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Aguti S, Gallus GN, Bianchi S, Salvatore S, Rubegni A, Berti G, Formichi P, De Stefano N, Malandrini A, Lopergolo D. Novel Biomarkers for Limb Girdle Muscular Dystrophy (LGMD). Cells 2024; 13:329. [PMID: 38391941 PMCID: PMC10886967 DOI: 10.3390/cells13040329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Revised: 01/22/2024] [Accepted: 02/02/2024] [Indexed: 02/24/2024] Open
Abstract
OBJECTIVE To identify novel biomarkers as an alternative diagnostic tool for limb girdle muscular dystrophy (LGMD). BACKGROUND LGMD encompasses a group of muscular dystrophies characterized by proximal muscles weakness, elevated CK levels and dystrophic findings on muscle biopsy. Heterozygous CAPN3 mutations are associated with autosomal dominant LGMD-4, while biallelic mutations can cause autosomal recessive LGMD-1. Diagnosis is currently often based on invasive methods requiring muscle biopsy or blood tests. In most cases Western blotting (WB) analysis from muscle biopsy is essential for a diagnosis, as muscle samples are currently the only known tissues to express the full-length CAPN3 isoform. METHODS We analyzed CAPN3 in a cohort including 60 LGMD patients. Selected patients underwent a complete neurological examination, electromyography, muscle biopsy, and skin biopsies for primary fibroblasts isolation. The amount of CAPN3 was evaluated by WB analysis in muscle and skin tissues. The total RNA isolated from muscle, fibroblast and urine was processed, and cDNA was used for qualitative analysis. The expression of CAPN3 was investigated by qRT-PCR. The CAPN3 3D structure has been visualized and analyzed using PyMOL. RESULTS Among our patients, seven different CAPN3 mutations were detected, of which two were novel. After sequencing CAPN3 transcripts from fibroblast and urine, we detected different CAPN3 isoforms surprisingly including the full-length transcript. We found comparable protein levels from fibroblasts and muscle tissue; in particular, patients harboring a novel CAPN3 mutation showed a 30% reduction in protein compared to controls from both tissues. CONCLUSIONS Our findings showed for the first time the presence of the CAPN3 full-length transcript in urine and skin samples. Moreover, we demonstrated surprisingly comparable CAPN3 protein levels between muscle and skin samples, thus allowing us to hypothesize the use of skin biopsy and probably of urine samples as an alternative less invasive method to assess the amount of CAPN3 when molecular diagnosis turns out to be inconclusive.
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Affiliation(s)
- Sara Aguti
- Department of Medicine, Surgery and Neurosciences, University of Siena, 53100 Siena, Italy; (S.A.); (G.N.G.); (S.B.); (S.S.); (G.B.); (P.F.); (N.D.S.); (A.M.)
- UOC Neurologia e Malattie Neurometaboliche, Azienda Ospedaliero-Universitaria Senese, Policlinico Le Scotte, Viale Bracci, 16, 53100 Siena, Italy
| | - Gian Nicola Gallus
- Department of Medicine, Surgery and Neurosciences, University of Siena, 53100 Siena, Italy; (S.A.); (G.N.G.); (S.B.); (S.S.); (G.B.); (P.F.); (N.D.S.); (A.M.)
- UOC Neurologia e Malattie Neurometaboliche, Azienda Ospedaliero-Universitaria Senese, Policlinico Le Scotte, Viale Bracci, 16, 53100 Siena, Italy
| | - Silvia Bianchi
- Department of Medicine, Surgery and Neurosciences, University of Siena, 53100 Siena, Italy; (S.A.); (G.N.G.); (S.B.); (S.S.); (G.B.); (P.F.); (N.D.S.); (A.M.)
- UOC Neurologia e Malattie Neurometaboliche, Azienda Ospedaliero-Universitaria Senese, Policlinico Le Scotte, Viale Bracci, 16, 53100 Siena, Italy
| | - Simona Salvatore
- Department of Medicine, Surgery and Neurosciences, University of Siena, 53100 Siena, Italy; (S.A.); (G.N.G.); (S.B.); (S.S.); (G.B.); (P.F.); (N.D.S.); (A.M.)
- UOC Neurologia e Malattie Neurometaboliche, Azienda Ospedaliero-Universitaria Senese, Policlinico Le Scotte, Viale Bracci, 16, 53100 Siena, Italy
| | - Anna Rubegni
- Molecular Medicine for Neurodegenerative and Neuromuscular Disease Unit, IRCCS Stella Maris Foundation, 56128 Pisa, Italy;
| | - Gianna Berti
- Department of Medicine, Surgery and Neurosciences, University of Siena, 53100 Siena, Italy; (S.A.); (G.N.G.); (S.B.); (S.S.); (G.B.); (P.F.); (N.D.S.); (A.M.)
- UOC Neurologia e Malattie Neurometaboliche, Azienda Ospedaliero-Universitaria Senese, Policlinico Le Scotte, Viale Bracci, 16, 53100 Siena, Italy
| | - Patrizia Formichi
- Department of Medicine, Surgery and Neurosciences, University of Siena, 53100 Siena, Italy; (S.A.); (G.N.G.); (S.B.); (S.S.); (G.B.); (P.F.); (N.D.S.); (A.M.)
- UOC Neurologia e Malattie Neurometaboliche, Azienda Ospedaliero-Universitaria Senese, Policlinico Le Scotte, Viale Bracci, 16, 53100 Siena, Italy
| | - Nicola De Stefano
- Department of Medicine, Surgery and Neurosciences, University of Siena, 53100 Siena, Italy; (S.A.); (G.N.G.); (S.B.); (S.S.); (G.B.); (P.F.); (N.D.S.); (A.M.)
- UOC Neurologia e Malattie Neurometaboliche, Azienda Ospedaliero-Universitaria Senese, Policlinico Le Scotte, Viale Bracci, 16, 53100 Siena, Italy
| | - Alessandro Malandrini
- Department of Medicine, Surgery and Neurosciences, University of Siena, 53100 Siena, Italy; (S.A.); (G.N.G.); (S.B.); (S.S.); (G.B.); (P.F.); (N.D.S.); (A.M.)
- UOC Neurologia e Malattie Neurometaboliche, Azienda Ospedaliero-Universitaria Senese, Policlinico Le Scotte, Viale Bracci, 16, 53100 Siena, Italy
| | - Diego Lopergolo
- Department of Medicine, Surgery and Neurosciences, University of Siena, 53100 Siena, Italy; (S.A.); (G.N.G.); (S.B.); (S.S.); (G.B.); (P.F.); (N.D.S.); (A.M.)
- UOC Neurologia e Malattie Neurometaboliche, Azienda Ospedaliero-Universitaria Senese, Policlinico Le Scotte, Viale Bracci, 16, 53100 Siena, Italy
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Belhassen I, Menassa R, Sakka S, Michel-Calemard L, Streichenberger N, Ayed DB, Bouattour N, Dammak M, Mhiri C. Mild limb girdle muscular dystrophy R9 phenotype caused by novel compound heterozygous FKRP gene mutation. Acta Myol 2023; 42:106-112. [PMID: 38406381 PMCID: PMC10883327 DOI: 10.36185/2532-1900-391] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Accepted: 12/19/2023] [Indexed: 02/27/2024]
Abstract
Fukutin-related protein (FKRP) mutations cause a broad spectrum of muscular dystrophies, from a relatively mild limb-girdle muscular dystrophy type 9 (LGMDR9) to severe congenital muscular dystrophy (CMD). This study aims to report two siblings belonging to a non-consanguineous Tunisian family harboring a novel compound heterozygous FKRP variant and presenting a mild LGDMR9 phenotype. For mutation screening, massive parallel sequencing was performed, followed by Sanger sequencing and multiplex ligation-dependent probe amplification (MLPA) to validate the existence of the discovered variants. The absence of alpha-dystroglycan was determined by immunohistochemistry. Brain and thigh magnetic resonance imaging (MRI) were performed to detect thigh and brain abnormalities. The two siblings had a late age at onset and clinical examination showed that the pelvic girdles had a predominantly proximal and symmetrical distribution of weakness without cardiac or respiratory involvement. They both had a modified Gardner-Medwin Walton Scale mGMWS grade of 4 and a modified Rankin Scale (mRS) score of 1. The DNA sequencing revealed a novel deletion of exons 2 and 3 in one allele and a missense mutation c.1364C > A, which has been reported to be responsible for congenital muscular dystrophy and mental retardation on the second allele. The simultaneous presence of the two variations in the two cases suggests that the variants segregate with the pathophysiology.
