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Reales G, Amos CI, Benveniste O, Chinoy H, De Bleecker J, De Paepe B, Doria A, Gregersen PK, Lamb JA, Limaye V, Lundberg IE, Machado PM, Maurer B, Miller FW, Molberg Ø, Pachman LM, Padyukov L, Radstake TR, Reed AM, Rider LG, Rothwell S, Selva-O'Callaghan A, Vencovský J, Wedderburn LR, Wallace C. Discovery of new myositis genetic associations through leveraging other immune-mediated diseases. HGG ADVANCES 2024; 5:100336. [PMID: 39044428 PMCID: PMC11350499 DOI: 10.1016/j.xhgg.2024.100336] [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: 01/16/2024] [Revised: 07/16/2024] [Accepted: 07/16/2024] [Indexed: 07/25/2024] Open
Abstract
Genome-wide association studies (GWASs) have been successful at finding associations between genetic variants and human traits, including the immune-mediated diseases (IMDs). However, the requirement of large sample sizes for discovery poses a challenge for learning about less common diseases, where increasing volunteer numbers might not be feasible. An example of this is myositis (or idiopathic inflammatory myopathies [IIM]s), a group of rare, heterogeneous autoimmune diseases affecting skeletal muscle and other organs, severely impairing life quality. Here, we applied a feature engineering method to borrow information from larger IMD GWASs to find new genetic associations with IIM and its subgroups. Combining this approach with two clustering methods, we found 17 IMDs genetically close to IIM, including some common comorbid conditions, such as systemic sclerosis and Sjögren's syndrome, as well as hypo- and hyperthyroidism. All IIM subtypes were genetically similar within this framework. Next, we colocalized IIM signals that overlapped IMD signals, and found seven potentially novel myositis associations mapped to immune-related genes, including BLK, IRF5/TNPO3, and ITK/HAVCR2, implicating a role for both B and T cells in IIM. This work proposes a new paradigm of genetic discovery in rarer diseases by leveraging information from more common IMD, and can be expanded to other conditions and traits beyond IMD.
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Affiliation(s)
- Guillermo Reales
- Cambridge Institute of Therapeutic Immunology and Infectious Disease (CITIID), University of Cambridge, Cambridge, UK; Department of Medicine, University of Cambridge, Cambridge, UK.
| | | | - Olivier Benveniste
- Department of Internal Medicine and Clinical Immunology, Pitié-Salpêtrière Hospital, Paris, France
| | - Hector Chinoy
- Department of Rheumatology, Salford Royal Hospital, Northern Care Alliance NHS Foundation Trust, Manchester Academic Health Science Centre, Salford, UK; Division of Musculoskeletal and Dermatological Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
| | - Jan De Bleecker
- Department of Neurology, Ghent University, Ghent, Belgium; Neuromuscular Reference Center, Ghent University Hospital, Ghent, Belgium
| | - Boel De Paepe
- Department of Neurology, Ghent University, Ghent, Belgium; Neuromuscular Reference Center, Ghent University Hospital, Ghent, Belgium
| | - Andrea Doria
- Rheumatology Unit, Department of Medicine, University of Padova, Padova, Italy
| | - Peter K Gregersen
- The Robert S. Boas Center for Genomics and Human Genetics, The Feinstein Institute, Manhasset, NY, USA
| | - Janine A Lamb
- Epidemiology and Public Health Group, Division of Population Health, Health Services Research & Primary Care, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
| | - Vidya Limaye
- Rheumatology Unit, Royal Adelaide Hospital, Adelaide, South Australia, Australia; Discipline of Medicine, Adelaide University, Adelaide, South Australia, Australia
| | - Ingrid E Lundberg
- Division of Rheumatology, Department of Medicine, Solna, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
| | - Pedro M Machado
- Department of Neuromuscular Diseases, UCL Queen Square Institute of Neurology. London, UK; Centre for Rheumatology, UCL Division of Medicine, University College London, London, UK
| | - Britta Maurer
