1
|
Slater N, Sooda A, McLeish E, Beer K, Brusch A, Shakya R, Bundell C, James I, Chopra A, Mastaglia FL, Needham M, Coudert JD. High-resolution HLA genotyping in inclusion body myositis refines 8.1 ancestral haplotype association to DRB1*03:01:01 and highlights pathogenic role of arginine-74 of DRβ1 chain. J Autoimmun 2024; 142:103150. [PMID: 38043487 DOI: 10.1016/j.jaut.2023.103150] [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: 09/28/2023] [Revised: 11/01/2023] [Accepted: 11/15/2023] [Indexed: 12/05/2023]
Abstract
OBJECTIVES Inclusion body myositis (IBM) is a progressive inflammatory-degenerative muscle disease of older individuals, with some patients producing anti-cytosolic 5'-nucleotidase 1A (NT5C1A, aka cN1A) antibodies. Human Leukocyte Antigens (HLA) is the highest genetic risk factor for developing IBM. In this study, we aimed to further define the contribution of HLA alleles to IBM and the production of anti-cN1A antibodies. METHODS We HLA haplotyped a Western Australian cohort of 113 Caucasian IBM patients and 112 ethnically matched controls using Illumina next-generation sequencing. Allele frequency analysis and amino acid alignments were performed using the Genentech/MiDAS bioinformatics package. Allele frequencies were compared using Fisher's exact test. Age at onset analysis was performed using the ggstatsplot package. All analysis was carried out in RStudio version 1.4.1717. RESULTS Our findings validated the independent association of HLA-DRB1*03:01:01 with IBM and attributed the risk to an arginine residue in position 74 within the DRβ1 protein. Conversely, DRB4*01:01:01 and DQA1*01:02:01 were found to have protective effects; the carriers of DRB1*03:01:01 that did not possess these alleles had a fourteenfold increased risk of developing IBM over the general Caucasian population. Furthermore, patients with the abovementioned genotype developed symptoms on average five years earlier than patients without. We did not find any HLA associations with anti-cN1A antibody production. CONCLUSIONS High-resolution HLA sequencing more precisely characterised the alleles associated with IBM and defined a haplotype linked to earlier disease onset. Identification of the critical amino acid residue by advanced biostatistical analysis of immunogenetics data offers mechanistic insights and future directions into uncovering IBM aetiopathogenesis.
Collapse
Affiliation(s)
- Nataliya Slater
- Murdoch University, Centre for Molecular Medicine and Innovative Therapeutics, Murdoch, WA, Australia
| | - Anuradha Sooda
- Murdoch University, Centre for Molecular Medicine and Innovative Therapeutics, Murdoch, WA, Australia
| | - Emily McLeish
- Murdoch University, Centre for Molecular Medicine and Innovative Therapeutics, Murdoch, WA, Australia
| | - Kelly Beer
- Murdoch University, Centre for Molecular Medicine and Innovative Therapeutics, Murdoch, WA, Australia; Perron Institute for Neurological and Translational Science, Nedlands, WA, Australia
| | - Anna Brusch
- PathWest Laboratory Medicine, Dept of Clinical Immunology, QEII Medical Centre, Nedlands, WA, Australia
| | - Rakesh Shakya
- PathWest Laboratory Medicine, Dept of Clinical Immunology, QEII Medical Centre, Nedlands, WA, Australia
| | - Christine Bundell
- PathWest Laboratory Medicine, Dept of Clinical Immunology, QEII Medical Centre, Nedlands, WA, Australia
| | - Ian James
- Perron Institute for Neurological and Translational Science, Nedlands, WA, Australia; Murdoch University, Institute for Immunology and Infection Diseases, Murdoch, WA, Australia
| | - Abha Chopra
- Murdoch University, Institute for Immunology and Infection Diseases, Murdoch, WA, Australia
| | - Frank L Mastaglia
- Perron Institute for Neurological and Translational Science, Nedlands, WA, Australia; University of Western Australia, Centre for Neuromuscular & Neurological Disorders, Crawley, WA, Australia
| | - Merrilee Needham
- Murdoch University, Centre for Molecular Medicine and Innovative Therapeutics, Murdoch, WA, Australia; Perron Institute for Neurological and Translational Science, Nedlands, WA, Australia; University of Notre Dame Australia, School of Medicine, Fremantle, WA, Australia; Fiona Stanley Hospital, Department of Neurology, Murdoch, WA, Australia
| | - Jerome D Coudert
- Murdoch University, Centre for Molecular Medicine and Innovative Therapeutics, Murdoch, WA, Australia; Perron Institute for Neurological and Translational Science, Nedlands, WA, Australia; University of Notre Dame Australia, School of Medicine, Fremantle, WA, Australia.
| |
Collapse
|
2
|
McLeish E, Sooda A, Slater N, Kachigunda B, Beer K, Paramalingam S, Lamont PJ, Chopra A, Mastaglia FL, Needham M, Coudert JD. Uncovering the significance of expanded CD8+ large granular lymphocytes in inclusion body myositis: Insights into T cell phenotype and functional alterations, and disease severity. Front Immunol 2023; 14:1153789. [PMID: 37063893 PMCID: PMC10098158 DOI: 10.3389/fimmu.2023.1153789] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Accepted: 03/10/2023] [Indexed: 04/03/2023] Open
Abstract
IntroductionInclusion body myositis (IBM) is a progressive inflammatory myopathy characterised by skeletal muscle infiltration and myofibre invasion by CD8+ T lymphocytes. In some cases, IBM has been reported to be associated with a systemic lymphoproliferative disorder of CD8+ T cells exhibiting a highly differentiated effector phenotype known as T cell Large Granular Lymphocytic Leukemia (T-LGLL). MethodsWe investigated the incidence of a CD8+ T-LGL lymphoproliferative disorder in 85 IBM patients and an aged-matched group of 56 Healthy Controls (HC). Further, we analysed the phenotypical characteristics of the expanded T-LGLs and investigated whether their occurrence was associated with any particular HLA alleles or clinical characteristics. ResultsBlood cell analysis by flow cytometry revealed expansion of T-LGLs in 34 of the 85 (40%) IBM patients. The T cell immunophenotype of T-LGLHIGH patients was characterised by increased expression of surface molecules including CD57 and KLRG1, and to a lesser extent of CD94 and CD56 predominantly in CD8+ T cells, although we also observed modest changes in CD4+ T cells and γδ T cells. Analysis of Ki67 in CD57+ KLRG1+ T cells revealed that only a small proportion of these cells was proliferating. Comparative analysis of CD8+ and CD4+ T cells isolated from matched blood and muscle samples donated by three patients indicated a consistent pattern of more pronounced alterations in muscles, although not significant due to small sample size. In the T-LGLHIGH patient group, we found increased frequencies of perforin-producing CD8+ and CD4+ T cells that were moderately correlated to combined CD57 and KLRG1 expression. Investigation of the HLA haplotypes of 75 IBM patients identified that carriage of the HLA-C*14:02:01 allele was significantly higher in T-LGLHIGH compared to T-LGLLOW individuals. Expansion of T-LGL was not significantly associated with seropositivity patient status for anti-cytosolic 5'-nucleotidase 1A autoantibodies. Clinically, the age at disease onset and disease duration were similar in the T-LGLHIGH and T-LGLLOW patient groups. However, metadata analysis of functional alterations indicated that patients with expanded T-LGL more frequently relied on mobility aids than T-LGLLOW patients indicating greater disease severity. ConclusionAltogether, these results suggest that T-LGL expansion occurring in IBM patients is correlated with exacerbated immune dysregulation and increased disease burden.
Collapse
Affiliation(s)
- Emily McLeish
- Centre for Molecular Medicine and Innovative Therapeutics, Murdoch University, Murdoch, WA, Australia
- *Correspondence: Emily McLeish, ; Jerome David Coudert,
| | - Anuradha Sooda
- Centre for Molecular Medicine and Innovative Therapeutics, Murdoch University, Murdoch, WA, Australia
| | - Nataliya Slater
- Centre for Molecular Medicine and Innovative Therapeutics, Murdoch University, Murdoch, WA, Australia
| | - Barbara Kachigunda
- Harry Butler Institute, Centre for Biosecurity and One Health, Murdoch University, Murdoch, WA, Australia
| | - Kelly Beer
- Perron Institute for Neurological and Translational Science, Nedlands, WA, Australia
| | | | - Phillipa J. Lamont
- Neurogenetic Unit, Department of Neurology, Royal Perth Hospital, Perth, WA, Australia
| | - Abha Chopra
- Centre for Molecular Medicine and Innovative Therapeutics, Murdoch University, Murdoch, WA, Australia
- Institute for Immunology and Infectious Diseases, Murdoch University, Murdoch, WA, Australia
| | - Frank Louis Mastaglia
- Perron Institute for Neurological and Translational Science, Nedlands, WA, Australia
| | - Merrilee Needham
- Centre for Molecular Medicine and Innovative Therapeutics, Murdoch University, Murdoch, WA, Australia
- Perron Institute for Neurological and Translational Science, Nedlands, WA, Australia
- School of Medicine, University of Notre Dame, Fremantle, WA, Australia
- Department of Neurology, Fiona Stanley Hospital, Murdoch, WA, Australia
| | - Jerome David Coudert
- Centre for Molecular Medicine and Innovative Therapeutics, Murdoch University, Murdoch, WA, Australia
- Perron Institute for Neurological and Translational Science, Nedlands, WA, Australia
- School of Medicine, University of Notre Dame, Fremantle, WA, Australia
- *Correspondence: Emily McLeish, ; Jerome David Coudert,
| |
Collapse
|
3
|
Abstract
The autoimmune inflammatory myopathies constitute a heterogeneous group of acquired myopathies that have in common the presence of endomysial inflammation and moderate to severe muscle weakness. Based on currently evolved distinct clinical, histologic, immunopathologic, and autoantibody features, these disorders can be best classified as dermatomyositis, necrotizing autoimmune myositis, antisynthetase syndrome-overlap myositis, and inclusion body myositis. Although polymyositis is no longer considered a distinct subset but rather an extinct entity, it is herein described because its clinicopathologic information has provided over many years fundamental information on T-cell-mediated myocytotoxicity, especially in reference to inclusion body myositis. Each inflammatory myopathy subset has distinct immunopathogenesis, prognosis, and response to immunotherapies, necessitating the need to correctly diagnose each subtype from the outset and avoid disease mimics. The paper describes the main clinical characteristics that aid in the diagnosis of each myositis subtype, highlights the distinct features on muscle morphology and immunopathology, elaborates on the potential role of autoantibodies in pathogenesis or diagnosis , and clarifies common uncertainties in reference to putative triggering factors such as statins and viruses including the 2019-coronavirus-2 pandemic. It extensively describes the main autoimmune markers related to autoinvasive myocytotoxic T-cells, activated B-cells, complement, cytokines, and the possible role of innate immunity. The concomitant myodegenerative features seen in inclusion body myositis along with their interrelationship between inflammation and degeneration are specifically emphasized. Finally, practical guidelines on the best therapeutic approaches are summarized based on up-to-date knowledge and controlled studies, highlighting the prospects of future immunotherapies and ongoing controversies.
