State of play in the neural hypothesis of muscular dystrophy

Neural regulation of alpha-dystroglycan biosynthesis and glycosylation in skeletal muscle

Alpha-dystroglycan (alpha-DG) is part of a complex of cell surface proteins linked to dystrophin or utrophin, which is distributed over the myofiber surface and is concentrated at neuromuscular junctions. In laminin overlays of muscle extracts from developing chick hindlimb muscle, alpha-DG first appears at embryonic day (E) 10 with an apparent molecular mass of 120 kDa. By E15 it is replaced by smaller (approximately 100 kDa) and larger (approximately 150 kDa) isoforms. The larger form increases in amount and in molecular mass (>200 kDa) as the muscle is innervated and the postsynaptic membrane differentiates (E10-E20), and then decreases dramatically in amount after hatching. In myoblasts differentiating in culture the molecular mass of alpha-DG is not significantly increased by their replication, fusion, or differentiation into myotubes. Monoclonal antibody IIH6, which recognizes a carbohydrate epitope on alpha-DG, preferentially binds to the larger forms, suggesting that the core protein is differentially glycosylated beginning at E16. Consistent with prior observations implicating the IIH6 epitope in laminin binding, the smaller forms of alpha-DG bind more weakly to laminin affinity columns than the larger ones. In blots of adult rat skeletal muscle probed with radiolabeled laminin or monoclonal antibody IIH6, alpha-DG appears as a >200-kDa band that decreases in molecular mass but increases in intensity following denervation. Northern blots reveal a single mRNA transcript, indicating that the reduction in molecular mass of alpha-DG after denervation is not obviously a result of alternative splicing but is likely due to posttranslational modification of newly synthesized molecules. The regulation of alpha-DG by the nerve and its increased affinity for laminin suggest that glycosylation of this protein may be important in myofiber-basement membrane interactions during development and after denervation.

Abnormalities expressed in long-term cultures of dorsal root ganglia from the dystrophic mouse

We have compared the development in long-term tissue culture of dorsal root ganglia taken from normal and dystrophic mice. Cultures were prepared from late fetal (15--20 days) or neonatal mice of either the C57BL/6 dy2j/dy2j dystrophic (dy) or C57BL/6J +/+ (control) strain and maintained until fully myelinated (5 weeks or more). Analysis by light and electron microscopy indicated that the substantial ensheathment failure present in certain dy nerve roots in vivo is not expressed in cultures; myelination and Schwann cell numbers are comparable to control cultures. On the other hand, many of the subtle abnormalities more recently described in distal parts of peripheral nerves of dystrophic mice are expressed in the dy cultures. These include: (a) discontinuity in the basal lamina surrounding both myelin-forming and non-myelinating Schwann cells: (b) elongated nodes of Ranvier occurring along otherwise well myelinated nerve fibers; (c) relatively short myelin internodes that are increased in thickness as well as irregularities of internode length along a nerve fiber; (d) Schwann cell nuclei substantially displaced from the central point of myelin internodes; and (e) occasional regions of incomplete ensheathment of unmyelinated nerve fibers. In discussing these observations, we present arguments that the dy nerve lesion may be explained by the presence of an abnormality in the extracellular matrix of the peripheral nerve tissues of the dy mouse.

Dystrophia myotonica. Peripheral nerve involvement and pathogenetic implications

A comparative electrophysioloical study of patients with dystrophia myotonica and control subjects is presented. The study includes estimation of the number of motor axons innervating the extensor digitorum brevis muscle and measurements of the conduction of M- and F-waves along the deep peroneal nerve. There is unequivocal electrophysiological evidence of nerve involvement in the disease. This was indicated by (a) prolongation of the terminal latencies and slowing of the motor conduction of the deep peroneal nerve (P less than 0.001), (b) delayed conduction of the F-wave along the proximal segments of the nerves (P less than 0.02-0.01), (c) reduced number of motor axons innervating the extensor digitorum brevis muscle (P less than 0.001), (d) high amplitude motor unit potentials and discrete EMG activity on the maximal volitional contraction of minimally affected muscles in one patient. However, if the muscle changes were secondary to the nerve involvement occurring in the disease, one would expect that the electrophysiological findings of neuropathy would become more prominent in patients with severe muscle wasting and weakness. Our results showed that in some patients with marked muscle atrophy and weakness there was no evidence of nerve involvement while in other patients with slight to moderate degree of muscle weakness the electrophysiological studies indicated peripheral neuropathy. Therefore, it appears that both the nerves and the muscles are independently affected by the pleiotropic action of the responsible gene and the evidence does not suggest that the muscle atrophy of patients with dystrophia myotonica is entirely neural.