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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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2
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Alawneh I, Stosic A, Gonorazky H. Muscle MRI patterns for limb girdle muscle dystrophies: systematic review. J Neurol 2023:10.1007/s00415-023-11722-1. [PMID: 37129643 DOI: 10.1007/s00415-023-11722-1] [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: 02/14/2023] [Revised: 04/06/2023] [Accepted: 04/11/2023] [Indexed: 05/03/2023]
Abstract
Limb girdle muscle dystrophies (LGMDs) are a group of inherited neuromuscular disorders comprising more than 20 genes. There have been increasing efforts to characterize this group with Muscle MRI. However, due to the complexity and similarities, the interpretation of the MRI patterns is usually done by experts in the field. Here, we proposed a step-by-step image interpretation of Muscle MRI in LGDM by evaluating the variability of muscle pattern involvement reported in the literature. A systematic review with an open start date to November 2022 was conducted to describe all LGMDs' muscle MRI patterns. Eighty-eight studies were included in the final review. Data were found to describe muscle MRI patterns for 15 out of 17 LGMDs types. Although the diagnosis of LGMDs is challenging despite the advanced genetic testing and other diagnostic modalities, muscle MRI is shown to help in the diagnosis of LGMDs. To further increase the yield for muscle MRI in the neuromuscular field, larger cohorts of patients need to be conducted.
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Affiliation(s)
- Issa Alawneh
- Department of Neurology, The Hospital for Sick Children, Toronto, Canada
| | - Ana Stosic
- Genetics and Genome Biology Program, The Hospital for Sick Children Research Institute, Toronto, Canada
| | - Hernan Gonorazky
- Department of Neurology, The Hospital for Sick Children, Toronto, Canada.
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3
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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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Mavillard F, Madruga-Garrido M, Rivas E, Servián-Morilla E, Ávila-Polo R, Marcos I, Morón FJ, Paradas C, Cabrera-Serrano M. NOVEL intronic CAPN3 Roma mutation alters splicing causing RNA mediated decay. Ann Clin Transl Neurol 2019; 6:2328-2333. [PMID: 31612648 PMCID: PMC6856619 DOI: 10.1002/acn3.50910] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2019] [Revised: 09/02/2019] [Accepted: 09/10/2019] [Indexed: 01/08/2023] Open
Abstract
CAPN3 mutations cause a limb girdle muscular dystrophy. Functional characterization of novel mutations facilitates diagnosis of future cases. We have identified a novel (c.1992 + 2T>G) CAPN3 mutation that disrupts the donor splice site of intron 17 splicing out exon 17, with mRNA levels severely reduced or undetectable. The mutation induces a strong change in the 3D structure of the mRNA which supports no‐go mRNA decay as the probable mechanism for RNA degradation. The mutation was identified in two unrelated Roma individuals showing a common ancestral origin and founder effect. This is the first Roma CAPN3 mutation to be reported.