Collapse
Affiliation(s)
- Marinos C Dalakas
- Department of Neurology, Thomas Jefferson University, Philadelphia, PA, United States; Neuroimmunology Unit National and Kapodistrian University of Athens Medical School, Athens, Greece.
| |
Collapse
|
4
|
Zeng L, Chen K, Xiao F, Zhu CY, Bai JY, Tan S, Long L, Wang Y, Zhou Q. Potential common molecular mechanisms between Sjögren syndrome and inclusion body myositis: a bioinformatic analysis and in vivo validation. Front Immunol 2023; 14:1161476. [PMID: 37153570 PMCID: PMC10160489 DOI: 10.3389/fimmu.2023.1161476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Accepted: 04/07/2023] [Indexed: 05/09/2023] Open
Abstract
Background Inclusion body myositis (IBM) is a slowly progressive inflammatory myopathy that typically affects the quadriceps and finger flexors. Sjögren's syndrome (SS), an autoimmune disorder characterized by lymphocytic infiltration of exocrine glands has been reported to share common genetic and autoimmune pathways with IBM. However, the exact mechanism underlying their commonality remains unclear. In this study, we investigated the common pathological mechanisms involved in both SS and IBM using a bioinformatic approach. Methods IBM and SS gene expression profiles were obtained from the Gene Expression Omnibus (GEO). SS and IBM coexpression modules were identified using weighted gene coexpression network analysis (WGCNA), and differentially expressed gene (DEG) analysis was applied to identify their shared DEGs. The hidden biological pathways were revealed using Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) analysis. Furthermore, protein-protein interaction (PPI) networks, cluster analyses, and hub shared gene identification were conducted. The expression of hub genes was validated by reverse transcription quantitative polymerase chain reaction (RT-qPCR). We then analyzed immune cell abundance patterns in SS and IBM using single-sample gene set enrichment analysis (ssGSEA) and investigated their association with hub genes. Finally, NetworkAnalyst was used to construct a common transcription factor (TF)-gene network. Results Using WGCNA, we found that 172 intersecting genes were closely related to viral infection and antigen processing/presentation. Based on DEG analysis, 29 shared genes were found to be upregulated and enriched in similar biological pathways. By intersecting the top 20 potential hub genes from the WGCNA and DEG sets, three shared hub genes (PSMB9, CD74, and HLA-F) were derived and validated to be active transcripts, which all exhibited diagnostic values for SS and IBM. Furthermore, ssGSEA showed similar infiltration profiles in IBM and SS, and the hub genes were positively correlated with the abundance of immune cells. Ultimately, two TFs (HDGF and WRNIP1) were identified as possible key TFs. Conclusion Our study identified that IBM shares common immunologic and transcriptional pathways with SS, such as viral infection and antigen processing/presentation. Furthermore, both IBM and SS have almost identical immune infiltration microenvironments, indicating similar immune responses may contribute to their association.
Collapse
Affiliation(s)
- Li Zeng
- Department of Neurology, Sichuan Academy of Medical Science and Sichuan Provincial People’s Hospital, University of Electronic Science and Technology of China, Chengdu, China
| | - Kai Chen
- Department of Neurology, Sichuan Academy of Medical Science and Sichuan Provincial People’s Hospital, University of Electronic Science and Technology of China, Chengdu, China
| | - Feng Xiao
- Department of Neurology, Sichuan Academy of Medical Science and Sichuan Provincial People’s Hospital, University of Electronic Science and Technology of China, Chengdu, China
| | - Chun-yan Zhu
- Department of Neurology, Sichuan Academy of Medical Science and Sichuan Provincial People’s Hospital, University of Electronic Science and Technology of China, Chengdu, China
| | - Jia-ying Bai
- Department of Neurology, Sichuan Academy of Medical Science and Sichuan Provincial People’s Hospital, University of Electronic Science and Technology of China, Chengdu, China
| | - Song Tan
- Department of Neurology, Sichuan Academy of Medical Science and Sichuan Provincial People’s Hospital, University of Electronic Science and Technology of China, Chengdu, China
- Sichuan Provincial Key Laboratory for Human Disease Gene Study, Sichuan Provincial People's Hospital, Chengdu, China
| | - Li Long
- Department of Rheumatology and Immunology, Sichuan Academy of Medical Science and Sichuan Provincial People’s Hospital, University of Electronic Science and Technology of China, Chengdu, China
- *Correspondence: Qiao Zhou, ; Yi Wang, ; Li Long,
| | - Yi Wang
- Department of Critical Care Medicine, Sichuan Academy of Medical Science and Sichuan Provincial People’s Hospital, University of Electronic Science and Technology of China, Chengdu, China
- *Correspondence: Qiao Zhou, ; Yi Wang, ; Li Long,
| | - Qiao Zhou
- Department of Rheumatology and Immunology, Sichuan Academy of Medical Science and Sichuan Provincial People’s Hospital, University of Electronic Science and Technology of China, Chengdu, China
- Clinical Immunology Translational Medicine Key Laboratory of Sichuan Province, Sichuan Provincial People’s Hospital, University of Electronic Science and Technology of China, Chengdu, China
- *Correspondence: Qiao Zhou, ; Yi Wang, ; Li Long,
| |
Collapse
|
5
|
Naddaf E. Inclusion body myositis: Update on the diagnostic and therapeutic landscape. Front Neurol 2022; 13:1020113. [PMID: 36237625 PMCID: PMC9551222 DOI: 10.3389/fneur.2022.1020113] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Accepted: 09/12/2022] [Indexed: 11/13/2022] Open
Abstract
Inclusion body myositis (IBM) is a progressive muscle disease affecting patients over the age of 40, with distinctive clinical and histopathological features. The typical clinical phenotype is characterized by prominent involvement of deep finger flexors and quadriceps muscles. Less common presentations include isolated dysphagia, asymptomatic hyper-CKemia, and axial or limb weakness beyond the typical pattern. IBM is associated with marked morbidity as majority of patients eventually become wheelchair dependent with limited use of their hands and marked dysphagia. Furthermore, IBM mildly affects longevity with aspiration pneumonia and respiratory complications being the most common cause of death. On muscle biopsy, IBM is characterized by a peculiar combination of endomysial inflammation, rimmed vacuoles, and protein aggregation. These histopathological features are reflective of the complexity of underlying disease mechanisms. No pharmacological treatment is yet available for IBM. Monitoring for swallowing and respiratory complications, exercise, and addressing mobility issues are the mainstay of management. Further research is needed to better understand disease pathogenesis and identify novel therapeutic targets.
Collapse
|
6
|
Tsamis KI, Boutsoras C, Kaltsonoudis E, Pelechas E, Nikas IP, Simos YV, Voulgari PV, Sarmas I. Clinical features and diagnostic tools in idiopathic inflammatory myopathies. Crit Rev Clin Lab Sci 2021; 59:219-240. [PMID: 34767470 DOI: 10.1080/10408363.2021.2000584] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Idiopathic inflammatory myopathies (IIMs) are rare autoimmune disorders affecting primarily muscles, but other organs can be involved. This review describes the clinical features, diagnosis and treatment for IIMs, namely polymyositis (PM), dermatomyositis (DM), sporadic inclusion body myositis (sIBM), immune-mediated necrotizing myopathy (IMNM), and myositis associated with antisynthetase syndrome (ASS). The diagnostic approach has been updated recently based on the discovery of circulating autoantibodies, which has enhanced the management of patients. Currently, validated classification criteria for IIMs allow clinical studies with well-defined sets of patients but diagnostic criteria to guide the care of individual patients in routine clinical practice are still missing. This review analyzes the clinical manifestations and laboratory findings of IIMs, discusses the efficiency of modern and standard methods employed in their workup, and delineates optimal practice for clinical care. Α multidisciplinary diagnostic approach that combines clinical, neurologic and rheumatologic examination, evaluation of electrophysiologic and morphologic muscle characteristics, and assessment of autoantibody immunoassays has been determined to be the preferred approach for effective management of patients with suspected IIMs.
Collapse
Affiliation(s)
- Konstantinos I Tsamis
- Department of Neurology, University Hospital of Ioannina, Ioannina, Greece.,School of Medicine, European University Cyprus, Nicosia, Cyprus.,Department of Physiology, Faculty of Medicine, School of Health Sciences, University of Ioannina, Ioannina, Greece
| | | | | | | | - Ilias P Nikas
- School of Medicine, European University Cyprus, Nicosia, Cyprus
| | - Yannis V Simos
- Department of Physiology, Faculty of Medicine, School of Health Sciences, University of Ioannina, Ioannina, Greece
| | | | - Ioannis Sarmas
- Department of Neurology, University Hospital of Ioannina, Ioannina, Greece
| |
Collapse
|
7
|
Pinto MV, Laughlin RS, Klein CJ, Mandrekar J, Naddaf E. Inclusion body myositis: correlation of clinical outcomes with histopathology, electromyography and laboratory findings. Rheumatology (Oxford) 2021; 61:2504-2511. [PMID: 34617994 DOI: 10.1093/rheumatology/keab754] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Revised: 09/27/2021] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE To determine whether histopathological, electromyographic and laboratory markers correlate with clinical measures in Inclusion Body Myositis (IBM). METHODS We reviewed our electronic medical records to identify patients with IBM according to ENMC 2011 criteria, seen between 2015 and 2020. We only included patients who had a muscle biopsy and needle electromyography (EMG) performed on the same muscle (opposite or same side). We used a detailed grading system (0- normal to 4- severe) to score histopathological and EMG findings. Clinical severity was assessed by the modified Rankin scale (mRS), muscle strength sum score (SSS), quadriceps strength and severity of dysphagia on swallow evaluation. Serum markers of interest were creatine kinase level, and cN-1A antibodies. RESULTS We included 50 IBM patients, with a median age of 69 years; 64% were males. Median disease duration at diagnosis was 51 months. On muscle biopsy, endomysial inflammation mainly correlated with dysphagia, and inversely correlated with mRS. Vacuoles and congophilic inclusions did not correlate with any of the clinical measures. On EMG, the shortness of motor unit potential (MUP) duration correlated with all clinical measures. Myotonic discharges, and not fibrillation potentials, correlated with the severity of inflammation. Serum markers did not have a statistically-significant correlation with any of the clinical measures. CONCLUSIONS Dysphagia was the main clinical feature of IBM correlating with endomysial inflammation. Otherwise, inclusion body myositis clinical measures had limited correlation with histopathological features in this study. The shortness of MUP duration correlated with all clinical measures.
Collapse
Affiliation(s)
- Marcus V Pinto
- Department of Neurology, Mayo Clinic, Rochester, MN, USA
| | | | | | - Jay Mandrekar
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN
| | - Elie Naddaf
- Department of Neurology, Mayo Clinic, Rochester, MN, USA
| |
Collapse
|
8
|
Zhang J, Khasanova E, Zhang L. Bioinformatics analysis of gene expression profiles of Inclusion body myositis. Scand J Immunol 2020; 91:e12887. [PMID: 32259312 DOI: 10.1111/sji.12887] [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: 12/24/2019] [Revised: 03/15/2020] [Accepted: 03/30/2020] [Indexed: 11/27/2022]
Abstract
Inclusion body myositis (IBM) is a disease with a poor prognosis and limited treatment options. This study aimed at exploring gene expression profile alterations, investigating the underlying mechanisms and identifying novel targets for IBM. We analysed two microarray datasets (GSE39454 and GSE128470) derived from the Gene Expression Omnibus (GEO) database. The GEO2R tool was used to screen out differentially expressed genes (DEGs) between IBM and normal samples. Gene Ontology(GO)function and Kyoto Encyclopedia of Genes and Genomes(KEGG)pathway enrichment analysis were performed using the Database for Annotation, Visualization and Integrated Discovery to identify the pathways and functional annotation of DEGs. Finally, protein-protein interaction (PPI) networks were constructed using STRING and Cytoscape, in order to identify hub genes. A total of 144 upregulated DEGs and one downregulated DEG were identified. The GO enrichment analysis revealed that the immune response was the most significantly enriched term within the DEGs. The KEGG pathway analysis identified 22 significant pathways, the majority of which could be divided into the immune and infectious diseases. Following the construction of PPI networks, ten hub genes with high degrees of connectivity were picked out, namely PTPRC, IRF8, CCR5, VCAM1, HLA-DRA, TYROBP, C1QB, HLA-DRB1, CD74 and CXCL9. Our research hypothesizes that autoimmunity plays an irreplaceable role in the pathogenesis of IBM. The novel DEGs and pathways identified in this study may provide new insight into the underlying mechanisms of IBM at the molecular level.
