1
|
Li C, Liu H, Yang L, Liu R, Yin G, Xie Q. Immune-mediated necrotizing myopathy: A comprehensive review of the pathogenesis, clinical features, and treatments. J Autoimmun 2024; 148:103286. [PMID: 39033686 DOI: 10.1016/j.jaut.2024.103286] [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: 03/16/2024] [Revised: 07/10/2024] [Accepted: 07/13/2024] [Indexed: 07/23/2024]
Abstract
Immune-mediated necrotizing myopathy (IMNM) is a rare and newly recognized autoimmune disease within the spectrum of idiopathic inflammatory myopathies. It is characterized by myositis-specific autoantibodies, elevated serum creatine kinase levels, inflammatory infiltrate, and weakness. IMNM can be classified into three subtypes based on the presence or absence of specific autoantibodies: anti-signal recognition particle myositis, anti-3-hydroxy-3-methylglutaryl-coenzyme A reductase myositis, and seronegative IMNM. In recent years, IMNM has gained increasing attention and emerged as a research hotspot. Recent studies have suggested that the pathogenesis of IMNM is linked to aberrant activation of immune system, including immune responses mediated by antibodies, complement, and immune cells, particularly macrophages, as well as abnormal release of inflammatory factors. Non-immune mechanisms such as autophagy and endoplasmic reticulum stress also participate in this process. Additionally, genetic variations associated with IMNM have been identified, providing new insights into the genetic mechanisms of the disease. Progress has also been made in IMNM treatment research, including the use of immunosuppressants and the development of biologics. Despite the challenges in understanding the etiology and treatment of IMNM, the latest research findings offer important guidance and insights for delving deeper into the disease's pathogenic mechanisms and identifying new therapeutic strategies.
Collapse
Affiliation(s)
- Changpei Li
- Department of Rheumatology and Immunology, West China Hospital, Sichuan University, Chengdu, China
| | - Hongjiang Liu
- Department of Rheumatology and Immunology, West China Hospital, Sichuan University, Chengdu, China
| | - Leiyi Yang
- Department of Rheumatology and Immunology, West China Hospital, Sichuan University, Chengdu, China
| | - Ruiting Liu
- Department of Rheumatology and Immunology, West China Hospital, Sichuan University, Chengdu, China
| | - Geng Yin
- Health Management Center, General Practice Medical Center, West China Hospital, Sichuan University, Chengdu, China.
| | - Qibing Xie
- Department of Rheumatology and Immunology, West China Hospital, Sichuan University, Chengdu, China.
| |
Collapse
|
2
|
Wu D, Cui Y, Cao Y, Wang Y, Zhang J, Guo Y, Yuan B. Clinical implications and mechanism of complement C1q in polymyositis. Appl Biochem Biotechnol 2024; 196:3088-3101. [PMID: 37624510 DOI: 10.1007/s12010-023-04692-7] [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] [Accepted: 08/16/2023] [Indexed: 08/26/2023]
Abstract
Polymyositis (PM) is the most common autoimmune disease in neurology and among muscle disorders; it is of great significance to thoroughly understand the mechanism of PM to find new diagnosis and treatment methods. This research intends to elucidate the clinical implications and mechanisms of complement C1q in polymyositis (PM). One hundred fifteen PM patients (research group, RG) and 120 healthy subjects (control group, CG) who visited our hospital between March 2017 and March 2020 were selected. Peripheral blood C1q and creatine kinase (CK) levels of both groups were measured, and their correlations with clinical symptoms and prognostic recurrence of PM. Additionally, to further understand the mechanism of action of C1q in PM, we purchased BALB/c mice and grouped them as follows: control group with normal feeding, PM group with PM modeling, intervention group with PM modeling, and intraperitoneal injection of gC1qR monoclonal antibody 60.11, a C1q protein receptor. Inflammatory factors and muscle histopathology were detected in all groups of mice. Finally, rat macrophages (mø) were isolated, and changes in the biological behavior of mø were observed after silencing the expression of gC1qR. Serum C1q and CK were both higher in RG than in CG, with favorable diagnostic effects on PM (P < 0.05). C1q and CK increased in symptomatic anti-ribonuclear protein antibody (RNP)-positive patients but decreased in anti Jo-1 antibody (Jo-1)- and anti-neutrophil cytoplasmic antibody (ANCA)-positive patients (P < 0.05). PM mice were observed with elevated gC1qR, while model mice exhibited severe infiltration of inflammatory cells in muscle tissue, increased pro-IFs, and reduced anti-IFs, and the animals in the intervention group showed improved conditions (P < 0.05). Finally, it was found that CD68, CD86 protein, and invasion capacity of gC1qR-sh-transfected cells decreased, while CD206 and CD163 increased (P < 0.05). C1q is elevated in PM and is strongly linked to the pathological process of PM. Inhibition of gC1qR expression reduced inflammatory infiltration in PM mice.