- Department of Rheumatology and Immunology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Frederick W Miller
- Environmental Autoimmunity Group, National Institute of Environmental Health Sciences, NIH, Bethesda, MD, USA
| | - Øyvind Molberg
- Department of Rheumatology, Oslo University Hospital, Oslo, Norway
| | - Lauren M Pachman
- Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Leonid Padyukov
- Division of Rheumatology, Department of Medicine, Solna, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
| | - Timothy R Radstake
- Department of Rheumatology and Clinical Immunology, University Medical Center, Utrecht, the Netherlands
| | - Ann M Reed
- Department of Pediatrics, Duke University, Durham, NC, USA
| | - Lisa G Rider
- Environmental Autoimmunity Group, National Institute of Environmental Health Sciences, NIH, Bethesda, MD, USA
| | - Simon Rothwell
- Centre for Genetics and Genomics Versus Arthritis, Centre for Musculoskeletal Research, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
| | - Albert Selva-O'Callaghan
- Internal Medicine Department, Vall d'Hebron General Hospital, Universitat Autonoma de Barcelona, Barcelona, Spain
| | - Jiri Vencovský
- Institute of Rheumatology and Department of Rheumatology, First Medical Faculty, Charles University, Prague, Czech Republic
| | - Lucy R Wedderburn
- Centre for Adolescent Rheumatology Versus Arthritis, UCL Great Ormond Street Institute of Child Health, University College London, London, UK; NIHR Biomedical Research Centre at Great Ormond Street Hospital, London, UK
| | - Chris Wallace
- Cambridge Institute of Therapeutic Immunology and Infectious Disease (CITIID), University of Cambridge, Cambridge, UK; Department of Medicine, University of Cambridge, Cambridge, UK; MRC Biostatistics Unit, University of Cambridge, Cambridge, UK
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Alf V, Opmeer Y, Shelton GD, Grinwis GCM, Matiasek K, Rosati M, Mandigers PJJ. Pathologic Changes in and Immunophenotyping of Polymyositis in the Dutch Kooiker Dog. Animals (Basel) 2024; 14:2519. [PMID: 39272303 PMCID: PMC11394232 DOI: 10.3390/ani14172519] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2024] [Revised: 08/26/2024] [Accepted: 08/28/2024] [Indexed: 09/15/2024] Open
Abstract
Earlier, we described a breed-specific inflammatory myopathy in Dutch Kooiker dogs (Het Nederlandse Kooikerhondje), one of the nine Dutch breeds. The disease commonly manifests itself with clinical signs of difficulty walking, muscle weakness, exercise intolerance, and/or dysphagia. In nearly all dogs' creatine kinase (CK) activity was elevated. Histopathology reveals the infiltration of inflammatory cells within the skeletal muscles. The objective of this study was to further investigate and characterize the histopathological changes in muscle tissue and immunophenotype the inflammatory infiltrates. FFPE fixed-muscle biopsies from 39 purebred Kooiker dogs were included and evaluated histopathologically according to a tailored classification scheme for skeletal muscle inflammation. As in other breed-related inflammatory myopathies, multifocal, mixed, and predominantly mononuclear cell infiltration was present, with an initial invasion of viable muscle fibres and the surrounding stroma leading to inflammation, necrosis, and tissue damage. Immunophenotyping primarily revealed lymphohistiocytic infiltrates, with CD3+ T-cells being the predominant inflammatory cell type, accompanied by CD8+ cytotoxic T-cells. The concurrent expression of MHC-II class molecules on myofibres suggests their involvement in initiating and maintaining inflammation. Additionally, CD20+ B-cells were identified, though in lower numbers compared to T-cells, and IBA-1-positive macrophages were frequently seen. These findings suggest a breed-specific subtype of polymyositis in Kooiker dogs, akin to other breeds. This study sheds light on the immune response activation, combining adaptive and innate mechanisms, contributing to our understanding of polymyositis in this breed.