Collapse
Affiliation(s)
- Jiuchang Zhang
- Department of Neurology, The First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China
| | - Elona Khasanova
- Department of Neurology, The First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China
| | - Liming Zhang
- Department of Neurology, The First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China
| |
Collapse
|
9
|
Abstract
PURPOSE OF REVIEW This article reviews the clinical, laboratory, and histopathologic features of sporadic inclusion body myositis (IBM) and explores its pathogenic overlap with inherited myopathies that have IBM-like pathology. RECENT FINDINGS Sporadic IBM is the most common acquired muscle disease in patients older than 50 years of age and is becoming more prevalent because of the increasing age of the population, the emerging development of more inclusive diagnostic criteria, and the advent of a diagnostic autoantibody. No effective therapy is known, and the pathogenic mechanism remains unclear. Some pathogenic insight can be gleaned from other myopathies with pathologic similarities or hereditary inclusion body myopathies. Although clinically distinct from sporadic IBM, preclinical models of hereditary inclusion body myopathy have offered an opportunity to move some therapies toward clinical development. SUMMARY Patients with sporadic IBM experience significant morbidity, and the disease is associated with a large unmet medical need. As therapies are developed, improved diagnosis will be essential. Early diagnosis relies on awareness, clinical history, physical examination, laboratory features, and appropriate muscle biopsy processing. Future research is needed to understand the natural history, identify genetic risk factors, and validate biomarkers to track disease progression. These steps are essential as we move toward therapeutic interventions.
Collapse
|
10
|
Gaig C, Ercilla G, Daura X, Ezquerra M, Fernández-Santiago R, Palou E, Sabater L, Höftberger R, Heidbreder A, Högl B, Iranzo A, Santamaria J, Dalmau J, Graus F. HLA and microtubule-associated protein tau H1 haplotype associations in anti-IgLON5 disease. NEUROLOGY-NEUROIMMUNOLOGY & NEUROINFLAMMATION 2019; 6:6/6/e605. [PMID: 31454761 PMCID: PMC6705627 DOI: 10.1212/nxi.0000000000000605] [Citation(s) in RCA: 44] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/04/2019] [Accepted: 07/01/2019] [Indexed: 12/19/2022]
Abstract
Objectives We investigated the associations with HLA and microtubule-associated protein tau (MAPT) H1 haplotype in anti-IgLON5 disease, a recently identified disorder characterized by gait instability, brainstem dysfunction, and a prominent sleep disorder in association with IgLON5 antibodies and pathologic findings of a novel neuronal-specific tauopathy. Methods We compared the HLA alleles and MAPT H1/H1 genotype of 35 patients with anti-IgLON5 with healthy controls. The on-line server tool NetMHCIIpan 3.1 was used to predict the IgLON5 peptide binding to HLA Class II molecules. Results The HLA-DRB1*10:01-DQB1*05:01 haplotype was overrepresented in patients with anti-IgLON5 disease (OR = 54.5; 95% CI: 22.2–133.9, p < 0.0001). In addition, HLA-DQA was genotyped in 27 patients, and 25 (92.6%) of them had DQ molecules composed by DQA1*01 and DQB1*05 chains compared with 148/542 (27.3%) controls (OR = 43.9; 95% CI: 10.4–185.5, p < 0.0001). Patients DRB1*10:01 positive developed more frequently sleep or bulbar symptoms than those carrying other HLA alleles (70.0% vs 26.7%; p = 0.011). Prediction algorithms identified 2 IgLON5 peptides (1 located in the signal sequence) that showed strong binding to HLA-DRB1*10:01 and other HLA-DRB1, but not to HLA-DQA and HLA-DQB molecules. The MAPT H1/H1 homozygous genotype was present in 20/24 (83.3%) anti-IgLON5 Caucasian patients compared with 54/116 (46.5%) healthy controls (p = 0.0007). Conclusions The robust association of anti-IgLON5 disease with distinct HLA Class II molecules supports a primary autoimmune origin. The significant association of MAPT H1 haplotype also suggests that an underlying neurodegenerative process could be involved in anti-IgLON5 disease.
Collapse
Affiliation(s)
- Carles Gaig
- From the Service of Neurology (C.G., A.I., J.S.), Hospital Clinic, Barcelona, Spain; Multidisciplinary Sleep Disorders Unit (C.G., A.I., J.S.), Hospital Clinic, Barcelona, Spain; Department of Immunology (G.E., E.P.), Hospital Clínic, Barcelona, Spain; Institute of Biotechnology and Biomedicine (X.D.), Universitat Autònoma de Barcelona, Barcelona, Spain; Institució Catalana de Recerca i Estudis Avançats (ICREA) (X.D., J.D.), Barcelona, Spain; Laboratory of Parkinson Disease and Other Neurodegenerative Movement Disorders (M.E., R.F.-S.), Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Neuroimmunology Program (L.S., J.D., F.G.), Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Institute of Neurology (R.H.), Medical University of Vienna, Austria; Institute for Sleep Medicine and Neuromuscular Disorders (A.H.), University Hospital Muenster, Muenster, Germany; Department of Neurology (B.H.), Medical University of Innsbruck, Innsbruck, Austria; and Department of Neurology (J.D.), University of Pennsylvania, Philadelphia, PA.
| | - Guadalupe Ercilla
- From the Service of Neurology (C.G., A.I., J.S.), Hospital Clinic, Barcelona, Spain; Multidisciplinary Sleep Disorders Unit (C.G., A.I., J.S.), Hospital Clinic, Barcelona, Spain; Department of Immunology (G.E., E.P.), Hospital Clínic, Barcelona, Spain; Institute of Biotechnology and Biomedicine (X.D.), Universitat Autònoma de Barcelona, Barcelona, Spain; Institució Catalana de Recerca i Estudis Avançats (ICREA) (X.D., J.D.), Barcelona, Spain; Laboratory of Parkinson Disease and Other Neurodegenerative Movement Disorders (M.E., R.F.-S.), Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Neuroimmunology Program (L.S., J.D., F.G.), Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Institute of Neurology (R.H.), Medical University of Vienna, Austria; Institute for Sleep Medicine and Neuromuscular Disorders (A.H.), University Hospital Muenster, Muenster, Germany; Department of Neurology (B.H.), Medical University of Innsbruck, Innsbruck, Austria; and Department of Neurology (J.D.), University of Pennsylvania, Philadelphia, PA
| | - Xavier Daura
- From the Service of Neurology (C.G., A.I., J.S.), Hospital Clinic, Barcelona, Spain; Multidisciplinary Sleep Disorders Unit (C.G., A.I., J.S.), Hospital Clinic, Barcelona, Spain; Department of Immunology (G.E., E.P.), Hospital Clínic, Barcelona, Spain; Institute of Biotechnology and Biomedicine (X.D.), Universitat Autònoma de Barcelona, Barcelona, Spain; Institució Catalana de Recerca i Estudis Avançats (ICREA) (X.D., J.D.), Barcelona, Spain; Laboratory of Parkinson Disease and Other Neurodegenerative Movement Disorders (M.E., R.F.-S.), Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Neuroimmunology Program (L.S., J.D., F.G.), Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Institute of Neurology (R.H.), Medical University of Vienna, Austria; Institute for Sleep Medicine and Neuromuscular Disorders (A.H.), University Hospital Muenster, Muenster, Germany; Department of Neurology (B.H.), Medical University of Innsbruck, Innsbruck, Austria; and Department of Neurology (J.D.), University of Pennsylvania, Philadelphia, PA
| | - Mario Ezquerra
- From the Service of Neurology (C.G., A.I., J.S.), Hospital Clinic, Barcelona, Spain; Multidisciplinary Sleep Disorders Unit (C.G., A.I., J.S.), Hospital Clinic, Barcelona, Spain; Department of Immunology (G.E., E.P.), Hospital Clínic, Barcelona, Spain; Institute of Biotechnology and Biomedicine (X.D.), Universitat Autònoma de Barcelona, Barcelona, Spain; Institució Catalana de Recerca i Estudis Avançats (ICREA) (X.D., J.D.), Barcelona, Spain; Laboratory of Parkinson Disease and Other Neurodegenerative Movement Disorders (M.E., R.F.-S.), Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Neuroimmunology Program (L.S., J.D., F.G.), Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Institute of Neurology (R.H.), Medical University of Vienna, Austria; Institute for Sleep Medicine and Neuromuscular Disorders (A.H.), University Hospital Muenster, Muenster, Germany; Department of Neurology (B.H.), Medical University of Innsbruck, Innsbruck, Austria; and Department of Neurology (J.D.), University of Pennsylvania, Philadelphia, PA
| | - Ruben Fernández-Santiago
- From the Service of Neurology (C.G., A.I., J.S.), Hospital Clinic, Barcelona, Spain; Multidisciplinary Sleep Disorders Unit (C.G., A.I., J.S.), Hospital Clinic, Barcelona, Spain; Department of Immunology (G.E., E.P.), Hospital Clínic, Barcelona, Spain; Institute of Biotechnology and Biomedicine (X.D.), Universitat Autònoma de Barcelona, Barcelona, Spain; Institució Catalana de Recerca i Estudis Avançats (ICREA) (X.D., J.D.), Barcelona, Spain; Laboratory of Parkinson Disease and Other Neurodegenerative Movement Disorders (M.E., R.F.-S.), Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Neuroimmunology Program (L.S., J.D., F.G.), Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Institute of Neurology (R.H.), Medical University of Vienna, Austria; Institute for Sleep Medicine and Neuromuscular Disorders (A.H.), University Hospital Muenster, Muenster, Germany; Department of Neurology (B.H.), Medical University of Innsbruck, Innsbruck, Austria; and Department of Neurology (J.D.), University of Pennsylvania, Philadelphia, PA
| | - Eduard Palou
- From the Service of Neurology (C.G., A.I., J.S.), Hospital Clinic, Barcelona, Spain; Multidisciplinary Sleep Disorders Unit (C.G., A.I., J.S.), Hospital Clinic, Barcelona, Spain; Department of Immunology (G.E., E.P.), Hospital Clínic, Barcelona, Spain; Institute of Biotechnology and Biomedicine (X.D.), Universitat Autònoma de Barcelona, Barcelona, Spain; Institució Catalana de Recerca i Estudis Avançats (ICREA) (X.D., J.D.), Barcelona, Spain; Laboratory of Parkinson Disease and Other Neurodegenerative Movement Disorders (M.E., R.F.-S.), Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Neuroimmunology Program (L.S., J.D., F.G.), Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Institute of Neurology (R.H.), Medical University of Vienna, Austria; Institute for Sleep Medicine and Neuromuscular Disorders (A.H.), University Hospital Muenster, Muenster, Germany; Department of Neurology (B.H.), Medical University of Innsbruck, Innsbruck, Austria; and Department of Neurology (J.D.), University of Pennsylvania, Philadelphia, PA
| | - Lidia Sabater
- From the Service of Neurology (C.G., A.I., J.S.), Hospital Clinic, Barcelona, Spain; Multidisciplinary Sleep Disorders Unit (C.G., A.I., J.S.), Hospital Clinic, Barcelona, Spain; Department of Immunology (G.E., E.P.), Hospital Clínic, Barcelona, Spain; Institute of Biotechnology and Biomedicine (X.D.), Universitat Autònoma de Barcelona, Barcelona, Spain; Institució Catalana de Recerca i Estudis Avançats (ICREA) (X.D., J.D.), Barcelona, Spain; Laboratory of Parkinson Disease and Other Neurodegenerative Movement Disorders (M.E., R.F.-S.), Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Neuroimmunology Program (L.S., J.D., F.G.), Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Institute of Neurology (R.H.), Medical University of Vienna, Austria; Institute for Sleep Medicine and Neuromuscular Disorders (A.H.), University Hospital Muenster, Muenster, Germany; Department of Neurology (B.H.), Medical University of Innsbruck, Innsbruck, Austria; and Department of Neurology (J.D.), University of Pennsylvania, Philadelphia, PA
