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Chen Y, Zhang S, Lu X, Xie W, Wang C, Zhai Z. Unusual cause of muscle weakness, type II respiratory failure and pulmonary hypertension: a case report of ryanodine receptor type 1(RYR1)-related myopathy. BMC Pulm Med 2024; 24:194. [PMID: 38649898 PMCID: PMC11034144 DOI: 10.1186/s12890-024-03016-7] [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: 12/25/2023] [Accepted: 04/15/2024] [Indexed: 04/25/2024] Open
Abstract
BACKGROUND Patients with congenital myopathies may experience respiratory involvement, resulting in restrictive ventilatory dysfunction and respiratory failure. Pulmonary hypertension (PH) associated with this condition has never been reported in congenital ryanodine receptor type 1(RYR1)-related myopathy. CASE PRESENTATION A 47-year-old woman was admitted with progressively exacerbated chest tightness and difficulty in neck flexion. She was born prematurely at week 28. Her bilateral lower extremities were edematous and muscle strength was grade IV-. Arterial blood gas analysis revealed hypoventilation syndrome and type II respiratory failure, while lung function test showed restrictive ventilation dysfunction, which were both worse in the supine position. PH was confirmed by right heart catheterization (RHC), without evidence of left heart disease, congenital heart disease, or pulmonary artery obstruction. Polysomnography indicated nocturnal hypoventilation. The ultrasound revealed reduced mobility of bilateral diaphragm. The level of creatine kinase was mildly elevated. Magnetic resonance imaging showed myositis of bilateral thigh muscle. Muscle biopsy of the left biceps brachii suggested muscle malnutrition and congenital muscle disease. Gene testing revealed a missense mutation in the RYR1 gene (exon33 c.C4816T). Finally, she was diagnosed with RYR1-related myopathy and received long-term non-invasive ventilation (NIV) treatment. Her symptoms and cardiopulmonary function have been greatly improved after 10 months. CONCLUSIONS We report a case of RYR1-related myopathy exhibiting hypoventilation syndrome, type II respiratory failure and PH associated with restrictive ventilator dysfunction. Pulmonologists should keep congenital myopathies in mind in the differential diagnosis of type II respiratory failure, especially in patients with short stature and muscle weakness.
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Affiliation(s)
- Yinong Chen
- Peking University China-Japan Friendship School of Clinical Medicine, Beijing, P.R. China
- National Center for Respiratory Medicine; State Key Laboratory of Respiratory Health and Multimorbidity; National Clinical Research Center for Respiratory Diseases; Institute of Respiratory Medicine, Chinese Academy of Medical Sciences; Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing, P.R. China
| | - Shuai Zhang
- National Center for Respiratory Medicine; State Key Laboratory of Respiratory Health and Multimorbidity; National Clinical Research Center for Respiratory Diseases; Institute of Respiratory Medicine, Chinese Academy of Medical Sciences; Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing, P.R. China.
| | - Xin Lu
- Department of Rheumatology, China-Japan Friendship Hospital, Beijing, P.R. China
| | - Wanmu Xie
- National Center for Respiratory Medicine; State Key Laboratory of Respiratory Health and Multimorbidity; National Clinical Research Center for Respiratory Diseases; Institute of Respiratory Medicine, Chinese Academy of Medical Sciences; Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing, P.R. China
| | - Chen Wang
- Peking University China-Japan Friendship School of Clinical Medicine, Beijing, P.R. China
- National Center for Respiratory Medicine; State Key Laboratory of Respiratory Health and Multimorbidity; National Clinical Research Center for Respiratory Diseases; Institute of Respiratory Medicine, Chinese Academy of Medical Sciences; Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing, P.R. China
- Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, P. R. China
- Department of Respiratory Medicine, Capital Medical University, Beijing, P.R. China
| | - Zhenguo Zhai
- Peking University China-Japan Friendship School of Clinical Medicine, Beijing, P.R. China.