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Affiliation(s)
- Fabiola Mavillard
- Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen del Rocío/CSIC, Universidad de Sevilla, Sevilla, Spain.,Centro Investigación Biomédica en Red Enfermedades Neurodegenerativas (CIBERNED), Instituto de salud Carlos III, Sevilla, Spain
| | - Marcos Madruga-Garrido
- Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen del Rocío/CSIC, Universidad de Sevilla, Sevilla, Spain.,Neuromuscular Disorder Unit, Pediatric Neurology Department, Hospital U. Virgen del Rocío, Sevilla, Spain
| | - Eloy Rivas
- Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen del Rocío/CSIC, Universidad de Sevilla, Sevilla, Spain.,Department of Pathology, Hospital U. Virgen del Rocío, Sevilla, Spain
| | - Emilia Servián-Morilla
- Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen del Rocío/CSIC, Universidad de Sevilla, Sevilla, Spain.,Centro Investigación Biomédica en Red Enfermedades Neurodegenerativas (CIBERNED), Instituto de salud Carlos III, Sevilla, Spain
| | - Rainiero Ávila-Polo
- Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen del Rocío/CSIC, Universidad de Sevilla, Sevilla, Spain.,Department of Pathology, Hospital U. Virgen del Rocío, Sevilla, Spain
| | - Irene Marcos
- Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen del Rocío/CSIC, Universidad de Sevilla, Sevilla, Spain.,Department of Maternal-Fetal Medicine, Genetics and Reproduction, Hospital U. Virgen del Rocío, Sevilla, Spain.,Centro Investigación Biomédica en Red Enfermedades Raras (CIBERER), Seville, Spain
| | - Francisco J Morón
- Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen del Rocío/CSIC, Universidad de Sevilla, Sevilla, Spain
| | - Carmen Paradas
- Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen del Rocío/CSIC, Universidad de Sevilla, Sevilla, Spain.,Centro Investigación Biomédica en Red Enfermedades Neurodegenerativas (CIBERNED), Instituto de salud Carlos III, Sevilla, Spain.,Department of Neurology, Hospital Virgen del Rocío, Sevilla, Spain
| | - Macarena Cabrera-Serrano
- Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen del Rocío/CSIC, Universidad de Sevilla, Sevilla, Spain.,Centro Investigación Biomédica en Red Enfermedades Neurodegenerativas (CIBERNED), Instituto de salud Carlos III, Sevilla, Spain.,Department of Neurology, Hospital Virgen del Rocío, Sevilla, Spain
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Yu M, Zheng Y, Jin S, Gang Q, Wang Q, Yu P, Lv H, Zhang W, Yuan Y, Wang Z. Mutational spectrum of Chinese LGMD patients by targeted next-generation sequencing. PLoS One 2017; 12:e0175343. [PMID: 28403181 PMCID: PMC5389788 DOI: 10.1371/journal.pone.0175343] [Citation(s) in RCA: 56] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2017] [Accepted: 03/24/2017] [Indexed: 12/21/2022] Open
Abstract
This study aimed to study the diagnostic value of targeted next-generation sequencing (NGS) in limb-girdle muscular dystrophies (LGMDs), and investigate the mutational spectrum of Chinese LGMD patients. We performed targeted NGS covering 420 genes in 180 patients who were consecutively suspected of LGMDs and underwent muscle biopsies from January 2013 to May 2015. The association between genotype and myopathological profiles was analyzed in the genetically confirmed LGMD patients. With targeted NGS, one or more rare variants were detected in 138 patients, of whom 113 had causative mutations, 10 sporadic patients had one pathogenic heterozygous mutation related to a recessive pattern of LGMDs, and 15 had variants of uncertain significance. No disease-causing mutation was found in the remaining 42 patients. Combined with the myopathological findings, we achieved a positive genetic diagnostic rate as 68.3% (123/180). Totally 105 patients were diagnosed as LGMDs with genetic basis. Among these 105 patients, the most common subtypes were LGMD2B in 52 (49.5%), LGMD2A in 26 (24.8%) and LGMD 2D in eight (7.6%), followed by LGMD1B in seven (6.7%), LGMD1E in four (3.8%), LGMD2I in three (2.9%), and LGMD2E, 2F, 2H, 2K, 2L in one patient (1.0%), respectively. Although some characteristic pathological changes may suggest certain LGMD subtypes, both heterogeneous findings in a certain subtype and overlapping presentations among different subtypes were not uncommon. The application of NGS, together with thorough clinical and myopathological evaluation, can substantially improve the molecular diagnostic rate in LGMDs. Confirming the genetic diagnosis in LGMD patients can help improve our understanding of their myopathological changes.