| | - Romana Höftberger
- From the Service of Neurology (C.G., A.I., J.S.), Hospital Clinic, Barcelona, Spain; Multidisciplinary Sleep Disorders Unit (C.G., A.I., J.S.), Hospital Clinic, Barcelona, Spain; Department of Immunology (G.E., E.P.), Hospital Clínic, Barcelona, Spain; Institute of Biotechnology and Biomedicine (X.D.), Universitat Autònoma de Barcelona, Barcelona, Spain; Institució Catalana de Recerca i Estudis Avançats (ICREA) (X.D., J.D.), Barcelona, Spain; Laboratory of Parkinson Disease and Other Neurodegenerative Movement Disorders (M.E., R.F.-S.), Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Neuroimmunology Program (L.S., J.D., F.G.), Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Institute of Neurology (R.H.), Medical University of Vienna, Austria; Institute for Sleep Medicine and Neuromuscular Disorders (A.H.), University Hospital Muenster, Muenster, Germany; Department of Neurology (B.H.), Medical University of Innsbruck, Innsbruck, Austria; and Department of Neurology (J.D.), University of Pennsylvania, Philadelphia, PA
| | - Anna Heidbreder
- From the Service of Neurology (C.G., A.I., J.S.), Hospital Clinic, Barcelona, Spain; Multidisciplinary Sleep Disorders Unit (C.G., A.I., J.S.), Hospital Clinic, Barcelona, Spain; Department of Immunology (G.E., E.P.), Hospital Clínic, Barcelona, Spain; Institute of Biotechnology and Biomedicine (X.D.), Universitat Autònoma de Barcelona, Barcelona, Spain; Institució Catalana de Recerca i Estudis Avançats (ICREA) (X.D., J.D.), Barcelona, Spain; Laboratory of Parkinson Disease and Other Neurodegenerative Movement Disorders (M.E., R.F.-S.), Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Neuroimmunology Program (L.S., J.D., F.G.), Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Institute of Neurology (R.H.), Medical University of Vienna, Austria; Institute for Sleep Medicine and Neuromuscular Disorders (A.H.), University Hospital Muenster, Muenster, Germany; Department of Neurology (B.H.), Medical University of Innsbruck, Innsbruck, Austria; and Department of Neurology (J.D.), University of Pennsylvania, Philadelphia, PA
| | - Birgit Högl
- From the Service of Neurology (C.G., A.I., J.S.), Hospital Clinic, Barcelona, Spain; Multidisciplinary Sleep Disorders Unit (C.G., A.I., J.S.), Hospital Clinic, Barcelona, Spain; Department of Immunology (G.E., E.P.), Hospital Clínic, Barcelona, Spain; Institute of Biotechnology and Biomedicine (X.D.), Universitat Autònoma de Barcelona, Barcelona, Spain; Institució Catalana de Recerca i Estudis Avançats (ICREA) (X.D., J.D.), Barcelona, Spain; Laboratory of Parkinson Disease and Other Neurodegenerative Movement Disorders (M.E., R.F.-S.), Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Neuroimmunology Program (L.S., J.D., F.G.), Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Institute of Neurology (R.H.), Medical University of Vienna, Austria; Institute for Sleep Medicine and Neuromuscular Disorders (A.H.), University Hospital Muenster, Muenster, Germany; Department of Neurology (B.H.), Medical University of Innsbruck, Innsbruck, Austria; and Department of Neurology (J.D.), University of Pennsylvania, Philadelphia, PA
| | - Alex Iranzo
- From the Service of Neurology (C.G., A.I., J.S.), Hospital Clinic, Barcelona, Spain; Multidisciplinary Sleep Disorders Unit (C.G., A.I., J.S.), Hospital Clinic, Barcelona, Spain; Department of Immunology (G.E., E.P.), Hospital Clínic, Barcelona, Spain; Institute of Biotechnology and Biomedicine (X.D.), Universitat Autònoma de Barcelona, Barcelona, Spain; Institució Catalana de Recerca i Estudis Avançats (ICREA) (X.D., J.D.), Barcelona, Spain; Laboratory of Parkinson Disease and Other Neurodegenerative Movement Disorders (M.E., R.F.-S.), Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Neuroimmunology Program (L.S., J.D., F.G.), Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Institute of Neurology (R.H.), Medical University of Vienna, Austria; Institute for Sleep Medicine and Neuromuscular Disorders (A.H.), University Hospital Muenster, Muenster, Germany; Department of Neurology (B.H.), Medical University of Innsbruck, Innsbruck, Austria; and Department of Neurology (J.D.), University of Pennsylvania, Philadelphia, PA
| | - Joan Santamaria
- From the Service of Neurology (C.G., A.I., J.S.), Hospital Clinic, Barcelona, Spain; Multidisciplinary Sleep Disorders Unit (C.G., A.I., J.S.), Hospital Clinic, Barcelona, Spain; Department of Immunology (G.E., E.P.), Hospital Clínic, Barcelona, Spain; Institute of Biotechnology and Biomedicine (X.D.), Universitat Autònoma de Barcelona, Barcelona, Spain; Institució Catalana de Recerca i Estudis Avançats (ICREA) (X.D., J.D.), Barcelona, Spain; Laboratory of Parkinson Disease and Other Neurodegenerative Movement Disorders (M.E., R.F.-S.), Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Neuroimmunology Program (L.S., J.D., F.G.), Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Institute of Neurology (R.H.), Medical University of Vienna, Austria; Institute for Sleep Medicine and Neuromuscular Disorders (A.H.), University Hospital Muenster, Muenster, Germany; Department of Neurology (B.H.), Medical University of Innsbruck, Innsbruck, Austria; and Department of Neurology (J.D.), University of Pennsylvania, Philadelphia, PA
| | - Josep Dalmau
- From the Service of Neurology (C.G., A.I., J.S.), Hospital Clinic, Barcelona, Spain; Multidisciplinary Sleep Disorders Unit (C.G., A.I., J.S.), Hospital Clinic, Barcelona, Spain; Department of Immunology (G.E., E.P.), Hospital Clínic, Barcelona, Spain; Institute of Biotechnology and Biomedicine (X.D.), Universitat Autònoma de Barcelona, Barcelona, Spain; Institució Catalana de Recerca i Estudis Avançats (ICREA) (X.D., J.D.), Barcelona, Spain; Laboratory of Parkinson Disease and Other Neurodegenerative Movement Disorders (M.E., R.F.-S.), Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Neuroimmunology Program (L.S., J.D., F.G.), Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Institute of Neurology (R.H.), Medical University of Vienna, Austria; Institute for Sleep Medicine and Neuromuscular Disorders (A.H.), University Hospital Muenster, Muenster, Germany; Department of Neurology (B.H.), Medical University of Innsbruck, Innsbruck, Austria; and Department of Neurology (J.D.), University of Pennsylvania, Philadelphia, PA
| | - Francesc Graus
- From the Service of Neurology (C.G., A.I., J.S.), Hospital Clinic, Barcelona, Spain; Multidisciplinary Sleep Disorders Unit (C.G., A.I., J.S.), Hospital Clinic, Barcelona, Spain; Department of Immunology (G.E., E.P.), Hospital Clínic, Barcelona, Spain; Institute of Biotechnology and Biomedicine (X.D.), Universitat Autònoma de Barcelona, Barcelona, Spain; Institució Catalana de Recerca i Estudis Avançats (ICREA) (X.D., J.D.), Barcelona, Spain; Laboratory of Parkinson Disease and Other Neurodegenerative Movement Disorders (M.E., R.F.-S.), Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Neuroimmunology Program (L.S., J.D., F.G.), Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Institute of Neurology (R.H.), Medical University of Vienna, Austria; Institute for Sleep Medicine and Neuromuscular Disorders (A.H.), University Hospital Muenster, Muenster, Germany; Department of Neurology (B.H.), Medical University of Innsbruck, Innsbruck, Austria; and Department of Neurology (J.D.), University of Pennsylvania, Philadelphia, PA
| |
Collapse
|
11
|
Kaiser Y, Eklund A, Grunewald J. Moving target: shifting the focus to pulmonary sarcoidosis as an autoimmune spectrum disorder. Eur Respir J 2019; 54:13993003.021532018. [PMID: 31000677 DOI: 10.1183/13993003.021532018] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2018] [Accepted: 04/01/2019] [Indexed: 12/27/2022]
Abstract
Despite more than a century of research, the causative agent(s) in sarcoidosis, a heterogeneous granulomatous disorder mainly affecting the lungs, remain(s) elusive. Following identification of genetic factors underlying different clinical phenotypes, increased understanding of CD4+ T-cell immunology, which is believed to be central to sarcoid pathogenesis, as well as the role of B-cells and other cells bridging innate and adaptive immunity, contributes to novel insights into the mechanistic pathways influencing disease resolution or chronicity. Hopefully, new perspectives and state-of-the-art technology will help to shed light on the still-elusive enigma of sarcoid aetiology. This perspective article highlights a number of recent advances in the search for antigenic targets in sarcoidosis, as well as the main arguments for sarcoidosis as a spectrum of autoimmune conditions, either as a result of an external (microbial) trigger and/or due to defective control mechanisms regulating the balance between T-cell activation and inhibition.
Collapse
Affiliation(s)
- Ylva Kaiser
- Respiratory Medicine Unit, Dept of Medicine, Solna and Center for Molecular Medicine, Karolinska Institutet and Karolinska University Hospital Solna, Stockholm, Sweden
| | - Anders Eklund
- Respiratory Medicine Unit, Dept of Medicine, Solna and Center for Molecular Medicine, Karolinska Institutet and Karolinska University Hospital Solna, Stockholm, Sweden
| | - Johan Grunewald
- Respiratory Medicine Unit, Dept of Medicine, Solna and Center for Molecular Medicine, Karolinska Institutet and Karolinska University Hospital Solna, Stockholm, Sweden
| |
Collapse
|
12
|
Naddaf E, Barohn RJ, Dimachkie MM. Inclusion Body Myositis: Update on Pathogenesis and Treatment. Neurotherapeutics 2018; 15:995-1005. [PMID: 30136253 PMCID: PMC6277289 DOI: 10.1007/s13311-018-0658-8] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Inclusion body myositis is the most common acquired myopathy after the age of 50. It is characterized by progressive asymmetric weakness predominantly affecting the quadriceps and/or finger flexors. Loss of ambulation and dysphagia are major complications of the disease. Inclusion body myositis can be associated with cytosolic 5'-nucleotidase 1A antibodies. Muscle biopsy usually shows inflammatory cells surrounding and invading non-necrotic muscle fibers, rimmed vacuoles, congophilic inclusions, and protein aggregates. Disease pathogenesis remains poorly understood and consists of an interplay between inflammatory and degenerative pathways. Antigen-driven, clonally restricted, cytotoxic T cells represent a main feature of the inflammatory component, whereas abnormal protein homeostasis with protein misfolding, aggregation, and dysfunctional protein disposal is the hallmark of the degenerative component. Inclusion body myositis remains refractory to treatment. Better understanding of the disease pathogenesis led to the identification of novel therapeutic targets, addressing both the inflammatory and degenerative pathways.
