A rare case of centronuclear myopathy with DNM2 mutation: genotype-phenotype correlation

The myotubular and centronuclear myopathy patient registry: a multifunctional tool for translational research

The Myotubular and Centronuclear Myopathy Registry is an international research database containing key longitudinal data on a diverse and growing cohort of individuals affected by this group of rare and ultra-rare neuromuscular conditions. It can inform and support all areas of translational research including epidemiological and natural history studies, clinical trial feasibility planning, recruitment for clinical trials or other research studies, stand-alone clinical studies, standards of care development, and provision of real-world evidence data. For ten years, it has also served as a valuable communications tool and provided a link between the scientific and patient communities. With the anticipated advent of disease-modifying therapies for these conditions, the registry is a key resource for the generation of post-authorisation data for regulatory decision-making, real world evidence, and patient-reported outcome measures. In this paper we present some key data from the current 444 registered individuals with the following genotype split: MTM1 n=270, DNM2 n=42, BIN1 n=4, TTN n=4, RYR1 n=12, other n=4, unknown n=108. The data presented are consistent with the current literature and the common understanding of a strong genotype/phenotype correlations in CNM, most notably the data supports the current knowledge that XLMTM is typically the most severe form of CNM. Additionally, we outline the ways in which the registry supports research, and, more generally, the importance of continuous investment and development to maintain the relevance of registries for all stakeholders. Further information on the registry and contact details are available on the registry website at www.mtmcnmregistry.org.

Paraspinal muscle morphology and composition in adolescent idiopathic scoliosis: A histological analysis

BACKGROUND

Adolescent idiopathic scoliosis (AIS) is a condition resulting in spinal deformity and tissue adaptation of the paraspinal muscles. Although prior studies have demonstrated asymmetries in fiber type and other energetic features of muscle on the concave side of the curve, muscle morphology, architecture, and composition have not been evaluated. Therefore, the purpose of this study was to compare differences in paraspinal muscle microarchitecture and composition between concave and convex sides of a scoliotic curve in individuals with AIS.

METHODS

Paraspinal muscle biopsies were obtained at the apex of the scoliotic curve in 29 individuals with AIS undergoing surgical deformity correction. Histological assays were performed to quantify fiber size, evidence of muscle degeneration and regeneration, and tissue composition (proportion of muscle, collagen, and fat). Differences between contralateral muscle samples were compared using two-tailed paired Student's t tests, and relationships between clinical characteristics (age and curve severity) and muscle characteristics were investigated using Pearson correlations.

RESULTS

Muscle fibers were significantly larger on the convex side of the curve apex (P = .001), but were lower than literature-based norms for healthy paraspinal muscle. There were no differences in amount of degeneration/regeneration (P = .490) or the proportion of muscle and collagen (P > .350) between the concave and convex sides, but high levels of collagen were observed. There was a trend toward higher fat content on the concave side (P = .074). Larger fiber size asymmetries were associated with greater age (r = .43, P = .046), and trended toward an association with greater curve severity (r = .40, P = .069).

CONCLUSIONS

This study demonstrates that although muscle fibers are larger on the convex side of the scoliotic curve in AIS, muscles on both sides are atrophic compared to non-scoliotic individuals, and demonstrate levels of collagen similar to severe degenerative spinal pathologies. These findings provide insight into biological maladaptations occurring in paraspinal muscle in the presence of AIS.

Caveolin-1 and dynamin-2 overexpression is associated with the progression of bladder cancer

Caveolae-mediated endocytosis regulates cell adhesion and growth in an anchorage-dependent manner. Studies of the endocytic function of caveolae have suggested a wide-ranging list of cargoes, including a number of receptors and extracellular proteins, ligands and nutrients from the extracellular matrix. Disruption of the processes of caveolae-mediated endocytosis mediated by signaling proteins is critical to cellular integrity. Caveolin-1 and dynamin-2 are the 2 major proteins associated with endocytotic function. Mechanistically, dynamin-2 has a co-equal role with caveolin-1 in terms of caveolae-derived endosome formation. Recent studies have revealed the pathological outcomes associated with the dysregulation of caveolin-1 and dynamin-2 expression. Increased expression levels of the gene for caveolin, Cav-1, resulting in augmented cellular metastasis and invasion, have been demonstrated in various types of cancer, and overexpression of the gene for dynamin-2, DNM2, has been associated with tumorigenesis in cervical, pancreatic and lung cancer. An increased expression of Cav-1 and DNM2 is known to be associated with the invasive behavior of cancer cells, and with cancer progression. Furthermore, it has been previously demonstrated that, in caveolar assembly and caveolae mediated endocytosis, Cav-1 interacts directly with DNM2 during the processes. Altered expression of the 2 genes is critical for the normal function of the cell. The expression patterns of Cav-1 and DNM2 have been previously examined in bladder cancer cell lines, and were each demonstrated to be overexpressed. In the present study, the expression levels of these 2 genes in bladder cancer samples were quantified. The gene expression levels of Cav-1 and DNM2 were identified to be increased 8.88- and 8.62-fold, respectively, in tumors compared with the normal controls. Furthermore, high-grade tumors exhibited significantly increased expression levels of Cav-1 and DNM2 (both P<0.0001) compared with the low-grade tumors. In addition, compared with normal control samples, the expression of the 2 genes in tumor samples was observed to be highly significant (P<0.0001), with a marked positive correlation identified for the tumors (Pearson's correlation coefficient, r=0.80 for the tumor samples vs. r=0.32 in the normal control samples). Taken together, the results of the present study demonstrated that the overexpression of Cav-1 and DNM2 genes, and a determination of their correlation coefficients, may be a potential risk factor for bladder cancer, in addition to other clinical factors.