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Abad C, Pinal-Fernandez I, Guillou C, Bourdenet G, Drouot L, Cosette P, Giannini M, Debrut L, Jean L, Bernard S, Genty D, Zoubairi R, Remy-Jouet I, Geny B, Boitard C, Mammen A, Meyer A, Boyer O. IFNγ causes mitochondrial dysfunction and oxidative stress in myositis. Nat Commun 2024; 15:5403. [PMID: 38926363 PMCID: PMC11208592 DOI: 10.1038/s41467-024-49460-1] [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: 07/28/2023] [Accepted: 06/06/2024] [Indexed: 06/28/2024] Open
Abstract
Idiopathic inflammatory myopathies (IIMs) are severe autoimmune diseases with poorly understood pathogenesis and unmet medical needs. Here, we examine the role of interferon γ (IFNγ) using NOD female mice deficient in the inducible T cell co-stimulator (Icos), which have previously been shown to develop spontaneous IFNγ-driven myositis mimicking human disease. Using muscle proteomic and spatial transcriptomic analyses we reveal profound myofiber metabolic dysregulation in these mice. In addition, we report muscle mitochondrial abnormalities and oxidative stress in diseased mice. Supporting a pathogenic role for oxidative stress, treatment with a reactive oxygen species (ROS) buffer compound alleviated myositis, preserved muscle mitochondrial ultrastructure and respiration, and reduced inflammation. Mitochondrial anomalies and oxidative stress were diminished following anti-IFNγ treatment. Further transcriptomic analysis in IIMs patients and human myoblast in vitro studies supported the link between IFNγ and mitochondrial dysfunction observed in mice. These results suggest that mitochondrial dysfunction, ROS and inflammation are interconnected in a self-maintenance loop, opening perspectives for mitochondria therapy and/or ROS targeting drugs in myositis.
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Affiliation(s)
- Catalina Abad
- Univ Rouen Normandie, Inserm, UMR1234, FOCIS Center of Excellence PAn'THER, F-76000, Rouen, France
| | - Iago Pinal-Fernandez
- Muscle Disease Unit, National Institute of Arthritis and Musculoskeletal and Skin Diseases, National Institutes of Health, Bethesda, MD, USA
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Clement Guillou
- Univ Rouen Normandie, Inserm US 51, CNRS UAR 2026, HeRacLeS PISSARO, F-76000, Rouen, France
| | - Gwladys Bourdenet
- Univ Rouen Normandie, Inserm, UMR1234, FOCIS Center of Excellence PAn'THER, F-76000, Rouen, France
| | - Laurent Drouot
- Univ Rouen Normandie, Inserm, UMR1234, FOCIS Center of Excellence PAn'THER, F-76000, Rouen, France
| | - Pascal Cosette
- Univ Rouen Normandie, Inserm US 51, CNRS UAR 2026, HeRacLeS PISSARO, F-76000, Rouen, France
- Univ Rouen Normandie, INSA Rouen Normandie, CNRS, Normandie Univ, PBS UMR 6270, F-76000, Rouen, France
| | - Margherita Giannini
- Translational Medicine Federation of Strasbourg, Team 3072, Faculty of Medicine, University of Strasbourg, Strasbourg, France
- Unité exploration fonctionnelle musculaire-service de physiologie, Centre National de Référence des Maladies Auto-Immunes Systémiques Rares de l'Est et du Sud-Ouest -Service de rhumatologie, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - Lea Debrut
- Translational Medicine Federation of Strasbourg, Team 3072, Faculty of Medicine, University of Strasbourg, Strasbourg, France
| | - Laetitia Jean
- Univ Rouen Normandie, Inserm, UMR1234, FOCIS Center of Excellence PAn'THER, F-76000, Rouen, France
| | - Sophie Bernard
- Univ Rouen Normandie, Inserm US51, CNRS UAR2026, HeRacLeS PRIMACEN, F-76000, Rouen, France
| | - Damien Genty
- CHU Rouen, Department of Pathology, F-76000, Rouen, France
| | - Rachid Zoubairi
- Univ Rouen Normandie, Inserm, UMR1234, FOCIS Center of Excellence PAn'THER, F-76000, Rouen, France
| | - Isabelle Remy-Jouet
- Univ Rouen Normandie, Inserm, UMR1096, BOSS facility, F-76000, Rouen, France
| | - Bernard Geny
- Translational Medicine Federation of Strasbourg, Team 3072, Faculty of Medicine, University of Strasbourg, Strasbourg, France
- Unité exploration fonctionnelle musculaire-service de physiologie, Centre National de Référence des Maladies Auto-Immunes Systémiques Rares de l'Est et du Sud-Ouest -Service de rhumatologie, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - Christian Boitard
- Cochin Institute, Paris Descartes University, Sorbonne Paris Cité, Paris, France
| | - Andrew Mammen
- Muscle Disease Unit, National Institute of Arthritis and Musculoskeletal and Skin Diseases, National Institutes of Health, Bethesda, MD, USA
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Department of Medicine, Division of Rheumatology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Alain Meyer
- Translational Medicine Federation of Strasbourg, Team 3072, Faculty of Medicine, University of Strasbourg, Strasbourg, France
- Unité exploration fonctionnelle musculaire-service de physiologie, Centre National de Référence des Maladies Auto-Immunes Systémiques Rares de l'Est et du Sud-Ouest -Service de rhumatologie, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - Olivier Boyer
- Univ Rouen Normandie, Inserm, UMR1234, FOCIS Center of Excellence PAn'THER, F-76000, Rouen, France.
- CHU Rouen, Department of Immunology and Biotherapy, F-76000, Rouen, France.
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2
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Lodin K, Espinosa-Ortega F, Lundberg IE, Alexanderson H. The Role of Exercise to Improve Physiological, Physical and Psychological Health Outcome in Idiopathic Inflammatory Myopathies (IIM). J Inflamm Res 2024; 17:3563-3585. [PMID: 38855165 PMCID: PMC11162627 DOI: 10.2147/jir.s377102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Accepted: 05/14/2024] [Indexed: 06/11/2024] Open
Abstract
Idiopathic inflammatory myopathies (IIM) impact all aspects of health, physiological, physical, and psychological. Hallmark symptoms of IIM are muscle weakness, reduced muscle endurance and aerobic capacity. Recently, pain and fatigue as well as anxiety and depression have emerged as common and debilitating symptoms in patients with IIM. The aim of this scoping review is to, in a holistic way, describe how IIM impact patients' physiological, physical, and psychological health and how exercise has a role to treat as well as potentially counteract the effects of the disease. Inflammation induces non-immune response and organ damage. These changes with additional impact of physical inactivity lead to muscle impairment and reduced aerobic capacity. Pain, fatigue and low psychological well-being and overall quality of life are also common health aspects of IIM. Medical treatment can reduce inflammation but has in turn serious side effects such as muscle atrophy, type-II diabetes, and hypertension, which exercise has the potential to treat, and perhaps also counteract. In addition, exercise improves muscle function, aerobic capacity and might also reduce fatigue and pain. New evidence shows that reducing systemic inflammation may also improve patient-reported subjective health, quality of life and psychological well-being. Exercise in combination with medical treatment is becoming an important part of the treatment for patients with IIM as exercise has the potential to promote health aspects of various dimensions in patients with IIM.