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Affiliation(s)
- Ikhlass Belhassen
- Laboratory of Neurogenetics, Parkinson Disease and Cerebrovascular Diseases (LR-12-SP-19), Habib Bourguiba University Hospital, University of Sfax, Tunisia
- Clinical Investigation Center, Habib Bourguiba University Hospital, Sfax, Tunisia
| | - Rita Menassa
- Service de Biochimie et Biologie Moléculaire, Centre de Biologie et Pathologie Est, Hospices Civils de Lyon, France
| | - Salma Sakka
- Laboratory of Neurogenetics, Parkinson Disease and Cerebrovascular Diseases (LR-12-SP-19), Habib Bourguiba University Hospital, University of Sfax, Tunisia
- Clinical Investigation Center, Habib Bourguiba University Hospital, Sfax, Tunisia
| | - Laurence Michel-Calemard
- Service de Biochimie et Biologie Moléculaire, Centre de Biologie et Pathologie Est, Hospices Civils de Lyon, France
| | - Nathalie Streichenberger
- Centre de Pathologie et Neuropathologie Est, Hospices Civils de Lyon; Université Claude Bernard Lyon1, Lyon, France
| | - Dorra Ben Ayed
- Laboratory of Neurogenetics, Parkinson Disease and Cerebrovascular Diseases (LR-12-SP-19), Habib Bourguiba University Hospital, University of Sfax, Tunisia
- Clinical Investigation Center, Habib Bourguiba University Hospital, Sfax, Tunisia
| | - Nadia Bouattour
- Laboratory of Neurogenetics, Parkinson Disease and Cerebrovascular Diseases (LR-12-SP-19), Habib Bourguiba University Hospital, University of Sfax, Tunisia
- Clinical Investigation Center, Habib Bourguiba University Hospital, Sfax, Tunisia
| | - Mariem Dammak
- Laboratory of Neurogenetics, Parkinson Disease and Cerebrovascular Diseases (LR-12-SP-19), Habib Bourguiba University Hospital, University of Sfax, Tunisia
- Clinical Investigation Center, Habib Bourguiba University Hospital, Sfax, Tunisia
| | - Chokri Mhiri
- Laboratory of Neurogenetics, Parkinson Disease and Cerebrovascular Diseases (LR-12-SP-19), Habib Bourguiba University Hospital, University of Sfax, Tunisia
- Clinical Investigation Center, Habib Bourguiba University Hospital, Sfax, Tunisia
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Motta IA, Gouveia ML, Braga AP, Andrade RS, Montenegro MF, Gurgel SN, Albuquerque KM, Souto PA, Cardoso FP, Araujo JS, Pinheiro MC, da Silva CE, Gurgel PA, Feder D, Perez MM, da Veiga GL, Alves BC, Fonseca FL, Carvalho AA. High Prevalence of a c.5979dupA Variant in the Dysferlin Gene (DYSF) in Individuals from a Semiarid Region of Brazil. Curr Genomics 2023; 24:330-335. [PMID: 38235354 PMCID: PMC10790335 DOI: 10.2174/0113892029257856231013115036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Revised: 07/04/2023] [Accepted: 09/20/2023] [Indexed: 01/19/2024] Open
Abstract
Background Dysferlinopathies represent a group of limb girdle or distal muscular dystrophies with an autosomal-recessive inheritance pattern resulting from the presence of pathogenic variants in the dysferlin gene (DYSF). Objective In this work, we describe a population from a small city in Brazil carrying the c.5979dupA pathogenic variant of DYSF responsible for limb girdle muscular dystrophy type 2R and distal muscular dystrophy. Methods Genotyping analyses were performed by qPCR using customized probe complementary to the region with the duplication under analysis in the DYSF. Results A total of 104 individuals were examined. c.5979dupA was identified in 48 (46.15%) individuals. Twenty-three (22%) were homozygotes, among whom 13 (56.5%) were female. A total of 91.3% (21) of homozygous individuals had a positive family history, and seven (30.4%) reported consanguineous marriages. Twenty-five (24%) individuals were heterozygous (25.8±16 years) for the same variant, among whom 15 (60%) were female. The mean CK level was 697 IU for homozygotes, 140.5 IU for heterozygotes and 176 IU for wild-type homo-zygotes. The weakness distribution pattern showed 17.3% of individuals with a proximal pattern, 13% with a distal pattern and 69.6% with a mixed pattern. Fatigue was present in 15 homozygotes and one heterozygote. Conclusion The high prevalence of this variant in individuals from this small community can be explained by a possible founder effect associated with historical, geographical and cultural aspects.
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Affiliation(s)
- Isabella A. Motta
- Neurorehabilitation service at Lauro Wanderley University Hospital, João Pessoa, Paraíba, Brazil
| | - Maria L.A. Gouveia
- Neurorehabilitation service at Lauro Wanderley University Hospital, João Pessoa, Paraíba, Brazil
| | - Ana P.M. Braga
- Neurorehabilitation service at Lauro Wanderley University Hospital, João Pessoa, Paraíba, Brazil
| | - Rafael S. Andrade
- Neurorehabilitation service at Lauro Wanderley University Hospital, João Pessoa, Paraíba, Brazil
| | - Mayra F.F. Montenegro
- Neurorehabilitation service at Lauro Wanderley University Hospital, João Pessoa, Paraíba, Brazil
| | - Sandra N. Gurgel
- Neurorehabilitation service at Lauro Wanderley University Hospital, João Pessoa, Paraíba, Brazil
| | - Keila M.F. Albuquerque
- Neurorehabilitation service at Lauro Wanderley University Hospital, João Pessoa, Paraíba, Brazil
| | - Priscilla A.N.G. Souto
- Neurorehabilitation service at Lauro Wanderley University Hospital, João Pessoa, Paraíba, Brazil
| | - Flávia P.B.F. Cardoso
- Neurorehabilitation service at Lauro Wanderley University Hospital, João Pessoa, Paraíba, Brazil
| | - Joseane S. Araujo
- Neurorehabilitation service at Lauro Wanderley University Hospital, João Pessoa, Paraíba, Brazil
| | - Mirella C.L. Pinheiro
- Neurorehabilitation service at Lauro Wanderley University Hospital, João Pessoa, Paraíba, Brazil
| | - Carlos E.P. da Silva
- Neurorehabilitation service at Lauro Wanderley University Hospital, João Pessoa, Paraíba, Brazil
| | - Pamella A.S. Gurgel
- Neurorehabilitation service at Lauro Wanderley University Hospital, João Pessoa, Paraíba, Brazil
| | - David Feder
- Department of Pharmacology, Centro Universitário FMABC, Santo André, SP, Brazil
| | - Matheus M. Perez
- Clinical Analysis Laboratory, Centro Universitário FMABC, Santo André, SP, Brazil
| | - Glaucia L. da Veiga
- Clinical Analysis Laboratory, Centro Universitário FMABC, Santo André, SP, Brazil
| | - Beatriz C.A. Alves
- Clinical Analysis Laboratory, Centro Universitário FMABC, Santo André, SP, Brazil
| | | | - Alzira A.S. Carvalho
- Department of Neurosciences – Neuromuscular service, Centro Universitário FMABC, Santo André, SP, Brazil
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Fontelonga T, Hall AJ, Brown JL, Jung YL, Alexander MS, Dominov JA, Mouly V, Vieira N, Zatz M, Vainzof M, Gussoni E. Tetraspanin CD82 Associates with Trafficking Vesicle in Muscle Cells and Binds to Dysferlin and Myoferlin. Adv Biol (Weinh) 2023; 7:e2300157. [PMID: 37434585 PMCID: PMC10784410 DOI: 10.1002/adbi.202300157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Revised: 06/26/2023] [Indexed: 07/13/2023]
Abstract
Tetraspanins organize protein complexes at the cell membrane and are responsible for assembling diverse binding partners in changing cellular states. Tetraspanin CD82 is a useful cell surface marker for prospective isolation of human myogenic progenitors and its expression is decreased in Duchenne muscular dystrophy (DMD) cell lines. The function of CD82 in skeletal muscle remains elusive, partly because the binding partners of this tetraspanin in muscle cells have not been identified. CD82-associated proteins are sought to be identified in human myotubes via mass spectrometry proteomics, which identifies dysferlin and myoferlin as CD82-binding partners. In human dysferlinopathy (Limb girdle muscular dystrophy R2, LGMDR2) myogenic cell lines, expression of CD82 protein is near absent in two of four patient samples. In the cell lines where CD82 protein levels are unaffected, increased expression of the ≈72 kDa mini-dysferlin product is identified using an antibody recognizing the dysferlin C-terminus. These data demonstrate that CD82 binds dysferlin/myoferlin in differentiating muscle cells and its expression can be affected by loss of dysferlin in human myogenic cells.
