Red blood cell and fibroblast membranes in Duchenne and myotonic muscular dystrophy

Properties of Ca2+-activated K+ channels in erythrocytes from patients with myotonic muscular dystrophy

Using the single-channel patch-clamp technique, Ca2+-activated K+ channels of erythrocytes from patients with myotonic muscular dystrophy (MyD) were studied. Elementary single-channel properties--conductance, rectification, kinetics, voltage- and calcium-dependence--measured in inside-out patches of MyD erythrocytes, did not differ significantly from those of control cells. The activity of the channels, studied in patches attached to red cells from MyD patients, exhibited mean patch currents which were significantly higher than the controls. The increased mean patch current was due to a higher opening frequency, associated with a reduced mean channel closed time. These results indicate that Ca2+-activated K+ channels of erythrocytes from patients either detect a higher intracellular calcium concentration and/or express an augmented calcium-sensitivity. Since these channels are targets for phosphorylation, our findings make it possible to identify defective kinase mechanisms, in minimally disturbed cells of the patient, at a molecular level of resolution.

Study on the erythrocytes from myotonic dystrophy with multi-nuclear NMR

We have studied the water permeability through membranes, the function of the Na pump, and glucose metabolism of erythrocytes of patients with myotonic muscular dystrophy (MyD) using 1H--, 23Na, and 13C-NMR techniques. A significant decrease in water permeability was recognized in the MyD erythrocyte membrane, and impaired Na pumping was suspected to be correlated with the former biochemical abnormalities in band III protein of MyD erythrocyte membrane. Significant acceleration of glycolysis in the erythrocyte for the first 160 minutes was also recognized in MyD; however, the production of lactate showed no difference between MyD and controls. The increased glucose uptake in MyD may be compensatory to the diminished pumping mechanism, but further information, such as inorganic phosphate permeability and the activity of the rate-limiting enzyme of erythrocyte glycolysis, is needed.

Abnormal M-wave responses during exercise in myotonic muscular dystrophy: a Na(+)--K+ pump defect?

Maximum M-waves (muscle compound action potentials) were studied in the abductor pollicis brevis (APB), extensor digitorum brevis (EDB), and tibialis anterior (TA) muscles of 12 patients with myotonic muscular dystrophy (MMD) and in the same number of control subjects, matched for age and sex. The peak-to-peak amplitudes and voltage-time areas of the responses were measured at rest, between 40 maximum voluntary contractions (each lasting 3 s) and also during a 2-min recovery period. In 34 of the 36 control muscles the M-waves potentiated during the period of intermittent voluntary contractions. In the MMD patients, however, the M waves exhibited initial declines in 25 of 30 muscles. In the APB and EDB muscles the normalized mean values for the smallest M-waves, recorded during the 350 s total observation periods, differed significantly between the 2 groups of subjects. It is suggested that the sarcolemmal Na(+)-K+ pump has a raised threshold for activation in MMD patients.

Intracellular elemental composition of single muscle fibres in muscular dystrophy and dystrophia myotonica

Seven patients with myotonic muscle dystrophy (MD), 6 with muscle dystrophy without myotonia (limb-girdle and facio-scapulo-humeral dystrophy) and 6 healthy volunteers were subjected to biopsy from the anterior tibial muscle (TA). Light microscopic examination of cryostat sections revealed pathological changes of different kind and degree--the occurrence of ring fibres and multiple central nuclei was the most consistent in advanced MD. X-ray microanalysis (XRMA) of single muscle fibres demonstrated the intracellular content of such elements as Na, Cl, K, Mg, S and P. The most conspicuous finding was the increase in Na and Cl and decrease in K demonstrated in MD. The highest levels of Na and Cl were found in ring fibres. Decrease in K was as high in structurally normal fibres of MD biopsies as in ring fibres and was also found in the muscle dystrophies without myotonia, but to a lesser degree than in MD. Thus, the decrease in K was not correlated to increase in Na and Cl. These changes in muscle fibre elemental content are discussed in relation to plasma membrane changes of erythrocytes in MD and especially the indications of disturbed anion channels.