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Affiliation(s)
- Vanessa Alf
- Section of Clinical and Comparative Neuropathology, Centre for Clinical Veterinary Medicine, Ludwig-Maximilians-Universität Munich, 80539 Munich, Germany
| | - Yvet Opmeer
- Expertise Centre of Genetics, Department of Clinical Sciences, Faculty of Veterinary Medicine, Utrecht University, 3584 CM Utrecht, The Netherlands
| | - G Diane Shelton
- Department of Pathology, School of Medicine, University of California, San Diego, CA 92093-0709, USA
| | - Guy C M Grinwis
- Department of Biomolecular Health Sciences, Faculty of Veterinary Medicine, Utrecht University, 3584 CL Utrecht, The Netherlands
| | - Kaspar Matiasek
- Section of Clinical and Comparative Neuropathology, Centre for Clinical Veterinary Medicine, Ludwig-Maximilians-Universität Munich, 80539 Munich, Germany
| | - Marco Rosati
- Section of Clinical and Comparative Neuropathology, Centre for Clinical Veterinary Medicine, Ludwig-Maximilians-Universität Munich, 80539 Munich, Germany
| | - Paul J J Mandigers
- Expertise Centre of Genetics, Department of Clinical Sciences, Faculty of Veterinary Medicine, Utrecht University, 3584 CM Utrecht, The Netherlands
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Al Hassan S, El Baba A, Bou Ghannam A. Case of Isolated Orbital Eosinophilic Myositis With Peripheral Eosinophilia: A Challenging Diagnosis. J Neuroophthalmol 2024:00041327-990000000-00673. [PMID: 38946030 DOI: 10.1097/wno.0000000000002201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/02/2024]
Affiliation(s)
- Sally Al Hassan
- Departments of Ophthalmology (SAH, ABG) and Pathology (AEB), American University of Beirut Medical Center, Beirut, Lebanon
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Nunes AM, Ramirez MM, Garcia-Collazo E, Jones TI, Jones PL. Muscle eosinophilia is a hallmark of chronic disease in facioscapulohumeral muscular dystrophy. Hum Mol Genet 2024; 33:872-883. [PMID: 38340007 PMCID: PMC11070135 DOI: 10.1093/hmg/ddae019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Revised: 01/23/2024] [Accepted: 01/24/2024] [Indexed: 02/12/2024] Open
Abstract
Facioscapulohumeral muscular dystrophy (FSHD) is a progressive myopathy caused by the aberrant increased expression of the DUX4 retrogene in skeletal muscle cells. The DUX4 gene encodes a transcription factor that functions in zygotic genome activation and then is silenced in most adult somatic tissues. DUX4 expression in FSHD disrupts normal muscle cell function; however, the downstream pathogenic mechanisms are still unclear. Histologically, FSHD affected muscles show a characteristic dystrophic phenotype that is often accompanied by a pronounced immune cell infiltration, but the role of the immune system in FSHD is not understood. Previously, we used ACTA1;FLExDUX4 FSHD-like mouse models varying in severity as discovery tools to identify increased Interleukin 6 and microRNA-206 levels as serum biomarkers for FSHD disease severity. In this study, we use the ACTA1;FLExDUX4 chronic FSHD-like mouse model to provide insight into the immune response to DUX4 expression in skeletal muscles. We demonstrate that these FSHD-like muscles are enriched with the chemoattractant eotaxin and the cytotoxic eosinophil peroxidase, and exhibit muscle eosinophilia. We further identified muscle fibers with positive staining for eosinophil peroxidase in human FSHD muscle. Our data supports that skeletal muscle eosinophilia is a hallmark of FSHD pathology.