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Affiliation(s)
| | - Arielle J. Hall
- Division of Genetics and Genomics, Boston Children’s Hospital, MA, USA
| | - Jaedon L. Brown
- Division of Genetics and Genomics, Boston Children’s Hospital, MA, USA
| | - Youngsook L. Jung
- Division of Genetics and Genomics, Boston Children’s Hospital, MA, USA
| | - Matthew S. Alexander
- Department of Pediatrics, Division of Neurology at Children’s of Alabama, University of Alabama at Birmingham, Birmingham, AL, USA
- Department of Genetics, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Janice A. Dominov
- Department of Neurology, University of Massachusetts Worcester, MA, USA
| | | | | | - Mayana Zatz
- Human Genome and Stem Cells Research Center, Biosciences Institute, University of São Paulo, São Paulo, BR
| | - Mariz Vainzof
- Human Genome and Stem Cells Research Center, Biosciences Institute, University of São Paulo, São Paulo, BR
| | - Emanuela Gussoni
- Division of Genetics and Genomics, Boston Children’s Hospital, MA, USA
- The Stem Cell Program, Boston Children’s Hospital, Boston, MA, USA
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Zídková J, Kramářová T, Kopčilová J, Réblová K, Haberlová J, Mazanec R, Voháňka S, Gřegořová A, Langová M, Honzík T, Šoukalová J, Ošlejšková H, Solařová P, Vyhnálková E, Fajkusová L. Genetic findings in Czech patients with limb girdle muscular dystrophy. Clin Genet 2023; 104:542-553. [PMID: 37526466 DOI: 10.1111/cge.14407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Revised: 07/03/2023] [Accepted: 07/13/2023] [Indexed: 08/02/2023]
Abstract
Limb girdle muscular dystrophies (LGMD) are a genetically heterogeneous group of muscular dystrophies. The study presents an overview of molecular characteristics of a large cohort of LGMD patients who are representative of the Czech LGMD population. We present 226 LGMD probands in which 433 mutant alleles carrying 157 different variants with a supposed pathogenic effect were identified. Fifty-four variants have been described only in the Czech LGMD population so far. LGMD R1 caplain3-related is the most frequent subtype of LGMD involving 53.1% of patients with genetically confirmed LGMD, followed by LGMD R9 FKRP-related (11.1%), and LGMD R12 anoctamin5-related (7.1%). If we consider identified variants, then all but five were small-scale variants. One large gene deletion was identified in the LAMA2 gene and two deletions in each of CAPN3 and SGCG. We performed comparison our result with other published studies. The results obtained in the Czech LGMD population clearly differ from the outcome of other LGMD populations in two aspects-we have a more significant proportion of patients with LGMD R1 calpain3-related and a smaller proportion of LGMD R2 dysferlin-related.
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Affiliation(s)
- Jana Zídková
- Centre of Molecular Biology and Genetics, University Hospital Brno and Masaryk University, Brno, Czech Republic
| | - Tereza Kramářová
- Centre of Molecular Biology and Genetics, University Hospital Brno and Masaryk University, Brno, Czech Republic
| | - Johana Kopčilová
- Centre of Molecular Biology and Genetics, University Hospital Brno and Masaryk University, Brno, Czech Republic
| | - Kamila Réblová
- Centre of Molecular Biology and Genetics, University Hospital Brno and Masaryk University, Brno, Czech Republic
| | - Jana Haberlová
- Department of Paediatric Neurology, 2nd Faculty of Medicine, Charles University in Prague and Motol University Hospital, Praha, Czech Republic
| | - Radim Mazanec
- Department of Neurology, 2nd Faculty of Medicine, Charles University and Motol University Hospital, Prague, Czech Republic
| | - Stanislav Voháňka
- Department of Neurology, University Hospital Brno, Brno, Czech Republic
| | - Andrea Gřegořová
- Department of Medical Genetics, University Hospital Ostrava, Ostrava, Czech Republic
| | - Martina Langová
- Department of Medical Genetics, Thomayer University Hospital, Praha, Czech Republic
| | - Tomáš Honzík
- Department of Paediatrics and Inherited Metabolic Disorders, First Faculty of Medicine, Charles University and General University Hospital in Prague, Praha, Czech Republic
| | - Jana Šoukalová
- Institute of Medical Genetics and Genomics, University Hospital Brno and Masaryk University, Brno, Czech Republic
| | - Hana Ošlejšková
- Department of Child Neurology, University Hospital Brno and Masaryk University, Brno, Czech Republic
| | - Pavla Solařová
- Department of Medical Genetics, University Hospital Hradec Králové, Hradec Králové, Czech Republic
| | - Emílie Vyhnálková
- Department of Biology and Medical Genetics, 2nd Faculty of Medicine, Charles University and Motol University Hospital, Prague, Czech Republic
| | - Lenka Fajkusová
- Centre of Molecular Biology and Genetics, University Hospital Brno and Masaryk University, Brno, Czech Republic
- Laboratory of Functional Genomics and Proteomics, National Centre for Biomolecular Research, Faculty of Science, Masaryk University, Brno, Czech Republic
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Kilroy EA, Burris R, Javelosa E, Waits J, Lek A, Rodgers R, Opgenorth H, Hesterlee S. The Muscular Dystrophy Association's neuroMuscular ObserVational Research Data Hub (MOVR): Design, Methods, and Initial Observations. J Neuromuscul Dis 2023; 10:365-380. [PMID: 36911943 DOI: 10.3233/jnd-221551] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/12/2023]
Abstract
BACKGROUND Neuromuscular disease (NMD) research is experiencing tremendous growth as a result of progress in diagnostics and therapeutics yet there continues to be a significant clinical data shortage for these rare diseases. To maximize the development and impact of new therapies, the Muscular Dystrophy Association (MDA) created the neuroMuscular ObserVational Research Data Hub (MOVR) as an observational research study that collects disease-specific measures from individuals living with NMDs in the United States. OBJECTIVE This manuscript provides a description of MOVR, participants enrolled in MOVR, and longitudinal data availability. METHODS MOVR collects longitudinal data from individuals diagnosed with ALS, BMD, DMD, FSHD, LGMD, Pompe disease, or SMA, and who are seen for care at a participating MDA Care Center. Data are entered from medical records into standardized electronic case report forms (eCRFs). These eCRFs capture participants' demographics, diagnostic journeys, clinical visits, and discontinuation from the study. RESULTS From January 2019 to May 2022, MOVR collected data from 50 participating care centers and 1,957 participants. Data from 1,923 participants who participated in MDA's pilot registry were migrated into MOVR, creating a total of 3,880 participants in MOVR. Initial analysis of aggregated data demonstrated that 91% of eCRFs were complete. Forty-three percent of participants had 3 or more encounters and 50% of all encounters were 5 months or less from the previous encounter. DISCUSSION As a centralized data hub for multiple NMDs, MOVR serves as a platform that can be used to inform disease understanding, guide clinical trial design, and accelerate drug development for NMDs.
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Affiliation(s)
| | | | | | | | - Angela Lek
- Muscular Dystrophy Association, Chicago, IL, USA
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Yogev Y, Shorer Z, Koifman A, Wormser O, Drabkin M, Halperin D, Dolgin V, Proskorovski-Ohayon R, Hadar N, Davidov G, Nudelman H, Zarivach R, Shelef I, Perez Y, Birk OS. Limb girdle muscular disease caused by HMGCR mutation and statin myopathy treatable with mevalonolactone. Proc Natl Acad Sci U S A 2023; 120:e2217831120. [PMID: 36745799 DOI: 10.1073/pnas.2217831120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Abstract
Myopathy is the main adverse effect of the widely prescribed statin drug class. Statins exert their beneficial effect by inhibiting HMG CoA-reductase, the rate-controlling enzyme of the mevalonate pathway. The mechanism of statin myopathy is yet to be resolved, and its treatment is insufficient. Through homozygosity mapping and whole exome sequencing, followed by functional analysis using confocal microscopy and biochemical and biophysical methods, we demonstrate that a distinct form of human limb girdle muscular disease is caused by a pathogenic homozygous loss-of-function missense mutation in HMG CoA reductase (HMGCR), encoding HMG CoA-reductase. We biochemically synthesized and purified mevalonolactone, never administered to human patients before, and establish the safety of its oral administration in mice. We then show that its oral administration is effective in treating a human patient with no significant adverse effects. Furthermore, we demonstrate that oral mevalonolactone resolved statin-induced myopathy in mice. We conclude that HMGCR mutation causes a late-onset severe progressive muscular disease, which shows similar features to statin-induced myopathy. Our findings indicate that mevalonolactone is effective both in the treatment of hereditary HMGCR myopathy and in a murine model of statin myopathy. Further large clinical trials are in place to enable the clinical use of mevalonolactone both in the rare orphan disease and in the more common statin myopathy.
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Katz M, Waddell LB, Yuen M, Bryen SJ, Oates E, Garton FC, Robertson T, Henderson RD, Cooper ST, McCombe PA. Case report: Adult-onset limb girdle muscular dystrophy in sibling pair due to novel homozygous LAMA2 missense variant. Front Neurol 2023; 14:1055639. [PMID: 36779065 PMCID: PMC9911805 DOI: 10.3389/fneur.2023.1055639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Accepted: 01/12/2023] [Indexed: 01/28/2023] Open
Abstract
Recessive pathogenic variants in the laminin subunit alpha 2 (LAMA2) gene cause a spectrum of disease ranging from severe congenital muscular dystrophy to later-onset limb girdle muscular dystrophy (LGMDR23). The phenotype of LGMDR23 is characterized by slowly progressive proximal limb weakness, contractures, raised creatine kinase, and sometimes distinctive cerebral white matter changes and/or epilepsy. We present two siblings, born to consanguineous parents, who developed adult-onset LGMDR23 associated with typical cerebral white matter changes and who both later developed dementia. The male proband also had epilepsy and upper motor neuron signs when he presented at age 72. Merosin immunohistochemistry and Western blot on muscle biopsies taken from both subjects was normal. Whole exome sequencing revealed a previously unreported homozygous missense variant in LAMA2 [Chr6(GRCh38):g.129297734G>A; NM_000426.3:c.2906G>A; p.(Cys969Tyr)] in the proband. The same homozygous LAMA2 variant was confirmed by Sanger sequencing in the proband's affected sister. These findings expand the genotypic and phenotypic spectrum of LGMDR23.