Sialic acid content in serum IgG from patients with myotonic dystrophy compared with healthy controls

One of the determinants of the lifetime of circulating glycoproteins is their content of the terminal carbohydrate sialic acid. In order to elucidate a possible mechanism behind reduced concentration of IgG in patients with myotonic dystrophy, serum IgG was isolated by affinity chromatography and its content of sialic acid determined. No difference between patients and healthy controls was found. The results provide further support to the idea that a host factor rather than an abnormality of the IgG molecule itself is responsible for the low concentration of serum IgG in this disease.

The physical state of the erythrocyte membrane in myotonic dystrophy

The molecular pathology of myotonic dystrophy is believed to be expressed at the plasma membrane level. Previous assessments of membrane fluidity, a marker of the biochemical state of the membrane, have yielded conflicting results. In this study, erythrocyte membrane fluidity was reevaluated using highly sensitive fluorescence probe techniques. Steady-state anisotropy was measured with diphenylhexatriene (DPH), trimethylaminophenyl-hexatriene (TMA-DPH) and phenylhexatrienylphenylpropionic acid, probing different regions of the membrane. In the patients, significantly increased steady-state anisotropy was obtained with DPH, probing the hydrophobic core of the membrane, while slightly reduced anisotropy was found with TMA-DPH. The dynamic properties of the membrane lipids were further examined by means of time-resolved measurements with DPH. The excited state decay kinetics could best be described by a bi-exponential decay model. A large redistribution of the probe populations and a reduction of the average order parameter were found in the patients indicating a less ordered or more fluid lipid matrix. These perturbations might be induced by a protein abnormality and altered protein-lipid interaction within the erythrocyte membrane.

Studies of water permeability and proteins of erythrocyte membranes in patients with Duchenne muscular dystrophy

The characteristics of water permeability of erythrocytes from 54 Duchenne muscular dystrophy (DMD) patients and age-matched controls have been determined by a pulse nuclear magnetic resonance (NMR) technique. A decreased permeability of erythrocyte membrane in DMD was definitely found at all temperatures between 15 and 42 degrees C, with normal values for the activation energy of water diffusion. No differences between DMD and control subjects in the pattern of erythrocyte membrane polypeptides separated by two-dimensional electrophoresis could be detected. The findings are discussed in relation to the molecular mechanisms of water diffusion across erythrocyte membrane and the problem of erythrocyte membrane abnormalities in DMD. A new interpretation of erythrocyte membrane alterations is proposed based on the recent findings regarding the molecular pathology of DMD.

Environmental influence on altered receptor function in a genetic disease: insulin and glucose affect insulin receptors in myotonic dystrophy

Insulin action in vivo and insulin binding to monocytes in vitro were correlated in patients with myotonic dystrophy (MyD) and compared with healthy controls. Confirming our previous studies and those of others, the present results show that the glucose infusion rate (DR), an estimate of in vivo insulin sensitivity, was significantly diminished in MyD. At the same per cent of ideal body weight DR in MyD patients was considerably less than controls suggesting that obesity could not solely account for decreased insulin sensitivity in MyD. The relative capacity (RC), and relative affinity (ED50) of the insulin receptor in monocytes was significantly less in patients. The relative affinity (ED50) was improved by changing environmental insulin levels while receptor numbers (RC) were not. Insulin sensitivity and RC showed a trend toward a positive correlation although this did not reach statistical significance. Our data suggest that the alteration of the insulin receptor in MyD is different from obesity and from other disorders of the motor unit such as amyotrophic lateral sclerosis, where insulin sensitivity and RC are reduced but ED50 is unchanged. Thus, in MyD the receptor may be one of the loci where the resistance occurs.

Sialic acid concentration in erythrocyte membrane subfractions in patients with myotonic dystrophy and healthy controls

Previous studies have shown a selective reduction of the sialic acid concentration in erythrocyte membranes in patients with myotonic dystrophy. In order to locate this deficiency, chloroform/methanol/H2O extractions of erythrocyte membranes were analyzed in patients with myotonic dystrophy and in matched healthy reference individuals. In the patients, significant reductions of the sialic acid concentration were found in the aqueous phase (p = 0.03) containing mainly glycophorin A as well as in the band-3-containing interphase (p less than 0.005). These findings may be related to certain previously reported membrane abnormalities in myotonic dystrophy.