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Affiliation(s)
- Meng Yu
- Department of Neurology, Peking University First Hospital, Beijing, China
| | - Yiming Zheng
- Department of Neurology, Peking University First Hospital, Beijing, China
| | - Suqin Jin
- Department of Neurology, Peking University First Hospital, Beijing, China
| | - Qiang Gang
- Department of Neurology, Peking University First Hospital, Beijing, China
| | - Qingqing Wang
- Department of Neurology, Peking University First Hospital, Beijing, China
| | - Peng Yu
- Science and Technology, Precisionmdx Inc., Beijing, China
| | - He Lv
- Department of Neurology, Peking University First Hospital, Beijing, China
| | - Wei Zhang
- Department of Neurology, Peking University First Hospital, Beijing, China
| | - Yun Yuan
- Department of Neurology, Peking University First Hospital, Beijing, China
| | - Zhaoxia Wang
- Department of Neurology, Peking University First Hospital, Beijing, China
- * E-mail:
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6
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Sánchez-Chapul L, Ángel-Muñoz MD, Ruano-Calderón L, Luna-Angulo A, Coral-Vázquez R, Hernández-Hernández Ó, Magaña JJ, León-Hernández SR, Escobar-Cedillo RE, Vargas S. Dysferlin quantification in monocytes for rapid screening for dysferlinopathies. Muscle Nerve 2016; 54:1064-1071. [PMID: 27104310 DOI: 10.1002/mus.25156] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/18/2016] [Indexed: 12/15/2022]
Abstract
INTRODUCTION In this study, we determined normal levels of dysferlin expression in CD14+ monocytes by flow cytometry (FC) as a screening tool for dysferlinopathies. METHODS Monocytes from 183 healthy individuals and 29 patients were immunolabeled, run on an FACScalibur flow cytometer, and analyzed by FlowJo software. RESULTS The relative quantity of dysferlin was expressed as mean fluorescence intensity (MFI). Performance of this diagnostic test was assessed by calculating likelihood ratios at different MFI cut-off points, which allowed definition of 4 disease classification groups in a simplified algorithm. CONCLUSION The MFI value may differentiate patients with dysferlinopathy from healthy individuals; it may be a useful marker for screening purposes. Muscle Nerve 54: 1064-1071, 2016.
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Affiliation(s)
- Laura Sánchez-Chapul
- División de Neurociencias, Instituto Nacional de Rehabilitación (INR), Calz. Mexico-Xochimilco 289, Col. Arenal de Guadalupe, Del. Tlalpan, 14389, Mexico City, Mexico
| | - Miguel Del Ángel-Muñoz
- División de Neurociencias, Instituto Nacional de Rehabilitación (INR), Calz. Mexico-Xochimilco 289, Col. Arenal de Guadalupe, Del. Tlalpan, 14389, Mexico City, Mexico
| | - Luis Ruano-Calderón
- Subdirección de Enseñanza y Capacitación, Investigación y Calidad en Salud, Secretaría de Salud del Estado de Durango (SSED), Durango City, Mexico
| | - Alexandra Luna-Angulo
- División de Neurociencias, Instituto Nacional de Rehabilitación (INR), Calz. Mexico-Xochimilco 289, Col. Arenal de Guadalupe, Del. Tlalpan, 14389, Mexico City, Mexico
| | - Ramón Coral-Vázquez
- Sección de Posgrado, Escuela Superior de Medicina, Instituto Politécnico Nacional (ESM-IPN), Mexico City, Mexico
| | | | - Jonathan J Magaña
- Laboratorio de Medicina Genómica, Servicio de Genética, (INR), Mexico City, Mexico
| | | | | | - Steven Vargas
- Laboratorio de Patología Experimental, Instituto Nacional de Neurología y Neurocirugía (INNN) "Manuel Velasco Suárez", Mexico City, Mexico
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7
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Richard I, Hogrel JY, Stockholm D, Payan CAM, Fougerousse F, Eymard B, Mignard C, Lopez de Munain A, Fardeau M, Urtizberea JA. Natural history of LGMD2A for delineating outcome measures in clinical trials. Ann Clin Transl Neurol 2016; 3:248-65. [PMID: 27081656 PMCID: PMC4818744 DOI: 10.1002/acn3.287] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2015] [Revised: 12/04/2015] [Accepted: 12/05/2015] [Indexed: 11/23/2022] Open