Collapse
Affiliation(s)
- Di Wu
- Department of Neurology, Affiliated Zhongda Hospital, Neuropsychiatric Institute, School of Medicine, Southeast University, No. 87, Dingjiaqiao, Gulou District, Nanjing, 210003, Jiangsu, China
| | - Yan Cui
- Department of Anesthesiology, Chest Branch of Nanjing Brain Hospital, Nanjing, 210000, Jiangsu, China
| | - Yujia Cao
- Department of Neurology, Affiliated Zhongda Hospital, Neuropsychiatric Institute, School of Medicine, Southeast University, No. 87, Dingjiaqiao, Gulou District, Nanjing, 210003, Jiangsu, China
| | - Yanjuan Wang
- Department of Neurology, Affiliated Zhongda Hospital, Neuropsychiatric Institute, School of Medicine, Southeast University, No. 87, Dingjiaqiao, Gulou District, Nanjing, 210003, Jiangsu, China
| | - Jinhua Zhang
- Department of Neurology, Affiliated Zhongda Hospital, Neuropsychiatric Institute, School of Medicine, Southeast University, No. 87, Dingjiaqiao, Gulou District, Nanjing, 210003, Jiangsu, China
| | - Yijing Guo
- Department of Neurology, Affiliated Zhongda Hospital, Neuropsychiatric Institute, School of Medicine, Southeast University, No. 87, Dingjiaqiao, Gulou District, Nanjing, 210003, Jiangsu, China
| | - Baoyu Yuan
- Department of Neurology, Affiliated Zhongda Hospital, Neuropsychiatric Institute, School of Medicine, Southeast University, No. 87, Dingjiaqiao, Gulou District, Nanjing, 210003, Jiangsu, China.
| |
Collapse
|
3
|
Sun H, Wang Z, Han Y, Wei X, Wang Y, Yu X. CD163+ macrophage density in perimysial connective tissue associated with prognosis in IMNM. Ann Clin Transl Neurol 2024; 11:1267-1279. [PMID: 38651547 PMCID: PMC11093240 DOI: 10.1002/acn3.52065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2024] [Revised: 03/18/2024] [Accepted: 03/28/2024] [Indexed: 04/25/2024] Open
Abstract
OBJECTIVE The pathological features of immune-mediated necrotizing myopathy (IMNM) are dominated by the infiltration of macrophages. We aimed to perform a histopathologic semiquantitative analysis to investigate the relationship between macrophage markers and prognosis. METHODS Semiquantitative analysis of histologic features was performed in 62 samples of IMNM. Independent risk factors were identified through univariate and multivariate regression analysis. Cluster analysis was performed using the partitioning around the medoids (PAM) method. Decision tree modeling was utilized to efficiently determine cluster labels for IMNM patients. The validity of the developmental cohort was assessed by accuracy in comparison with the validation cohort. RESULTS The most enriched groups in patients with IMNM were macrophages expressing CD206 and CD163. In the multivariate logistic regression model, the high density of CD163+ macrophages in perimysial connective tissue increased the risk of unfavorable prognosis (p = 0.025, OR = 1.463, 95% CI: 1.049-2.041). In cluster analysis, patients in Cluster 1, with lower CD163+ macrophage density and inflammatory burden, had a more favorable prognosis. Conversely, patients in Cluster 3, which were enriched for CD163+ macrophages in the perimysial connective tissue, had the most severe clinical features and the worst prognosis. Correlations were found between the density of CD163+ macrophages in connective tissue and symptom duration (R2 = 0.166, p < 0.001), dysphagia (p = 0.004), cardiac involvement (p = 0.021), CK (R2 = 0.067, p = 0.042), CRP (R2 = 0.117, p < 0.001), and ESR (R2 = 0.171, p < 0.001). CONCLUSION The density of CD163+ macrophages in perimysial connective tissue may serve as a potential marker for the prediction of IMNM prognosis.