Alterations of lipid composition in a dystrophic muscle cell line

The composition of neutral lipids and phospholipids was determined in normal (Cb7) and dystrophic (DyA4) cell lines, derived from cloned satellite cells from control and dystrophic C57BL/6J/dydy mice. The results obtained showed that dystrophic cells contain a higher relative distribution of phospholipids than their normal counterparts. Moreover, the distribution of individual phospholipids differs between normal and dystrophic cells, with increased percentage of acidic phospholipids and reduced proportion of phosphatidylcholine in dystrophic cells. Cholesterol was increased but free fatty acids decreased in dystrophic cells. The possible pathogenetic significance and functional consequences of these abnormalities are discussed.

Effect of phorbol esters and liposome-delivered phospholipids on the differentiation program of normal and dystrophic satellite cells

Satellite cells, isolated from hind limb of normal C57BL/6J mice, differentiate in culture in the presence of concentrations of phorbol esters which inhibit differentiation of embryonic myoblasts. However, if phosphatidylserine containing liposomes were added to the culture medium together with TPA, differentiation of satellite cells was reversibly inhibited. Under these conditions, the withdrawal of these cells from the cell cycle still occurred as in untreated cells. Phosphatidylserine liposomes alone or liposomes containing phosphatidylcholine (either alone or in combination with TPA) had no effect on satellite cell differentiation. In the case of satellite cells from dystrophic C57BL/6J/dydy mice, TPA addition (0.1 microM) to the culture medium partially (about 70%) inhibited morphological and biochemical differentiation. This effect could be prevented by preincubating dystrophic satellite cells with liposomes containing phosphatidylcholine but not other phospholipids. These data indicate that it is possible to change the sensitivity to TPA of satellite cells by modifying the phospholipid composition of their plasma membrane. Possible relationships of these phenomena with activation of protein kinase C or phosphatidylinositol breakdown have been investigated. The results obtained are discussed with regard to possible modulation of the intracellular response to agonist binding.

Altered distribution of protein kinase C in dystrophic muscle cells and its modulation by liposome-delivered phospholipids

The activity and subcellular distribution of the calcium-phospholipid dependent protein kinase (protein kinase C) were studied in normal and dystrophic muscle cells in vitro. Clonal strains of satellite cells, isolated from normal and dystrophic (C57BL/6J/dydy) mice, differentiate in vitro at a comparable level (over 80% of fusion). Differentiated myotubes were homogenized and separated into a soluble and a particulate fraction. The activity of protein kinase C was assayed in both fractions, and was found to be mainly in the cytosol of normal cells, whereas it was mainly associated to the membrane fraction of dystrophic cells. This altered distribution of the enzyme was likely consequent to alterations in the phospholipid composition of the dystrophic cell membrane, since it was possible to partially revert the situation by modifying the membranes with liposome-delivered phospholipids. Splenic lymphocytes from dystrophic mice showed an altered distribution of protein kinase C similar to that observed in muscle cells. The possible biochemical basis and the functional consequences of this altered distribution of the enzyme in the dystrophic cells are discussed.

Tissue culture studies of muscle disorders: Part 2. Biochemical studies, nerve-muscle culture, metabolic myopathies, and animal models

This review continues with studies of protein, lipid, and purine metabolism of Duchenne muscular dystrophy (DMD) cells in vitro and of muscle cells in combined culture with nerve cells. In vitro studies of human metabolic myopathies are tabulated. Results using the hamster, chicken, and mouse (dy25, dy, mdg, and mdx) myopathies are discussed. Interesting findings include suggestions of altered collagen synthesis by DMD cells. Analysis of cell proteins by two-dimensional gel electrophoresis and the use of combined nerve-muscle cultures remain important areas of development. It is disappointing that so few attempts have been made to repeat significant findings in this field, and when a number of laboratories have examined the same phenomenon, the results are often contradictory. It remains to be shown how these various abnormalities found in cells in vitro are related to each other and to those pathologic features of diseased muscle observed in vivo.

Phosphorylation of intact erythrocytes in human muscular dystrophy

The uptake of exogenous 32Pi into the membrane proteins of intact erythrocytes was measured in 8 patients with Duchenne muscular dystrophy. No abnormalities were noted after autoradiographic analysis. This contrasts with earlier results obtained when isolated membranes were phosphorylated with gamma-[32P]ATP, and suggests a possible reinterpretation of those experiments.

