Ultrastructural study of globular inclusions in human skeletal muscle mitochondria

Increased intra-mitochondrial lipofuscin aggregates with spherical dense body formation in mitochondrial myopathy

Lipofuscin aggregation may result from incomplete degradation of damaged mitochondria by autophagy-lysosome pathway, and intra-mitochondrial lipofuscin aggregation may exacerbate mitochondrial abnormalities in mitochondrial myopathy (MM) and mitochondrial disease. We examined vastus lateralis muscle biopsies from 24 patients with pathologically diagnosed MM and clinically diagnosed chronic progressive external ophthalmoplegia, in comparison to the biopsies from 3 other groups:10 patients with inclusion body myositis (IBM), 11 younger adults, and 10 older subjects with no to minimal myopathic changes. Lipofuscin aggregation in muscle fibres was assessed on autofluorescence microscopy, some histochemical stains, and electron microscopy (EM). EM analyses demonstrated intra-mitochondrial lipofuscin aggregates, spherical dense bodies (SDBs), and paracrystalline inclusions (PCIs) which were semi-quantitatively assessed. Intra-mitochondrial lipofuscin aggregates showed no significant differences between groups of MM patients and older subjects or IBM patients, but significant differences between groups of younger adults and others with associated age-related changes. Intra-mitochondrial SDBs were significantly more in MM patients than in older subjects, IBM patients, and younger adults. There was a significant positive correlation between intra-mitochondrial lipofuscin aggregates and SDBs. These findings suggest that intra-mitochondrial formation of lipofuscin SDBs is more in MM and contributing to the pathophysiology of mitochondrial disease.

Multiple muscle cell alterations in a case of encephalomyopathy

Skeletal muscle from an encephalomyopathy was examined by morphological and biochemical modalities. Mitochondria displayed variability in size, numbers per myocyte, and morphology. Certain organelles had stacks of dense cristae, others contained variable numbers of crystalloids or several lipid droplets. In isolated skeletal muscle mitochondria, oxidative phosphorylation was reduced, but activities of the electron transport chain components were unaffected. This is the second case of adult onset encephalomyopathy with a phenotype overlapping MERRF and Kearns-Sayre syndrome associated with a heteroplasmic mtDNA 3255G > A mutation in the tRNA(UUR(LEU)). This study emphasizes the desirability of a multidisciplinary approach in the diagnosis of complex myopathies.

Immunocytochemical study of dystrophin at the myotendinous junction

Dystrophin is the protein whose deficiency results in Duchenne muscular dystrophy. The protein has homologies with a number of cytoskeletal proteins, is localized at the muscle sarcolemma and it may provide stability to the muscle plasma membrane. Using immunocytochemical techniques, we have studied dystrophin localization at the myotendinous junction, a region of membrane complexity that requires more stability because it is subjected to great mechanical stress during the transmission of contractile force to the tendon. The results showed subsarcolemmal deposits of dystrophin at the junctional folds of the myotendon as well as membrane-associated dystrophin at extrajunctional sarcolemma. The findings suggest that dystrophin may be one of the components linking terminal actin filaments to the subplasmalemmal surface of the junctional folds of the myotendon.

Mitochondrial myopathies

Mitochondrial myopathies are clinically heterogeneous disorders that can affect multiple systems besides skeletal muscle (mitochondrial encephalomyopathies or cytopathies) and are usually defined by morphological abnormalities of muscle mitochondria. There are a few distinctive syndromes, such as the Kearns-Sayre syndrome; myoclonus epilepsy with ragged-red fibers; and mitochondrial myopathy, encephalopathy, lactic acidosis, and strokelike episodes. Biochemically, mitochondrial myopathies can be divided into defects of substrate utilization, oxidation-phosphorylation coupling, and the respiratory chain. Because mitochondria have their own DNA and their own translation and transcription apparatuses, mitochondrial myopathies can be due to defects of either a nuclear or mitochondrial genome and can be transmitted by mendelian or maternal inheritance.