Collapse
Affiliation(s)
- Elie Naddaf
- Neuromuscular Medicine Division, Department of Neurology, Mayo Clinic, Rochester, Minnesota, 55905, USA
| | - Richard J Barohn
- Neuromuscular Medicine Division, Department of Neurology, University of Kansas Medical Center, Kansas City, Kansas, 66103, USA
| | - Mazen M Dimachkie
- Neuromuscular Medicine Division, Department of Neurology, University of Kansas Medical Center, Kansas City, Kansas, 66103, USA.
| |
Collapse
|
13
|
Abstract
PURPOSE OF REVIEW Our goal is to review the recent literature pertaining to the genetics of sporadic inclusion body myositis (IBM). RECENT FINDINGS In a study of 252 IBM patients, the class II MHC allele HLA-DRB1*03:01 showed the most significant association with IBM, and that risk could be largely attributed to amino acids within the peptide-binding pocket. Candidate gene sequencing identified rare missense variants in proteins regulating protein homeostasis including VCP and SQSTM1. An unbiased approach employing exome sequencing of genes encoding rimmed vacuole proteins identified FYCO1 variants in IBM. Ongoing GWAS approaches may shed new light on genetic risk factors for IBM. Many variants have been reported at an increased frequency in IBM in small studies; however, only HLA association has shown genome-wide significance. Future studies are needed to validate variants in larger cohorts and to understand the molecular roles these risk factors play in IBM.
Collapse
Affiliation(s)
- Kyla A Britson
- Departments of Neurology and Neuroscience, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Graduate program in Cellular and Molecular Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Stephanie Y Yang
- Departments of Neurology and Neuroscience, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Graduate program in Human Genetics, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Thomas E Lloyd
- Departments of Neurology and Neuroscience, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
| |
Collapse
|
14
|
Abstract
PURPOSE OF REVIEW To review the advances in our understanding of the genetics of inclusion body myositis (IBM) in the past year. RECENT FINDINGS One large genetic association study focusing on immune-related genes in IBM has refined the association within the human leukocyte antigen (HLA) region to HLA-DRB1 alleles, and identified certain amino acid positions in HLA-DRB1 that may explain this risk. A suggestive association with CCR5 may indicate genetic overlap with other autoimmune diseases. Sequencing studies of candidate genes involved in related neuromuscular or neurodegenerative diseases have identified rare variants in VCP and SQSTM1. Proteomic studies of rimmed vacuoles in IBM and subsequent genetic analyses of candidate genes identified rare missense variants in FYCO1. Complex, large-scale mitochondrial deletions in cytochrome c oxidase-deficient muscle fibres expand our understanding of mitochondrial abnormalities in IBM. SUMMARY The pathogenesis of IBM is likely multifactorial, including inflammatory and degenerative changes, and mitochondrial abnormalities. There has been considerable progress in our understanding of the genetic architecture of IBM, using complementary genetic approaches to investigate these different pathways.
Collapse
Affiliation(s)
- Simon Rothwell
- Centre for Musculoskeletal Research, Division of Musculoskeletal and Dermatological Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, The University of Manchester, Manchester
| | - James B. Lilleker
- Centre for Musculoskeletal Research, Division of Musculoskeletal and Dermatological Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, The University of Manchester, Manchester
- Greater Manchester Neurosciences Centre, Manchester Academic Health Science Centre, Salford Royal NHS Foundation Trust, Stott Lane, Salford
| | - Janine A. Lamb
- Centre for Epidemiology, Division of Population Health, Health Services Research and Primary Care, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, The University of Manchester, Manchester, UK
| |
Collapse
|
15
|
Rothwell S, Cooper RG, Lundberg IE, Gregersen PK, Hanna MG, Machado PM, Herbert MK, Pruijn GJM, Lilleker JB, Roberts M, Bowes J, Seldin MF, Vencovsky J, Danko K, Limaye V, Selva‐O'Callaghan A, Platt H, Molberg Ø, Benveniste O, Radstake TRDJ, Doria A, De Bleecker J, De Paepe B, Gieger C, Meitinger T, Winkelmann J, Amos CI, Ollier WE, Padyukov L, Lee AT, Lamb JA, Chinoy H. Immune-Array Analysis in Sporadic Inclusion Body Myositis Reveals HLA-DRB1 Amino Acid Heterogeneity Across the Myositis Spectrum. Arthritis Rheumatol 2017; 69:1090-1099. [PMID: 28086002 PMCID: PMC5516174 DOI: 10.1002/art.40045] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2016] [Accepted: 01/10/2017] [Indexed: 01/03/2023]
Abstract
OBJECTIVE Inclusion body myositis (IBM) is characterized by a combination of inflammatory and degenerative changes affecting muscle. While the primary cause of IBM is unknown, genetic factors may influence disease susceptibility. To determine genetic factors contributing to the etiology of IBM, we conducted the largest genetic association study of the disease to date, investigating immune-related genes using the Immunochip. METHODS A total of 252 Caucasian patients with IBM were recruited from 11 countries through the Myositis Genetics Consortium and compared with 1,008 ethnically matched controls. Classic HLA alleles and amino acids were imputed using SNP2HLA. RESULTS The HLA region was confirmed as the most strongly associated region in IBM (P = 3.58 × 10-33 ). HLA imputation identified 3 independent associations (with HLA-DRB1*03:01, DRB1*01:01, and DRB1*13:01), although the strongest association was with amino acid positions 26 and 11 of the HLA-DRB1 molecule. No association with anti-cytosolic 5'-nucleotidase 1A-positive status was found independent of HLA-DRB1*03:01. There was no association of HLA genotypes with age at onset of IBM. Three non-HLA regions reached suggestive significance, including the chromosome 3 p21.31 region, an established risk locus for autoimmune disease, where a frameshift mutation in CCR5 is thought to be the causal variant. CONCLUSION This is the largest, most comprehensive genetic association study to date in IBM. The data confirm that HLA is the most strongly associated region and identifies novel amino acid associations that may explain the risk in this locus. These amino acid associations differentiate IBM from polymyositis and dermatomyositis and may determine properties of the peptide-binding groove, allowing it to preferentially bind autoantigenic peptides. A novel suggestive association within the chromosome 3 p21.31 region suggests a role for CCR5.
Collapse
Affiliation(s)
| | | | | | | | | | | | - Megan K. Herbert
- Beth Israel Deaconess Medical Center, Boston, Massachusetts, and Radboud University NijmegenNijmegenThe Netherlands
| | | | - James B. Lilleker
- University of Manchester, Manchester, UK, and Salford Royal NHS Foundation TrustSalfordUK
| | | | | | | | | | | | - Vidya Limaye
- Royal Adelaide Hospital, AdelaideSouth AustraliaAustralia
| | | | | | | | | | | | | | | | | | | | - Thomas Meitinger
- Technische Universität München, Munich, Germany, and Helmholtz Zentrum MünchenNeuherbergGermany
| | - Juliane Winkelmann
- Technische Universität München, Munich, Germany, and Helmholtz Zentrum MünchenNeuherbergGermany
| | | | | | | | - Annette T. Lee
- Feinstein Institute for Medical ResearchManhassetNew York
| | | | - Hector Chinoy
- Central Manchester University Hospitals NHS Foundation Trust, University of ManchesterManchesterUK
| | | |
Collapse
|
16
|
Johari M, Arumilli M, Palmio J, Savarese M, Tasca G, Mirabella M, Sandholm N, Lohi H, Hackman P, Udd B. Association study reveals novel risk loci for sporadic inclusion body myositis. Eur J Neurol 2017; 24:572-577. [PMID: 28233382 DOI: 10.1111/ene.13244] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2016] [Accepted: 01/04/2017] [Indexed: 11/28/2022]
Abstract
BACKGROUND AND PURPOSE The aim was to identify potential genetic risk factors associated with sporadic inclusion body myositis (sIBM). METHODS An association based case-control approach was utilized on whole exome sequencing data of 30 Finnish sIBM patients and a control cohort (n = 193). A separate Italian cohort of sIBM patients (n = 12) was used for evaluation of the results. RESULTS Seven single nucleotide polymorphisms were identified in five genes that have a considerably higher observed frequency in Finnish sIBM patients compared to the control population, and the previous association of the genetic human leukocyte antigen region was confirmed. CONCLUSIONS All seven identified variants could individually or in combination increase the susceptibility for sIBM.
Collapse
Affiliation(s)
- M Johari
- Folkhälsan Institute of Genetics, Medicum, University of Helsinki, Helsinki, Finland
| | - M Arumilli
- Folkhälsan Institute of Genetics, Medicum, University of Helsinki, Helsinki, Finland.,Research Programs Unit, Molecular Neurology, University of Helsinki, Helsinki, Finland.,Department of Veterinary Biosciences, University of Helsinki, Helsinki, Finland
| | - J Palmio
- Neuromuscular Research Center, Tampere University and University Hospital, Tampere, Finland
| | - M Savarese
- Folkhälsan Institute of Genetics, Medicum, University of Helsinki, Helsinki, Finland
| | - G Tasca
- Institute of Neurology, Policlinico 'A. Gemelli' Foundation University Hospital, Rome, Italy
| | - M Mirabella
- Institute of Neurology, Catholic University School of Medicine, Rome, Italy
| | - N Sandholm
- Folkhälsan Institute of Genetics, Medicum, University of Helsinki, Helsinki, Finland.,Abdominal Center Nephrology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.,Research Program Unit, Diabetes and Obesity, University of Helsinki, Helsinki, Finland
| | - H Lohi
- Folkhälsan Institute of Genetics, Medicum, University of Helsinki, Helsinki, Finland.,Research Programs Unit, Molecular Neurology, University of Helsinki, Helsinki, Finland.,Department of Veterinary Biosciences, University of Helsinki, Helsinki, Finland
| | - P Hackman
- Folkhälsan Institute of Genetics, Medicum, University of Helsinki, Helsinki, Finland
| | - B Udd
- Folkhälsan Institute of Genetics, Medicum, University of Helsinki, Helsinki, Finland.,Neuromuscular Research Center, Tampere University and University Hospital, Tampere, Finland.,Department of Neurology, Vaasa Central Hospital, Vaasa, Finland
| |
Collapse
|
17
|
Güttsches AK, Brady S, Krause K, Maerkens A, Uszkoreit J, Eisenacher M, Schreiner A, Galozzi S, Mertens-Rill J, Tegenthoff M, Holton JL, Harms MB, Lloyd TE, Vorgerd M, Weihl CC, Marcus K, Kley RA. Proteomics of rimmed vacuoles define new risk allele in inclusion body myositis. Ann Neurol 2017; 81:227-239. [PMID: 28009083 DOI: 10.1002/ana.24847] [Citation(s) in RCA: 49] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2016] [Revised: 11/22/2016] [Accepted: 12/11/2016] [Indexed: 12/29/2022]
Abstract
OBJECTIVE Sporadic inclusion body myositis (sIBM) pathogenesis is unknown; however, rimmed vacuoles (RVs) are a constant feature. We propose to identify proteins that accumulate within RVs. METHODS RVs and intact myofibers were laser microdissected from skeletal muscle of 18 sIBM patients and analyzed by a sensitive mass spectrometry approach using label-free spectral count-based relative protein quantification. Whole exome sequencing was performed on 62 sIBM patients. Immunofluorescence was performed on patient and mouse skeletal muscle. RESULTS A total of 213 proteins were enriched by >1.5 -fold in RVs compared to controls and included proteins previously reported to accumulate in sIBM tissue or when mutated cause myopathies with RVs. Proteins associated with protein folding and autophagy were the largest group represented. One autophagic adaptor protein not previously identified in sIBM was FYCO1. Rare missense coding FYCO1 variants were present in 11.3% of sIBM patients compared with 2.6% of controls (p = 0.003). FYCO1 colocalized at RVs with autophagic proteins such as MAP1LC3 and SQSTM1 in sIBM and other RV myopathies. One FYCO1 variant protein had reduced colocalization with MAP1LC3 when expressed in mouse muscle. INTERPRETATION This study used an unbiased proteomic approach to identify RV proteins in sIBM that included a novel protein involved in sIBM pathogenesis. FYCO1 accumulates at RVs, and rare missense variants in FYCO1 are overrepresented in sIBM patients. These FYCO1 variants may impair autophagic function, leading to RV formation in sIBM patient muscle. FYCO1 functionally connects autophagic and endocytic pathways, supporting the hypothesis that impaired endolysosomal degradation underlies the pathogenesis of sIBM. Ann Neurol 2017;81:227-239.