Tissue culture studies of muscle disorders: Part 1. Techniques, cell growth, morphology, cell surface

Tissue culture has been used extensively in studies of human inherited disorders, and its application in the field of the neuromuscular disorders has increased rapidly in recent years. This review, covering the period 1977 to 1984, deals with tissue culture studies of both human and animal muscle disorders, although Duchenne muscular dystrophy (DMD) figures prominently because of the overwhelming interest in that disorder. The review is in two parts. In the first part, I discuss technical innovations in the field, the morphology and growth of cells, and a variety of studies related to the cell surface. Important findings in relation to DMD include reports of abnormal growth rates and reduced lifespan of DMD cells, hypersensitivity to DNA-damaging agents, abnormal cell-to-cell and cell-to-substratum adhesion, and a more "fluid" cell membrane. However, these findings are controversial or have so far been reported only by single laboratories.

Decreased water permeability of erythrocyte membranes in patients with Duchenne muscular dystrophy

The water proton relaxation times of erythrocytes (T'2a) from 15 Duchenne muscular dystrophy (DMD) patients and age-matched controls have been determined by a pulse nuclear magnetic resonance technique. Statistically significant higher values of T'2a were noted for the DMD erythrocytes, both in the presence or absence of p-chloromercuribenzene sulfonate, a potent inhibitor of water diffusion through erythrocyte membrane. As the values of T'2a are inversely related to the water permeability, the results indicate a decreased permeability of erythrocyte membrane in DMD. The findings are discussed in relation to the molecular mechanisms of water diffusion across erythrocyte membrane and in regard to the general problem of membrane abnormalities in DMD.

Method for the preparation of human erythrocyte membrane with low basal calcium ATPase, responsive to stimulation

A simple procedure for preparing erythrocyte membranes with low basal Ca2+ ATPase activity is described, which is stimulated several-fold by the addition of hemolysate in the incubation mixture. The cells are hemolyzed in hypotonic imidazole buffer and resulting membranes are washed with hypotonic phosphate buffer (pH 8.0) and the hemolyzing medium. The membrane preparations also have Mg2+-stimulated and Na+-K+-stimulated ATPase activities. The method allows the comparison of basal Ca2+ ATPase as well as hemolysate- or calmodulin-stimulated Ca2+ ATPase activities and thus may be useful in studying Ca2+ ATPase activity in various physiopathological conditions.

Concanavalin A binding to fibroblasts from Duchenne muscular dystrophy patients and age-matched controls

An investigation of [125I]Con A binding to skin fibroblasts from Duchenne muscular dystrophy patients and age-matched controls was carried out. The age groups examined were 5-6 years, 11-12 years, and 15-17 years. Only small differences in binding abilities were observed between dystrophic cells and matched controls. When data was examined as micrograms Con A bound/micrograms protein, dystrophic fibroblasts bound slightly more lectin compared to controls with the 5-6 and 11-12 year age groups, whereas the 15-17 years age group bound slightly less Con A compared to normal controls. However, analysis of binding data as lectin bound/cell showed slightly reduced binding of Con A to dystrophic cells from all age groups when compared to matched controls. It was also found that the amount of Con A bound by both normal and dystrophic fibroblasts markedly increased with the age of the donor. Obviously several factors must be taken into account when analyzing lectin binding data obtained with human fibroblasts. Taken as a whole, our studies do not provide evidence for significant modification of cell surface Con A receptors on fibroblasts from Duchenne muscular dystrophy patients.

Membrane protein phosphorylation in the intact erythrocytes of genetically dystrophic hamsters

Membrane protein phosphorylation has been measured in both normal and dystrophic (BIO 53.58) hamsters. After radiolabeling intact erythrocytes with exogenous 32Pi, band 3 polypeptides from dystrophic hamsters had increased incorporation of 32P, compared to age-matched controls. This was verified by membrane protein fractionation. The use of intact cell phosphorylation avoids many of the sources of experimental variability noted in experiments with isolated membranes. This work, using an animal model for the disease, supports the hypothesis of a generalized membrane defect in the muscular dystrophies.