Collapse
Affiliation(s)
- Hui Sun
- Department of Neurology and Neuroscience CenterThe First Hospital of Jilin University, Jilin UniversityChangchunChina
- Center for Rare DiseasesThe First Hospital of Jilin University, Jilin UniversityChangchunChina
| | - Zi‐Yi Wang
- Department of Neurology and Neuroscience CenterThe First Hospital of Jilin University, Jilin UniversityChangchunChina
| | - Ye Han
- Department of Neurology and Neuroscience CenterThe First Hospital of Jilin University, Jilin UniversityChangchunChina
- Center for Rare DiseasesThe First Hospital of Jilin University, Jilin UniversityChangchunChina
| | - Xiao‐Jing Wei
- Department of Neurology and Neuroscience CenterThe First Hospital of Jilin University, Jilin UniversityChangchunChina
- Center for Rare DiseasesThe First Hospital of Jilin University, Jilin UniversityChangchunChina
| | - Yong‐Chun Wang
- Department of Neurology and Neuroscience CenterThe First Hospital of Jilin University, Jilin UniversityChangchunChina
| | - Xue‐Fan Yu
- Department of Neurology and Neuroscience CenterThe First Hospital of Jilin University, Jilin UniversityChangchunChina
- Center for Rare DiseasesThe First Hospital of Jilin University, Jilin UniversityChangchunChina
| |
Collapse
|
4
|
Connolly CM, Gupta L, Fujimoto M, Machado PM, Paik JJ. Idiopathic inflammatory myopathies: current insights and future frontiers. THE LANCET. RHEUMATOLOGY 2024; 6:e115-e127. [PMID: 38267098 DOI: 10.1016/s2665-9913(23)00322-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Revised: 10/24/2023] [Accepted: 11/29/2023] [Indexed: 01/26/2024]
Abstract
Idiopathic inflammatory myopathies are a group of autoimmune diseases with a broad spectrum of clinical presentations, primarily characterised by immune-mediated muscle injury. Until recently, there was little insight into the pathogenesis of idiopathic inflammatory myopathies, which challenged the recognition of the breadth of heterogeneity of this group of diseases as well as the development of new therapeutics. However, the landscape of idiopathic inflammatory myopathies is evolving. In the past decade, advances in diagnostic tools have facilitated an enhanced understanding of the underlying disease mechanisms in idiopathic inflammatory myopathies, enabling the expansion of therapeutic trials. The fields of transcriptomics, prot§eomics, and machine learning offer the potential to gain greater insights into the underlying pathophysiology of idiopathic inflammatory myopathies. Harnessing insights gained from these sophisticated tools could contribute to the identification of differences at a molecular level among patients, accelerating the development of targeted, tailored therapies. Bolstered by the validation and standardisation of robust outcome measures, many promising therapies are in clinical trial development. Although challenges remain, there is great optimism in the field due to the progress in innovative diagnostics, outcome measures, and therapeutic approaches. In this Review, we discuss the expanding landscape of idiopathic inflammatory myopathies as the frontier of precision medicine becomes imminent.
