similarity with other LGMDs or neuromuscular disorders. In this setting, NGS panels are highly recommended to perform differential diagnosis, identify new causative mutations and enable genotype-phenotype correlations. In this manuscript, the case of a patient affected by LGMD2A is reported, for which the application of a defined custom designed NGS panel allowed to confirm the diagnosis of calpainopathy linked with two heterozygous variants in CAPN3, namely c.550delA and c.1813G>C. The first variant has been extensively described in relation to calpainopathy. The second variant c.1813G>C, instead, is novel and has been predicted to be probably damaging. In addition, NGS analysis on the proband revealed a heterozygous variant (c.550C>T) in the LMNA gene, which is associated with dilated cardiomyopathy. The variant is novel and has been predicted to be deleterious by subsequent bioinformatic analysis. Successively, segregation analysis was performed on family members. Interestingly, none of them showed neuromuscular symptoms but the mother was diagnosed with bradycardia and syncopal episodes and showed a positive family history for cardiomyopathy. The segregation analysis reported that the proband inherited the c.1813G>C (CAPN3) from the father who was a healthy carrier. The mother was positive for c.550delA (CAPN3) and c.550C>T (LMNA), suggesting thereby a possible genetic explanation for her cardiovascular problems. Segregation analysis, therefore, confirmed the inheritance pattern of the variants carried by the proband and highlighted a familiarity for cardiomyopathy which should not be neglected. The NGS analysis was further performed on the partner of the proband, to estimate the reproductive risk of the couple. The partner was negative to NGS screening, suggesting thereby a low risk to have an affected child with calpainopathy and 50% probability to inherit the LMNA variant. This case report showed the clinical utility of the NGS panel in providing accurate LGMD2A diagnosis and identifying complex phenotypes originating from mutations in multiple genes. However, NGS results should always be accomplished by a dedicated genetic counseling, not only to evaluate the recurrence and reproductive risks but also to uncover unexpected findings which can be clinically significant.
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Affiliation(s)
- Claudia Strafella
- Molecular Genetics Laboratory Unione Italiana Lotta Distrofia Muscolare (UILDM), Santa Lucia Foundation, Rome, Italy.,Department of Biomedicine and Prevention, Tor Vergata University, Rome, Italy
| | - Giulia Campoli
- Molecular Genetics Laboratory Unione Italiana Lotta Distrofia Muscolare (UILDM), Santa Lucia Foundation, Rome, Italy
| | - Rosaria Maria Galota
- Molecular Genetics Laboratory Unione Italiana Lotta Distrofia Muscolare (UILDM), Santa Lucia Foundation, Rome, Italy
| | - Valerio Caputo
- Molecular Genetics Laboratory Unione Italiana Lotta Distrofia Muscolare (UILDM), Santa Lucia Foundation, Rome, Italy.,Department of Biomedicine and Prevention, Tor Vergata University, Rome, Italy
| | - Giulia Pagliaroli
- Molecular Genetics Laboratory Unione Italiana Lotta Distrofia Muscolare (UILDM), Santa Lucia Foundation, Rome, Italy
| | - Stefania Carboni
- Molecular Genetics Laboratory Unione Italiana Lotta Distrofia Muscolare (UILDM), Santa Lucia Foundation, Rome, Italy
| | - Stefania Zampatti
- Molecular Genetics Laboratory Unione Italiana Lotta Distrofia Muscolare (UILDM), Santa Lucia Foundation, Rome, Italy
| | - Cristina Peconi
- Molecular Genetics Laboratory Unione Italiana Lotta Distrofia Muscolare (UILDM), Santa Lucia Foundation, Rome, Italy
| | - Julia Mela
- Molecular Genetics Laboratory Unione Italiana Lotta Distrofia Muscolare (UILDM), Santa Lucia Foundation, Rome, Italy
| | - Cristina Sancricca
- Fondazione Policlinico Universitario A. Gemelli IRCCS, UOC Neurofisiopatologia, Rome, Italy.,Unione Italiana Lotta Distrofia Muscolare (UILDM), Sezione Laziale, Rome, Italy
| | - Guido Primiano
- Fondazione Policlinico Universitario A. Gemelli IRCCS, UOC Neurofisiopatologia, Rome, Italy
| | - Giulietta Minozzi
- Department of Veterinary Medicine, University of Milan, Milan, Italy
| | - Serenella Servidei
- Fondazione Policlinico Universitario A. Gemelli IRCCS, UOC Neurofisiopatologia, Rome, Italy
| | - Raffaella Cascella
- Molecular Genetics Laboratory Unione Italiana Lotta Distrofia Muscolare (UILDM), Santa Lucia Foundation, Rome, Italy.,Department of Biomedical Sciences, Catholic University Our Lady of Good Counsel, Tirana, Albania
| | - Emiliano Giardina
- Molecular Genetics Laboratory Unione Italiana Lotta Distrofia Muscolare (UILDM), Santa Lucia Foundation, Rome, Italy.,Department of Biomedicine and Prevention, Tor Vergata University, Rome, Italy