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Affiliation(s)
- Matthew Katz
- Department of Neurology, Royal Brisbane and Women's Hospital, Herston, QLD, Australia,*Correspondence: Matthew Katz ✉
| | - Leigh B. Waddell
- Kids Research, Kids Neuroscience Centre, The Children's Hospital at Westmead, Sydney, NSW, Australia,Discipline of Child and Adolescent Health, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Michaela Yuen
- Kids Research, Kids Neuroscience Centre, The Children's Hospital at Westmead, Sydney, NSW, Australia,Discipline of Child and Adolescent Health, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Samantha J. Bryen
- Kids Research, Kids Neuroscience Centre, The Children's Hospital at Westmead, Sydney, NSW, Australia,Discipline of Child and Adolescent Health, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Emily Oates
- School of Biotechnology and Biomolecular Sciences, University of New South Wales, Sydney, NSW, Australia
| | - Fleur C. Garton
- Institute for Molecular Biosciences, The University of Queensland, St Lucia, QLD, Australia
| | - Thomas Robertson
- Department of Pathology, Royal Brisbane and Women's Hospital, Herston, QLD, Australia,School of Biomedical Sciences, The University of Queensland, St Lucia, QLD, Australia
| | | | - Sandra T. Cooper
- Kids Research, Kids Neuroscience Centre, The Children's Hospital at Westmead, Sydney, NSW, Australia,Discipline of Child and Adolescent Health, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia,The Children's Medical Research Institute, Sydney, NSW, Australia
| | - Pamela A. McCombe
- Department of Neurology, Royal Brisbane and Women's Hospital, Herston, QLD, Australia,Centre for Clinical Research, The University of Queensland, Herston, QLD, Australia
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9
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Cosemans G, Merckx C, De Bleecker JL, De Paepe B. Inducible Heat Shock Protein 70 Levels in Patients and the mdx Mouse Affirm Regulation during Skeletal Muscle Regeneration in Muscular Dystrophy. Front Biosci (Schol Ed) 2022; 14:19. [PMID: 36137979 DOI: 10.31083/j.fbs1403019] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Revised: 05/16/2022] [Accepted: 05/26/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Stress-inducible heat shock protein 70 (HSP70) is both a protective chaperone involved in protein homeostasis and an immune regulator. In both capacities, HSP70 has been implicated in muscle disorders, yet with fragmented and differing results. In this study we aimed to compare results obtained in the mouse model for the severest form of muscular dystrophy (MD) equivalent to Duchenne MD, termed the mdx mouse, with results obtained in human MD. METHODS Skeletal muscle and serum samples were obtained from 11 healthy controls, 11 fully characterized patients diagnosed with Becker MD and limb girdle MD (LGMD), and six muscle disease controls. In addition, muscle extracts were prepared from tibialis anterior of mdx and control mice at ages 4, 8 and 12 weeks. The HSP70 levels were quantified using RT-PCR, western blotting and protein arrays, and localized in muscle tissue sections using double immunofluorescence. RESULTS We found selective and significant 2.2-fold upregulation of HSP70 protein in mdx tibialis muscle at the earliest disease phase only. In LGMD and Becker MD patients, HSP70 protein levels were not significantly different from those of healthy muscle and serum. HSP70 was localized to regenerating muscle fibers both in mouse and human MD skeletal muscle tissues. Toll-like receptor (TLR) 2 and TLR4 expression was moderately increased on the sarcolemma in MD muscle, yet protein levels were not significantly different from normal controls. CONCLUSIONS HSP70 upregulation in MD appears disease stage-dependent, marking the phase of most active muscle regeneration in the mdx mouse. We postulate that well-timed supportive therapeutic interventions with HSP70 agonists could potentially improve muscle tissue's regenerative capacities in MD, attenuating loss of muscle mass while we await gene therapies to become more widely available.
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Affiliation(s)
- Gwenny Cosemans
- Laboratory for Neuropathology, Department of Neurology, Ghent University, 9000 Ghent, Belgium
- Ghent-Fertility and Stem cell Team (G-FaST), Department of Human Structure and Repair, Ghent University, 9000 Ghent, Belgium
| | - Caroline Merckx
- Laboratory for Neuropathology, Department of Neurology, Ghent University, 9000 Ghent, Belgium
| | - Jan L De Bleecker
- Laboratory for Neuropathology, Department of Neurology, Ghent University, 9000 Ghent, Belgium
- Neuromuscular Reference Center, Ghent University Hospital, 9000 Ghent, Belgium
| | - Boel De Paepe
- Laboratory for Neuropathology, Department of Neurology, Ghent University, 9000 Ghent, Belgium
- Neuromuscular Reference Center, Ghent University Hospital, 9000 Ghent, Belgium
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10
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Reash NF, James MK, Alfano LN, Mayhew AG, Jacobs M, Iammarino MA, Holsten S, Sakamoto C, Tateishi T, Yajima H, Duong T, de Wolf B, Gee R, Bharucha-Goebel DX, Bravver E, Mori-Yoshimura M, Bushby K, Rufibach LE, Straub V, Lowes LP. Comparison of strength testing modalities in dysferlinopathy. Muscle Nerve 2022; 66:159-166. [PMID: 35506767 DOI: 10.1002/mus.27570] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Revised: 04/29/2022] [Accepted: 05/02/2022] [Indexed: 11/10/2022]
Abstract
INTRODUCTION/AIMS Dysferlinopathy demonstrates heterogeneity in muscle weakness between patients, which can progress at different rates over time. Changing muscle strength due to disease progression or from an investigational product is associated with changing functional ability. The purpose of this study was to compare three methods of strength testing used in the Clinical Outcome Study (COS) for dysferlinopathy to understand which method and which muscle groups were most sensitive to change over time. METHODS Patients were evaluated at each study visit using functional scales, manual muscle testing, and handheld dynamometry (HHD) at all 15 sites. A fixed-frame system (Fixed) was used at a subset of seven sites. Screening and baseline visits were evaluated for reliability. Data over a 1-year period were analyzed to determine sensitivity to change among strength modalities and individual muscle groups. RESULTS HHD and Fixed captured significant change across 1 year in summed muscle strength score of four muscle groups (P < .01). Strength summed scores were significantly correlated with functional scales (rho = 0.68-0.92, P < .001). Individual muscle groups, however, showed high levels of variability between visits. DISCUSSION Although both HHD and Fixed demonstrate change over 12 months, HHD is a less expensive option that provides data on a continuous scale and may be easier to implement. Due to variability in strength measures, researchers should carefully consider use of strength testing as an outcome and may wish to select functional measures with less variability as clinical trial endpoints.
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Affiliation(s)
- Natalie F Reash
- The Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, Ohio
| | - Meredith K James
- The John Walton Muscular Dystrophy Research Centre, Translational and Clinical Research Institute, Newcastle University and Newcastle Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Lindsay N Alfano
- The Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, Ohio
| | - Anna G Mayhew
- The John Walton Muscular Dystrophy Research Centre, Translational and Clinical Research Institute, Newcastle University and Newcastle Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Marni Jacobs
- Center for Translational Science, Division of Biostatistics and Study Methodology, Children's National Health System, Washington, DC.,Pediatrics, Epidemiology and Biostatistics, George Washington University, Washington, DC
| | - Megan A Iammarino
- The Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, Ohio
| | - Scott Holsten
- Neuroscience Institute, Carolinas Neuromuscular/ALS-MDA Center, Carolinas HealthCare System, Charlotte, North Carolina
| | - Chikako Sakamoto
- Department of Physical Rehabilitation, National Center Hospital, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Takayuki Tateishi
- Department of Physical Rehabilitation, National Center Hospital, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Hiroyuki Yajima
- Department of Physical Rehabilitation, National Center Hospital, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Tina Duong
- Cooperative International Neuromuscular Research Group, Children's National Health System, Washington, DC.,Lucile Salter Packard Children's Hospital at Stanford, Neurology, Palo Alto, California.,Department of Neurology and Neurological Sciences, Stanford University School of Medicine, Stanford, California
| | - Brittney de Wolf
- Cooperative International Neuromuscular Research Group, Children's National Health System, Washington, DC
| | - Richard Gee
- Lucile Salter Packard Children's Hospital at Stanford, Neurology, Palo Alto, California
| | - Diana X Bharucha-Goebel
- Department of Neurology Children's National Health System, Washington, DC.,National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, Maryland
| | - Elena Bravver
- Neuroscience Institute, Carolinas Neuromuscular/ALS-MDA Center, Carolinas HealthCare System, Charlotte, North Carolina
| | - Madoka Mori-Yoshimura
- Department of Neurology, National Center Hospital, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Kate Bushby
- The John Walton Muscular Dystrophy Research Centre, Translational and Clinical Research Institute, Newcastle University and Newcastle Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
| | | | - Volker Straub
- The John Walton Muscular Dystrophy Research Centre, Translational and Clinical Research Institute, Newcastle University and Newcastle Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Linda P Lowes
- The Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, Ohio
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11
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Revsbech KL, Rudolf K, Sheikh AM, Khawajazada T, de Stricker Borch J, Dahlqvist JR, Løkken N, Witting N, Vissing J. Axial muscle involvement in patients with Limb girdle muscular dystrophy type R9. Muscle Nerve 2022; 65:405-414. [PMID: 35020210 DOI: 10.1002/mus.27491] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Revised: 01/06/2022] [Accepted: 01/06/2022] [Indexed: 11/05/2022]
Abstract
INTRODUCTION/AIMS Limb girdle muscular dystrophy type R9 (LGMDR9) is characterized by progressive weakness of the shoulder and hip girdles. Involvement of proximal extremity muscles is well-described whereas information about axial muscle involvement is lacking. It is important to recognize the involvement of axial muscles to understand functional challenges for the patients. The aim of this study was to investigate the involvement of axial and leg muscles in patients with LGMDR9. METHODS This observational, cross-sectional study investigated fat replacement of axial and leg muscles in 14 patients with LGMDR9 and 13 matched, healthy controls using quantitative MRI (Dixon technique). We investigated paraspinal muscles at three levels, psoas major at the lumbar level, and leg muscles in the thigh and calf. Trunk strength was assessed with stationary dynamometry and manual muscle tests. RESULTS Patients with LGMDR9 had significantly increased fat replacement of all investigated axial muscles compared with healthy controls (p < 0.05). Trunk extension and flexion strength were significantly reduced in patients. Extension strength correlated negatively with mean fat fraction of paraspinal muscles. Fat fractions of all investigated leg muscles were significantly increased vs. controls, with the posterior thigh muscles being the most severely affected. DISCUSSION Patients with LGMDR9 have severe involvement of their axial muscles and correspondingly have reduced trunk extension and flexion strength. Our findings define the axial muscles as some of the most severely involved muscle groups in LGMDR9, which should be considered in the clinical management of the disorder and monitoring of disease progression.