Abstract
Objective Limb‐girdle muscular dystophy 2A (LGMD2A, OMIM) is a slowly progressive myopathy caused by the deficiency in calpain 3, a calcium‐dependent cysteine protease of the skeletal muscle. Methods In this study, we carried out an observational study of clinical manifestations and disease progression in genetically confirmed LGMD2A patients for up to 4 years. A total of 85 patients, aged 14–65 years, were recruited in three centers located in metropolitan France, the Basque country, and the Reunion Island. They were followed up every 6 months for 2 years and a subgroup was assessed annually thereafter for two more years. Data collected for all patients included clinical history, blood parameters, muscle strength assessed by manual muscle testing (MMT) and quantitative muscle testing, functional scores, and pulmonary and cardiac functions. In addition, CT scans of the lower limbs were performed in a subgroup of patients. Results Our study confirms the clinical description of a slowly progressive disorder with onset in the first or second decade of life with some degree of variability related to gender and mutation type. The null mutations lead to a more severe phenotype while compound heterozygote patients are the least affected. Muscle weakness is remarkably symmetrical and predominant in the axial muscles of the trunk and proximal muscles of the lower limb. There was a high correlation between the weakness at individual muscle level as assessed by MMT and the loss of density in CT scan analysis. Interpretation All the generated data will help to determine the endpoints for further clinical studies.
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Affiliation(s)
- Isabelle Richard
- INSERMU 951 INTEGRARE Research Unit Evr F-91002 France; Généthon 1 bis rue de l'Internationale Evry F-91002 France
| | | | - Daniel Stockholm
- INSERMU 951 INTEGRARE Research Unit Evr F-91002 France; Généthon 1 bis rue de l'Internationale Evry F-91002 France; Ecole Pratique des Hautes Etudes Paris France
| | - Christine A M Payan
- Institut de Myologie GH Pitié-Salpêtriere Paris France; Present address: Institut de Neurosciences Translationnelles de Paris Service de Pharmacologie Clinique Hôpital Pitié-Salpêtrière Paris France
| | - Françoise Fougerousse
- Généthon1bis rue de l'Internationale Evry F-91002 France; Present address: Laboratoire Servier Neuilly/Seine France
| | | | - Bruno Eymard
- Institut de Myologie GH Pitié-Salpêtriere Paris France
| | - Claude Mignard
- Centre de Référence des maladies Neuromusculaires et Neurologiques rares du CHU de la Réunion La Réunion France
| | - Adolfo Lopez de Munain
- Service de Neurologie Hospital Donostia Biodonostia Institute CIBERNED University of the Basque Country UPV-EHU San Sebastian Spain
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8
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Fanin M, Angelini C. Protein and genetic diagnosis of limb girdle muscular dystrophy type 2A: The yield and the pitfalls. Muscle Nerve 2015; 52:163-73. [PMID: 25900067 DOI: 10.1002/mus.24682] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/09/2015] [Indexed: 12/20/2022]
Abstract
Limb girdle muscular dystrophy type 2A (LGMD2A) is the most frequent form of LGMD worldwide. Comprehensive clinical assessment and laboratory testing is essential for diagnosis of LGMD2A. Muscle immunoblot analysis of calpain-3 is the most useful tool to direct genetic testing, as detection of calpain-3 deficiency has high diagnostic value. However, calpain-3 immunoblot testing lacks sensitivity in about 30% of cases due to gene mutations that inactivate the enzyme. The best diagnostic strategy should be determined on a case-by-case basis, depending on which tissues are available, and which molecular and/or genetic methods are adopted. In this work we survey the current knowledge, advantages, limitations, and pitfalls of protein testing and mutation detection in LGMD2A and provide an update of genetic epidemiology.