Collapse
Affiliation(s)
- Anne-Katrin Güttsches
- Department of Neurology, Heimer Institute for Muscle Research, University Hospital Bergmannsheil, Ruhr-University Bochum, Bochum, Germany
| | - Stefen Brady
- Department of Neurology, Southmead Hospital, Bristol, United Kingdom
| | - Kathryn Krause
- Department of Neurology, Heimer Institute for Muscle Research, University Hospital Bergmannsheil, Ruhr-University Bochum, Bochum, Germany.,Medizinisches Proteom-Center, Ruhr-University Bochum, Bochum, Germany
| | - Alexandra Maerkens
- Department of Neurology, Heimer Institute for Muscle Research, University Hospital Bergmannsheil, Ruhr-University Bochum, Bochum, Germany.,Medizinisches Proteom-Center, Ruhr-University Bochum, Bochum, Germany
| | - Julian Uszkoreit
- Medizinisches Proteom-Center, Ruhr-University Bochum, Bochum, Germany
| | - Martin Eisenacher
- Medizinisches Proteom-Center, Ruhr-University Bochum, Bochum, Germany
| | - Anja Schreiner
- Department of Neurology, Heimer Institute for Muscle Research, University Hospital Bergmannsheil, Ruhr-University Bochum, Bochum, Germany
| | - Sara Galozzi
- Medizinisches Proteom-Center, Ruhr-University Bochum, Bochum, Germany
| | - Janine Mertens-Rill
- Department of Neurology, Heimer Institute for Muscle Research, University Hospital Bergmannsheil, Ruhr-University Bochum, Bochum, Germany
| | - Martin Tegenthoff
- Department of Neurology, Heimer Institute for Muscle Research, University Hospital Bergmannsheil, Ruhr-University Bochum, Bochum, Germany
| | - Janice L Holton
- MRC Centre for Neuromuscular Diseases, UCL Institute of Neurology, London, United Kingdom.,Department of Molecular Neuroscience, Queen Square Brain Bank, UCL Institute of Neurology, London, United Kingdom
| | | | - Thomas E Lloyd
- Johns Hopkins University School of Medicine, Baltimore, MD
| | - Matthias Vorgerd
- Department of Neurology, Heimer Institute for Muscle Research, University Hospital Bergmannsheil, Ruhr-University Bochum, Bochum, Germany
| | - Conrad C Weihl
- Department of Neurology and Hope Center for Neurological Disorders, Washington University School of Medicine, Saint Louis, MO
| | - Katrin Marcus
- Medizinisches Proteom-Center, Ruhr-University Bochum, Bochum, Germany
| | - Rudolf A Kley
- Department of Neurology, Heimer Institute for Muscle Research, University Hospital Bergmannsheil, Ruhr-University Bochum, Bochum, Germany
| |
Collapse
|
18
|
Abstract
PURPOSE OF REVIEW To describe recent developments in the genetics of sporadic inclusion body myositis (sIBM). RECENT FINDINGS Genes located within major histocompatibility complex regions remain the strongest genetic association with sIBM. The rs10527454 polymorphism in the TOMM40 gene seems to have a disease modifying effect on sIBM by delaying the onset of symptoms, and this effect may be enhanced by the APOE ε3/ε3 genotype. Rare variants in the VCP and SQSTM1 genes have been identified in sIBM patients in two studies using targeted next-generation sequencing and whole-exome sequencing. Two studies have confirmed the correlation between the amount of cytochrome c oxidase -deficient fibres and the proportion of mitochondrial DNA (mtDNA) deletions in sIBM. Some rare variants in mtDNA-related nuclear genes have also been reported. SUMMARY There have been advances in the genetics of sIBM over the past 2 years facilitated by the use of next-generation sequencing. Genes that cause hereditary IBM, which has clinical or pathological features resembling sIBM, have provided clues to the genetic basis of sIBM. To date, genes located in major histocompatibility complex regions and genes involved in protein homeostasis or mtDNA maintenance have been implicated in sIBM. Whole-exome sequencing-association studies, RNA sequencing, and whole-genome sequencing in large sIBM cohorts will be key tools to unravel the genetics of sIBM and its contribution to disease aetiopathogenesis.
Collapse
|
19
|
Needham M, Mastaglia FL. Sporadic inclusion body myositis: A review of recent clinical advances and current approaches to diagnosis and treatment. Clin Neurophysiol 2015; 127:1764-73. [PMID: 26778717 DOI: 10.1016/j.clinph.2015.12.011] [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] [Received: 10/12/2015] [Revised: 12/08/2015] [Accepted: 12/13/2015] [Indexed: 01/01/2023]
Abstract
Sporadic inclusion body myositis is the most frequent acquired myopathy of middle and later life and is distinguished from other inflammatory myopathies by its selective pattern of muscle involvement and slowly progressive course, and by the combination of inflammatory and degenerative muscle pathology and multi-protein deposits in muscle tissue. This review summarises the findings of recent studies that provide a more complete picture of the clinical phenotype and natural history of the disease and its global prevalence and genetic predisposition. Current diagnostic criteria, including the role of electrophysiological and muscle imaging studies and the recently identified anti-5'-nucleotidase (anti-cN1A) antibody in diagnosis are also discussed as well as current trends in the treatment of the disease.
Collapse
Affiliation(s)
- Merrilee Needham
- Institute for Immunology and Infectious Diseases, Murdoch University, Western Australia, Australia; Fiona Stanley Hospital, Murdoch, Western Australia, Australia; Notre Dame University, Fremantle, Western Australia, Australia.
| | - Frank L Mastaglia
- Institute for Immunology and Infectious Diseases, Murdoch University, Western Australia, Australia
| |
Collapse
|
20
|
Miller FW, Chen W, O’Hanlon TP, Cooper RG, Vencovsky J, Rider LG, Danko K, Wedderburn LR, Lundberg IE, Pachman LM, Reed AM, Ytterberg SR, Padyukov L, Selva-O’Callaghan A, Radstake TR, Isenberg DA, Chinoy H, Ollier WE, Scheet P, Peng B, Lee A, Byun J, Lamb JA, Gregersen PK, Amos CI. Genome-wide association study identifies HLA 8.1 ancestral haplotype alleles as major genetic risk factors for myositis phenotypes. Genes Immun 2015; 16:470-80. [PMID: 26291516 PMCID: PMC4840953 DOI: 10.1038/gene.2015.28] [Citation(s) in RCA: 87] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2015] [Revised: 06/15/2015] [Accepted: 06/18/2015] [Indexed: 02/06/2023]
Abstract
Autoimmune muscle diseases (myositis) comprise a group of complex phenotypes influenced by genetic and environmental factors. To identify genetic risk factors in patients of European ancestry, we conducted a genome-wide association study (GWAS) of the major myositis phenotypes in a total of 1710 cases, which included 705 adult dermatomyositis, 473 juvenile dermatomyositis, 532 polymyositis and 202 adult dermatomyositis, juvenile dermatomyositis or polymyositis patients with anti-histidyl-tRNA synthetase (anti-Jo-1) autoantibodies, and compared them with 4724 controls. Single-nucleotide polymorphisms showing strong associations (P<5×10(-8)) in GWAS were identified in the major histocompatibility complex (MHC) region for all myositis phenotypes together, as well as for the four clinical and autoantibody phenotypes studied separately. Imputation and regression analyses found that alleles comprising the human leukocyte antigen (HLA) 8.1 ancestral haplotype (AH8.1) defined essentially all the genetic risk in the phenotypes studied. Although the HLA DRB1*03:01 allele showed slightly stronger associations with adult and juvenile dermatomyositis, and HLA B*08:01 with polymyositis and anti-Jo-1 autoantibody-positive myositis, multiple alleles of AH8.1 were required for the full risk effects. Our findings establish that alleles of the AH8.1 comprise the primary genetic risk factors associated with the major myositis phenotypes in geographically diverse Caucasian populations.
Collapse
Affiliation(s)
- Frederick W. Miller
- National Institute of Environmental Health Sciences, National Institutes of Health, Bethesda, Maryland 20892
| | - Wei Chen
- M.D. Anderson Cancer Center, Houston, Texas 77030
| | - Terrance P. O’Hanlon
- National Institute of Environmental Health Sciences, National Institutes of Health, Bethesda, Maryland 20892
| | - Robert G. Cooper
- MRC/ARUK Institute for Ageing and Chronic Disease, University of Liverpool, United Kingdom, L69 3GA
| | - Jiri Vencovsky
- Institute of Rheumatology, Charles University, Prague, Czech Republic; Na Slupi, 12850 Prague
| | - Lisa G. Rider
- National Institute of Environmental Health Sciences, National Institutes of Health, Bethesda, Maryland 20892
| | - Katalin Danko
- 3 Department of Internal Medicine, Division of Immunology University of Debrecen, Debrecen, Hungary H-4032
| | - Lucy R. Wedderburn
- Institute of Child Health, University College London, London, United Kingdom, WC1N 1EH
| | - Ingrid E. Lundberg
- Rheumatology Unit, Department of Medicine, Karolinska University Hospital, Solna, Karolinska Institutet, Stockholm, Sweden SE-171 77
| | - Lauren M. Pachman
- Department of Pediatric Rheumatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois 60611
| | | | | | - Leonid Padyukov
- Rheumatology Unit, Department of Medicine, Karolinska University Hospital, Solna, Karolinska Institutet, Stockholm, Sweden SE-171 77
| | | | - Timothy R. Radstake
- Department of Rheumatology and Clinical Immunology, Laboratory for Translational Immunology, Utrecht University Medical Center; and Nijmegen Center for Molecular Life Sciences, Nijmegen, The Netherlands 6500.HB
| | - David A. Isenberg
- Division of Medicine, University College London, London, United Kingdom WC1E63T
| | - Hector Chinoy
- The National Institute for Health Research Manchester Musculoskeletal Biomedical Research Unit, Centre for Musculoskeletal Research, University of Manchester, Manchester, United Kingdom M139PT
| | - William E.R. Ollier
- Centre for Integrated Genomic Medical Research, Manchester Academic Health Science Centre, University of Manchester, Manchester, United Kingdom M13 9PT
| | - Paul Scheet
- M.D. Anderson Cancer Center, Houston, Texas 77030
| | - Bo Peng
- M.D. Anderson Cancer Center, Houston, Texas 77030
| | - Annette Lee
- Robert S. Boas Center for Genomics and Human Genetics, Feinstein Institute for Medical Research, Manhasset, New York 11030
| | - Jinyoung Byun
- Department of Community and Family Medicine, Dartmouth College, Hanover, New Hampshire 03755
| | - Janine A. Lamb
- Centre for Integrated Genomic Medical Research, Manchester Academic Health Science Centre, University of Manchester, Manchester, United Kingdom M13 9PT
| | - Peter K. Gregersen
- Robert S. Boas Center for Genomics and Human Genetics, Feinstein Institute for Medical Research, Manhasset, New York 11030
| | - Christopher I. Amos
- Department of Community and Family Medicine, Dartmouth College, Hanover, New Hampshire 03755
| | | |
Collapse
|
21
|
Abstract
Sporadic inclusion body myositis is the most common inflammatory muscle disorder preferentially affecting males over the age of 40 years. Progressive muscle weakness of the finger flexors and quadriceps muscles results in loss of independence with activities of daily living and eventual wheelchair dependence. Initial signs of disease are often overlooked and can lead to mis- or delayed diagnosis. The underlying cause of disease is unknown, and disease progression appears refractory to available treatment options. This review discusses the clinical presentation of inclusion body myositis and the current efforts in diagnosis, and focuses on the current state of research for both nonpharmacological and pharmacological treatment options for this patient group.