Duchenne muscular dystrophy: pathogenetic aspects and genetic prevention

Duchenne muscular dystrophy (DMD) is the most common sex linked lethal disease in man (one case in about 4000 male live births). The patients are wheelchair bound around the age of 8-10 years and usually die before the age of 20 years. The mutation rate, estimated by different methods and from different population studies, is in the order of 7 X 10(-5), which is higher than for any other X-linked genetic disease. Moreover, unlike other X linked diseases such as hemophilia A or Lesh-Nyhan's disease, there seems to be no sex difference for the mutation rates in DMD. Several observations of DMD in girls bearing X-autosomal translocations and linkage studies on two X chromosomal DNA restriction fragment length polymorphisms indicate that the DMD locus is situated on the short arm of the X chromosome, between Xp11 and Xp22. It may be of considerable length, and perhaps consisting of actively coding and non-active intervening DNA sequences. Thus unequal crossing over during meiosis in females could theoretically account for a considerable proportion of new mutations. However, there is no structurally or functionally abnormal protein known that might represent the primary gene product, nor has any pathogenetic mechanism leading to the observed biochemical and histological alterations been elucidated. Among the numerous pathogenetic concepts the hypothesis of a structural or/and functional defect of the muscular plasma membrane is still the most attractive. It would explain both the excess of muscular constituents found in serum of patients and carriers, such as creatine kinase (CK), as well as the excessive calcium uptake by dystrophic muscle fibres, which, prior to necrosis, could lead to hypercontraction, rupture of myofilaments in adjacent sarcomeres and by excessive Ca uptake to mitochondrial damage causing crucial energy loss. The results of studies on structural and functional membrane abnormalities in cells other than muscle tissue, e.g., erythrocytes, lymphocytes and cultured fibroblasts, indicate that the DMD mutation is probably demonstrable in these tissues. However, most of the findings are still difficult to reproduce or even controversial. DMD is an incurable disease; therefore most effort, in research as well as in practical medicine, is concentrated upon its prevention.(ABSTRACT TRUNCATED AT 400 WORDS)

Carbohydrate composition of erythrocyte membranes and glycosidase activities in serum in patients with myotonic dystrophy, limb-girdle dystrophy and congenital myotonia

A number of abnormalities in cell membrane function, including cells other than muscle cells, have been described in patients with inherited muscular diseases such as myotonic dystrophy and congenital myotonia. The basic molecular defects are, however, still unknown. The complex carbohydrates of membrane-bound glycoconjugates are of vital importance for the normal performance of the cell membrane. In this study the concentrations of the three major carbohydrates (sialic acid, galactose and hexosamines) of the erythrocyte membrane were therefore determined in patients with myotonic dystrophy, limb-girdle dystrophy and congenital myotonia. The activities of relevant glycosidases in serum were also assayed. In each of the three diseases pertinent changes of the carbohydrate pattern were found. In patients with myotonic dystrophy the sialic acid and in patients with limb-girdle dystrophy the hexosamine concentration was significantly reduced (P less than 0.0005). The sialic acid, galactose and hexosamine concentrations were all significantly increased in patients with congenital myotonia. No increase of the neuraminidase (sialidase) activity was found in sera from patients with myotonic dystrophy. In patients with limb-girdle dystrophy, the activities of serum hexosaminidases were normal. These results support the contention that certain inherited muscular diseases may represent generalized membrane disorders, and suggests that disturbances of membrane-bound glycoproteins and/or glycolipids might be of importance in the pathogenesis of some of these disorders.