Collapse
Affiliation(s)
- Caoilfhionn M Connolly
- Division of Rheumatology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Latika Gupta
- Department of Rheumatology, Royal Wolverhampton Hospitals NHS Trust, Wolverhampton, UK; Division of Musculoskeletal and Dermatological Sciences, Centre for Musculoskeletal Research, School of Biological Sciences, The University of Manchester, Manchester, UK; Department of Rheumatology, City Hospital, Sandwell and West Birmingham Hospitals NHS Trust, Birmingham, UK
| | - Manabu Fujimoto
- Department of Dermatology, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Pedro M Machado
- Department of Neuromuscular Diseases, UCL Queen Square Institute of Neurology, University College London, London, UK; Centre for Rheumatology, University College London, London, UK; National Institute for Health and Care Research University College London Hospitals Biomedical Research Centre, University College London Hospitals NHS Foundation Trust, London, UK; Department of Rheumatology, Northwick Park Hospital, London North West University Healthcare NHS Trust, London, UK
| | - Julie J Paik
- Division of Rheumatology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
| |
Collapse
|
5
|
Liu H, Deng L, Guo Y, Liu H, Chen B, Zhang J, Ran J, Yin G, Xie Q. Comprehensive transcriptomic analysis and machine learning reveal unique gene expression profiles in patients with immune-mediated necrotizing myopathy. J Gene Med 2024; 26:e3598. [PMID: 37743820 DOI: 10.1002/jgm.3598] [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: 05/06/2023] [Revised: 07/22/2023] [Accepted: 09/07/2023] [Indexed: 09/26/2023] Open
Abstract
BACKGROUND Immune-mediated necrotizing myopathy (IMNM) is an autoimmune myopathy characterized by severe proximal weakness and muscle fiber necrosis, yet its pathogenesis remains unclear. So far, there are few bioinformatics studies on underlying pathogenic genes and infiltrating immune cell profiles of IMNM. Therefore, we aimed to characterize differentially expressed genes (DEGs) and infiltrating cells in IMNM muscle biopsy specimens, which may be useful for elucidating the pathogenesis of IMNM. METHODS Three datasets (GSE39454, GSE48280 and GSE128470) of gene expression profiling related to IMNM were obtained from the Gene Expression Omnibus database. Data were normalized, and DEG analysis was performed using the limma package. Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analyses of DEGs were performed using clusterProfiler. The CIBERSORT algorithm was performed to identify infiltrating cells. Machine learning algorithm and gene set enrichment analysis (GSEA) were performed to find distinctive gene signatures and the underlying signaling pathways of IMNM. RESULTS DEG analysis identified upregulated and downregulated in IMNM muscle compared to the gene expression levels of other groups. GO and KEGG analysis showed that the pathogenesis of IMNM was notable for the under-representation of pathways that were important in dermatomyositis and inclusion body myositis. Three immune cells (M2 macrophages, resting dendritic cells and resting natural killer cells) with differential infiltration and five key genes (NDUFAF7, POLR2J, CD99, ARF5 and SKAP2) in patients with IMNM were identified through the CIBERSORT and machine learning algorithm. The GSEA results revealed that the key genes were remarkably enriched in diverse immunological and muscle metabolism-related pathways. CONCLUSIONS We comprehensively explored immunological landscape of IMNM, which is indicative for the research of IMNM pathogenesis.