- National Center for Respiratory Medicine; State Key Laboratory of Respiratory Health and Multimorbidity; National Clinical Research Center for Respiratory Diseases; Institute of Respiratory Medicine, Chinese Academy of Medical Sciences; Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing, P.R. China.
- Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, P. R. China.
- Department of Respiratory Medicine, Capital Medical University, Beijing, P.R. China.
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Dehghanian Reyhan V, Ghafouri F, Sadeghi M, Miraei-Ashtiani SR, Kastelic JP, Barkema HW, Shirali M. Integrated Comparative Transcriptome and circRNA-lncRNA-miRNA-mRNA ceRNA Regulatory Network Analyses Identify Molecular Mechanisms Associated with Intramuscular Fat Content in Beef Cattle. Animals (Basel) 2023; 13:2598. [PMID: 37627391 PMCID: PMC10451991 DOI: 10.3390/ani13162598] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Revised: 08/05/2023] [Accepted: 08/08/2023] [Indexed: 08/27/2023] Open
Abstract
Intramuscular fat content (IMF), one of the most important carcass traits in beef cattle, is controlled by complex regulatory factors. At present, molecular mechanisms involved in regulating IMF and fat metabolism in beef cattle are not well understood. Our objective was to integrate comparative transcriptomic and competing endogenous RNA (ceRNA) network analyses to identify candidate messenger RNAs (mRNAs) and regulatory RNAs involved in molecular regulation of longissimus dorsi muscle (LDM) tissue for IMF and fat metabolism of 5 beef cattle breeds (Angus, Chinese Simmental, Luxi, Nanyang, and Shandong Black). In total, 34 circRNAs, 57 lncRNAs, 15 miRNAs, and 374 mRNAs were identified by integrating gene ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analyses. Furthermore, 7 key subnets with 16 circRNAs, 43 lncRNAs, 7 miRNAs, and 237 mRNAs were detected through clustering analyses, whereas GO enrichment analysis of identified RNAs revealed 48, 13, and 28 significantly enriched GO terms related to IMF in biological process, molecular function, and cellular component categories, respectively. The main metabolic-signaling pathways associated with IMF and fat metabolism that were enriched included metabolic, calcium, cGMP-PKG, thyroid hormone, and oxytocin signaling pathways. Moreover, MCU, CYB5R1, and BAG3 genes were common among the 10 comparative groups defined as important candidate marker genes for fat metabolism in beef cattle. Contributions of transcriptome profiles from various beef breeds and a competing endogenous RNA (ceRNA) regulatory network underlying phenotypic differences in IMF provided novel insights into molecular mechanisms associated with meat quality.
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Affiliation(s)
- Vahid Dehghanian Reyhan
- Department of Animal Science, University College of Agriculture and Natural Resources, University of Tehran, Karaj 77871-31587, Iran; (V.D.R.); (F.G.); (S.R.M.-A.)
| | - Farzad Ghafouri
- Department of Animal Science, University College of Agriculture and Natural Resources, University of Tehran, Karaj 77871-31587, Iran; (V.D.R.); (F.G.); (S.R.M.-A.)
| | - Mostafa Sadeghi
- Department of Animal Science, University College of Agriculture and Natural Resources, University of Tehran, Karaj 77871-31587, Iran; (V.D.R.); (F.G.); (S.R.M.-A.)
| | - Seyed Reza Miraei-Ashtiani
- Department of Animal Science, University College of Agriculture and Natural Resources, University of Tehran, Karaj 77871-31587, Iran; (V.D.R.); (F.G.); (S.R.M.-A.)
| | - John P. Kastelic
- Faculty of Veterinary Medicine, University of Calgary, Calgary, AB T2N 4N1, Canada; (J.P.K.); (H.W.B.)
| | - Herman W. Barkema
- Faculty of Veterinary Medicine, University of Calgary, Calgary, AB T2N 4N1, Canada; (J.P.K.); (H.W.B.)