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Affiliation(s)
- Andreia M Nunes
- Department of Pharmacology, University of Nevada, Reno School of Medicine, 1664 N. Virginia St., Reno, NV 89557, United States
| | - Monique M Ramirez
- Department of Pharmacology, University of Nevada, Reno School of Medicine, 1664 N. Virginia St., Reno, NV 89557, United States
| | - Enrique Garcia-Collazo
- Department of Pharmacology, University of Nevada, Reno School of Medicine, 1664 N. Virginia St., Reno, NV 89557, United States
| | - Takako Iida Jones
- Department of Pharmacology, University of Nevada, Reno School of Medicine, 1664 N. Virginia St., Reno, NV 89557, United States
| | - Peter L Jones
- Department of Pharmacology, University of Nevada, Reno School of Medicine, 1664 N. Virginia St., Reno, NV 89557, United States
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Fermon C, Lessard LER, Fenouil T, Meyer A, Faruch-Bilfeld M, Robert M, Landel V, Hot A, Authier FJ, Streichenberger N, Gallay L. Revisiting idiopathic eosinophilic myositis: towards a clinical-pathological continuum from the muscle to the fascia and skin. Rheumatology (Oxford) 2023; 62:2220-2229. [PMID: 36200845 PMCID: PMC10234208 DOI: 10.1093/rheumatology/keac556] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Accepted: 09/14/2022] [Indexed: 08/10/2023] Open
Abstract
OBJECTIVES Idiopathic inflammatory myopathies are mainly defined by inflammatory infiltrates within the muscle (lymphocytes and macrophages). Eosinophil muscle infiltration has been described in idiopathic eosinophilic myositis (IEM) and rarely in EF. This study aimed to further delineate the nosological frame of idiopathic eosinophil muscle infiltration through the exhaustive analysis of IEM and EF patients. METHODS This multicentre retrospective case series included IEM patients diagnosed between 2000 and 2022. IEM inclusion criteria were eosinophilic muscle infiltration with myositis pathological features, after the exclusion of differential diagnoses. An additional group of EF patients diagnosed between 2016 and 2022 was constituted. Inclusion criteria were an EF diagnosis and fascia thickening with inflammatory infiltrate. RESULTS A total of 20 IEM cases and 10 EF cases were included. The median (interquartile range) age at diagnosis was 65 (49-70) years; there were 18 males. Data analysis delineated four subgroups: focal EM (FEM, n = 3), diffuse EM (DEM, n = 6), eosinophilic myofasciitis (EMF, n = 11) and EF (n = 10). FEM represented a limited and benign form of myositis. DEM cases presented objective muscle impairment with eosinophilic muscle infiltration. EMF patients presented subjective muscle impairment (myalgia, 55%), fasciitis (on histology and/or imaging), eosinophilic muscle infiltration and frequent hypereosinophilia (55%). EF patients presented myalgia (50%), muscle lesions on histology with fascia-restricted inflammatory infiltrates with (60%) or without (40%) eosinophils. CONCLUSIONS The analysis of IEM and EF patient characteristics delineates four subgroups (FEM, DEM, EMF and EF) in terms of clinical, laboratory, imaging, pathological and outcome specificities, and proposes an adapted diagnostic and care management approach.
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Affiliation(s)
- Cécile Fermon
- Service de Médecine Interne, Centre Hospitalier Universitaire Edouard Herriot, Hospices Civils de Lyon, Lyon, France
| | - Lola E R Lessard
- Service d’Electroneuromyographie et Pathologies Neuromusculaires, Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Lyon, France
- Laboratoire Physiopathologie et Génétique du Neurone et du Muscle (PGNM), CNRS UMR5261—INSERM U1315, Institut NeuroMyoGène—Université Claude Bernard Lyon 1, Lyon, France
| | - Tanguy Fenouil
- Service de Cytologie et d'Anatomie Pathologique, Département de Neuropathologie, Groupement Hospitalier Est, Hospices Civils de Lyon, Lyon, France
| | - Alain Meyer
- Centre de Reference des Maladies Autoimmunes Rares, Service de Rhumatologie, Exploration Fonctionnelle Musculaires, Service de Physiologie, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
- EA3072 Université de Strasbourg, Strasbourg, France
| | - Marie Faruch-Bilfeld
- Service d’Imagerie, Centre Hospitalier Universitaire de Toulouse, Hôpital Pierre Paul Riquet, Toulouse, France
| | - Marie Robert
- Service de Médecine Interne, Centre Hospitalier Universitaire Edouard Herriot, Hospices Civils de Lyon, Lyon, France
| | - Verena Landel
- Direction de la Recherche en Santé, Hospices Civils de Lyon, Lyon, France
| | - Arnaud Hot
- Service de Médecine Interne, Centre Hospitalier Universitaire Edouard Herriot, Hospices Civils de Lyon, Lyon, France
| | - François-Jérôme Authier
- Université Paris Est-Créteil, INSERM, IMRB U955, Team Relaix, Créteil, France
- Centre de Référence « Nord-Est-Ile de France » pour les Pathologies Neuromusculaires, FILNEMUS, Paris, France