Collapse
Affiliation(s)
- Hongjiang Liu
- Department of Rheumatology and Immunology, West China Hospital, Sichuan University, Chengdu, China
| | - Lin Deng
- National Key Laboratory of Fundamental Science on Synthetic Vision, Sichuan University, Chengdu, China
| | - Yixue Guo
- Department of Laboratory Medicine, West China Hospital, Sichuan University, Chengdu, China
| | - Huan Liu
- Department of Rheumatology and Immunology, West China Hospital, Sichuan University, Chengdu, China
| | - Bo Chen
- Department of Rheumatology and Immunology, West China Hospital, Sichuan University, Chengdu, China
| | - Jiaqian Zhang
- Department of Rheumatology and Immunology, West China Hospital, Sichuan University, Chengdu, China
| | - Jingjing Ran
- Department of Rheumatology and Immunology, West China Hospital, Sichuan University, Chengdu, China
| | - Geng Yin
- Health Management Center, General Practice Medical Center, West China Hospital, Sichuan University, Chengdu, China
| | - Qibing Xie
- Department of Rheumatology and Immunology, West China Hospital, Sichuan University, Chengdu, China
| |
Collapse
|
6
|
Fornaro M, Girolamo F, Cacciapaglia F, Carabellese G, Bizzoca R, Scioscia C, Coladonato L, Lopalco G, Ruggieri M, Mastrapasqua M, Fari G, D'Abbicco D, Iannone F. Plasma pentraxin 3 in idiopathic inflammatory myopathies: a possible new biomarker of disease activity. Clin Exp Immunol 2023; 214:94-102. [PMID: 37280166 PMCID: PMC10711351 DOI: 10.1093/cei/uxad063] [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: 02/22/2023] [Revised: 04/24/2023] [Accepted: 06/06/2023] [Indexed: 06/08/2023] Open
Abstract
Pentraxin-3 (PTX3) is a component of humoral innate immunity with essential functions both in promotion and resolution of inflammation. We aimed to study the PTX3 in the plasma and in the muscle of patients with idiopathic inflammatory myopathies (IIM) and whether PTX3 may correlate with disease activity. Plasma PTX3 levels were assessed in 20 patients with IIMs, 10 dermatomyositis (DM), and 10 polymyositis (PM), compared to 10 patients with rheumatoid arthritis (RA) and 10 healthy donors (HDs) aged, sex, and body mass index matched. Disease activity in IIMs was assessed by Myositis Disease Activity Assessment Visual Analog Scale (MYOACT), while disease activity score on 28 joints (DAS28) was used for RA patients. Muscle histopathology and immunohistochemical (IHC) analyses were also performed. Mean plasma PTX3 levels were significantly higher in IIM patients than HDs (518 ± 260 pg/ml vs. 275 ± 114 pg/ml, P = 0.009). Linear regression analysis adjusted for age, sex, and disease duration showed a direct correlation between PTX3 and CPK levels (β: 0.590), MYOACT (β: 0.759), and physician global assessment of disease activity (β: 0.832) in IIMs. No association between PTX3 levels and DAS28 was found in RA. Global PTX3 pixel fraction was higher in IIM than HDs muscle, but a lower PTX3 expression was found in perifascicular areas of DM and in myofibers with sarcolemmal staining for membrane attack complement. PTX3 plasma levels were increased in IIMs and correlated with disease activity suggesting a possible role as biomarker of disease activity. PTX3 showed a different distribution in DM or PM muscle.
Collapse
Affiliation(s)
- M Fornaro
- Unit of Rheumatology, Department of Precision and Regenerative Medicine - Area Jonica (DiMePRe-J), University of Bari, Bari, Italy
| | - F Girolamo