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Affiliation(s)
- Karin Lodin
- Division of Rheumatology, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden
- Department of Gastro, Dermatology and Rheumatology, Theme Inflammation and Aging, Karolinska University Hospital, Stockholm, Sweden
| | - Fabricio Espinosa-Ortega
- Division of Rheumatology, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden
- Department of Gastro, Dermatology and Rheumatology, Theme Inflammation and Aging, Karolinska University Hospital, Stockholm, Sweden
| | - Ingrid E Lundberg
- Division of Rheumatology, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden
- Department of Gastro, Dermatology and Rheumatology, Theme Inflammation and Aging, Karolinska University Hospital, Stockholm, Sweden
| | - Helene Alexanderson
- Division of Rheumatology, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden
- Medical Unit Allied Health Professionals, Theme Women’s Health and Health Professionals, Karolinska University Hospital, Stockholm, Sweden
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3
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Wang S, Tang Y, Chen X, Song S, Chen X, Zhou Q, Zeng L. Mitochondrial-related hub genes in dermatomyositis: muscle and skin datasets-based identification and in vivo validation. Front Genet 2024; 15:1325035. [PMID: 38389573 PMCID: PMC10882082 DOI: 10.3389/fgene.2024.1325035] [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: 10/20/2023] [Accepted: 01/23/2024] [Indexed: 02/24/2024] Open
Abstract
Background: Mitochondrial dysfunction has been implicated in the pathogenesis of dermatomyositis (DM), a rare autoimmune disease affecting the skin and muscles. However, the genetic basis underlying dysfunctional mitochondria and the development of DM remains incomplete. Methods: The datasets of DM muscle and skin tissues were retrieved from the Gene Expression Omnibus database. The mitochondrial related genes (MRGs) were retrieved from MitoCarta. DM-related modules in muscle and skin tissues were identified with the analysis of weighted gene co-expression network (WGCNA), and then compared with the MRGs to obtain the overlapping mitochondrial related module genes (mito-MGs). Subsequently, differential expression genes (DEGs) obtained from muscle and skin datasets were overlapped with MRGs to identify mitochondrial related DEGs (mito-DEGs). Next, functional enrichment analysis was applied to analyze possible relevant biological pathways. We used the Jvenn online tool to intersect mito-MGs with mito-DEGs to identify hub genes and validate them using reverse transcription quantitative polymerase chain reaction (RT-qPCR) and immunohistochemistry staining. In addition, we evaluated immune infiltration in muscle and skin tissues of DM patients using the one-sample gene set enrichment analysis (ssGSEA) algorithm and predicted potential transcription factor (TF) -gene network by NetworkAnalyst. Results: The WGCNA analysis revealed 105 mito-MGs, while the DEG analysis identified 3 mito-DEGs. These genes showed functional enrichment for amino acid metabolism, energy metabolism and oxidative phosphorylation. Through the intersection analysis of the mito-MGs from the WGCNA analysis and the mito-DEGs from the DEG set, three DM mito-hub genes (IFI27, CMPK2, and LAP3) were identified and validated by RT-qPCR and immunohistochemistry analysis. Additionally, positive correlations were observed between hub genes and immune cell abundance. The TF-hub gene regulatory network revealed significant interactions involving ERG, VDR, and ZFX with CMPK2 and LAP3, as well as SOX2 with LAP3 and IFI27, and AR with IFI27 and CMPK2. Conclusion: The mito-hub genes (IFI27, CMPK2, and LAP3) are identified in both muscles and skin tissues from DM patients. These genes may be associated with immune infiltration in DM, providing a new entry point for the pathogenesis of DM.
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Affiliation(s)
- Shuo Wang
- School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Yiping Tang
- Department of Internal Medicine, Sichuan Academy of Medical Science and Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China
| | - Xixi Chen
- 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
| | - Siyuan Song
- Baylor College of Medicine, Houston, TX, United States
| | - Xi Chen
- Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, Houston, TX, United States
| | - 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
| | - 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
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Hedberg‐Oldfors C, Lindgren U, Visuttijai K, Lööf D, Roos S, Thomsen C, Oldfors A. Respiratory chain dysfunction in perifascicular muscle fibres in patients with dermatomyositis is associated with mitochondrial DNA depletion. Neuropathol Appl Neurobiol 2022; 48:e12841. [PMID: 35894812 PMCID: PMC9805229 DOI: 10.1111/nan.12841] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Revised: 06/26/2022] [Accepted: 07/07/2022] [Indexed: 01/09/2023]
Abstract
AIMS Patients with dermatomyositis (DM) suffer from reduced aerobic metabolism contributing to impaired muscle function, which has been linked to cytochrome c oxidase (COX) deficiency in muscle tissue. This mitochondrial respiratory chain dysfunction is typically seen in perifascicular regions, which also show the most intense inflammatory reaction along with capillary loss and muscle fibre atrophy. The objective of this study was to investigate the pathobiology of the oxidative phosphorylation deficiency in DM. METHODS Muscle biopsy specimens with perifascicular COX deficiency from five juveniles and seven adults with DM were investigated. We combined immunohistochemical analyses of subunits in the respiratory chain including complex I (subunit NDUFB8), complex II (succinate dehydrogenase, subunit SDHB) and complex IV (COX, subunit MTCO1) with in situ hybridisation, next generation deep sequencing and quantitative polymerase chain reaction (PCR). RESULTS There was a profound deficiency of complexes I and IV in the perifascicular regions with enzyme histochemical COX deficiency, whereas succinate dehydrogenase activity and complex II were preserved. In situ hybridisation of mitochondrial RNA showed depletion of mitochondrial DNA (mtDNA) transcripts in the perifascicular regions. Analysis of mtDNA by next generation deep sequencing and quantitative PCR in affected muscle regions showed an overall reduction of mtDNA copy number particularly in the perifascicular regions. CONCLUSION The respiratory chain dysfunction in DM muscle is associated with mtDNA depletion causing deficiency of complexes I and IV, which are partially encoded by mtDNA, whereas complex II, which is entirely encoded by nuclear DNA, is preserved. The depletion of mtDNA indicates a perturbed replication of mtDNA explaining the muscle pathology and the disturbed aerobic metabolism.
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Affiliation(s)
- Carola Hedberg‐Oldfors
- Department of Laboratory Medicine, Institute of BiomedicineSahlgrenska Academy at the University of GothenburgGothenburgSweden
| | - Ulrika Lindgren
- Department of Laboratory Medicine, Institute of BiomedicineSahlgrenska Academy at the University of GothenburgGothenburgSweden,Neuromuscular Center, Department of NeurologySahlgrenska University HospitalGothenburgSweden
| | - Kittichate Visuttijai
- Department of Laboratory Medicine, Institute of BiomedicineSahlgrenska Academy at the University of GothenburgGothenburgSweden
| | - Daniel Lööf
- Department of Laboratory Medicine, Institute of BiomedicineSahlgrenska Academy at the University of GothenburgGothenburgSweden
| | - Sara Roos
- Department of Laboratory Medicine, Institute of BiomedicineSahlgrenska Academy at the University of GothenburgGothenburgSweden
| | - Christer Thomsen
- Department of Laboratory Medicine, Institute of BiomedicineSahlgrenska Academy at the University of GothenburgGothenburgSweden
| | - Anders Oldfors
- Department of Laboratory Medicine, Institute of BiomedicineSahlgrenska Academy at the University of GothenburgGothenburgSweden
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5
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Liu M, Li L, Dai T, Hou Y, Li W, Zhao Y, Fang Q, Yan C. Gasdermine E-Dependent Mitochondrial Pyroptotic Pathway in Dermatomyositis: A Possible Mechanism of Perifascicular Atrophy. J Neuropathol Exp Neurol 2020; 79:551-561. [PMID: 32296846 DOI: 10.1093/jnen/nlaa023] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2020] [Indexed: 12/24/2022] Open
Abstract
Different mechanisms have been proposed to explain the pathological basis of perifascicular atrophy (PFA), a pathognomonic histologic feature of dermatomyositis (DM); however, the detailed mechanisms remain to be elucidated. There is mitochondrial dysfunction in PFA and expression of mitochondrial apoptosis molecules has been reported in DM. Overexpression of gasdermin E (GSDME) can turn mitochondrial apoptosis to mitochondrial pyroptosis, a newly characterized form of programmed cell death. We determined the expression of proteins involved in the caspase-3- and GSDME-dependent mitochondrial pyroptotic pathway, including BAX, BAK, cytochrome C, caspase-9, caspase-3, GSDME, and IL-1α, in biopsied muscles from DM and control patients. Immunohistochemical analysis showed that those markers were expressed in most fibers in PFA in DM. GSDME-positive and IL-1α-positive staining was mainly localized around punched-out vacuoles or sarcolemma. These markers were significantly upregulated at the protein and mRNA levels in DM versus controls. Our results suggest that caspase-3- and GSDME-dependent mitochondrial pyroptosis are involved in the pathogenetic mechanisms of PFA in DM and that targeting GSDME-dependent mitochondrial pyroptosis may be an effective therapeutic approach for this condition.