Alterations in regional myocardial metabolism, perfusion, and wall motion in Duchenne muscular dystrophy studied by radionuclide imaging

Studies at necropsy have shown that the cardiomyopathy of Duchenne muscular dystrophy selects the posterobasal and contiguous lateral left ventricular (LV) walls as initial and primary sites of myocardial dystrophy in the absence of small-vessel coronary artery disease in these areas. The present investigation was designed chiefly to determine whether a myocardial metabolic abnormality could be identified in these same areas during a patient's life. Positron emission computed tomography was used to study regional LV metabolism with 18F 2-fluorodeoxyglucose, and metabolism and/or perfusion was studied with 13NH3. In addition, all subjects had the following performed: thallium-201 scans, technetium-99m multiple-gated equilibrium blood pool imaging, electrocardiograms, vectorcardiograms, and M mode and two-dimensional echocardiograms. 18F 2-fluorodeoxyglucose activity was selectively increased in the posterobasal and posterolateral walls of the left ventricle in 11 of 12 patients with technically adequate images, indicating accelerated regional exogenous glucose utilization. 13NH3 activity was selectively decreased in the same areas in 13 of 15 patients, indicating either a regional metabolic alteration in uptake and trapping, a reduction in regional blood flow, or both. These data identify a myocardial metabolic abnormality concentrated in specific segments of the LV free wall in living patients with Duchenne dystrophy.

Order measurements in plasma membranes from Duchenne dystrophy fibroblasts

Plasma membranes have been isolated using different methods from Duchenne dystrophy and control human skin fibroblasts. Fluorescence techniques were utilized to resolve the rotational properties and the degree of hindered rotation of the fluorescent probe, 1,6-diphenyl-1,3,5-hexatriene in the membranes. Under specific conditions of fibroblast processing and membrane fractionation, plasma membranes from Duchenne fibroblasts showed significantly less order (0.0125 greater than P less than 0.0025) and less hindrance to probe rotation than membranes from control fibroblasts. The order differences did not seem to be the result of heterogeneity in the membrane environment sampled by the probe. The frequency dependence of the fluorescence lifetime for diphenylhexatriene indicated no measurable contribution by a short lifetime component. Analysis of diphenylhexatriene rotation in the plasma membranes using the 'wobbling-in-cone' theory suggested that both the angle of probe rotation (theta c) and the rotational rate (Dw) were important parameters in understanding the variations between Duchenne and control membranes at 16, 22 and 30 degrees C. Electron spin resonance studies with 5'-doxylstearic acid at 25 degrees C confirmed our fluorescence results. The segmental motion exhibited by the spin label revealed less order in the Duchenne membranes.

Decreased osmotic fragility in heritable canine myopathy

Osmotic fragility was examined in red blood cells from dogs with a heritable muscle disorder that clinically resembles a muscular dystrophy. Several erythrocyte abnormalities have been reported in patients with certain forms of muscular dystrophy and it is thought that these changes reflect genetically induced alterations in the plasma membrane. It is believed that the examination of erythrocytes may eventually lead to the understanding of membrane involvement in muscle disorders. In this study, the mean osmotic fragility was found to be significantly lower in affected cells than in normal cells. These differences were maintained regardless of changes in incubation temperature (5 degrees, 20 degrees, or 35 degrees C) and pH (6.5, 7.0, 7.5, or 8.0). Quantitative analysis of glycolytic metabolites and adenine nucleotide concentrations revealed little variance between erythrocytes from normal and affected animals. Similarly, the pattern of membrane protein phosphorylation in intact erythrocytes from affected animals did not differ from that observed when erythrocytes from normal animals were examined. Of the red cell indices measured, the erythrocyte count in affected animals was moderately increased, but both the mean corpuscular volume and mean corpuscular hemoglobin content were significantly reduced. From these data it is concluded that the decrease in osmotic fragility cannot be explained by differences in cell metabolism or energy production. However, the decrease in affected cell mean corpuscular volume and mean corpuscular hemoglobin content may be correlated with the decrease in osmotic fragility in a manner similar to that observed in the hemolytic disorder of beta-thalassemia.

Abnormalities of erythrocytes in Duchenne muscular dystrophy

Erythrocytes from patients with Duchenne muscular dystrophy (DMD) were studied in relation to the extracellular calcium ion concentration. The shape of fresh erythrocytes in DMD was normal and not affected by Ca++. When DMD erythrocytes were stored in buffer solution with Ca++, however, the rate of the shape change over time was enhanced compared with that of cells from normal controls. The calcium content of DMD erythrocytes stored in buffer solution with Ca++ and dextrose was also two and one-half times that of control cells. In contrast, when DMD erythrocytes were stored in buffer solution with dextrose but without Ca++, no differences from controls were observed. The adenosine triphosphate content of DMD erythrocytes stored in the buffer solution was not affected by Ca++ concentration.