- Unit of Human Anatomy and Histology, Department of Translational Biomedicine and Neuroscience "DiBraiN", University of Bari, Bari, Italy
| | - F Cacciapaglia
- Unit of Rheumatology, Department of Precision and Regenerative Medicine - Area Jonica (DiMePRe-J), University of Bari, Bari, Italy
| | - G Carabellese
- Rheumatology Clinic, Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
| | - R Bizzoca
- Unit of Rheumatology, Department of Precision and Regenerative Medicine - Area Jonica (DiMePRe-J), University of Bari, Bari, Italy
| | - C Scioscia
- Unit of Rheumatology, Department of Precision and Regenerative Medicine - Area Jonica (DiMePRe-J), University of Bari, Bari, Italy
| | - L Coladonato
- Unit of Rheumatology, Department of Precision and Regenerative Medicine - Area Jonica (DiMePRe-J), University of Bari, Bari, Italy
| | - G Lopalco
- Unit of Rheumatology, Department of Precision and Regenerative Medicine - Area Jonica (DiMePRe-J), University of Bari, Bari, Italy
| | - M Ruggieri
- Neurochemistry Laboratory, Department of Translational Biomedicine and Neuroscience "DiBraiN", University of Bari, Bari, Italy
| | - M Mastrapasqua
- Neurochemistry Laboratory, Department of Translational Biomedicine and Neuroscience "DiBraiN", University of Bari, Bari, Italy
| | - G Fari
- Department of Translational Biomedicine and Neuroscience "DiBraiN", University of Bari, Bari, Italy
| | - D D'Abbicco
- Institute of General Surgery "G Marinaccio", Department of Precision and Regenerative Medicine - Area Jonica (DiMePRe-J), University of Bari, Bari, Italy
| | - F Iannone
- Unit of Rheumatology, Department of Precision and Regenerative Medicine - Area Jonica (DiMePRe-J), University of Bari, Bari, Italy
| |
Collapse
|
7
|
Cappelletti C, Brugnoni R, Bonanno S, Andreetta F, Salerno F, Canioni E, Vattemi GNA, Tonin P, Mantegazza R, Maggi L. Toll-like receptors and IL-7 as potential biomarkers for immune-mediated necrotizing myopathies. Eur J Immunol 2023; 53:e2250326. [PMID: 37562045 DOI: 10.1002/eji.202250326] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2022] [Revised: 06/05/2023] [Accepted: 08/09/2023] [Indexed: 08/12/2023]
Abstract
We aimed to verify whether the immune system may represent a source of potential biomarkers for the stratification of immune-mediated necrotizing myopathies (IMNMs) subtypes. A group of 22 patients diagnosed with IMNM [7 with autoantibodies against signal recognition particle (SRP) and 15 against 3-hydroxy-3-methyl-glutaryl-coenzyme A reductase (HMGCR)] and 12 controls were included. A significant preponderance of M1 macrophages was observed in both SRP+ and HMGCR+ muscle samples (p < 0.0001 in SRP+ and p = 0.0316 for HMGCR+ ), with higher values for SRP+ (p = 0.01). Despite the significant increase observed in the expression of TLR4 and all endosomal Toll-like receptors (TLRs) at protein level in IMNM muscle tissue, only TLR7 has been shown considerably upregulated compared to controls at transcript level (p = 0.0026), whereas TLR9 was even decreased (p = 0.0223). Within IMNM subgroups, TLR4 (p = 0.0116) mRNA was significantly increased in SRP+ compared to HMGCR+ patients. Within IMNM group, only IL-7 was differentially expressed between SRP+ and HMGCR+ patients, with higher values in SRP+ patients (p = 0.0468). Overall, innate immunity represents a key player in pathological mechanisms of IMNM. TLR4 and the inflammatory cytokine IL-7 represent potential immune biomarkers able to differentiate between SRP+ and HMGCR+ patients.