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Affiliation(s)
- Meirong Liu
- From the Department of Neurology, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China
| | - Ling Li
- Department of Neurology, Qilu Hospital (Qingdao), Qingdao, Shandong, China
| | - Tingjun Dai
- Department of Neurology and Research Institute of Neuromuscular and Neurodegenerative Diseases, Qilu Hospital, Shandong University, Jinan, Shandong , China
| | - Ying Hou
- Department of Neurology and Research Institute of Neuromuscular and Neurodegenerative Diseases, Qilu Hospital, Shandong University, Jinan, Shandong , China
| | - Wei Li
- Department of Neurology and Research Institute of Neuromuscular and Neurodegenerative Diseases, Qilu Hospital, Shandong University, Jinan, Shandong , China
| | - Yuying Zhao
- Department of Neurology and Research Institute of Neuromuscular and Neurodegenerative Diseases, Qilu Hospital, Shandong University, Jinan, Shandong , China
| | - Qi Fang
- From the Department of Neurology, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China
| | - Chuanzhu Yan
- Department of Neurology, Qilu Hospital (Qingdao), Qingdao, Shandong, China.,Department of Neurology and Research Institute of Neuromuscular and Neurodegenerative Diseases, Qilu Hospital, Shandong University, Jinan, Shandong , China.,Brain Science Research Institute, Shandong University, Jinan, Shandong, China.,Mitochondrial Medicine Laboratory, Qilu Hospital (Qingdao), Qingdao, Shandong, China
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Liu D, Zuo X, Luo H, Zhu H. The altered metabolism profile in pathogenesis of idiopathic inflammatory myopathies. Semin Arthritis Rheum 2020; 50:627-635. [PMID: 32502727 DOI: 10.1016/j.semarthrit.2020.05.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2020] [Revised: 04/28/2020] [Accepted: 05/11/2020] [Indexed: 11/29/2022]
Abstract
Idiopathic inflammatory myopathies (IIMs) are a group of heterogeneous autoimmune diseases characterized by muscle weakness, muscle inflammation and extramuscular manifestations. Despite extensive efforts, the mechanisms of IIMs remain largely unknown, and treatment is still a challenge for physicians. Metabolism changes have emerged as a crucial player in autoimmune diseases, such as systemic lupus erythematosus (SLE) and rheumatoid arthritis (RA). However, little is known about metabolism changes in IIMs. In this review, we focus on the alteration of metabolism profile in IIMs, and the relationships with clinical information. We highlight the potential roles of metabolism in the pathogenesis of IIMs and discuss future perspectives for metabolic checkpoint-based therapeutic interventions.
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Affiliation(s)
- Di Liu
- Department of Rheumatology, Xiangya Hospital, Central South University, 87 Xiangya Road, Changsha, Hunan 410008, People's Republic of China
| | - Xiaoxia Zuo
- Department of Rheumatology, Xiangya Hospital, Central South University, 87 Xiangya Road, Changsha, Hunan 410008, People's Republic of China
| | - Hui Luo
- Department of Rheumatology, Xiangya Hospital, Central South University, 87 Xiangya Road, Changsha, Hunan 410008, People's Republic of China
| | - Honglin Zhu
- Department of Rheumatology, Xiangya Hospital, Central South University, 87 Xiangya Road, Changsha, Hunan 410008, People's Republic of China.
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7
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Greenberg SA. Inclusion body myositis: clinical features and pathogenesis. Nat Rev Rheumatol 2020; 15:257-272. [PMID: 30837708 DOI: 10.1038/s41584-019-0186-x] [Citation(s) in RCA: 146] [Impact Index Per Article: 36.5] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Inclusion body myositis (IBM) is often viewed as an enigmatic disease with uncertain pathogenic mechanisms and confusion around diagnosis, classification and prospects for treatment. Its clinical features (finger flexor and quadriceps weakness) and pathological features (invasion of myofibres by cytotoxic T cells) are unique among muscle diseases. Although IBM T cell autoimmunity has long been recognized, enormous attention has been focused for decades on several biomarkers of myofibre protein aggregates, which are present in <1% of myofibres in patients with IBM. This focus has given rise, together with the relative treatment refractoriness of IBM, to a competing view that IBM is not an autoimmune disease. Findings from the past decade that implicate autoimmunity in IBM include the identification of a circulating autoantibody (anti-cN1A); the absence of any statistically significant genetic risk factor other than the common autoimmune disease 8.1 MHC haplotype in whole-genome sequencing studies; the presence of a marked cytotoxic T cell signature in gene expression studies; and the identification in muscle and blood of large populations of clonal highly differentiated cytotoxic CD8+ T cells that are resistant to many immunotherapies. Mounting evidence that IBM is an autoimmune T cell-mediated disease provides hope that future therapies directed towards depleting these cells could be effective.
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Affiliation(s)
- Steven A Greenberg
- Department of Neurology, Brigham and Women's Hospital, Boston, MA, USA. .,Children's Hospital Computational Health Informatics Program, Boston Children's Hospital, Boston, MA, USA. .,Harvard Medical School, Boston, MA, USA.
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8
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Pagano TB, Prisco F, De Biase D, Piegari G, Maurelli MP, Rinaldi L, Cringoli G, Papparella S, Paciello O. Muscular Sarcocystosis in Sheep Associated With Lymphoplasmacytic Myositis and Expression of Major Histocompatibility Complex Class I and II. Vet Pathol 2019; 57:272-280. [PMID: 31801417 DOI: 10.1177/0300985819891257] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Sarcocystosis is a protozoal disease affecting a wide range of animals. The aims of this study were to characterize the following in sheep: (1) the muscle pathology in Sarcocystis infection, (2) the inflammatory infiltrate and its relationship to severity of infection, and (3) immune markers expressed by parasitized muscle fibers and parasitic cysts. Skeletal muscle samples from 78 sheep slaughtered in southern Italy were snap frozen and analyzed by histopathology, immunohistochemistry, and immunofluorescence. Polymerase chain reaction (PCR) and sequencing were used for Sarcocystis species identification. All 40 muscle samples tested were PCR-positive for Sarcocystis tenella. Histologically, cysts were identified in 76/78 cases (97%), associated with an endomysial infiltrate of lymphocytes and plasma cells. The T cells were predominantly CD8+, with fewer CD4+ or CD79α+ cells. Eosinophils were absent. Notably, sarcolemmal immunopositivity for major histocompatibility complex (MHC) I and II was found in 76/78 cases (97%) and 75/78 cases (96%), respectively, both in samples with and in those without evident inflammatory infiltrate. The number of cysts was positively correlated with inflammation. In addition, MHC I was detected in 55/78 cyst walls (72%), and occasionally co-localized with the membrane-associated protein dystrophin. The findings suggest that muscle fibers respond to the presence of cysts by expression of MHC I and II. The possible role of MHC I and II in the inflammatory response and on the cyst wall is also discussed.