| | - Masoud Shirali
- Agri-Food and Biosciences Institute, Hillsborough BT26 6DR, UK
- School of Biological Sciences, Queen’s University Belfast, Belfast BT9 5AJ, UK
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Lester EB, Larsen MJ, Laulund LW, Illum N, Dunkhase-Heinl U, Schrøder HD, Fagerberg CR. Ryanodine receptor 1 related myasthenia like myopathy responsive to pyridostigmine. Eur J Med Genet 2023; 66:104706. [PMID: 36669590 DOI: 10.1016/j.ejmg.2023.104706] [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: 03/08/2022] [Revised: 10/06/2022] [Accepted: 01/15/2023] [Indexed: 01/19/2023]
Abstract
Disease causing variants in the Ryanodine receptor 1 (RYR1) gene are a common cause for congenital myopathy and for malignant hyperthermia susceptibility. We report a 17 year old boy with congenital muscle weakness progressing to a myasthenia like myopathy with muscle weakness, fatigability, ptosis, and ophthalmoplegia. Muscle biopsy showed predominance and atrophy of type 1 fibers. Whole-exome trio sequencing revealed three variants in the RYR1-gene in the patient: c.6721C > T,p.(Arg2241*) and c.2122G > A,p.(Asp708Asn) in cis position, and the c.325C > T,p.(Arg109Trp) variant in trans. Treatment with pyridostigmine improved symptoms. This case supports that a myasthenia like phenotype is part of the phenotypic spectrum of RYR1 related disorders, and that treatment with pyridostigmine can be beneficial for patients with this phenotype.
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Affiliation(s)
- Emilie Boye Lester
- Department of Clinical Genetics, Odense University Hospital, Odense, Denmark
| | - Martin Jakob Larsen
- Department of Clinical Genetics, Odense University Hospital, Odense, Denmark
| | | | - Niels Illum
- H. C. Andersen Children's Hospital, Odense University Hospital, Odense, Denmark
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Mohajer B, Dolatshahi M, Moradi K, Najafzadeh N, Eng J, Zikria B, Wan M, Cao X, Roemer FW, Guermazi A, Demehri S. Role of Thigh Muscle Changes in Knee Osteoarthritis Outcomes: Osteoarthritis Initiative Data. Radiology 2022; 305:169-178. [PMID: 35727152 PMCID: PMC9524577 DOI: 10.1148/radiol.212771] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Revised: 04/12/2022] [Accepted: 05/06/2022] [Indexed: 11/11/2022]
Abstract
Background Longitudinal data on the association of quantitative thigh muscle MRI markers with knee osteoarthritis (KOA) outcomes are scarce. These associations are of clinical importance, with potential use for thigh muscle-directed disease-modifying interventions. Purpose To measure KOA-associated longitudinal changes in MRI-derived muscle cross-sectional area (CSA) and adipose tissue and their association with downstream symptom worsening and knee replacement (KR). Materials and Methods In a secondary analysis of the Osteoarthritis Initiative multicenter prospective cohort (February 2004 through October 2015), knees of participants with available good-quality thigh MRI scans at baseline and at least one follow-up visit were included and classified as with and without KOA according to baseline radiographic Kellgren-Lawrence grade of 2 or higher and matched for confounders with use of propensity score matching. An automated deep learning model for thigh MRI two-dimensional segmentation was developed and tested. Markers of muscle CSA and intramuscular adipose tissue (intra-MAT) were measured at baseline and 2nd- and 4th-year follow-up (period 1) and compared between knees with and without KOA by using linear mixed-effect regression models. Furthermore, in knees with KOA, the association of period 1 changes in muscle markers with risk of KR (Cox proportional hazards) and symptom worsening (mixed-effect models) during the 4th to 9th year (period 2) was evaluated. Results This study included 4634 matched thighs (2317 with and 2317 without KOA) of 2344 participants (mean age, 62 years ± 9 [SD]; 1292 women). Compared with those without, knees with KOA had a decrease in quadriceps CSA (mean difference, -8.21 mm2/year; P = .004) and an increase in quadriceps intra-MAT (1.98 mm2/year; P = .007). Decreased CSA and increased intra-MAT of quadriceps during period 1 was predictive of downstream (period 2) KOA symptom worsening (Western Ontario and McMaster Universities Osteoarthritis Index total score: odds ratio, 0.24 [negative association] [P < .001] and 1.38 [P = .012], respectively). Quadriceps CSA changes were negatively associated with higher future KR risk (hazard ratio, 0.70; P < .001). Conclusion Knee osteoarthritis was associated with longitudinal MRI-derived decreased quadriceps cross-sectional area and increased intramuscular adipose tissue. These potentially modifiable risk factors were predictive of downstream symptom worsening and knee replacement. Clinical trial registration no. NCT00080171 © RSNA, 2022 Online supplemental material is available for this article.