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Kramerova I, Torres JA, Eskin A, Nelson SF, Spencer MJ. Calpain 3 and CaMKIIβ signaling are required to induce HSP70 necessary for adaptive muscle growth after atrophy. Hum Mol Genet 2019. [PMID: 29528394 PMCID: PMC5905633 DOI: 10.1093/hmg/ddy071] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Mutations in CAPN3 cause autosomal recessive limb girdle muscular dystrophy 2A. Calpain 3 (CAPN3) is a calcium dependent protease residing in the myofibrillar, cytosolic and triad fractions of skeletal muscle. At the triad, it colocalizes with calcium calmodulin kinase IIβ (CaMKIIβ). CAPN3 knock out mice (C3KO) show reduced triad integrity and blunted CaMKIIβ signaling, which correlates with impaired transcriptional activation of myofibrillar and oxidative metabolism genes in response to running exercise. These data suggest a role for CAPN3 and CaMKIIβ in gene regulation that takes place during adaptation to endurance exercise. To assess whether CAPN3- CaMKIIβ signaling influences skeletal muscle remodeling in other contexts, we subjected C3KO and wild type mice to hindlimb unloading and reloading and assessed CaMKIIβ signaling and gene expression by RNA-sequencing. After induced atrophy followed by 4 days of reloading, both CaMKIIβ activation and expression of inflammatory and cellular stress genes were increased. C3KO muscles failed to activate CaMKIIβ signaling, did not activate the same pattern of gene expression and demonstrated impaired growth at 4 days of reloading. Moreover, C3KO muscles failed to activate inducible HSP70, which was previously shown to be indispensible for the inflammatory response needed to promote muscle recovery. Likewise, C3KO showed diminished immune cell infiltration and decreased expression of pro-myogenic genes. These data support a role for CaMKIIβ signaling in induction of HSP70 and promotion of the inflammatory response during muscle growth and remodeling that occurs after atrophy, suggesting that CaMKIIβ regulates remodeling in multiple contexts: endurance exercise and growth after atrophy.
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Affiliation(s)
- Irina Kramerova
- Department of Neurology, David Geffen School of Medicine, University of California, Los Angeles, CA 90095, USA.,Center for Duchenne Muscular Dystrophy, University of California, Los Angeles, CA 90095, USA
| | - Jorge A Torres
- Department of Neurology, David Geffen School of Medicine, University of California, Los Angeles, CA 90095, USA.,Center for Duchenne Muscular Dystrophy, University of California, Los Angeles, CA 90095, USA
| | - Ascia Eskin
- Center for Duchenne Muscular Dystrophy, University of California, Los Angeles, CA 90095, USA.,Department of Human Genetics, David Geffen School of Medicine, University of California, Los Angeles, CA 90095, USA
| | - Stanley F Nelson
- Center for Duchenne Muscular Dystrophy, University of California, Los Angeles, CA 90095, USA.,Department of Human Genetics, David Geffen School of Medicine, University of California, Los Angeles, CA 90095, USA
| | - Melissa J Spencer
- Department of Neurology, David Geffen School of Medicine, University of California, Los Angeles, CA 90095, USA.,Center for Duchenne Muscular Dystrophy, University of California, Los Angeles, CA 90095, USA
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45
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Martinez-Thompson JM, Moore SA, Liewluck T. A novel CAPN3 mutation in late-onset limb-girdle muscular dystrophy with early respiratory insufficiency. J Clin Neurosci 2018; 53:229-231. [PMID: 29685414 DOI: 10.1016/j.jocn.2018.04.025] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2018] [Accepted: 04/09/2018] [Indexed: 11/19/2022]
Abstract
We describe a 70 year-old independently ambulatory man with a 10-year history of progressive axial and limb-girdle weakness, hyperCKemia, and a 5-year history of dyspnea requiring nocturnal ventilatory support due to a known c.1309C>T (p.Arg437Cys) variant and a novel in-frame deletion of exons 17-19 in the calpain-3 encoding gene (CAPN3). Pulmonary function tests revealed neuromuscular respiratory weakness. Biceps femoris biopsy showed chronic myopathic changes, numerous lobulated fibers, and reduced calpain-3 immunoreactivity. Muscle immunoblot showed markedly reduced calpain-3 expression. Respiratory insufficiency is uncommon in autosomal recessive calpainopathy, and generally develops in the advanced stages of the disease when individuals become wheelchair-dependent. Our patient broadens the phenotypic spectrum of recessive calpainopathy to include early respiratory insufficiency and also further expands its molecular spectrum.
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Affiliation(s)
| | - Steven A Moore
- Department of Pathology, University of Iowa, Iowa City, IA, United States
| | - Teerin Liewluck
- Department of Neurology, Mayo Clinic, Rochester, MN, United States
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46
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Lostal W, Urtizberea JA, Richard I. 233rd ENMC International Workshop:: Clinical Trial Readiness for Calpainopathies, Naarden, The Netherlands, 15-17 September 2017. Neuromuscul Disord 2018; 28:540-549. [PMID: 29655529 DOI: 10.1016/j.nmd.2018.03.010] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2018] [Accepted: 03/19/2018] [Indexed: 11/28/2022]
Affiliation(s)
- William Lostal
- INTEGRARE, Genethon, Inserm, University of Evry, Université Paris-Saclay, Evry, 91002, France
| | | | - Isabelle Richard
- INTEGRARE, Genethon, Inserm, University of Evry, Université Paris-Saclay, Evry, 91002, France.