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Affiliation(s)
- Teresa Bruna Pagano
- Department of Veterinary Medicine and Animal Production, Unit of Pathology, University of Naples Federico II, Naples, Italy
| | - Francesco Prisco
- Department of Veterinary Medicine and Animal Production, Unit of Pathology, University of Naples Federico II, Naples, Italy
| | - Davide De Biase
- Department of Veterinary Medicine and Animal Production, Unit of Pathology, University of Naples Federico II, Naples, Italy
| | - Giuseppe Piegari
- Department of Veterinary Medicine and Animal Production, Unit of Pathology, University of Naples Federico II, Naples, Italy
| | - Maria Paola Maurelli
- Department of Veterinary Medicine and Animal Production, Unit of Parasitology, University of Naples Federico II, Naples, Italy
| | - Laura Rinaldi
- Department of Veterinary Medicine and Animal Production, Unit of Parasitology, University of Naples Federico II, Naples, Italy
| | - Giuseppe Cringoli
- Department of Veterinary Medicine and Animal Production, Unit of Parasitology, University of Naples Federico II, Naples, Italy
| | - Serenella Papparella
- Department of Veterinary Medicine and Animal Production, Unit of Pathology, University of Naples Federico II, Naples, Italy
| | - Orlando Paciello
- Department of Veterinary Medicine and Animal Production, Unit of Pathology, University of Naples Federico II, Naples, Italy
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9
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Papadimas GK, Kokkinis C, Xirou S, Chrysanthou M, Kararizou E, Papadopoulos C. Polymyositis with mitochondrial pathology or atypical form of sporadic inclusion body myositis: case series and review of the literature. Rheumatol Int 2019; 39:1459-1466. [PMID: 31055642 DOI: 10.1007/s00296-019-04314-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2018] [Accepted: 04/26/2019] [Indexed: 11/29/2022]
Abstract
Polymyositis with mitochondrial pathology (PM-Mito) is a rare form of idiopathic inflammatory myopathy with no definite diagnostic criteria and similarities to both PM and sporadic inclusion body myositis (s-IBM). The aim of this study is to address the dilemma of whether PM-Mito is a subtype of inflammatory myopathy or represents a disease falling into the spectrum of s-IBM. Herein, we report four female patients diagnosed with PM-Mito, highlighting their rather atypical clinical and histopathological characteristics that seem to indicate a diagnosis away from s-IBM. Muscle weakness was rather proximal and symmetrical and lacked the selective pattern observed in s-IBM. Patients had large-scale deletions in mtDNA, reflecting the mitochondrial component in the pathology of the disease. Conclusively, our study adds to the limited data in the literature on whether PM-Mito is a distinct form of myositis or represents a prodromal stage of s-IBM. Although the latter seems to be supported by a substantial body of evidence, there are, however, important differences, such as the different patterns of muscle weakness, and the good response to treatment observed in some patients. Larger-scale studies are certainly needed to clarify pathogenesis and clinical characteristics of PM-Mito patients, especially in therapeutic and prognostic terms.
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Affiliation(s)
- George K Papadimas
- 1st Department of Neurology, Medical School, Eginition Hospital, National and Kapodistrian University of Athens, 74, Vas. Sophias Ave, 11528, Athens, Greece.
| | - Charalampos Kokkinis
- Department of Medical Genetics, Medical School, St. Sofia's Children's Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Sophia Xirou
- 1st Department of Neurology, Medical School, Eginition Hospital, National and Kapodistrian University of Athens, 74, Vas. Sophias Ave, 11528, Athens, Greece
| | - Margarita Chrysanthou
- 1st Department of Neurology, Medical School, Eginition Hospital, National and Kapodistrian University of Athens, 74, Vas. Sophias Ave, 11528, Athens, Greece
| | - Evangelia Kararizou
- 1st Department of Neurology, Medical School, Eginition Hospital, National and Kapodistrian University of Athens, 74, Vas. Sophias Ave, 11528, Athens, Greece
| | - Constantinos Papadopoulos
- 1st Department of Neurology, Medical School, Eginition Hospital, National and Kapodistrian University of Athens, 74, Vas. Sophias Ave, 11528, Athens, Greece
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10
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The clinical and histopathological features of idiopathic inflammatory myopathies with asymmetric muscle involvement. J Clin Neurosci 2019; 65:46-53. [PMID: 31060889 DOI: 10.1016/j.jocn.2019.04.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2018] [Revised: 02/01/2019] [Accepted: 04/12/2019] [Indexed: 12/25/2022]
Abstract
The objective is to determine the frequency of idiopathic inflammatory myopathies (IIMs) with asymmetric muscle involvement (IIMs-A) as initial manifestations in total IIMs and to compare the demographic, clinical, histopathological and radiological characteristics of IIMs-A with classical IIMs (IIMs-C). We retrospectively reviewed the clinical, laboratory, muscle images, histopathological features and treatment response of patients at the Qilu hospital who were diagnosed as IIMs from April 2005 to August 2017. We found among 134 IIMs patients, 13(9.2%) patients with IIMs-A were identified, of which 7 patients were diagnosed as dermatomyositis (DM), 2 as polymyositis (PM), 4 as immune-mediated necrotizing myopathy (IMNM) using the European Neuromuscular Centre (ENMC) criteria. The mean age of our group was 59.1 years old. The duration from the initial symptoms to the first examination was less than 12 months in 12 patients (92.3%). 46.2% patients accompanied with weakness of distal limbs and bulbar symptoms. Finger flexion involvement was found in 5 patients (38.5%). There was no patient that finger flexion was weaker than shoulder abduction. The creatine kinase (CK) level in the serum ranged from 41 IU/L to 9125 IU/L (average: 3192.7 ± 2769.9 IU/L). Serum positive anti-mitochondrial antibodies (AMAs) were found in four patients (30.8%). Endomysial fibrosis and inflammatory cell infiltration were detected in 92.3%, 84.6% patients respectively. Mitochondrial abnormalities in histopathological finding of muscle biopsy were seen in 100% cases. The major histocompatibility complex class I (MHC-I) (84.6%) and class II (MHC-II) (92.3%) expressed on muscle biopsies from almost all cases of our patients. MAC antibody, however, was detected in only 20-40% patients. Eight patients (61.5%) had favorable outcomes. The conclusion was that IIMs-A presented mainly in DM, generally with mitochondrial abnormality and highly positive AMAs. The relationship between the presence of AMAs and the asymmetric muscle involvement in DM needs to be further clarified. We should also consider the diagnosis of IIMs when the patient has features of positive AMAs and asymmetric muscle involvement.
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11
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Shelton GD, Minor KM, Li K, Naviaux JC, Monk J, Wang L, Guzik E, Guo LT, Porcelli V, Gorgoglione R, Lasorsa FM, Leegwater PJ, Persico AM, Mickelson JR, Palmieri L, Naviaux RK. A Mutation in the Mitochondrial Aspartate/Glutamate Carrier Leads to a More Oxidizing Intramitochondrial Environment and an Inflammatory Myopathy in Dutch Shepherd Dogs. J Neuromuscul Dis 2019; 6:485-501. [PMID: 31594244 PMCID: PMC6918910 DOI: 10.3233/jnd-190421] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
BACKGROUND Inflammatory myopathies are characterized by infiltration of inflammatory cells into muscle. Typically, immune-mediated disorders such as polymyositis, dermatomyositis and inclusion body myositis are diagnosed. OBJECTIVE A small family of dogs with early onset muscle weakness and inflammatory muscle biopsies were investigated for an underlying genetic cause. METHODS Following the histopathological diagnosis of inflammatory myopathy, mutational analysis including whole genome sequencing, functional transport studies of the mutated and wild-type proteins, and metabolomic analysis were performed. RESULTS Whole genome resequencing identified a pathological variant in the SLC25A12 gene, resulting in a leucine to proline substitution at amino acid 349 in the mitochondrial aspartate-glutamate transporter known as the neuron and muscle specific aspartate glutamate carrier 1 (AGC1). Functionally reconstituting recombinant wild-type and mutant AGC1 into liposomes demonstrated a dramatic decrease in AGC1 transport activity and inability to transfer reducing equivalents from the cytosol into mitochondria. Targeted, broad-spectrum metabolomic analysis from affected and control muscles demonstrated a proinflammatory milieu and strong support for oxidative stress. CONCLUSIONS This study provides the first description of a metabolic mechanism in which ablated mitochondrial glutamate transport markedly reduced the import of reducing equivalents into mitochondria and produced a highly oxidizing and proinflammatory muscle environment and an inflammatory myopathy.