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Affiliation(s)
- Karoline Lolk Revsbech
- Copenhagen Neuromuscular Center, Department of Neurology, University of Copenhagen, Rigshospitalet, Copenhagen, Denmark
| | - Karen Rudolf
- Copenhagen Neuromuscular Center, Department of Neurology, University of Copenhagen, Rigshospitalet, Copenhagen, Denmark
| | - Aisha Munawar Sheikh
- Copenhagen Neuromuscular Center, Department of Neurology, University of Copenhagen, Rigshospitalet, Copenhagen, Denmark
| | - Tahmina Khawajazada
- Copenhagen Neuromuscular Center, Department of Neurology, University of Copenhagen, Rigshospitalet, Copenhagen, Denmark
| | - Josefine de Stricker Borch
- Copenhagen Neuromuscular Center, Department of Neurology, University of Copenhagen, Rigshospitalet, Copenhagen, Denmark
| | - Julia Rebecka Dahlqvist
- Copenhagen Neuromuscular Center, Department of Neurology, University of Copenhagen, Rigshospitalet, Copenhagen, Denmark
| | - Nicoline Løkken
- Copenhagen Neuromuscular Center, Department of Neurology, University of Copenhagen, Rigshospitalet, Copenhagen, Denmark
| | - Nanna Witting
- Copenhagen Neuromuscular Center, Department of Neurology, University of Copenhagen, Rigshospitalet, Copenhagen, Denmark
| | - John Vissing
- Copenhagen Neuromuscular Center, Department of Neurology, University of Copenhagen, Rigshospitalet, Copenhagen, Denmark
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12
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Richardson M, Mayhew A, Muni-Lofra R, Murphy LB, Straub V. Prevalence of Pain within Limb Girdle Muscular Dystrophy R9 and Implications for Other Degenerative Diseases. J Clin Med 2021; 10:5517. [PMID: 34884219 DOI: 10.3390/jcm10235517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Revised: 11/19/2021] [Accepted: 11/21/2021] [Indexed: 11/17/2022] Open
Abstract
Our primary aim was to establish the prevalence of pain within limb girdle muscular dystrophy R9 (LGMDR9). As part of the Global FKRP Registry, patients are asked to complete the Short Form McGill Pain Questionnaire (SF-MPQ) annually. We used the results of this questionnaire to determine individuals’ maximum pain score and total pain score and examined overall pain intensity and associations between pain intensity and LGMDR9 genotypes, age, and ambulatory status. We also considered the pain descriptors used and pain progression over time. Of the 502 patients, 87% reported current pain and 25% reported severe current pain. We found no associations in pain severity between the different genotypes of LGMDR9. However, we did find statistically significant associations between pain severity and ambulatory status and between our paediatric and adult populations. We found pain descriptors to be more common words that one may associate with non-neural pain, and we found that a significant number of individuals (69%) reported a fluctuating pain pattern over time. We concluded that pain should be considered a significant issue among individuals with LGMDR9 requiring management. Implications regarding assessment of pain for other degenerative diseases are discussed.
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13
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Gidaro T, Gasnier E, Annoussamy M, Vissing J, Attarian S, Mozaffar T, Iyadurai S, Wagner KR, Vissière D, Walker G, Shukla SS, Servais L. Home-based gait analysis as an exploratory endpoint during a multicenter phase 1 trial in limb girdle muscular dystrophy type R2 and facioscapulohumeral muscular dystrophy. Muscle Nerve 2021; 65:237-242. [PMID: 34687225 DOI: 10.1002/mus.27446] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Revised: 10/17/2021] [Accepted: 10/18/2021] [Indexed: 01/20/2023]
Abstract
INTRODUCTION/AIMS Limb girdle muscular dystrophy type 2B (LGMDR2) and facioscapulohumeral muscular dystrophy (FSHD) are genetic muscular dystrophies with an increasing number of potential therapeutic approaches. The aim of this study is to report the data of exploratory digital outcomes extracted from wearable magneto-inertial sensors used in a non-controlled environment for ambulant patients with FSHD and LGMDR2 in a short-term, multicenter clinical study. METHODS Digital outcomes (stride length, stride speed, and walk parameters in a non-controlled environment) were used as exploratory outcomes in the open-label study ATYR1940-C-004 in ambulant patients during the 3 mo of ATYR1940 treatment and 1 mo of follow-up. Activity and gait variables were calculated from the data recorded in 30-day sub-periods using the sensors. For each sub-period, activity and gait parameters were compared between FSHD and LGMDR2 patients. Change from baseline over the 4-mo study period was assessed. RESULTS Ten patients (5 FSHD, 5 LGMDR2) were ambulant and compliant for analysis. Gait parameters, but not activity variables, were significantly lower in LGMDR2 compared to FSHD patients at baseline. Longitudinal analyses showed a slight but significant decrease in stride speed at month 4 for all subjects. Activity variables such as total number of strides per day were highly variable from month to month in individual patients, and no visit effects were found for this variable. DISCUSSION The present study suggests that home-recorded stride speed constitutes a precise and sensitive outcome in ambulant patients with FSHD and LGMDR2.
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Affiliation(s)
| | | | | | - John Vissing
- Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Shahram Attarian
- Reference Center for Neuromuscular Disorders and ALS CHU la Timon, Marseille, France
| | | | - Stanley Iyadurai
- Department of Neurology, Johns Hopkins All Children's Hospital, Saint-Pétersbourg, Florida, USA
| | - Kathryn R Wagner
- Kennedy Krieger Institute, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | | | | | | | - Laurent Servais
- I-Motion, Institute of Myology, Paris, France.,Division of Child Neurology, Reference Center for Neuromuscular Diseases, Department of Paediatrics, University Hospital Liège & University of Liège, Liège, Belgium.,MDUK Oxford Neuromuscular Centre, University of Oxford, Oxford, UK
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14
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Abstract
Cells maintain their cytosolic calcium (Ca2+) in nanomolar range and use controlled increase in Ca2+ for intracellular signaling. With the extracellular Ca2+ in the millimolar range, there is a steep Ca2+ gradient across the plasma membrane (PM). Thus, injury that damages PM, leads to a cytosolic Ca2+ overload, which helps activate PM repair (PMR) response. However, in order to survive, the cells must cope with the Ca2+ overload. In a recent study (Chandra et al. J Cell Biol, doi: 10.1083/jcb.202006035) we have examined how cells cope with injury-induced cytosolic Ca2+ overload. By monitoring Ca2+ dynamics in the cytosol and endoplasmic reticulum (ER), we found that PM injury-triggered increase in cytosolic Ca2+ is taken up by the ER. Pharmacological inhibition of ER Ca2+ uptake interferes with this process and compromises the repair ability of the injured cells. Muscle cells from patients and mouse model for the muscular dystrophy showed that lack of Anoctamin 5 (ANO5)/Transmembrane protein 16E (TMEM16E), an ER-resident putative Ca2+-activated chloride channel (CaCC), are poor at coping with cytosolic Ca2+ overload. Pharmacological inhibition of CaCC and lack of ANO5, both prevent Ca2+ uptake into ER. These studies identify a requirement of Cl- uptake by the ER in sequestering injury-triggered cytosolic Ca2+ increase in the ER. Further, these studies show that ER helps injured cells cope with Ca2+ overload during PMR, lack of which contributes to muscular dystrophy due to mutations in the ANO5 protein.