Collapse
Affiliation(s)
- Cristina Cappelletti
- U.O. Neurology IV, Neuroimmunology and Neuromuscular Diseases Unit., Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Raffaella Brugnoni
- U.O. Neurology IV, Neuroimmunology and Neuromuscular Diseases Unit., Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Silvia Bonanno
- U.O. Neurology IV, Neuroimmunology and Neuromuscular Diseases Unit., Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Francesca Andreetta
- U.O. Neurology IV, Neuroimmunology and Neuromuscular Diseases Unit., Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Franco Salerno
- U.O. Neurology IV, Neuroimmunology and Neuromuscular Diseases Unit., Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Eleonora Canioni
- U.O. Neurology IV, Neuroimmunology and Neuromuscular Diseases Unit., Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Gaetano Nicola Alfio Vattemi
- Department of Neurosciences, Biomedicine and Movement Sciences, Section of Clinical Neurology, University of Verona, Verona, Italy
| | - Paola Tonin
- Department of Neurosciences, Biomedicine and Movement Sciences, Section of Clinical Neurology, University of Verona, Verona, Italy
| | - Renato Mantegazza
- U.O. Neurology IV, Neuroimmunology and Neuromuscular Diseases Unit., Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Lorenzo Maggi
- U.O. Neurology IV, Neuroimmunology and Neuromuscular Diseases Unit., Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| |
Collapse
|
8
|
Wang Y, Zhao Y, Yu M, Wei L, Zhang W, Wang Z, Yuan Y. Clinicopathological and circulating cell-free DNA profile in myositis associated with anti-mitochondrial antibody. Ann Clin Transl Neurol 2023; 10:2127-2138. [PMID: 37723899 PMCID: PMC10647000 DOI: 10.1002/acn3.51901] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Revised: 08/23/2023] [Accepted: 09/08/2023] [Indexed: 09/20/2023] Open
Abstract
OBJECTIVE Anti-mitochondrial antibodies (AMAs) are associated with idiopathic inflammatory myopathies (IIMs). We aimed to summarize the clinicopathological characteristics, assess circulating cell-free mitochondrial DNA (ccf-mtDNA), and circulating cell-free nuclear DNA (ccf-nDNA) in AMA-associated IIMs. METHODS Medical records of 37 IIMs patients with AMAs were reviewed. Circulating cell-free mtDNA and ccf-nDNA levels in sera from IIMs patients with AMAs (n = 21), disease controls (n = 66) and healthy controls (HCs) (n = 23) were measured and compared. Twenty-eight immune-mediated necrotizing myopathy (IMNM) patients, 23 dermatomyositis (DM) patients, and 15 anti-synthetase syndrome (ASS) patients were enrolled as disease controls. Correlations between variables were analyzed. RESULTS Limb weakness was observed in 75.7% and neck weakness in 56.8% of patients. Cardiac involvement occurred in 51.4% of patients. Muscle pathology revealed 81.1% of IMNM, 5.4% polymyositis, and 13.5% nonspecific myositis. Microinfarction was observed in 8.1% of patients. Serum ccf-mtDNA levels in AMA-associated IIMs were significantly higher than those in HCs (p < 0.001), but no significant differences between AMA-associated IIMs and IMNM, DM, or ASS. Serum ccf-nDNA levels in AMA-associated IIMs were significantly higher than those in HCs (p = 0.02), and significantly lower than those in DM (p = 0.02). Serum ccf-nDNA levels correlated negatively with MMT8 total scores (rs = -0.458, p = 0.037) and positively with mRS scores (rs = 0.486, p = 0.025). Serum ccf-nDNA levels were significantly higher in the non-remission group (p < 0.01). INTERPRETATION AMA-associated IIMs exhibit distinct clinicopathological features. Serum ccf-nDNA may serve as a potential marker for disease severity and prognosis in AMA-associated IIMs.
Collapse
Affiliation(s)
- Yikang Wang
- Department of NeurologyPeking University First HospitalBeijing100034China
| | - Yawen Zhao
- Department of NeurologyPeking University First HospitalBeijing100034China
| | - Meng Yu
- Department of NeurologyPeking University First HospitalBeijing100034China
| | - Luhua Wei
- Department of NeurologyPeking University First HospitalBeijing100034China
| | - Wei Zhang
- Department of NeurologyPeking University First HospitalBeijing100034China
- Beijing Key Laboratory of Neurovascular Disease DiscoveryBeijing100034China