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Affiliation(s)
- G. Diane Shelton
- Department of Pathology, School of Medicine, University of California San Diego, La Jolla, CA, USA
| | - Katie M. Minor
- Department of Veterinary and Biomedical Sciences, College of Veterinary Medicine, University of Minnesota, Saint Paul, MN, USA
| | - Kefeng Li
- The Mitochondrial and Metabolic Disease Center, School of Medicine, University of California San Diego, San Diego, CA, USA
| | - Jane C. Naviaux
- Department of Neurosciences, School of Medicine, University of California San Diego, La Jolla, CA, USA
| | - Jon Monk
- The Mitochondrial and Metabolic Disease Center, School of Medicine, University of California San Diego, San Diego, CA, USA
| | - Lin Wang
- The Mitochondrial and Metabolic Disease Center, School of Medicine, University of California San Diego, San Diego, CA, USA
| | - Elizabeth Guzik
- Department of Veterinary and Biomedical Sciences, College of Veterinary Medicine, University of Minnesota, Saint Paul, MN, USA
| | - Ling T. Guo
- Department of Pathology, School of Medicine, University of California San Diego, La Jolla, CA, USA
| | - Vito Porcelli
- Department of Biosciences, Biotechnology and Biopharmaceutics, University of Bari Aldo Moro, Bari, Italy
| | - Ruggiero Gorgoglione
- Department of Biosciences, Biotechnology and Biopharmaceutics, University of Bari Aldo Moro, Bari, Italy
| | - Francesco M. Lasorsa
- Institute of Biomembranes, Bioenergetics and Molecular Biotechnologies, Consiglio Nazionale delle Ricerche, Bari, Italy
| | - Peter J. Leegwater
- Department of Clinical Sciences of Companion Animals, Utrecht University, Utrecht, 3508, The Netherlands
| | - Antonio M. Persico
- Interdepartmental Program “Autism 0–90”, “G. Martino” Hospital, University of Messina, Messina, Italy
| | - James R. Mickelson
- Department of Veterinary and Biomedical Sciences, College of Veterinary Medicine, University of Minnesota, Saint Paul, MN, USA
| | - Luigi Palmieri
- Department of Biosciences, Biotechnology and Biopharmaceutics, University of Bari Aldo Moro, Bari, Italy
- Institute of Biomembranes, Bioenergetics and Molecular Biotechnologies, Consiglio Nazionale delle Ricerche, Bari, Italy
| | - Robert K. Naviaux
- Department of Pathology, School of Medicine, University of California San Diego, La Jolla, CA, USA
- The Mitochondrial and Metabolic Disease Center, School of Medicine, University of California San Diego, San Diego, CA, USA
- Department of Medicine, School of Medicine, University of California San Diego, La Jolla, CA, USA
- Department of Pediatrics, School of Medicine, University of California San Diego, La Jolla, CA, USA
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12
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Cerbelli B, Pisano A, Colafrancesco S, Pignataro MG, Biffoni M, Berni S, De Luca A, Riccieri V, Priori R, Valesini G, d'Amati G, Giordano C. Anti-aminoacyl-tRNA synthetase-related myositis and dermatomyositis: clues for differential diagnosis on muscle biopsy. Virchows Arch 2017; 472:477-487. [PMID: 29147923 DOI: 10.1007/s00428-017-2269-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2017] [Revised: 09/19/2017] [Accepted: 11/12/2017] [Indexed: 12/19/2022]
Abstract
Anti-synthetase syndrome is an autoimmune disease characterized by autoantibodies toward amino acyl-tRNA synthetases (ARS), anti-Jo 1 being the most commonly detected. Muscle damage develops in up to 90% of ARS-positive patients, characterized by a necrotizing myositis restricted to the perifascicular region. This topographic distribution of muscle damage may lead to a misdiagnosis of dermatomyositis (DM) at muscle biopsy. We compared morphological, immunohistochemical, and histoenzymatic features of muscle from ARS-positive patients (n = 11) with those of DM (n = 7) providing clues for their differential diagnosis. In addition, we evaluated markers of mitochondrial damage to provide a further distinction between these two entities. Necrosis occurred in the majority of ARS patients, mainly located in the perifascicular region. It was often limited to small foci of fibers, always associated with myocyte regeneration. This last often overwhelmed necrosis, representing occasionally the main finding. In DM, necrosis/regeneration was scarce while the peculiar feature was a diffuse atrophy of perifascicular fibers. These last showed decreased cytochrome c oxidase (COX) stain and mitochondrial DNA depletion, consistent with mitochondrial dysfunction. In contrast to DM, ARS displayed scattered COX-deficient fibers, not restricted to the perifascicular region. This feature occurred in up to 91% of patients, being prominent only in two.
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Affiliation(s)
- Bruna Cerbelli
- Department of Radiological, Oncological and Pathological Sciences, Sapienza University of Rome, Policlinico Umberto I, Viale Regina Elena 324, 00161, Rome, Italy
| | - Annalinda Pisano
- Department of Radiological, Oncological and Pathological Sciences, Sapienza University of Rome, Policlinico Umberto I, Viale Regina Elena 324, 00161, Rome, Italy
| | - Serena Colafrancesco
- Department of Internal Medicine and Medical Specialties, Rheumatology Unit, Sapienza University of Rome, 00161, Rome, Italy
| | - Maria Gemma Pignataro
- Department of Radiological, Oncological and Pathological Sciences, Sapienza University of Rome, Policlinico Umberto I, Viale Regina Elena 324, 00161, Rome, Italy
| | - Marco Biffoni
- Department of Surgical Science, Sapienza University of Rome, 00161, Rome, Italy
| | - Silvia Berni
- Department of Radiological, Oncological and Pathological Sciences, Sapienza University of Rome, Policlinico Umberto I, Viale Regina Elena 324, 00161, Rome, Italy
| | - Antonia De Luca
- Department of Radiological, Oncological and Pathological Sciences, Sapienza University of Rome, Policlinico Umberto I, Viale Regina Elena 324, 00161, Rome, Italy
| | - Valeria Riccieri
- Department of Internal Medicine and Medical Specialties, Rheumatology Unit, Sapienza University of Rome, 00161, Rome, Italy
| | - Roberta Priori
- Department of Internal Medicine and Medical Specialties, Rheumatology Unit, Sapienza University of Rome, 00161, Rome, Italy
| | - Guido Valesini
- Department of Internal Medicine and Medical Specialties, Rheumatology Unit, Sapienza University of Rome, 00161, Rome, Italy
| | - Giulia d'Amati
- Department of Radiological, Oncological and Pathological Sciences, Sapienza University of Rome, Policlinico Umberto I, Viale Regina Elena 324, 00161, Rome, Italy
| | - Carla Giordano
- Department of Radiological, Oncological and Pathological Sciences, Sapienza University of Rome, Policlinico Umberto I, Viale Regina Elena 324, 00161, Rome, Italy.
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13
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IFN-β-induced reactive oxygen species and mitochondrial damage contribute to muscle impairment and inflammation maintenance in dermatomyositis. Acta Neuropathol 2017. [PMID: 28623559 DOI: 10.1007/s00401-017-1731-9] [Citation(s) in RCA: 74] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Dermatomyositis (DM) is an autoimmune disease associated with enhanced type I interferon (IFN) signalling in skeletal muscle, but the mechanisms underlying muscle dysfunction and inflammation perpetuation remain unknown. Transcriptomic analysis of early untreated DM muscles revealed that the main cluster of down-regulated genes was mitochondria-related. Histochemical, electron microscopy, and in situ oxygraphy analysis showed mitochondrial abnormalities, including increased reactive oxygen species (ROS) production and decreased respiration, which was correlated with low exercise capacities and a type I IFN signature. Moreover, IFN-β induced ROS production in human myotubes was found to contribute to mitochondrial malfunctions. Importantly, the ROS scavenger N-acetyl cysteine (NAC) prevented mitochondrial dysfunctions, type I IFN-stimulated transcript levels, inflammatory cell infiltrate, and muscle weakness in an experimental autoimmune myositis mouse model. Thus, these data highlight a central role of mitochondria and ROS in DM. Mitochondrial dysfunctions, mediated by IFN-β induced-ROS, contribute to poor exercise capacity. In addition, mitochondrial dysfunctions increase ROS production that drive type I IFN-inducible gene expression and muscle inflammation, and may thus self-sustain the disease. Given that current DM treatments only induce partial recovery and expose to serious adverse events (including muscular toxicity), protecting mitochondria from dysfunctions may open new therapeutic avenues for DM.