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Affiliation(s)
- Goutam Chandra
- Center of Genetic Medicine Research, Children's National Research Institute, 111 Michigan Av NW, Washington, DC 20010, Washington, DC.,Inter University Centre for Biomedical Research & Super Specialty Hospital, Mahatma Gandhi University Campus at Thalappady, Kottayam, Kerala, India
| | - Davi A G Mázala
- Center of Genetic Medicine Research, Children's National Research Institute, 111 Michigan Av NW, Washington, DC 20010, Washington, DC.,Department of Kinesiology, College of Health Professions, Towson University, Maryland, U.S.A
| | - Jyoti K Jaiswal
- Center of Genetic Medicine Research, Children's National Research Institute, 111 Michigan Av NW, Washington, DC 20010, Washington, DC.,Department of Genomics and Precision Medicine, George Washington University School of Medicine and Health Sciences, Washington, DC
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15
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Liu J, Campagna J, John V, Damoiseaux R, Mokhonova E, Becerra D, Meng H, McNally EM, Pyle AD, Kramerova I, Spencer MJ. A Small-Molecule Approach to Restore a Slow-Oxidative Phenotype and Defective CaMKIIβ Signaling in Limb Girdle Muscular Dystrophy. Cell Rep Med 2020; 1:100122. [PMID: 33205074 PMCID: PMC7659555 DOI: 10.1016/j.xcrm.2020.100122] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2019] [Revised: 08/07/2020] [Accepted: 09/21/2020] [Indexed: 12/21/2022]
Abstract
Mutations in CAPN3 cause limb girdle muscular dystrophy R1 (LGMDR1, formerly LGMD2A) and lead to progressive and debilitating muscle wasting. Calpain 3 deficiency is associated with impaired CaMKIIβ signaling and blunted transcriptional programs that encode the slow-oxidative muscle phenotype. We conducted a high-throughput screen on a target of CaMKII (Myl2) to identify compounds to override this signaling defect; 4 were tested in vivo in the Capn3 knockout (C3KO) model of LGMDR1. The leading compound, AMBMP, showed good exposure and was able to reverse the LGMDR1 phenotype in vivo, including improved oxidative properties, increased slow fiber size, and enhanced exercise performance. AMBMP also activated CaMKIIβ signaling, but it did not alter other pathways known to be associated with muscle growth. Thus, AMBMP treatment activates CaMKII and metabolically reprograms skeletal muscle toward a slow muscle phenotype. These proof-of-concept studies lend support for an approach to the development of therapeutics for LGMDR1.
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MESH Headings
- Acyltransferases/genetics
- Acyltransferases/metabolism
- Animals
- Calcium-Calmodulin-Dependent Protein Kinase Type 2/genetics
- Calcium-Calmodulin-Dependent Protein Kinase Type 2/metabolism
- Calpain/deficiency
- Calpain/genetics
- Cardiac Myosins/genetics
- Cardiac Myosins/metabolism
- Cell Line
- Creatine Kinase, Mitochondrial Form/genetics
- Creatine Kinase, Mitochondrial Form/metabolism
- Female
- Gene Expression Regulation
- Male
- Mice
- Mice, Inbred C57BL
- Mice, Knockout
- Muscle Proteins/deficiency
- Muscle Proteins/genetics
- Muscle, Skeletal/drug effects
- Muscle, Skeletal/metabolism
- Muscle, Skeletal/pathology
- Muscular Dystrophies, Limb-Girdle/drug therapy
- Muscular Dystrophies, Limb-Girdle/genetics
- Muscular Dystrophies, Limb-Girdle/metabolism
- Muscular Dystrophies, Limb-Girdle/pathology
- Myoblasts/drug effects
- Myoblasts/metabolism
- Myoblasts/pathology
- Myosin Light Chains/genetics
- Myosin Light Chains/metabolism
- Oxidative Stress
- Phenotype
- Physical Conditioning, Animal
- Protein Isoforms/genetics
- Protein Isoforms/metabolism
- Pyrimidines/pharmacology
- Signal Transduction
- Small Molecule Libraries/pharmacology
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Affiliation(s)
- Jian Liu
- Department of Neurology, David Geffen School of Medicine at University of California, Los Angeles, Los Angeles, CA, USA
| | - Jesus Campagna
- Department of Neurology, David Geffen School of Medicine at University of California, Los Angeles, Los Angeles, CA, USA
| | - Varghese John
- Department of Neurology, David Geffen School of Medicine at University of California, Los Angeles, Los Angeles, CA, USA
| | - Robert Damoiseaux
- Department of Pharmacology, David Geffen School of Medicine and Molecular Screening Shared Resource, Crump Imaging Institute, University of California, Los Angeles, Los Angeles, CA, USA
| | - Ekaterina Mokhonova
- Department of Neurology, David Geffen School of Medicine at University of California, Los Angeles, Los Angeles, CA, USA
| | - Diana Becerra
- Department of Neurology, David Geffen School of Medicine at University of California, Los Angeles, Los Angeles, CA, USA
| | - Huan Meng
- Department of Medicine, David Geffen School of Medicine and California Nanosystems Institute, University of California, Los Angeles, Los Angeles, CA, USA
| | - Elizabeth M. McNally
- Center for Genetic Medicine, Northwestern University, Feinberg School of Medicine, Chicago, IL, USA
| | - April D. Pyle
- Department of Microbiology, Immunology and Medical Genetics, David Geffen School of Medicine at University of California, Los Angeles, Los Angeles, CA, USA
- Eli and Edythe Broad Center of Regenerative Medicine and Stem Cell Research, University of California, Los Angeles, Los Angeles, CA, USA
| | - Irina Kramerova
- Department of Neurology, David Geffen School of Medicine at University of California, Los Angeles, Los Angeles, CA, USA
| | - Melissa J. Spencer
- Department of Neurology, David Geffen School of Medicine at University of California, Los Angeles, Los Angeles, CA, USA
- Eli and Edythe Broad Center of Regenerative Medicine and Stem Cell Research, University of California, Los Angeles, Los Angeles, CA, USA
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16
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Magri F, Brusa R, Bello L, Peverelli L, Del Bo R, Govoni A, Cinnante C, Colombo I, Fortunato F, Tironi R, Corti S, Grimoldi N, Sciacco M, Bresolin N, Pegoraro E, Moggio M, Comi GP. Limb girdle muscular dystrophy due to LAMA2 gene mutations: new mutations expand the clinical spectrum of a still challenging diagnosis. Acta Myol 2020; 39:67-82. [PMID: 32904964 PMCID: PMC7460730 DOI: 10.36185/2532-1900-009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Accepted: 05/27/2020] [Indexed: 11/03/2022]
Abstract
Mutations in LAMA2 gene, encoding merosin, are generally responsible of a severe congenital-onset muscular dystrophy (CMD type 1A) characterized by severe weakness, merosin absence at muscle analysis and white matter alterations at brain Magnetic Resonance Imaging (MRI). Recently, LAMA2 mutations have been acknowledged as responsible of LGMD R23, despite only few cases with slowly progressive adult-onset and partial merosin deficiency have been reported. We describe 5 independent Italian subjects presenting with progressive limb girdle muscular weakness, brain white matter abnormalities, merosin deficiency and LAMA2 gene mutations. We detected 7 different mutations, 6 of which are new. All patients showed normal psicomotor development and slowly progressive weakness with onset spanning from childhood to forties. Creatin-kinase levels were moderately elevated. One patient showed dilated cardiomyopathy. Muscle MRI allowed to evaluate the degree and pattern of muscular involvement in all patients. Brain MRI was fundamental in order to address and/or support the molecular diagnosis, showing typical widespread white matter hyperintensity in T2-weighted sequences. Interestingly these alterations were associated with central nervous system involvement in 3 patients who presented epilepsy and migraine. Muscle biopsy commonly but not necessarily revealed dystrophic features. Western-blot was usually more accurate than immunohystochemical analysis in detecting merosin deficiency. The description of these cases further enlarges the clinical spectrum of LAMA2-related disorders. Moreover, it supports the inclusion of LGMD R23 in the new classification of LGMD. The central nervous system involvement was fundamental to address the diagnosis and should be always included in the diagnostic work-up of undiagnosed LGMD.