Collapse
Affiliation(s)
- Lindsay N Alfano
- Nationwide Children's Hospital, Center for Gene Therapy, Columbus, OH, USA
| | - Linda P Lowes
- Nationwide Children's Hospital, Center for Gene Therapy, Columbus, OH, USA
| |
Collapse
|
22
|
Dobloug GC, Antal EA, Sveberg L, Garen T, Bitter H, Stjärne J, Grøvle L, Gran JT, Molberg Ø. High prevalence of inclusion body myositis in Norway; a population-based clinical epidemiology study. Eur J Neurol 2014; 22:672-e41. [DOI: 10.1111/ene.12627] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2014] [Accepted: 10/17/2014] [Indexed: 01/14/2023]
Affiliation(s)
- G. C. Dobloug
- Department of Rheumatology; Oslo University Hospital (OUH); Oslo Norway
| | | | - L. Sveberg
- Department of Neurology; OUH; Oslo Norway
| | - T. Garen
- Department of Rheumatology; Oslo University Hospital (OUH); Oslo Norway
| | - H. Bitter
- Department of Rheumatology; Sørlandet Hospital; Kristiansand Norway
| | - J. Stjärne
- Department of Rheumatology; Betanien Hospital; Skien Norway
| | - L. Grøvle
- Department of Rheumatology; Sykehuset Østfold; Moss Norway
| | - J. T. Gran
- Department of Rheumatology; Oslo University Hospital (OUH); Oslo Norway
| | - Ø. Molberg
- Department of Rheumatology; Oslo University Hospital (OUH); Oslo Norway
- Institute of Clinical Medicine; University of Oslo; Oslo Norway
| |
Collapse
|
23
|
Mastaglia FL, Needham M. Inclusion body myositis: a review of clinical and genetic aspects, diagnostic criteria and therapeutic approaches. J Clin Neurosci 2014; 22:6-13. [PMID: 25510538 DOI: 10.1016/j.jocn.2014.09.012] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2014] [Accepted: 09/14/2014] [Indexed: 10/24/2022]
Abstract
Inclusion body myositis is the most common myopathy in patients over the age of 40 years encountered in neurological practice. Although it is usually sporadic, there is increasing awareness of the influence of genetic factors on disease susceptibility and clinical phenotype. The diagnosis is based on recognition of the distinctive pattern of muscle involvement and temporal profile of the disease, and the combination of inflammatory and myodegenerative changes and protein deposits in the muscle biopsy. The diagnostic importance of immunohistochemical staining for major histocompatibility complex I and II antigens, for the p62 protein, and of the recently identified anti-cN1A autoantibody in the serum, are discussed. The condition is generally poorly responsive to conventional immune therapies but there have been relatively few randomised controlled trials and most of these have been under-powered and of short duration. There is an urgent need for further well-designed multicentre trials of existing and novel therapies that may alter the natural history of the disease.
Collapse
Affiliation(s)
- Frank L Mastaglia
- Institute of Immunology and Infectious Diseases, Murdoch University, Murdoch, WA, Australia; Western Australian Neuroscience Research Institute, Queen Elizabeth II Medical Centre, Verdun Street, Nedlands, WA 6009, Australia.
| | - Merrilee Needham
- Institute of Immunology and Infectious Diseases, Murdoch University, Murdoch, WA, Australia; Western Australian Neuroscience Research Institute, Queen Elizabeth II Medical Centre, Verdun Street, Nedlands, WA 6009, Australia
| |
Collapse
|
24
|
Machado PM, Ahmed M, Brady S, Gang Q, Healy E, Morrow JM, Wallace AC, Dewar L, Ramdharry G, Parton M, Holton JL, Houlden H, Greensmith L, Hanna MG. Ongoing developments in sporadic inclusion body myositis. Curr Rheumatol Rep 2014; 16:477. [PMID: 25399751 PMCID: PMC4233319 DOI: 10.1007/s11926-014-0477-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Sporadic inclusion body myositis (IBM) is an acquired muscle disorder associated with ageing, for which there is no effective treatment. Ongoing developments include: genetic studies that may provide insights regarding the pathogenesis of IBM, improved histopathological markers, the description of a new IBM autoantibody, scrutiny of the diagnostic utility of clinical features and biomarkers, the refinement of diagnostic criteria, the emerging use of MRI as a diagnostic and monitoring tool, and new pathogenic insights that have led to novel therapeutic approaches being trialled for IBM, including treatments with the objective of restoring protein homeostasis and myostatin blockers. The effect of exercise in IBM continues to be investigated. However, despite these ongoing developments, the aetiopathogenesis of IBM remains uncertain. A translational and multidisciplinary collaborative approach is critical to improve the diagnosis, treatment, and care of patients with IBM.
Collapse
Affiliation(s)
- Pedro M. Machado
- MRC Centre for Neuromuscular Diseases, Institute of Neurology, University College London, Box 102, 8-11 Queen Square, London, WC1N 3BG UK
| | - Mhoriam Ahmed
- MRC Centre for Neuromuscular Diseases, Institute of Neurology, University College London, Box 102, 8-11 Queen Square, London, WC1N 3BG UK
- Sobell Department of Motor Neuroscience and Movement Disorders, Institute of Neurology, University College London, Queen Square, London, WC1N 3BG UK
| | - Stefen Brady
- MRC Centre for Neuromuscular Diseases, Institute of Neurology, University College London, Box 102, 8-11 Queen Square, London, WC1N 3BG UK
| | - Qiang Gang
- MRC Centre for Neuromuscular Diseases, Institute of Neurology, University College London, Box 102, 8-11 Queen Square, London, WC1N 3BG UK
| | - Estelle Healy
- MRC Centre for Neuromuscular Diseases, Institute of Neurology, University College London, Box 102, 8-11 Queen Square, London, WC1N 3BG UK
| | - Jasper M. Morrow
- MRC Centre for Neuromuscular Diseases, Institute of Neurology, University College London, Box 102, 8-11 Queen Square, London, WC1N 3BG UK
| | - Amanda C. Wallace
- MRC Centre for Neuromuscular Diseases, Institute of Neurology, University College London, Box 102, 8-11 Queen Square, London, WC1N 3BG UK
| | - Liz Dewar
- MRC Centre for Neuromuscular Diseases, Institute of Neurology, University College London, Box 102, 8-11 Queen Square, London, WC1N 3BG UK
| | - Gita Ramdharry
- MRC Centre for Neuromuscular Diseases, Institute of Neurology, University College London, Box 102, 8-11 Queen Square, London, WC1N 3BG UK
| | - Matthew Parton
- MRC Centre for Neuromuscular Diseases, Institute of Neurology, University College London, Box 102, 8-11 Queen Square, London, WC1N 3BG UK
| | - Janice L. Holton
- MRC Centre for Neuromuscular Diseases, Institute of Neurology, University College London, Box 102, 8-11 Queen Square, London, WC1N 3BG UK
| | - Henry Houlden
- MRC Centre for Neuromuscular Diseases, Institute of Neurology, University College London, Box 102, 8-11 Queen Square, London, WC1N 3BG UK
| | - Linda Greensmith
- MRC Centre for Neuromuscular Diseases, Institute of Neurology, University College London, Box 102, 8-11 Queen Square, London, WC1N 3BG UK
- Sobell Department of Motor Neuroscience and Movement Disorders, Institute of Neurology, University College London, Queen Square, London, WC1N 3BG UK
| | - Michael G. Hanna
- MRC Centre for Neuromuscular Diseases, Institute of Neurology, University College London, Box 102, 8-11 Queen Square, London, WC1N 3BG UK
| |
Collapse
|
25
|
|
26
|
Rider LG, Dankó K, Miller FW. Myositis registries and biorepositories: powerful tools to advance clinical, epidemiologic and pathogenic research. Curr Opin Rheumatol 2014; 26:724-41. [PMID: 25225838 PMCID: PMC5081267 DOI: 10.1097/bor.0000000000000119] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
PURPOSE OF REVIEW Clinical registries and biorepositories have proven extremely useful in many studies of diseases, especially rare diseases. Given their rarity and diversity, the idiopathic inflammatory myopathies, or myositis syndromes, have benefited from individual researchers' collections of cohorts of patients. Major efforts are being made to establish large registries and biorepositories that will allow many additional studies to be performed that were not possible before. Here, we describe the registries developed by investigators and patient support groups that are currently available for collaborative research purposes. RECENT FINDINGS We have identified 46 myositis research registries, including many with biorepositories, which have been developed for a wide variety of purposes and have resulted in great advances in understanding the range of phenotypes, clinical presentations, risk factors, pathogenic mechanisms, outcome assessment, therapeutic responses, and prognoses. These are now available for collaborative use to undertake additional studies. Two myositis patient registries have been developed for research, and myositis patient support groups maintain demographic registries with large numbers of patients available to be contacted for potential research participation. SUMMARY Investigator-initiated myositis research registries and biorepositories have proven extremely useful in understanding many aspects of these rare and diverse autoimmune diseases. These registries and biorepositories, in addition to those developed by myositis patient support groups, deserve continued support to maintain the momentum in this field as they offer major opportunities to improve understanding of the pathogenesis and treatment of these diseases in cost-effective ways.
Collapse
Affiliation(s)
- Lisa G. Rider
- Environmental Autoimmunity Group, Program of Clinical Research, National Institute of Environmental Health Sciences, National Institutes of Health (NIH), DHHS, Bethesda, MD
| | - Katalin Dankó
- Division of Immunology, 3rd Dept. of Internal Medicine, Medical and Health Science Center, University of Debrecen, Debrecen, Hungary
| | - Frederick W. Miller
- Environmental Autoimmunity Group, Program of Clinical Research, National Institute of Environmental Health Sciences, National Institutes of Health (NIH), DHHS, Bethesda, MD
| |
Collapse
|
27
|
Gang Q, Bettencourt C, Machado P, Hanna MG, Houlden H. Sporadic inclusion body myositis: the genetic contributions to the pathogenesis. Orphanet J Rare Dis 2014; 9:88. [PMID: 24948216 PMCID: PMC4071018 DOI: 10.1186/1750-1172-9-88] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2014] [Accepted: 06/12/2014] [Indexed: 11/10/2022] Open
Abstract
Sporadic inclusion body myositis (sIBM) is the commonest idiopathic inflammatory muscle disease in people over 50 years old. It is characterized by slowly progressive muscle weakness and atrophy, with typical pathological changes of inflammation, degeneration and mitochondrial abnormality in affected muscle fibres. The cause(s) of sIBM are still unknown, but are considered complex, with the contribution of multiple factors such as environmental triggers, ageing and genetic susceptibility. This review summarizes the current understanding of the genetic contributions to sIBM and provides some insights for future research in this mysterious disease with the advantage of the rapid development of advanced genetic technology. An international sIBM genetic study is ongoing and whole-exome sequencing will be applied in a large cohort of sIBM patients with the aim of unravelling important genetic risk factors for sIBM.