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14
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Pasolini MP, Pagano TB, Costagliola A, Biase DD, Lamagna B, Auletta L, Fatone G, Greco M, Coluccia P, Vincenzo V, Pirozzi C, Raso GM, Santoro P, Manna G, Papparella S, Paciello O. Inflammatory Myopathy in Horses With Chronic Piroplasmosis. Vet Pathol 2017; 55:133-143. [PMID: 28718360 DOI: 10.1177/0300985817716262] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Horses affected by chronic piroplasmosis may develop poor performance and muscle atrophy. Here we investigate the pathological and immunopathological aspects of myopathy occurring in chronic equine piroplasmosis. The study included 16 horses serologically positive for equine piroplasms presenting with clinical signs and supporting serum biochemical evidence of a myopathy. Skeletal muscle was evaluated by histopathology, immunohistochemistry, indirect immunofluorescence, and molecular detection of piroplasms and inflammatory cytokines in skeletal muscle. Histologic lesions included muscle fiber atrophy (100% of cases), degenerative changes (13/16, 81%), and perivascular perimysial and endomysial lymphocytic infiltrates (81% of cases). In 15 cases (94%), muscle fibers had strong immunostaining for major histocompatibility complex classes I and II. T lymphocyte populations were mainly CD3+, CD8+, and CD4+ in equal proportions, with a lower number of CD79α+ cells. The serum from affected horses was tested by indirect immunofluorescence for binding of IgG, IgM, or IgA to sections of normal equine muscle to detect circulating autoantibodies against muscle antigen(s). In all cases, distinct sarcolemmal staining was detected in sections incubated with serum from affected horses, in contrast to sections incubated with phosphate-buffered saline or equine control sera. Reverse transcription polymerase chain reaction (RT-PCR) testing of muscles from affected animals revealed a significant increase of interferon-γ, interleukin-12, and tumor necrosis factor-α gene expression compared to healthy controls. Theileria equi or Babesia caballi was not detected in samples of affected muscle by RT-PCR. Thus, inflammatory myopathy associated with equine piroplasmosis may involve an autoimmune pathogenesis with upregulation of inflammatory cytokines that may cause myofiber atrophy and degeneration.
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Affiliation(s)
- Maria P Pasolini
- 1 Unit of Surgery, Department of Veterinary Medicine and Animal Productions, University of Naples Federico II, Naples, Italy
| | - Teresa B Pagano
- 2 Unit of Pathology, Department of Veterinary Medicine and Animal Productions, University of Naples Federico II, Naples, Italy
| | - Alessandro Costagliola
- 2 Unit of Pathology, Department of Veterinary Medicine and Animal Productions, University of Naples Federico II, Naples, Italy
| | - Davide De Biase
- 2 Unit of Pathology, Department of Veterinary Medicine and Animal Productions, University of Naples Federico II, Naples, Italy
| | - Barbara Lamagna
- 1 Unit of Surgery, Department of Veterinary Medicine and Animal Productions, University of Naples Federico II, Naples, Italy
| | | | - Gerardo Fatone
- 1 Unit of Surgery, Department of Veterinary Medicine and Animal Productions, University of Naples Federico II, Naples, Italy
| | - Michele Greco
- 1 Unit of Surgery, Department of Veterinary Medicine and Animal Productions, University of Naples Federico II, Naples, Italy
| | - Pierpaolo Coluccia
- 1 Unit of Surgery, Department of Veterinary Medicine and Animal Productions, University of Naples Federico II, Naples, Italy
| | - Veneziano Vincenzo
- 3 Unit of Parasitology, Department of Veterinary Medicine and Animal Productions, University of Naples Federico II, Naples, Italy
| | - Claudio Pirozzi
- 4 Department of Pharmacy, University of Naples Federico II, Naples, Italy
| | | | | | - Giuseppe Manna
- 6 National Reference Centre for Equine Diseases, Istituto Zooprofilattico Sperimentale "M. Aleandri," Rome, Italy
| | - Serenella Papparella
- 2 Unit of Pathology, Department of Veterinary Medicine and Animal Productions, University of Naples Federico II, Naples, Italy
| | - Orlando Paciello
- 2 Unit of Pathology, Department of Veterinary Medicine and Animal Productions, University of Naples Federico II, Naples, Italy
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15
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Chen J, Wang J, Zhang J, Pu C. 3- n-Butylphthalide reduces the oxidative damage of muscles in an experimental autoimmune myositis animal model. Exp Ther Med 2017; 14:2085-2093. [PMID: 28962128 PMCID: PMC5609169 DOI: 10.3892/etm.2017.4766] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2016] [Accepted: 03/23/2017] [Indexed: 01/18/2023] Open
Abstract
3-n-Butylphthalide (NBP) protects the mitochondria and reduces apoptosis in multiple disease models. However, it remains to be determined whether NBP can protect muscle cells from oxidative stress, lipid peroxidation and apoptosis in myositis. In the present study, a myosin immunization protocol was applied to induce experimental autoimmune myositis (EAM) in guinea pigs. After 4 weeks, a low- or high-dose NBP solution was injected intraperitoneally into the guinea pigs, with saline solution serving as the negative control. After 10 days, the guinea pigs were sacrificed and muscle cells were isolated for analysis. The results revealed that NBP increased the superoxide dismutase and catalase activity, and reduced malondialdehyde activity in the EAM model. Furthermore, NBP enhanced ATPase activity in muscle mitochondrial membranes and muscle fiber membranes, reduced the number of apoptotic cells, and differentially regulated the Bcl-2, Bax and BAD mRNA and protein expression levels in muscle tissues and sera. NBP directly protects muscle mitochondria and muscle cells from oxidative damage. Notably, NBP reduced muscle cell apoptosis. Thus, it is speculated that, as an antioxidant treatment, NBP may benefit individuals with myopathy.
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Affiliation(s)
- Juan Chen
- Department of Neurology, Chinese PLA Medical School, Beijing 100853, P.R. China.,Department of Neurology, The 309th Hospital of PLA, Beijing 100091, P.R. China
| | - Jingyang Wang
- Department of Neurology, Chinese PLA Medical School, Beijing 100853, P.R. China
| | - Jiyan Zhang
- Laboratory of Immunology, Academy of Military Medical Sciences, Beijing 100850, P.R. China
| | - Chuanqiang Pu
- Department of Neurology, Chinese PLA Medical School, Beijing 100853, P.R. China
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16
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Munters LA, Loell I, Ossipova E, Raouf J, Dastmalchi M, Lindroos E, Chen YW, Esbjörnsson M, Korotkova M, Alexanderson H, Nagaraju K, Crofford LJ, Jakobsson PJ, Lundberg IE. Endurance Exercise Improves Molecular Pathways of Aerobic Metabolism in Patients With Myositis. Arthritis Rheumatol 2016; 68:1738-50. [DOI: 10.1002/art.39624] [Citation(s) in RCA: 49] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2015] [Accepted: 01/26/2016] [Indexed: 01/26/2023]
Affiliation(s)
- Li Alemo Munters
- Vanderbilt University, Nashville, Tennessee, and Karolinska Institutet and Karolinska University Hospital; Solna Stockholm Sweden
| | - Ingela Loell
- Karolinska Institutet and Karolinska University Hospital; Solna Stockholm Sweden
| | - Elena Ossipova
- Karolinska Institutet and Karolinska University Hospital; Solna Stockholm Sweden
| | - Joan Raouf
- Karolinska Institutet and Karolinska University Hospital; Solna Stockholm Sweden
| | - Maryam Dastmalchi
- Karolinska Institutet and Karolinska University Hospital; Solna Stockholm Sweden
| | - Eva Lindroos
- Karolinska Institutet and Karolinska University Hospital; Solna Stockholm Sweden
| | - Yi-Wen Chen
- George Washington University and Children's National Medical Center; Washington DC
| | - Mona Esbjörnsson
- Karolinska Institutet and Karolinska University Hospital; Solna Stockholm Sweden
| | - Marina Korotkova
- Karolinska Institutet and Karolinska University Hospital; Solna Stockholm Sweden
| | - Helene Alexanderson
- Karolinska Institutet and Karolinska University Hospital; Solna Stockholm Sweden
| | - Kanneboyina Nagaraju
- George Washington University and Children's National Medical Center; Washington DC
| | | | - Per-Johan Jakobsson
- Karolinska Institutet and Karolinska University Hospital; Solna Stockholm Sweden
| | - Ingrid E. Lundberg
- Karolinska Institutet and Karolinska University Hospital; Solna Stockholm Sweden
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17