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Affiliation(s)
- Marina Fanin
- Department of Neurosciences, Biomedical Campus "Pietro d'Abano," via Giuseppe Orus 2B, 35129, Padova, Italy
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Limb-girdle muscular dystrophy type 2a with mutation in CAPN3: the first report in Taiwan. Pediatr Neonatol 2015; 56:62-5. [PMID: 23597518 DOI: 10.1016/j.pedneo.2013.01.018] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2012] [Revised: 09/17/2012] [Accepted: 01/30/2013] [Indexed: 11/23/2022] Open
Abstract
The autosomal recessive limb-girdle muscular dystrophy type 2A (LGMD2A) is caused by mutations in the calpain 3 (CAPN3) gene, and it is characterized by selective atrophy and weakness of proximal limb and girdle muscles. We report a 33-year-old woman with initial presentations of exercise intolerance and running difficulty at age 15 years. At presentation, waddling gait, positive Gowers' sign, and marked muscle atrophy in pelvic and leg muscles were noted. Muscle computed tomography (CT) imaging demonstrated symmetric involvement of the posterior thigh muscles with relative sparing of vastus lateralis, sartorius, and gracilis. Muscle biopsy revealed a dystrophic change and many lobulated fibers on NADH-tetrazolium reductase staining. Genetic analysis of the CAPN3 gene identified a novel homozygous mutation of c2047_2050 del4, p.Lys683fs mutation, confirming the first LGMD2A patient in Taiwan.
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10
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Mahmood OA, Jiang X, Zhang Q. Limb-girdle muscular dystrophy subtypes: First-reported cohort from northeastern China. Neural Regen Res 2014; 8:1907-18. [PMID: 25206500 PMCID: PMC4145977 DOI: 10.3969/j.issn.1673-5374.2013.20.010] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2013] [Accepted: 06/25/2013] [Indexed: 12/02/2022] Open
Abstract
The relative frequencies of different subtypes of limb-girdle muscular dystrophies vary widely among different populations. We estimated the percentage of limb-girdle muscular dystrophy subtypes in Chinese people based on 68 patients with limb-girdle muscular dystrophy from the Myology Clinic, Neurology Department, First Hospital of Jilin University, China. A diagnosis of calpainopathy was made in 12 cases (17%), and dysferlin deficiency in 10 cases (15%). Two biopsies revealed α-sarcoglycan deficiency (3%), and two others revealed a lack of caveolin-3 (3%). A diagnosis of unclassified limb-girdle muscular dystrophy was made in the remaining patients (62%). The appearances of calpain 3- and dysferlin-deficient biopsies were similar, though rimmed vacuoles were unique to dysferlinopathy, while inflammatory infiltrates were present in both these limb-girdle muscular dystrophy type 2D biopsies. Macrophages were detected in seven dysferlinopathy biopsies. The results of this study suggest that the distribution of limb-girdle muscular dystrophy subtypes in the Han Chinese population is similar to that reported in the West. The less necrotic, regenerating and inflammatory appearance of limb-girdle muscular dystrophy type 2A, but with more lobulated fibers, supports the idea that calpainopathy is a less active, but more chronic disease than dysferlinopathy. Unusual features indicated an extended limb-girdle muscular dystrophy disease spectrum. The use of acid phosphatase stain should be considered in suspected dysferlinopathies. To the best of our knowledge, this is the first report to define the relative proportions of the various forms of limb-girdle muscular dystrophy in China, based on protein testing.
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Affiliation(s)
- Omar Abdulmonem Mahmood
- Department of Neurology, Affiliated First Hospital of Jilin University, Changchun 130021, Jilin Province, China ; Department of Neuromedicine, Mosul Medical College, 41002, Mosul, Iraq
| | - Xinmei Jiang
- Department of Neurology, Affiliated First Hospital of Jilin University, Changchun 130021, Jilin Province, China
| | - Qi Zhang
- Department of Neurology, Affiliated First Hospital of Jilin University, Changchun 130021, Jilin Province, China
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11
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Luo SS, Xi JY, Zhu WH, Zhao CB, Lu JH, Lin J, Wang Y, Lu J, Qiao K. Genetic variability and clinical spectrum of Chinese patients with limb-girdle muscular dystrophy type 2A. Muscle Nerve 2012; 46:723-9. [DOI: 10.1002/mus.23381] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/06/2012] [Indexed: 11/10/2022]
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