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Affiliation(s)
- Bahram Mohajer
- From the Division of Musculoskeletal Radiology, Russell H. Morgan Department of Radiology and Radiological Science (B.M., S.D.), Russell H. Morgan Department of Radiology and Radiological Science (J.E.), and Department of Orthopedic Surgery (B.Z., M.W., X.C.), Johns Hopkins University School of Medicine, 601 N Caroline St, JHOC 3142, Baltimore, MD 21287; Tehran University of Medical Sciences, School of Medicine, Tehran, Iran (M.D., K.M.); Sharif University of Technology, Tehran, Iran (N.N.); Department of Radiology, Boston University School of Medicine, Boston, Mass (F.W.R., A.G.); and Department of Radiology, University of Erlangen-Nuremberg, Erlangen, Germany (F.W.R.)
| | - Mahsa Dolatshahi
- From the Division of Musculoskeletal Radiology, Russell H. Morgan Department of Radiology and Radiological Science (B.M., S.D.), Russell H. Morgan Department of Radiology and Radiological Science (J.E.), and Department of Orthopedic Surgery (B.Z., M.W., X.C.), Johns Hopkins University School of Medicine, 601 N Caroline St, JHOC 3142, Baltimore, MD 21287; Tehran University of Medical Sciences, School of Medicine, Tehran, Iran (M.D., K.M.); Sharif University of Technology, Tehran, Iran (N.N.); Department of Radiology, Boston University School of Medicine, Boston, Mass (F.W.R., A.G.); and Department of Radiology, University of Erlangen-Nuremberg, Erlangen, Germany (F.W.R.)
| | - Kamyar Moradi
- From the Division of Musculoskeletal Radiology, Russell H. Morgan Department of Radiology and Radiological Science (B.M., S.D.), Russell H. Morgan Department of Radiology and Radiological Science (J.E.), and Department of Orthopedic Surgery (B.Z., M.W., X.C.), Johns Hopkins University School of Medicine, 601 N Caroline St, JHOC 3142, Baltimore, MD 21287; Tehran University of Medical Sciences, School of Medicine, Tehran, Iran (M.D., K.M.); Sharif University of Technology, Tehran, Iran (N.N.); Department of Radiology, Boston University School of Medicine, Boston, Mass (F.W.R., A.G.); and Department of Radiology, University of Erlangen-Nuremberg, Erlangen, Germany (F.W.R.)
| | - Nima Najafzadeh
- From the Division of Musculoskeletal Radiology, Russell H. Morgan Department of Radiology and Radiological Science (B.M., S.D.), Russell H. Morgan Department of Radiology and Radiological Science (J.E.), and Department of Orthopedic Surgery (B.Z., M.W., X.C.), Johns Hopkins University School of Medicine, 601 N Caroline St, JHOC 3142, Baltimore, MD 21287; Tehran University of Medical Sciences, School of Medicine, Tehran, Iran (M.D., K.M.); Sharif University of Technology, Tehran, Iran (N.N.); Department of Radiology, Boston University School of Medicine, Boston, Mass (F.W.R., A.G.); and Department of Radiology, University of Erlangen-Nuremberg, Erlangen, Germany (F.W.R.)