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Pinal-Fernandez I, Casciola-Rosen LA, Christopher-Stine L, Corse AM, Mammen AL. The Prevalence of Individual Histopathologic Features Varies according to Autoantibody Status in Muscle Biopsies from Patients with Dermatomyositis. J Rheumatol 2015; 41:2347-51. [DOI: 10.3899/jrheum.141443] [Citation(s) in RCA: 64] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Objective.Individual dermatomyositis (DM)-associated autoantibodies are associated with distinct clinical phenotypes. This study was undertaken to explore the association of these autoantibodies with specific muscle biopsy features.Methods.DM subjects with a muscle biopsy reviewed at Johns Hopkins had sera screened for autoantibodies recognizing Mi-2, transcriptional intermediary factor 1-γ (TIF1-γ), NXP2, MDA5, Ro52, PM-Scl, and Jo1. We also included anti-Jo1–positive patients with polymyositis (PM) who had a biopsy read at Johns Hopkins. Analyzed histological features included perifascicular atrophy, perivascular inflammation, mitochondrial dysfunction, primary inflammation, and myofiber necrosis. Duration of disease, biopsy location, and treatment at biopsy were also analyzed.Results.We studied 91 DM and 7 anti-Jo1–positive patients with PM. In univariate analyses, TIF1-γ+ patients had more mitochondrial dysfunction (47% vs 18%; p = 0.05), NXP2+ patients had less primary inflammation (0% vs 28%; p = 0.01), Mi-2+ patients had more primary inflammation (50% vs 19%; p = 0.03), and PM-Scl+ patients had more primary inflammation (67% vs 18%; p = 0.004) than those who were negative for each autoantibody. Although reliability was limited because of small sample numbers, multivariate analysis confirmed that TIF1-γ+ patients had more mitochondrial dysfunction [prevalence ratio (PR) 2.6, 95% CI 1.0–6.5, p = 0.05] and PM-Scl+ patients had more primary inflammation (PR 5.2, 95% CI 2.0–13.4; p = 0.001) independent of disease duration at biopsy, biopsy site, and treatment at biopsy. No differences in muscle biopsy features were noted between anti-Jo1–positive patients diagnosed with DM and PM.Conclusion.The prevalence of different histological features varies according to autoantibody status in DM. Muscle biopsy features are similar in anti-Jo1 patients with and without a rash.
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18
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New insights into the benefits of exercise for muscle health in patients with idiopathic inflammatory myositis. Curr Rheumatol Rep 2015; 16:429. [PMID: 24879535 DOI: 10.1007/s11926-014-0429-4] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
With recommended treatment, a majority with idiopathic inflammatory myopathy (IIM) develop muscle impairment and poor health. Beneficial effects of exercise have been reported on muscle performance, aerobic capacity and health in chronic polymyositis and dermatomyositis and to some extent in active disease and inclusion body myositis (IBM). Importantly, randomized controlled trials (RCTs) indicate that improved health and decreased clinical disease activity could be mediated through increased aerobic capacity. Recently, reports seeking mechanisms underlying effects of exercise in skeletal muscle indicate increased aerobic capacity (i.e. increased mitochondrial capacity and capillary density, reduced lactate levels), activation of genes in aerobic phenotype and muscle growth programs, and down regulation in genes related to inflammation. Altogether, exercise contributes to both systemic and within-muscle adaptations demonstrating that exercise is fundamental to improve muscle performance and health in IIM. There is a need for RCTs to study effects of exercise in active disease and IBM.
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19
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Regional Ischemic Immune Myopathy: A Paraneoplastic Dermatomyopathy. J Neuropathol Exp Neurol 2014; 73:1126-33. [DOI: 10.1097/nen.0000000000000132] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
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20
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Joshi PR, Vetterke M, Hauburger A, Tacik P, Stoltenburg G, Hanisch F. Functional relevance of mitochondrial abnormalities in sporadic inclusion body myositis. J Clin Neurosci 2014; 21:1959-63. [PMID: 25311418 DOI: 10.1016/j.jocn.2014.05.051] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2014] [Revised: 05/21/2014] [Accepted: 05/30/2014] [Indexed: 10/24/2022]
Abstract
Cytochrome c oxidase (COX)-deficient fibers and multiple mitochondrial DNA (mtDNA) deletions are frequent findings in sporadic inclusion body myositis (s-IBM). However, the functional impact of these defects is not known. We investigated oxygen desaturation during exercise using the forearm exercise test, accumulation of lactate during exercise using a cycle ergometry test and mitochondrial changes (COX-deficient fibers, biochemical activities of respiratory chain complexes, multiple mtDNA deletions by long-range polymerase chain reaction) in 10 patients with s-IBM and compared the findings with age and sex-matched normal and diseased controls (without mitochondrial disorders) as well as patients with mitochondrial disorder due to nuclear gene defects resulting in multiple mtDNA deletions (MITO group). The mean age of the s-IBM patients was 68.2 ± 5.7 years (range: 56-75). Patients with s-IBM had statistically significantly reduced oxygen desaturation (ΔsO2) during the handgrip exercise (p<0.05) and elevated peak serum lactate levels during cycle ergometry compared to normal controls (p<0.05). The percentage of COX-deficient fibers in s-IBM and MITO patients was significantly increased compared to normal controls (p<0.01). Five out of nine s-IBM patients had multiple mtDNA deletions. Thirty-three percent of s-IBM patients showed an increased citrate synthase content and decreased activities of complex IV (COX). The biochemical pattern of respiratory chain complexes in patients with s-IBM and MITO was similar. Histopathological analysis showed similar changes in s-IBM and MITO due to nuclear gene defects. Functional tests reflecting mitochondrial impairment suggest a contribution of mitochondrial defects to disease-related symptoms such as fatigue and exertion-induced symptoms.
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Affiliation(s)
- Pushpa Raj Joshi
- Department of Neurology, Martin-Luther-University Halle-Wittenberg, Ernst-Grube-Str. 40, 06120 Halle (Saale), Germany.
| | - Mirjam Vetterke
- Department of Neurology, Martin-Luther-University Halle-Wittenberg, Ernst-Grube-Str. 40, 06120 Halle (Saale), Germany
| | - Anja Hauburger
- Department of Neurology, Martin-Luther-University Halle-Wittenberg, Ernst-Grube-Str. 40, 06120 Halle (Saale), Germany
| | - Pawel Tacik
- Department of Neurology, Hannover Medical School, Hannover, Germany
| | - Gisela Stoltenburg
- Department of Neurology, Martin-Luther-University Halle-Wittenberg, Ernst-Grube-Str. 40, 06120 Halle (Saale), Germany; Institute of Cell Biology and Neurobiology, Charité, Universitätsmedizin Berlin, Berlin, Germany
| | - Frank Hanisch
- Department of Neurology, Martin-Luther-University Halle-Wittenberg, Ernst-Grube-Str. 40, 06120 Halle (Saale), Germany
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21
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Vattemi G, Marini M, Di Chio M, Colpani M, Guglielmi V, Tomelleri G. Polymyositis in solid organ transplant recipients receiving tacrolimus. J Neurol Sci 2014; 345:239-43. [PMID: 25130930 DOI: 10.1016/j.jns.2014.07.036] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2014] [Revised: 06/17/2014] [Accepted: 07/15/2014] [Indexed: 10/24/2022]
Abstract
Tacrolimus, also known as FK506, is an immunosuppressive agent widely used for the prevention of acute allograft rejection in organ transplantation and for the treatment of immunological diseases. This study reports two male patients who underwent solid organ transplantation (liver and kidney). After transplant, the patients received continuous immunosuppressive therapy with oral tacrolimus and later presented clinical manifestations and laboratory signs of myopathy. Muscle biopsies of both patients clearly documented an inflammatory myopathy with the histological features of polymyositis including CD8+ T cells which invaded healthy muscle fibers and expressed granzyme B and perforin, many CD68+ macrophages and MHC class I antigen upregulation on the surface of most fibers. Because of the temporal association while receiving tacrolimus and since other possible causes for myopathy were excluded, the most likely cause of polymyositis in our patients was tacrolimus toxicity. We suggest that patients on tacrolimus should be carefully monitored for serum CK levels and clinical signs of muscle disease.