Collapse
Affiliation(s)
- Qiang Gang
- Department of Molecular Neuroscience, Institute of Neurology, University College London, Queen Square, London WC1N 3BG, UK.
| | | | | | | | | |
Collapse
|
28
|
Abstract
PURPOSE OF REVIEW To review the progress that has been made in understanding the genetics of the idiopathic inflammatory myopathies (IIMs) in the past 2 years, with particular focus on polymyositis, dermatomyositis and inclusion body myositis. RECENT FINDINGS Candidate gene studies in the Japanese population have implicated signal transducer and activator of transcription 4 as a risk locus for IIM, and HLA-DRB1 as a risk locus for anti-melanoma differentiation-associated gene 5-positive dermatomyositis. Evidence for gene-environment interactions has been found between HLA-DRB1*03 and smoking as a risk factor for the development of anti-histidyl tRNA synthetase antibodies, and HLA-DRB1*11:01 and statins for the development of anti-hydroxymethyl glutaryl-coenzyme A reductase-positive statin-induced myopathy. The HLA-DRB1*03:01/*01:01 genotype confers the highest disease risk in inclusion body myositis. A recent genome-wide association study has been performed in dermatomyositis. The most significant signals were in the major histocompatibility complex region, with other loci suggesting evidence of genetic overlap with different autoimmune diseases. SUMMARY Recent association and gene-environment interaction studies have increased our knowledge of genetic risk factors for the IIMs. Ongoing international collaborations will facilitate larger and more meaningful genetic studies revealing much about the genetic architecture of these complex diseases.
Collapse
|
29
|
Schmidt J, Dalakas MC. Inclusion body myositis: from immunopathology and degenerative mechanisms to treatment perspectives. Expert Rev Clin Immunol 2014; 9:1125-33. [DOI: 10.1586/1744666x.2013.842467] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
|
30
|
Polymorphism in the TOMM40 gene modifies the risk of developing sporadic inclusion body myositis and the age of onset of symptoms. Neuromuscul Disord 2013; 23:969-74. [DOI: 10.1016/j.nmd.2013.09.008] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2013] [Revised: 08/28/2013] [Accepted: 09/10/2013] [Indexed: 10/26/2022]
|
31
|
Rose MR. 188th ENMC International Workshop: Inclusion Body Myositis, 2-4 December 2011, Naarden, The Netherlands. Neuromuscul Disord 2013; 23:1044-55. [PMID: 24268584 DOI: 10.1016/j.nmd.2013.08.007] [Citation(s) in RCA: 242] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2013] [Revised: 08/13/2013] [Accepted: 08/19/2013] [Indexed: 11/29/2022]
Affiliation(s)
- M R Rose
- Dept of Neurology, Kings College Hospital, Denmark Hill, London SE5 9RS, United Kingdom.
| | | |
Collapse
|
32
|
Rojana-udomsart A, Mitrpant C, James I, Witt C, Needham M, Day T, Kiers L, Corbett A, Martinez P, Wilton SD, Mastaglia FL. Analysis of HLA-DRB3 alleles and supertypical genotypes in the MHC Class II region in sporadic inclusion body myositis. J Neuroimmunol 2013; 254:174-7. [DOI: 10.1016/j.jneuroim.2012.09.003] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2012] [Revised: 08/04/2012] [Accepted: 09/03/2012] [Indexed: 12/01/2022]
|
33
|
High-resolution HLA-DRB1 genotyping in an Australian inclusion body myositis (s-IBM) cohort: An analysis of disease-associated alleles and diplotypes. J Neuroimmunol 2012; 250:77-82. [DOI: 10.1016/j.jneuroim.2012.05.003] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2012] [Revised: 04/30/2012] [Accepted: 05/03/2012] [Indexed: 11/19/2022]
|
34
|
Mammen AL, Gaudet D, Brisson D, Christopher-Stine L, Lloyd TE, Leffell MS, Zachary AA. Increased frequency of DRB1*11:01 in anti-hydroxymethylglutaryl-coenzyme A reductase-associated autoimmune myopathy. Arthritis Care Res (Hoboken) 2012; 64:1233-7. [PMID: 22422616 PMCID: PMC3400716 DOI: 10.1002/acr.21671] [Citation(s) in RCA: 57] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
OBJECTIVE To investigate the association of anti-hydroxymethylglutaryl-coenzyme A reductase (anti-HMGCR) myopathy with HLA class I and II antigens. METHODS HLA antigens were determined in 1) 20 white and 8 African American anti-HMGCR patients, 2) 487 white and 167 African American controls, and 3) 51 white subjects with mild self-limited statin intolerance. RESULTS White anti-HMGCR patients had a higher frequency of the combination HLA-DR11, DQA5, and DQB7 than controls or statin-intolerant subjects (70% versus 17%; odds ratio [OR] 11.7 [95% confidence interval (95% CI) 4.0-35.3], P = 4.1 × 10(-7) and 70% versus 21%; OR 8.3 [95% CI 2.2-33.9], P = 5.4 × 10(-4) , respectively). This combination was not increased in African American anti-HMGCR subjects compared to controls (13% versus 3%; OR 4.6 [95% CI 0.2-53.3], P = 0.2). However, DR11 was increased in African American anti-HMGCR patients compared to controls (88% versus 21%; OR 26.4 [95% CI 3.1-590.3], P = 0.0002). High-resolution mapping showed that 95% with DR11 had DRB1*11:01. DQA1 and DQB6 were less frequent in white anti-HMGCR-positive patients compared to controls (25% versus 65%; OR 0.2 [95% CI 0.1-0.5], P = 5.5 × 10(-4) and 0% versus 45%; OR 0.0 [95% CI 0.0-0.3], P = 2.1 × 10(-5) , respectively). DRB11 was not associated with particular disease features. CONCLUSION DRB1*11:01 is associated with an increased risk of anti-HMGCR myopathy in whites and African Americans. These findings suggest a mechanistic link between statin exposure, increased HMGCR expression, and the possible presentation of HMGCR-derived peptide(s) by DRB1*11:01.
Collapse
Affiliation(s)
- Andrew L Mammen
- Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
| | | | | | | | | | | | | |
Collapse
|
35
|
Rojana-udomsart A, Needham M, Luo Y, Fabian V, Walters S, Zilko P, Mastaglia F. The association of sporadic inclusion body myositis and Sjögren's syndrome in carriers of HLA-DR3 and the 8.1 MHC ancestral haplotype. Clin Neurol Neurosurg 2011; 113:559-63. [DOI: 10.1016/j.clineuro.2011.03.016] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2010] [Revised: 03/13/2011] [Accepted: 03/22/2011] [Indexed: 01/28/2023]
|
36
|
Scott AP, Laing NG, Mastaglia F, Needham M, Walter MC, Dalakas MC, Allcock RJ. Recombination mapping of the susceptibility region for sporadic inclusion body myositis within the major histocompatibility complex. J Neuroimmunol 2011; 235:77-83. [DOI: 10.1016/j.jneuroim.2011.02.011] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2010] [Revised: 01/25/2011] [Accepted: 02/21/2011] [Indexed: 01/19/2023]
|
37
|
Chinoy H, Lamb JA, Ollier WER, Cooper RG. Recent advances in the immunogenetics of idiopathic inflammatory myopathy. Arthritis Res Ther 2011; 13:216. [PMID: 21658295 PMCID: PMC3218878 DOI: 10.1186/ar3327] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
This review summarizes the previous and current literature on the immunogenetics of idiopathic inflammatory myopathy (IIM) and updates the research progress that has been made over the past decade. A substantial part of the genetic risk for developing adult- and juvenile-onset IIM lies within the major histocompatibility complex (MHC), and a tight relationship exists between individual human leukocyte antigen alleles and specific serological subtypes, which in turn dictate clinical disease phenotypes. Multiple genetic regions outside of the MHC are increasingly being identified in conferring IIM disease susceptibility. We are still challenged with the task of studying a serologically and clinically heterogeneous disorder that is rarer by orders of magnitude than the likes of rheumatoid arthritis. An ongoing and internationally coordinated IIM genome-wide association study may provide further insights into IIM immunogenetics.
Collapse
Affiliation(s)
- Hector Chinoy
- Rheumatic Diseases Centre, Manchester Academic Health Science Centre, The University of Manchester, Salford Royal NHS Foundation Trust, Stott Lane, Salford, M6 8HD, UK
- Musculoskeletal Research Group, School of Translational Medicine, Manchester Academic Health Science Centre, The University of Manchester, Oxford Road, M13 9PT Manchester, UK
| | - Janine A Lamb
- Centre for IIntegrated Genomic Medical Research, Manchester Academic Health Science Centre, The University of Manchester, Oxford Road, M13 9PT Manchester, UK
| | - William ER Ollier
- Centre for IIntegrated Genomic Medical Research, Manchester Academic Health Science Centre, The University of Manchester, Oxford Road, M13 9PT Manchester, UK
| | - Robert G Cooper
- Rheumatic Diseases Centre, Manchester Academic Health Science Centre, The University of Manchester, Salford Royal NHS Foundation Trust, Stott Lane, Salford, M6 8HD, UK
- Centre for IIntegrated Genomic Medical Research, Manchester Academic Health Science Centre, The University of Manchester, Oxford Road, M13 9PT Manchester, UK
| |
Collapse
|
38
|
|
39
|
Abstract
Sporadic inclusion-body myositis is a common inflammatory myopathy, which is often misdiagnosed. In contrast to other forms of myositis, no effective treatment is available. The disease leads to severe wasting of the quadriceps and long-finger flexors, so patients gradually lose ambulation and hand-grip strength. The pathology includes an intrafiber accumulation of aberrant molecules, such as β-amyloid, as well as an inflammatory cascade, with overexpression of key cytokines and chemokines, and the attack of muscle fibers by autoaggressive cytotoxic T cells. Recent data point to an early cell-stress response in muscle fibers and a unique interplay between inflammatory and degenerative pathomechanisms. Current efforts aim to improve methods for early diagnosis and design more effective targeted treatment strategies. This article will highlight recent advances in understanding the disease pathology, and how to identify promising candidate molecules for future clinical trials.
Collapse
Affiliation(s)
- Jens Schmidt
- Department of Neurology, University Medical Centre, Göttingen, Germany
- Department of Neuroimmunology, Institute for Multiple Sclerosis Research and Hertie Foundation, University Medical Centre, Göttingen, Germany
| | - Marinos C Dalakas
- Department of Neurosciences, Imperial College, London, UK
- Department of Neurology, Thomas Jefferson University, 900, Walnut St, Suite 200, PA 19107, USA
| |
Collapse
|
40
|
Current world literature. Curr Opin Rheumatol 2010; 22:704-12. [PMID: 20881793 DOI: 10.1097/bor.0b013e3283404094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
41
|
Schmidt J, Dalakas MC. Pathomechanisms of inflammatory myopathies: recent advances and implications for diagnosis and therapies. ACTA ACUST UNITED AC 2010; 4:241-50. [DOI: 10.1517/17530051003713499] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
|