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47
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Martinez-Thompson JM, Niu Z, Tracy JA, Moore SA, Swenson A, Wieben ED, Milone M. Autosomal dominant calpainopathy due to heterozygous CAPN3 C.643_663del21. Muscle Nerve 2018; 57:679-683. [PMID: 28881388 PMCID: PMC5915624 DOI: 10.1002/mus.25970] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/03/2017] [Indexed: 01/13/2023]
Abstract
INTRODUCTION A calpain-3 (CAPN3) gene heterozygous deletion (c.643_663del21) was recently linked to autosomal dominant (AD) limb-girdle muscular dystrophy. However, the possibility of digenic disease was raised. We describe 3 families with AD calpainopathy carrying this isolated mutation. METHODS Probands heterozygous for CAPN3 c.643_663del21 were identified by targeted next generation or whole exome sequencing. Clinical findings were collected for probands and families. Calpain-3 muscle Western blots were performed in 3 unrelated individuals. RESULTS Probands reported variable weakness in their 40s or 50s, with myalgia, back pain, or hyperlordosis. Pelvic girdle muscles were affected with adductor and hamstring sparing. Creatine kinase was normal to 1,800 U/L, independent of weakness severity. Imaging demonstrated lumbar paraspinal muscle atrophy. Electromyographic findings and muscle biopsies were normal to mildly myopathic. Muscle calpain-3 expression was reduced. DISCUSSION This study provides further evidence for AD calpainopathy associated with CAPN3 c.643_663del21. No pathogenic variants in other genes known to cause myopathy were detected. Muscle Nerve 57: 679-683, 2018.
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Affiliation(s)
| | - Zhiyv Niu
- Department of Laboratory Medicine & Pathology, Mayo Clinic, Rochester, Minnesota, USA
- Department of Clinical Genomics, Mayo Clinic, Rochester, Minnesota, USA
| | - Jennifer A Tracy
- Department of Neurology, Mayo Clinic, 200 First Street SW, Rochester, Minnesota, 55905, USA
| | - Steven A Moore
- Department of Pathology University of Iowa, Iowa City, Iowa, USA
| | - Andrea Swenson
- Department of Neurology, University of Iowa, Iowa City, Iowa, USA
| | - Eric D Wieben
- Department of Biochemistry & Molecular Biology, Mayo Clinic, Rochester, Minnesota, USA
| | - Margherita Milone
- Department of Neurology, Mayo Clinic, 200 First Street SW, Rochester, Minnesota, 55905, USA
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Hogrel JY, Ollivier G, Ledoux I, Hébert LJ, Eymard B, Puymirat J, Bassez G. Relationships between grip strength, myotonia, and CTG expansion in myotonic dystrophy type 1. Ann Clin Transl Neurol 2017; 4:921-925. [PMID: 29296622 PMCID: PMC5740258 DOI: 10.1002/acn3.496] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2017] [Revised: 10/02/2017] [Accepted: 10/02/2017] [Indexed: 02/01/2023] Open
Abstract
In myotonic dystrophy type 1, several studies have suggested causal relationships between CTG repeat length and the severity of symptoms, such as weakness or myotonia. We aimed to explore these relationships in a large population of 144 DM1 patients. All patients underwent clinical and functional assessments using a standardized test for grip strength and myotonia assessment. Myotonia was assessed using a fully automatic software based on mathematical modeling of relaxation force curve. CTG repeat length was statistically correlated with both myotonia and grip strength, which are two major primary neuromuscular symptoms of DM1 patients. However, these relationships are not clinically meaningful and not predictive at the individual level.
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Affiliation(s)
| | | | | | | | - Bruno Eymard
- Institut de Myologie GH Pitié-Salpêtrière Paris France
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49
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Vissing J, Duno M. Reply: Dominant LGMD2A: alternative diagnosis or hidden digenism? Brain 2016; 140:e8. [DOI: 10.1093/brain/aww283] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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50
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Sáenz A, López de Munain A. Dominant LGMD2A: alternative diagnosis or hidden digenism? Brain 2016; 140:e7. [PMID: 27818383 DOI: 10.1093/brain/aww281] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Amets Sáenz
- Neurosciences Area, Biodonostia Health Research Institute, San Sebastian, Spain.,CIBERNED, Center for Networked Biomedical Research on Neurodegenerative Diseases, Madrid, Spain
| | - Adolfo López de Munain
- Neurosciences Area, Biodonostia Health Research Institute, San Sebastian, Spain .,CIBERNED, Center for Networked Biomedical Research on Neurodegenerative Diseases, Madrid, Spain.,Department of Neurosciences, University of the Basque Country UPV-EHU, San Sebastian, Spain.,Department of Neurology. University Donostia Hospital, San Sebastian, Spain
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