The sialic acid and galactose concentrations in erythrocyte membranes in patients with myotonic dystrophy, limb-girdle and facioscapulohumeral dystrophy

Sialic acid is an important constituent of membrane-bound glycoproteins and glycolipids. It occurs linked to galactose at the surface of the membrane and is involved in, e.g., cation exchange, receptor function, maintenance of membrane polarity and intercellular interactions. In myotonic dystrophy there is evidence of an as yet basically undefined plasma-membrane abnormality. Considering the importance of sialic acid in membrane function, sialic acid as well as galactose concentrations were measured in erythrocyte membranes from 17 patients with myotonic dystrophy and compared to 17 matched healthy controls. There was a highly significant (P less than 0.0005) reduction of the sialic acid concentration in the patients, while no significant difference in galactose concentration was found. In 16 patients with limb-girdle and facioscapulohumeral dystrophy, sialic acid and galactose concentrations did not differ from matched controls. The possible importance of a reduced concentration of membrane-bound sialic acid in myotonic dystrophy is discussed in relation to previously reported biochemical membrane abnormalities in this disease.

Analysis of erythrocyte membrane proteins from dystrophic hamsters

To search for potentially mutant proteins, we have investigated erythrocyte ghost proteins from normal and dystrophic hamster by two-dimensional gel electrophoresis. No significant differences are observed between dystrophic and normal erythrocytes in their peptide patterns on SDS-polyacrylamide gel electrophoresis while on two-dimensional gels a protein spot of approximate Mr 20 000 with an approximate isoelectric point of 4.5 is found in erythrocytes from dystrophic animals and is consistently absent in normal erythrocytes. A large population of erythrocyte (60%) from dystrophic hamsters shows distorted shape as visualized by scanning electron microscopy. The nature of this protein and its relevance in hamster muscular dystrophy are at present not known.

Membrane alterations in skeletal muscle fibers of dystrophic mice

Skeletal muscle fibers from dystrophic mice and littermate controls (ReJ-129) were characterized electrically and then injected with an intracellular marker. In this way they could be identified for examination with an electron microscope to correlate the relative time course of electrical and ultrastructural alterations resulting from the dystrophic process. On the average, dystrophic muscle fibers displayed decreased membrane potentials (-59 +/- 1.2 vs -79 +/- 0.7 mV for normals), decreased specific membrane resistivity (517 +/- 27 vs 642 +/- 34 omega-cm2 for normals), and depressed action potential (AP) maximum rates of rise (+Vmax) (352 +/- 9 vs 417 +/- 9 V/s for normals) and amplitudes (92 +/- 1.2 vs 102 +/- 1.0 mV for normals) at an experimentally polarized membrane potential of -90 mV. Membrane resistivity and AP +Vmax were decreased even in those fibers from dystrophic muscles that displayed normal ultrastructure (classified visually and by ratio of sarcoplasmic reticulum to total cell volume). These findings support the membrane hypothesis of muscular dystrophy that membrane lesions are the primary lesion in the disease process.

The distribution of inside-out and right-side-out erythrocyte membrane vesicles in Duchenne progressive muscular dystrophy

In ten cases of Duchenne muscular dystrophy, the distribution of erythrocyte ghost vesicles in dextran 110 gradient was examined. When compared with controls a greater number of inside-out vesicles was observed. It is suggested that the tendency to form abnormally oriented vesicles could result from structural abnormalities of the erythrocyte membranes.

Evidence against a generalized membrane defect in dystrophic mice platelets

The response of the membrane-bound enzyme AChE to changes in temperatures was investigated to test the applicability of the "generalized membrane defect" hypothesis proposed for human myotonic and Duchenne muscular dystrophies to the two forms of muscular dystrophy expressed in mice. For intact platelets from homozygous normal and dystrophic mice of both strains, a break (Tc) occurred in the Arrhenius plot of AChE activity at approximately 22 C. Solubilization of membrane-bound AChE by Triton X-100 produced a nonlinear Arrhenius plot over the temperature range (7.7 C to 37 C) in normal and dystrophic mice of both strains. However, in the presence of phospholipase A2 + C and Triton X-100, a linear Arrhenius plot was produced indicating that the membrane-bound enzyme is normally modulated by a bulk lipid domain as well as by a tightly bound (immobilized) phospholipid domain. The temperature response of platelet AChE from normal and dystrophic mice of both strains was not significantly different. These results showing normal temperature kinetics of AChE do not lend support to the theory of a membrane defect in the platelets of dystrophic mice.

