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

Dystrophin and the integrity of the sarcolemma in Duchenne muscular dystrophy

It is suggested that in Duchenne muscular dystrophy the absence of dystrophin, which is probably a cytoskeletal protein underlying the sarcolemma, causes changes in stretch-activated cation channels rather than direct mechanical tearing of the surface membrane.

Erythrocyte membrane ATPase and calcium pumping activities in porcine malignant hyperthermia

To investigate possible abnormalities in erythrocyte membrane enzyme activities in the pharmacogenetic disorder MH, membrane ATPase activities have been examined in erythrocyte ghosts prepared from red blood cells of MHS and normal swine. While no differences were noted in Mg2+-ATPase activities, the (Na+, K+)-ATPase activity of MHS erythrocyte ghosts was less than that of normal ghosts. Ca2+-ATPase activity exhibited low- and high-affinity Ca2+-binding sites in both types of erythrocyte ghost. While the Km for Ca2+ was greater for normal than for MHS erythrocyte ghosts at the high-affinity Ca2+-binding site, the reverse was true at the low-affinity Ca2+-binding site. Irrespective of the type of calcium binding site occupied, the Vmax for normal erythrocyte ghost Ca2+-ATPase activity was greater than that for MHS ghosts. In the presence of calmodulin, there was now no difference between MHS and normal erythrocyte ghosts in either the Km for Ca2+ or the Vmax of the Ca2+-ATPase activity. To determine if the calcium pumping activity of intact MHS and normal pig erythrocytes differed, calcium efflux from the 45Ca-loaded erythrocytes was determined; this activity was significantly greater for MHS than for normal erythrocytes. Thus, the present study confirms that there are abnormalities in the membranes of MHS pig red blood cells. However, we conclude that these abnormalities are unlikely to result in an impaired ability of MHS erythrocytes to regulate their cytosolic Ca2+ concentration.

Calcium-related defects in cardiac and skeletal muscles of dystrophic mice

Ca2+ ATPase and calcium binding proteins were studied in cardiac and skeletal muscles of normal and dystrophic mice. In normal and dystrophic mice, Ca2+ ATPase was quite reduced in cardiac muscle compared to skeletal muscle and was, unlike skeletal muscle, insensitive to orthovanadate. Ca2+ ATPase in skeletal muscle of dystrophic mice was reduced as compared to normal mice. In both cases (normal and dystrophic), calcium binding proteins were the same (identical molecular weight). The effect of 2 drugs (Polymixine B and Bepridil) which decrease protein bound calcium was studied: the muscle proteins of dystrophic mice did not present the same sensitivity to Bepridil as controls. These findings suggest the existence of a calcium-related defect in skeletal and cardiac muscle of dystrophic mice.

Impaired biosynthesis of highly unsaturated phosphatidylcholines: a hypothesis on the molecular etiology of some muscular dystrophies

A brief review of the literature concerning the synthesis of phosphatidylcholine and phosphatidylethanolamine in muscle suggests that the cytidine pathways are replaced by the recently proposed acyl-specific de novo and salvage glycerolphosphodiester pathways (Infante, 1984) in fully differentiated muscle. An analysis of published data suggests an impaired synthesis of 4,7,10,13,16,19-docosahexaenoic phosphatidylcholine, at the level of de novo sn-3-glycerolphosphorylcholine synthesis, as the primary defect in Duchenne and (dy) murine muscular dystrophies. This phosphatidylcholine species is postulated to be required for optimum sarcoplasmic Ca2+ transport activity. It is proposed that this impairment initiates the secondary series of events which lead to the observed pathology of these diseases. Based on some predictions of the hypothesis, potential diagnosis and treatments are suggested.