| | - John Eng
- From the Division of Musculoskeletal Radiology, Russell H. Morgan Department of Radiology and Radiological Science (B.M., S.D.), Russell H. Morgan Department of Radiology and Radiological Science (J.E.), and Department of Orthopedic Surgery (B.Z., M.W., X.C.), Johns Hopkins University School of Medicine, 601 N Caroline St, JHOC 3142, Baltimore, MD 21287; Tehran University of Medical Sciences, School of Medicine, Tehran, Iran (M.D., K.M.); Sharif University of Technology, Tehran, Iran (N.N.); Department of Radiology, Boston University School of Medicine, Boston, Mass (F.W.R., A.G.); and Department of Radiology, University of Erlangen-Nuremberg, Erlangen, Germany (F.W.R.)
| | - Bashir Zikria
- From the Division of Musculoskeletal Radiology, Russell H. Morgan Department of Radiology and Radiological Science (B.M., S.D.), Russell H. Morgan Department of Radiology and Radiological Science (J.E.), and Department of Orthopedic Surgery (B.Z., M.W., X.C.), Johns Hopkins University School of Medicine, 601 N Caroline St, JHOC 3142, Baltimore, MD 21287; Tehran University of Medical Sciences, School of Medicine, Tehran, Iran (M.D., K.M.); Sharif University of Technology, Tehran, Iran (N.N.); Department of Radiology, Boston University School of Medicine, Boston, Mass (F.W.R., A.G.); and Department of Radiology, University of Erlangen-Nuremberg, Erlangen, Germany (F.W.R.)
| | - Mei Wan
- From the Division of Musculoskeletal Radiology, Russell H. Morgan Department of Radiology and Radiological Science (B.M., S.D.), Russell H. Morgan Department of Radiology and Radiological Science (J.E.), and Department of Orthopedic Surgery (B.Z., M.W., X.C.), Johns Hopkins University School of Medicine, 601 N Caroline St, JHOC 3142, Baltimore, MD 21287; Tehran University of Medical Sciences, School of Medicine, Tehran, Iran (M.D., K.M.); Sharif University of Technology, Tehran, Iran (N.N.); Department of Radiology, Boston University School of Medicine, Boston, Mass (F.W.R., A.G.); and Department of Radiology, University of Erlangen-Nuremberg, Erlangen, Germany (F.W.R.)
| | - Xu Cao
- From the Division of Musculoskeletal Radiology, Russell H. Morgan Department of Radiology and Radiological Science (B.M., S.D.), Russell H. Morgan Department of Radiology and Radiological Science (J.E.), and Department of Orthopedic Surgery (B.Z., M.W., X.C.), Johns Hopkins University School of Medicine, 601 N Caroline St, JHOC 3142, Baltimore, MD 21287; Tehran University of Medical Sciences, School of Medicine, Tehran, Iran (M.D., K.M.); Sharif University of Technology, Tehran, Iran (N.N.); Department of Radiology, Boston University School of Medicine, Boston, Mass (F.W.R., A.G.); and Department of Radiology, University of Erlangen-Nuremberg, Erlangen, Germany (F.W.R.)
| | - Frank W. Roemer
- From the Division of Musculoskeletal Radiology, Russell H. Morgan Department of Radiology and Radiological Science (B.M., S.D.), Russell H. Morgan Department of Radiology and Radiological Science (J.E.), and Department of Orthopedic Surgery (B.Z., M.W., X.C.), Johns Hopkins University School of Medicine, 601 N Caroline St, JHOC 3142, Baltimore, MD 21287; Tehran University of Medical Sciences, School of Medicine, Tehran, Iran (M.D., K.M.); Sharif University of Technology, Tehran, Iran (N.N.); Department of Radiology, Boston University School of Medicine, Boston, Mass (F.W.R., A.G.); and Department of Radiology, University of Erlangen-Nuremberg, Erlangen, Germany (F.W.R.)
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