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Affiliation(s)
- Francesca Magri
- Dino Ferrari Center, Neurology Unit, Department of Pathophysiology and Transplantation, IRCCS Foundation Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Roberta Brusa
- Dino Ferrari Center, Neurology Unit, Department of Pathophysiology and Transplantation, IRCCS Foundation Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Luca Bello
- Department of Neuroscience, University of Padua, Italy
| | - Lorenzo Peverelli
- Dino Ferrari Center, Neuromuscular and Rare Disease Unit, Department of Pathophysiology and Transplantation, IRCCS Foundation Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Roberto Del Bo
- Dino Ferrari Center, Neurology Unit, Department of Pathophysiology and Transplantation, IRCCS Foundation Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Alessandra Govoni
- Dino Ferrari Center, Neurology Unit, Department of Pathophysiology and Transplantation, IRCCS Foundation Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Claudia Cinnante
- Neuroradiology Unit, IRCCS Foundation Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Irene Colombo
- Dino Ferrari Center, Neuromuscular and Rare Disease Unit, Department of Pathophysiology and Transplantation, IRCCS Foundation Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Francesco Fortunato
- Dino Ferrari Center, Neurology Unit, Department of Pathophysiology and Transplantation, IRCCS Foundation Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Roberto Tironi
- Dino Ferrari Center, Neuromuscular and Rare Disease Unit, Department of Pathophysiology and Transplantation, IRCCS Foundation Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Stefania Corti
- Dino Ferrari Center, Neurology Unit, Department of Pathophysiology and Transplantation, IRCCS Foundation Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.,Dino Ferrari Center, Neurology Unit, Department of Pathophysiology and Transplantation, IRCCS Foundation Ca' Granda Ospedale Maggiore Policlinico, University of Milan, Italy
| | - Nadia Grimoldi
- Neurosurgery Unit, IRCCS Foundation Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Monica Sciacco
- Dino Ferrari Center, Neuromuscular and Rare Disease Unit, Department of Pathophysiology and Transplantation, IRCCS Foundation Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Nereo Bresolin
- Dino Ferrari Center, Neurology Unit, Department of Pathophysiology and Transplantation, IRCCS Foundation Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | | | - Maurizio Moggio
- Dino Ferrari Center, Neuromuscular and Rare Disease Unit, Department of Pathophysiology and Transplantation, IRCCS Foundation Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Giacomo Pietro Comi
- Dino Ferrari Center, Neurology Unit, Department of Pathophysiology and Transplantation, IRCCS Foundation Ca' Granda Ospedale Maggiore Policlinico, University of Milan, Italy.,Dino Ferrari Center, Neuromuscular and Rare Disease Unit, Department of Pathophysiology and Transplantation, IRCCS Foundation Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
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Guha TK, Pichavant C, Calos MP. Plasmid-Mediated Gene Therapy in Mouse Models of Limb Girdle Muscular Dystrophy. Mol Ther Methods Clin Dev 2019; 15:294-304. [PMID: 31890729 DOI: 10.1016/j.omtm.2019.10.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2019] [Accepted: 10/09/2019] [Indexed: 11/30/2022]
Abstract
We delivered plasmid DNA encoding therapeutic genes to the muscles of mouse models of limb girdle muscular dystrophy (LGMD) 2A, 2B, and 2D, deficient in calpain3, dysferlin, and alpha-sarcoglycan, respectively. We also delivered the human follistatin gene, which has the potential to increase therapeutic benefit. After intramuscular injection of DNA, electroporation was applied to enhance delivery to muscle fibers. When plasmids encoding the human calpain3 or dysferlin cDNA sequences were injected into quadriceps muscles of LGMD2A and LGMD2B mouse models, respectively, in 3-month studies, robust levels of calpain3 and dysferlin proteins were detected. We observed a statistically significant decrease in Evans blue dye penetration in LGMD2B mouse muscles after delivery of the dysferlin gene, consistent with repair of the muscle membrane defect in these mice. The therapeutic value of delivery of the genes for alpha-sarcoglycan and follistatin was documented by significant drops in Evans blue dye penetration in gastrocnemius muscles of LGMD2D mice. These results indicated for the first time that a combined gene therapy involving both alpha-sarcoglycan and follistatin would be valuable for LGMD2D patients. We suggest that this non-viral gene delivery method should be explored for its translational potential in patients.
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Israeli D, Cosette J, Corre G, Amor F, Poupiot J, Stockholm D, Montus M, Gjata B, Richard I. An AAV-SGCG Dose-Response Study in a γ-Sarcoglycanopathy Mouse Model in the Context of Mechanical Stress. Mol Ther Methods Clin Dev 2019; 13:494-502. [PMID: 31194043 DOI: 10.1016/j.omtm.2019.04.007] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/17/2018] [Accepted: 04/23/2019] [Indexed: 12/04/2022]
Abstract
Sarcoglycanopathies are rare autosomic limb girdle muscular dystrophies caused by mutations in one of the genes coding for sarcoglycans. Sarcoglycans form a complex, which is an important part of the dystrophin-associated glycoprotein complex and which protects the sarcolemma against muscle contraction-induced damage. Absence of one of the sarcoglycans on the plasma membrane reduces the stability of the whole complex and perturbs muscle fiber membrane integrity. There is currently no curative treatment for any of the sarcoglycanopathies. A first clinical trial to evaluate the safety of a recombinant AAV2/1 vector expressing γ-sarcoglycan using an intramuscular route of administration showed limited expression of the transgene and good tolerance of the approach. In this report, we undertook a dose-effect study in mice to evaluate the efficiency of an AAV2/8-expressing γ-sarcoglycan controlled by a muscle-specific promoter with a systemic mode of administration. We observed a dose-related efficiency with a nearly complete restoration of gamma sarcoglycan (SGCG) expression, histological appearance, biomarker level, and whole-body strength at the highest dose tested. In addition, our data suggest that a high expression threshold level must be achieved for effective protection of the transduced muscle, while a suboptimal transgene expression level might be less protective in the context of mechanical stress.
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Mojbafan M, Nilipour Y, Tonekaboni SH, Bagheri SD, Bagherian H, Sharifi Z, Zeinali Z, Tavakkoly-Bazzaz J, Zeinali S. A rare form of limb girdle muscular dystrophy (type 2E) seen in an Iranian family detected by autozygosity mapping. J Neurogenet 2017; 30:1-4. [PMID: 27276190 DOI: 10.3109/01677063.2016.1141208] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Sarcoglycanopathies (SGPs) constitute a subgroup of autosomal recessive limb girdle muscular dystrophies (LGMDs) which are caused by mutations in sarcoglycan (SGs) genes. SG proteins form a core complex consisting of α, β, γ and δ sarcoglycans which are encoded by SGCA, SGCB, SGCG and SGCD genes, respectively. Genetic defect, in any of these SG proteins, results in instability of the whole complex. This effect can be helpful in interpreting muscle biopsy results. Autozygosity mapping is a gene mapping approach which can be applied in large consanguineous families for tracking the defective gene in most autosomal recessive disorders. In the present study, we used autozygosity mapping, to find the gene responsible for muscular dystrophy. Proband was a 10-year-old boy referred to our center for ruling out DMD (Duchenne muscular dystrophy). According to the pedigree and clinical reports, we assessed him for SGPs. Haplotyping, using the four short tandem repeat (STR) markers for each of the SG genes, showed that the phenotype may segregate with SGCB gene; and observing two crossing overs which occurred within the gene suggested that the mutation might be in the first two exons of SGCB gene. Mutation analysis showed a 26 bp duplication (10 bp before the initiation codon till 13 bp after the ATG start codon). This will cause a frameshift in protein synthesis.
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Affiliation(s)
- Marzieh Mojbafan
- a Department of Molecular Medicine , Biotechnology Research Center, Pasteur Institute of Iran , Tehran , Iran ;,b Department of Medical Genetics , School of Medicine, Tehran University of Medical Sciences , Tehran , Iran
| | - Yalda Nilipour
- c Pediatric Pathology Research Center, Mofid Children's Hospital, Shahid Beheshti Medical University [SBMU] , Tehran , Iran
| | - Seyed Hasan Tonekaboni
- d Pediatric Neurology Center of Excellence, Department of Pediatric Neurology , Mofid Children Hospital, Faculty of Medicine, ShahidBeheshti Medical university , Tehran , Iran
| | | | | | | | - Zahra Zeinali
- e Kawsar Human Genetics Research Center , Tehran , Iran
| | - Javad Tavakkoly-Bazzaz
- b Department of Medical Genetics , School of Medicine, Tehran University of Medical Sciences , Tehran , Iran
| | - Sirous Zeinali
- a Department of Molecular Medicine , Biotechnology Research Center, Pasteur Institute of Iran , Tehran , Iran ;,e Kawsar Human Genetics Research Center , Tehran , Iran
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20
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Magri F, Nigro V, Angelini C, Mongini T, Mora M, Moroni I, Toscano A, D'angelo MG, Tomelleri G, Siciliano G, Ricci G, Bruno C, Corti S, Musumeci O, Tasca G, Ricci E, Monforte M, Sciacco M, Fiorillo C, Gandossini S, Minetti C, Morandi L, Savarese M, Fruscio GD, Semplicini C, Pegoraro E, Govoni A, Brusa R, Del Bo R, Ronchi D, Moggio M, Bresolin N, Comi GP. The italian limb girdle muscular dystrophy registry: Relative frequency, clinical features, and differential diagnosis. Muscle Nerve 2016; 55:55-68. [PMID: 27184587 DOI: 10.1002/mus.25192] [Citation(s) in RCA: 66] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/13/2016] [Indexed: 02/04/2023]
Abstract
INTRODUCTION Limb girdle muscular dystrophies (LGMDs) are characterized by high molecular heterogeneity, clinical overlap, and a paucity of specific biomarkers. Their molecular definition is fundamental for prognostic and therapeutic purposes. METHODS We created an Italian LGMD registry that included 370 molecularly defined patients. We reviewed detailed retrospective and prospective data and compared each LGMD subtype for differential diagnosis purposes. RESULTS LGMD types 2A and 2B are the most frequent forms in Italy. The ages at disease onset, clinical progression, and cardiac and respiratory involvement can vary greatly between each LGMD subtype. In a set of extensively studied patients, targeted next-generation sequencing (NGS) identified mutations in 36.5% of cases. CONCLUSION Detailed clinical characterization combined with muscle tissue analysis is fundamental to guide differential diagnosis and to address molecular tests. NGS is useful for diagnosing forms without specific biomarkers, although, at least in our study cohort, several LGMD disease mechanisms remain to be identified. Muscle Nerve 55: 55-68, 2017.