The free cytoplasmic Ca2+ levels in duchenne muscular dystrophy lymphocytes

An increased cellular Ca2+ content has been associated with Duchenne muscular dystrophy (DMD). However, estimates of the free cytoplasmic Ca2+ concentration ([Ca2+]i) in cells of DMD patients were not available. We compared the [Ca2+]i levels of normal and DMD peripheral blood lymphocytes and Epstein-Barr virus-transformed lymphoblasts using the novel probe, quin 2, an internally trapped fluorescent indicator. The [Ca2+]i levels of normal and DMD cells were not significantly different.

Canine malignant hyperthermia susceptibility: erythrocytic defects--osmotic fragility, glucose-6-phosphate dehydrogenase deficiency and abnormal Ca2+ homeostasis

Two dogs were diagnosed as malignant hyperthermia susceptible based on increased susceptibility (P less than 0.001) of biopsied muscle to caffeine-induced contracture. Erythrocytes from malignant hyperthermia and normal dogs were then examined for an antioxidant system deficiency. Values for serum muscle enzymes, reticulocytes and corpuscular hemoglobin were mildly elevated. Osmotic fragility was increased: hemolysis occurred at a NaCl concentration 10 mM higher than for normal dogs (P less than 0.001). A 35% glucose-6-phosphate dehydrogenase deficiency (P less than 0.001) with a 40% compensatory increase (P less than 0.01) in 6-phosphogluconate dehydrogenase activity was found. The membrane Ca2+-activated ATPase activity was abnormal: 100% increased with a 40% decreased Arrhenius activation energy (P less than 0.005) and increased thermostability. A 40% increased intracellular accumulation of total Ca2+ occurred in response to in vitro energy depletion in erythrocytes from one malignant hyperthermia dog (P less than 0.01). The multifactorial pattern of inheritance and the broad spectrum of malignant hyperthermia susceptibility are proposed to result from an antioxidant system deficit unmasking or aggravating an intrinsic muscle membrane anomaly. An individual from a family with a history of malignant hyperthermia or unexplained anesthetic death should be considered malignant hyperthermia susceptible if erythrocyte osmotic fragility is abnormal and there is a mild, unexplained elevation in serum creatine kinase.

Erythrocyte (Ca2+ + Mg2+)-ATPase activity and calcium homeostasis in Duchenne muscular dystrophy

Because the erythrocyte (RBC) in Duchenne's muscular dystrophy (DMD) is thought to be a suitable experimental paradigm for the sarcolemma, the RBC membrane-bound enzyme (Ca2+ + Mg2+)-ATPase has been investigated as to its relevance to abnormalities of calcium metabolism in DMD muscle. In this study, RBC (Ca2+ + Mg2+)-ATPase activity, intracellular calcium and potassium contents and complete hemogram were examined in 10 DMD patients and 16 age-matched controls. (Ca2+ + Mg2+)-ATPase activity was found elevated in the DMD RBC, consistent with reports from previous studies, but no abnormalities in intracellular calcium, potassium or hemograms were detected. It seems that although the (Ca2+ + Mg2+)-ATPase activity is changed, it bears no relevance to calcium homeostasis in DMD RBC. It is inferred that the increase in intramuscular calcium in DMD muscle, which is also found in other neuromuscular diseases, may be a non-specific finding in the diseased muscle and part of the final common pathway leading toward cellular degeneration and death.

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

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

Ca2+ transport in erythrocytes from patients with Duchenne muscular dystrophy

Erythrocyte membranes, isolated after step-wise hemolysis in buffered sucrose (Tris-sucrose membranes), showed higher Ca2+ Mg2+-ATPase activity than erythrocyte membranes obtained after hemolysis in Tris-HCl, and washing in EDTA (Tris-EDTA membranes). In Tris-sucrose membranes, the activity was not stimulated by the addition of monovalent cations, or calmodulin. Differences reported for the activity and properties of Ca2+ Mg2+-ATPase between Tris-EDTA membranes of Duchenne patients and controls, were not found in Tris-sucrose membranes. Also the activity and properties of the Ca2+-pump in resealed erythrocyte membranes were not changed.

Abnormalities of erythrocytes in Duchenne muscular dystrophy

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