| | - Zhaoxia Wang
- Department of NeurologyPeking University First HospitalBeijing100034China
- Beijing Key Laboratory of Neurovascular Disease DiscoveryBeijing100034China
- Key Laboratory for Neuroscience, National Health Commission of the People's Republic of ChinaPeking UniversityBeijing100083China
| | - Yun Yuan
- Department of NeurologyPeking University First HospitalBeijing100034China
- Beijing Key Laboratory of Neurovascular Disease DiscoveryBeijing100034China
- Key Laboratory for Neuroscience, National Health Commission of the People's Republic of ChinaPeking UniversityBeijing100083China
| |
Collapse
|
9
|
Mastrapasqua M, Rossi R, De Cosmo L, Resta A, Errede M, Bizzoca A, Zampatti S, Resta N, Giardina E, Ruggieri M, Virgintino D, Annese T, Laforgia N, Girolamo F. Autophagy increase in Merosin-Deficient Congenital Muscular Dystrophy type 1A. Eur J Transl Myol 2023; 33:11501. [PMID: 37522802 PMCID: PMC10583158 DOI: 10.4081/ejtm.2023.11501] [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: 05/31/2023] [Accepted: 06/15/2023] [Indexed: 08/01/2023] Open
Abstract
The autophagy process recycles dysfunctional cellular components and protein aggregates by sequestering them in autophagosomes directed to lysosomes for enzymatic degradation. A basal level of autophagy is essential for skeletal muscle maintenance. Increased autophagy occurs in several forms of muscular dystrophy and in the merosin-deficient congenital muscular dystrophy 1A mouse model (dy3k/dy3k) lacking the laminin-α2 chain. This pilot study aimed to compare autophagy marker expression and autophagosomes presence using light and electron microscopes and western blotting in diagnostic muscle biopsies from newborns affected by different congenital muscular myopathies and dystrophies. Morphological examination showed dystrophic muscle features, predominance of type 2A myofibers, accumulation of autophagosomes in the subsarcolemmal areas, increased number of autophagosomes overexpressing LC3b, Beclin-1 and ATG5, in the merosin-deficient newborn suggesting an increased autophagy. In Duchenne muscular dystrophy, nemaline myopathy, and spinal muscular atrophy the predominant accumulation of p62+ puncta rather suggests an autophagy impairment.
Collapse
Affiliation(s)
- Mariangela Mastrapasqua
- Department of Translational Biomedicine and Neuroscience (DiBraiN), University of Bari 'Aldo Moro', Bari.
| | - Roberta Rossi
- Section of Pathology, Department of Precision and Regenerative Medicine and Jonian Area (DiMePRe-J), University of Bari "Aldo Moro", Bari.
| | - Lucrezia De Cosmo
- Neonatology and Neonatal Intensive Care Unit, Ospedale SS. Annunziata, Taranto.
| | - Annalisa Resta
- Neonatology and Neonatal Intensive Care Unit, Ospedale Miulli, Acquaviva delle Fonti.
| | - Mariella Errede
- Department of Translational Biomedicine and Neuroscience (DiBraiN), University of Bari 'Aldo Moro', Bari.
| | - Antonella Bizzoca
- Department of Translational Biomedicine and Neuroscience (DiBraiN), University of Bari 'Aldo Moro', Bari.
| | - Stefania Zampatti
- Laboratory of Genomic Medicine - Santa Lucia Foundation - IRCCS, Roma.
| | - Nicoletta Resta
- Medical Genetics Unit, Department of Precision and Regenerative Medicine and Ionian Area (DiMePRe-J), University of Bari "Aldo Moro", Bari.
| | - Emiliano Giardina
- Laboratory of Genomic Medicine - Santa Lucia Foundation - IRCCS, Roma.
| | - Maddalena Ruggieri
- Department of Translational Biomedicine and Neuroscience (DiBraiN), University of Bari 'Aldo Moro', Bari.
| | - Daniela Virgintino
- Department of Translational Biomedicine and Neuroscience (DiBraiN), University of Bari 'Aldo Moro', Bari.
| | - Tiziana Annese
- Department of Translational Biomedicine and Neuroscience (DiBraiN), University of Bari 'Aldo Moro', Bari, Italy; Department of Medicine and Surgery, Libera Università del Mediterraneo (LUM) Giuseppe Degennaro University, Bari.
| | - Nicola Laforgia
- Neonatology and Neonatal Intensive Care Unit, Department of Interdisciplinary Medicine (DIM), University of Bari "Aldo Moro", Bari.
| | - Francesco Girolamo
- Department of Translational Biomedicine and Neuroscience (DiBraiN), University of Bari 'Aldo Moro', Bari.
| |
Collapse
|