Decreased chemiluminescence in thymocytes of dystrophic hamsters

When thymocytes are stimulated they generate reactive oxygen species, which under appropriate conditions produce chemiluminescence (CL). The reactions occur near the cell surface. Since genetically determined muscular dystrophies are currently considered "membrane diseases," we tested the CL of thymocytes from dystrophic hamsters, strain BIO 14.6, in comparison with control animals of the Rb-strain. CL of 33 x 10(6) thymocytes each was monitored in a liquid scintillation counter at 32 C. Dystrophic cells stimulated with concanavalin A (Con A) reached only 60% of the normal peak CL. When stimulated with the calcium ionophore A23187, dystrophic cells exhibited only 40% of the peak CL of control cells. The thymus weight of dystrophic hamsters was significantly reduced. It is not known yet whether these alterations of the thymus are secondary to extrathymic factors or whether they are intrinsic to the thymocyte. If the latter is true, it would be an indication that the genetic defect of dystrophic hamsters is also expressed in the thymus.

Erythrocyte-ghost Ca2+-stimulated Mg2+-dependent adenosine triphosphatase in Duchenne muscular dystrophy

The Ca2+-stimulated Mg2-dependent ATPase activities (Ca2+-ATPase) of erythrocyte-ghost membranes from patients with Duchenne muscular dystrophy (DMD) and carriers of DMD were compared with activities of normal controls. The Ca2+-ATPase activity of DMD-patient ghost preparations was found to follow the same pattern of activation by Ca2+ as the control membranes. However, the Ca2+-ATPase activity in DMD and some DMD-carrier preparations was substantially elevated compared with controls. To characterize further the elevated Ca2+-ATPase activity found in DMD-patient ghost membrane preparations, we estimated kinetic parameters using both fine adjustment and weighting methods to analyse our experimental data. It was established that in both DMD and DMD-carrier preparations the increase in Ca2+-ATPase activity was reflected by a significant increase in Vmax. rather than by any change in Km. The response of the membrane Ca2+-ATPase activity to changes in temperature was also investigated. In all preparations a break in the Arrhenius plot occurred at 20 degrees C, and in DMD and DMD-carrier preparations an elevated Ca2+-ATPase activity was detected at all temperatures. Above 20 degrees C the activation energy for all types of preparation was the same, whereas below this temperature there appeared to be an elevated activation in DMD and DMD-carrier preparations compared with normal controls. The concept that a generalized alteration in the physicochemical nature of the membrane lipid domain may be responsible for the many abnormal membrane properties reported in DMD is discussed.

Increased [32P]-phosphorylation of tryptic peptides of erythrocyte spectrin in Duchenne muscular dystrophy

Increased [32P]-incorporation in tryptic peptides of the erythrocyte membrane protein spectrin Band 2 in Duchenne muscular dystrophy (DMD) was studied in a consecutive series of 10 matched DMD/control pairs. Spectrin was [32P]-phosphorylated by cyclic AMP-independent endogenous membrane protein kinase in the presence of [gamma-32P]ATP. [32P]-labeled spectrin was isolated, purified, and subjected to tryptic cleavage with excess trypsin. The resulting peptides were separated on a high-resolution 5%/15% stacking SDS--polyacrylamide gel electrophoresis system. Liquid scintillation counting was performed on sequential slices of unstained gels. A broad [32P]-labeled band containing a number of [32P]-polypeptides was found to be more highly [32P]-phosphorylated in DMD patients than in their matched controls. This band migrated with an apparent molecular mass of 4.8-5.2 kilodaltons and contained approximately 55% of total [32P] radioactivity covalently bound to spectrin peptides. These data demonstrated an increased [32P]-phosphorylation of an identifiable tryptic peptide fraction in DMD that is consistent with previous reports of increased spectrin Band 2 [32P]-phosphorylation in DMD.