- UH Histologie/Département de Pathologie, Centre Hospitalier Universitaire Henri Mondor, Assistance Publique-Hôpitaux de Paris, Créteil, France
| | | | - Laure Gallay
- Correspondence to: Laure Gallay, Service de Médecine Interne du Pr Arnaud Hot, Hôpital Edouard Herriot, 5 Place d’Arsonval, F-69003 Lyon, France. E-mail:
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Galluzzo C, Chiapparoli I, Corrado A, Cantatore FP, Salvarani C, Pipitone N. Rare forms of inflammatory myopathies - part I, generalized forms. Expert Rev Clin Immunol 2023; 19:169-183. [PMID: 36469633 DOI: 10.1080/1744666x.2023.2154656] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
INTRODUCTION The idiopathic inflammatory myopathies traditionally comprise dermatomyositis, polymyositis, immune-mediated necrotizing myopathy, anti-synthetase syndrome, and inclusion body myositis. In this review, we aimed to cover the less common forms of generalized myositis. AREAS COVERED We identified rare forms of widespread myositis on the basis of list provided by the homepage of the Neuromuscular disease center of Washington University, USA and on the basis of the authors' knowledge. We searched PubMed® and EMBASE® for relevant articles on these forms with the aim of providing as much as possible information on their clinical manifestations as well as guidance on their work-up and treatment. EXPERT OPINION There is substantial heterogeneity among the various rare forms of generalized myositis in terms of their frequency and characterization. Some forms are reasonably well defined, while others may not represent truly well-defined diseases, but rather variants of other myopathies. The landscape of rare forms appears to have evolved over time, with some forms now being better characterized, while others, such as SARS-Cov-2- and immune checkpoint inhibitor-related myositis have come to the fore only in recent years. Knowledge about rare forms of myositis can aid in their recognition and treatment.
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Affiliation(s)
- Claudio Galluzzo
- Department of internal Medicine, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Ilaria Chiapparoli
- Department of internal Medicine, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Ada Corrado
- Rheumatology Clinic, Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
| | - Francesco Paolo Cantatore
- Rheumatology Clinic, Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
| | - Carlo Salvarani
- Department of internal Medicine, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy.,Università di Modena e Reggio Emilia, Modena, Italy
| | - Nicolò Pipitone
- Department of internal Medicine, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
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Galluzzo C, Chiapparoli I, Corrado A, Cantatore FP, Salvarani C, Pipitone N. Rare forms of inflammatory myopathies - part II, localized forms. Expert Rev Clin Immunol 2023; 19:185-191. [PMID: 36469645 DOI: 10.1080/1744666x.2023.2154655] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
INTRODUCTION The idiopathic inflammatory myopathies traditionally comprise dermatomyositis, polymyositis, the anti-synthetase syndromes, immune-mediated necrotizing myopathy and inclusion body myositis. However, there are uncommon localized forms that are less known. In this review, we aimed to cover these uncommon forms. AREAS COVERED We identified rare forms of localized myositis on the basis of list provided by the homepage of the Neuromuscular disease center of Washington University, USA and on the basis of the authors' knowledge. We searched PubMed® for relevant articles on these forms with the aim of providing as much as possible information on their clinical manifestations as well as guidance on their work-up and treatment. EXPERT OPINION herein, we provide un updated description of rare forms of localized myositis. These forms are often difficult to diagnose because of their localized nature and are sometimes misdiagnosed as tumors. Knowledge about these rare forms of localized myositis can aid in their recognition and treatment.
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Affiliation(s)
- Claudio Galluzzo
- Department of Internal Medicine, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Ilaria Chiapparoli
- Department of Internal Medicine, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Ada Corrado
- Department of Medical and Surgical Sciences, Rheumatology Clinic, University of Foggia, Foggia, Italy
| | - Francesco Paolo Cantatore
- Department of Medical and Surgical Sciences, Rheumatology Clinic, University of Foggia, Foggia, Italy
| | - Carlo Salvarani
- Department of Internal Medicine, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy.,Department of Internal Medicine, Università di Modena e Reggio Emilia, Modena, Italy
| | - Nicolò Pipitone
- Department of Internal Medicine, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
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