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Affiliation(s)
- Gaetano Vattemi
- Department of Neurological and Movement Sciences, Section of Clinical Neurology, University of Verona, Italy
| | - Matteo Marini
- Department of Neurological and Movement Sciences, Section of Clinical Neurology, University of Verona, Italy
| | - Marzia Di Chio
- Department of Medicine and Public Health, Section of Pharmacology, University of Verona, Verona, Italy
| | - Maria Colpani
- Department of Gastroenterology, Liver Transplantation Unit, "Ospedali Riuniti", Bergamo, Italy
| | - Valeria Guglielmi
- Department of Neurological and Movement Sciences, Section of Clinical Neurology, University of Verona, Italy
| | - Giuliano Tomelleri
- Department of Neurological and Movement Sciences, Section of Clinical Neurology, University of Verona, Italy.
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Bhansing KJ, Lammens M, Knaapen HKA, van Riel PLCM, van Engelen BGM, Vonk MC. Scleroderma-polymyositis overlap syndrome versus idiopathic polymyositis and systemic sclerosis: a descriptive study on clinical features and myopathology. Arthritis Res Ther 2014; 16:R111. [PMID: 24886750 PMCID: PMC4060195 DOI: 10.1186/ar4562] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2013] [Accepted: 04/24/2014] [Indexed: 01/16/2023] Open
Abstract
INTRODUCTION The objective was to characterize the clinical and myopathologic features of patients with scleroderma-polymyositis (SSc-PM) overlap compared with a population of patients with systemic sclerosis (SSc) and polymyositis (PM). METHODS A three-way comparison of patients with SSc-PM overlap (n = 25) with patients with SSc (n = 397) and PM (n = 40) on clinical and myopathologic features and causes of death. One neuropathologist blinded for the diagnosis evaluated all recent available muscle biopsies. Biopsies were scored for presence of inflammation, necrotic muscle fibers, rimmed vacuoles, fibrosis, and immunohistochemical staining. Clinical or myopathologic characteristics were compared by using the χ(2) test or one-way analysis of variance (ANOVA). RESULTS The prevalence of SSc-PM overlap in the Nijmegen Systemic Sclerosis cohort was 5.9%. The mortality was 32% (eight of 25) in SSc-PM, of which half was related to cardiac diseases. The prevalence of pulmonary fibrosis was significantly increased in SSc-PM (83%) (P = 0.04) compared with SSc (49%) and PM (53%). SSc or myositis-specific antibodies were nearly absent in the SSc-PM group. In almost all biopsies (96%) of SSc-PM patients, necrotic muscle fibers were present, which was significantly increased compared with PM patients (P = 0.02). CONCLUSIONS Patients with SSc-PM have increased prevalence of pulmonary fibrosis and cardiac disease as the cause of death compared with patients with SSc and PM . In addition, we found that necrotizing muscle fibers with inflammation characterize SSc-PM overlap in muscle biopsies. Further research should focus on underlying mechanisms causing necrosis, inflammation, and fibrosis and their relation to pulmonary involvement and mortality in patients with SSc-PM overlap.
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Mancuso M, Orsucci D, Ienco EC, Ricci G, Ali G, Servadio A, Fontanini G, Filosto M, Vielmi V, Rocchi A, Petrozzi L, LoGerfo A, Siciliano G. An “inflammatory” mitochondrial myopathy. A case report. Neuromuscul Disord 2013; 23:907-10. [DOI: 10.1016/j.nmd.2013.07.011] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2012] [Revised: 06/07/2013] [Accepted: 07/31/2013] [Indexed: 01/01/2023]
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Abstract
PURPOSE OF REVIEW We discuss pathology-based characterization and classification of acquired immune and inflammatory myopathies (IIMs). RECENT FINDINGS Several types of IIMs do not fit well into the typical IIM subclassifications: dermatomyositis, polymyositis and inclusion body myositis (IBM). Myopathologic features that can provide additional diagnostic clarification in IIM are types of muscle fiber pathology; immune changes (cellular and humoral); and tissues with distinctive involvement (connective tissue, vessels and muscle fibers). Pathologic classification categories include immune myopathies with perimysial pathology (IMPP), a group that can be associated with antisynthetase antibodies; myovasculopathies, including childhood dermatomyositis; immune polymyopathies, active myopathies with little inflammation such as the myopathy with signal recognition particle antibodies; immune myopathies with endomysial pathology (IM-EP), illustrated by brachio-cervical inflammatory myopathy (BCIM); histiocytic inflammatory myopathies, like sarcoid myopathy; and inflammatory myopathies with vacuoles, aggregates and mitochondrial pathology (IM-VAMP), which have inclusion body myositis as a pathologic subtype and are poorly treatable. Some myopathologic features, like B-cell foci and alkaline phosphatase staining of capillaries or perimysium, are more likely to be present in treatable categories of IIM. SUMMARY Myopathology can be used to classify IIM. Identification of distinctive myopathologic changes in IIM can improve diagnostic and prognostic accuracy and focus treatment, therapeutic trials and studies of pathogenic factors.
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Milisenda JC, Prieto-González S, Grau JM. Miositis con cuerpos de inclusión (forma esporádica). ACTA ACUST UNITED AC 2012. [DOI: 10.1016/j.semreu.2011.10.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Current world literature. Curr Opin Rheumatol 2011; 23:620-5. [PMID: 21960037 DOI: 10.1097/bor.0b013e32834ccef6] [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]
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Current world literature. Curr Opin Neurol 2011; 24:511-6. [PMID: 21900773 DOI: 10.1097/wco.0b013e32834be5c1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Vishwanath S, Abdullah M, Elbalkhi A, Ambrus JL. Metabolic myopathy presenting with polyarteritis nodosa: a case report. J Med Case Rep 2011; 5:262. [PMID: 21718511 PMCID: PMC3148996 DOI: 10.1186/1752-1947-5-262] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2011] [Accepted: 06/30/2011] [Indexed: 11/10/2022] Open
Abstract
Introduction To the best of our knowledge, we describe for the first time a patient in whom an unusual metabolic myopathy was identified after failure to respond to curative therapy for a systemic vasculitis, polyarteritis nodosa. We hope this report will heighten awareness of common metabolic myopathies that may present later in life. It also speculates on the potential relationship between metabolic myopathy and systemic vasculitis. Case presentation A 78-year-old African-American woman with a two-year history of progressive fatigue and exercise intolerance presented to our facility with new skin lesions and profound muscle weakness. Skin and muscle biopsies demonstrated a medium-sized artery vasculitis consistent with polyarteritis nodosa. Biochemical studies of the muscle revealed diminished cytochrome C oxidase activity (0.78 μmol/minute/g tissue; normal range 1.03 to 3.83 μmol/minute/g tissue), elevated acid maltase activity (23.39 μmol/minute/g tissue; normal range 1.74 to 9.98 μmol/minute/g tissue) and elevated neutral maltase activity (35.89 μmol/minute/g tissue; normal range 4.35 to 16.03 μmol/minute/g tissue). Treatment for polyarteritis nodosa with prednisone and cyclophosphamide resulted in minimal symptomatic improvement. Additional management with a diet low in complex carbohydrates and ubiquinone, creatine, carnitine, folic acid, α-lipoic acid and ribose resulted in dramatic clinical improvement. Conclusions Our patient's initial symptoms of fatigue, exercise intolerance and progressive weakness were likely related to her complex metabolic myopathy involving both the mitochondrial respiratory chain and glycogen storage pathways. Management of our patient required treatment of both the polyarteritis nodosa as well as metabolic myopathy. Metabolic myopathies are common and should be considered in any patient with exercise intolerance. Metabolic myopathies may complicate the management of various disease states.
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Affiliation(s)
- Sahana Vishwanath
- Department of Medicine, SUNY at Buffalo School of Medicine, 100 High Street, Buffalo, NY 14203, USA.
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