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Affiliation(s)
- Francesca Magri
- Dino Ferrari Centre, Department of Pathophysiology and Transplantation, University of Milan, Neurology Unit, IRCCS Foundation Ca' Granda, Ospedale Maggiore Policlinico, Via Francesco Sforza 35, 20122, Milan, Italy
| | - Vincenzo Nigro
- Department of General Pathology, University of Naples, Naples, Italy.,Telethon Institute of Genetics and Medicine, Naples, Italy
| | | | - Tiziana Mongini
- Department of Neurosciences Rita Levi Montalcini, University of Torino, Torino, Italy
| | - Marina Mora
- Neuromuscular Diseases and Neuroimmunology Unit, Fondazione IRCCS Istituto Neurologico C. Besta, Milan, Italy
| | - Isabella Moroni
- Child Neurology Unit, IRCCS Foundation Istituto Neurologico C. Besta, Milan, Italy
| | - Antonio Toscano
- Department of Clinically and Experimental Medicine, University of Messina, Italy
| | | | | | - Gabriele Siciliano
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Giulia Ricci
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Claudio Bruno
- Center of Myology and Neurodegenerative Diseases, Istituto Giannina Gaslini, Genova
| | - Stefania Corti
- Dino Ferrari Centre, Department of Pathophysiology and Transplantation, University of Milan, Neurology Unit, IRCCS Foundation Ca' Granda, Ospedale Maggiore Policlinico, Via Francesco Sforza 35, 20122, Milan, Italy
| | - Olimpia Musumeci
- Department of Clinically and Experimental Medicine, University of Messina, Italy
| | | | - Enzo Ricci
- Department of Neurology, Policlinico Universitario A. Gemelli, University Cattolica del Sacro Cuore of Rome, Rome, Italy
| | - Mauro Monforte
- Department of Neurology, Policlinico Universitario A. Gemelli, University Cattolica del Sacro Cuore of Rome, Rome, Italy
| | - Monica Sciacco
- Dino Ferrari Centre, Neuromuscular and Rare Diseases Unit, IRCCS Foundation Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | | | - Sandra Gandossini
- Neuromuscular Unit-IRCCS E. Medea Bosisio Parini, Bosisio Parini, Italy
| | - Carlo Minetti
- Center of Myology and Neurodegenerative Diseases, Istituto Giannina Gaslini, Genova
| | - Lucia Morandi
- Neuromuscular Diseases and Neuroimmunology Unit, Fondazione IRCCS Istituto Neurologico C. Besta, Milan, Italy
| | - Marco Savarese
- Department of General Pathology, University of Naples, Naples, Italy.,Telethon Institute of Genetics and Medicine, Naples, Italy
| | - Giuseppina Di Fruscio
- Department of General Pathology, University of Naples, Naples, Italy.,Telethon Institute of Genetics and Medicine, Naples, Italy
| | | | - Elena Pegoraro
- Department of Neurosciences, University of Padua, Padua, Italy
| | - Alessandra Govoni
- Dino Ferrari Centre, Department of Pathophysiology and Transplantation, University of Milan, Neurology Unit, IRCCS Foundation Ca' Granda, Ospedale Maggiore Policlinico, Via Francesco Sforza 35, 20122, Milan, Italy
| | - Roberta Brusa
- Dino Ferrari Centre, Department of Pathophysiology and Transplantation, University of Milan, Neurology Unit, IRCCS Foundation Ca' Granda, Ospedale Maggiore Policlinico, Via Francesco Sforza 35, 20122, Milan, Italy
| | - Roberto Del Bo
- Dino Ferrari Centre, Department of Pathophysiology and Transplantation, University of Milan, Neurology Unit, IRCCS Foundation Ca' Granda, Ospedale Maggiore Policlinico, Via Francesco Sforza 35, 20122, Milan, Italy
| | - Dario Ronchi
- Dino Ferrari Centre, Department of Pathophysiology and Transplantation, University of Milan, Neurology Unit, IRCCS Foundation Ca' Granda, Ospedale Maggiore Policlinico, Via Francesco Sforza 35, 20122, Milan, Italy
| | - Maurizio Moggio
- Dino Ferrari Centre, Neuromuscular and Rare Diseases Unit, IRCCS Foundation Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Nereo Bresolin
- Dino Ferrari Centre, Department of Pathophysiology and Transplantation, University of Milan, Neurology Unit, IRCCS Foundation Ca' Granda, Ospedale Maggiore Policlinico, Via Francesco Sforza 35, 20122, Milan, Italy
| | - Giacomo Pietro Comi
- Dino Ferrari Centre, Department of Pathophysiology and Transplantation, University of Milan, Neurology Unit, IRCCS Foundation Ca' Granda, Ospedale Maggiore Policlinico, Via Francesco Sforza 35, 20122, Milan, Italy
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Fanin M, Angelini C. Protein and genetic diagnosis of limb girdle muscular dystrophy type 2A: The yield and the pitfalls. Muscle Nerve 2015; 52:163-73. [PMID: 25900067 DOI: 10.1002/mus.24682] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/09/2015] [Indexed: 12/20/2022]
Abstract
Limb girdle muscular dystrophy type 2A (LGMD2A) is the most frequent form of LGMD worldwide. Comprehensive clinical assessment and laboratory testing is essential for diagnosis of LGMD2A. Muscle immunoblot analysis of calpain-3 is the most useful tool to direct genetic testing, as detection of calpain-3 deficiency has high diagnostic value. However, calpain-3 immunoblot testing lacks sensitivity in about 30% of cases due to gene mutations that inactivate the enzyme. The best diagnostic strategy should be determined on a case-by-case basis, depending on which tissues are available, and which molecular and/or genetic methods are adopted. In this work we survey the current knowledge, advantages, limitations, and pitfalls of protein testing and mutation detection in LGMD2A and provide an update of genetic epidemiology.
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Affiliation(s)
- Marina Fanin
- Department of Neurosciences, Biomedical Campus "Pietro d'Abano," via Giuseppe Orus 2B, 35129, Padova, Italy
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Schade van Westrum SM, Dekker LRC, de Voogt WG, Wilde AAM, Ginjaar IB, de Visser M, van der Kooi AJ. Cardiac involvement in Dutch patients with sarcoglycanopathy: a cross-sectional cohort and follow-up study. Muscle Nerve 2015; 50:909-13. [PMID: 24619517 DOI: 10.1002/mus.24233] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/03/2014] [Indexed: 11/11/2022]
Abstract
INTRODUCTION The aim of this study is to describe the frequency, nature, severity, and progression of cardiac abnormalities in a cohort of Dutch sarcoglycanopathy patients. METHODS In this cross-sectional cohort study, patients were interviewed using a standardized questionnaire and assigned a functional score. Electrocardiography (ECG), echocardiography, and 24-h ECG were performed. RESULTS Twenty-four patients with sarcoglycanopathy had a median age of 25 years (range, 8-59 years). Beta blockers were used by 13%, and 17% used angiotensin-converting enzyme inhibitors. ECG abnormalities were present in 5 (21%), and 4 (17%) fulfilled the criteria for dilated cardiomyopathy (DCM). There were no significant differences in median age or severity of disease between patients with or without DCM. Eleven patients were examined earlier. Median follow-up time was 10 years. Two of the 11 patients (18%) developed DCM during follow-up. CONCLUSIONS Seventeen percent of the patients with sarcoglycanopathy were found to have dilated cardiomyopathy. We recommend biannual cardiac monitoring, including ECG and echocardiography.
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SCHRöDER THOMAS, FUCHSS JOHANN, SCHNEIDER ILKA, STOLTENBURG-DIDINGER GISELA, HANISCH FRANK. Eosinophils in hereditary and inflammatory myopathies. Acta Myol 2013; 32:148-53. [PMID: 24803842 PMCID: PMC4006278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
It is not known whether eosinophilic myositis is a specific histopathological feature of limb girdle muscular dystrophy 2A (LGMD2A). Number and location of eosinophils in skeletal muscle biopsies (n=100) was analysed by Giemsa and modified hematoxylin/eosin staining in patients with genetically confirmed myopathies (LGMD2A, LGMD2B, LGMD2L, facioscapulohumeral muscular dystrophy, dystrophinopathy), histologically confirmed idiopathic inflammatory myopathies (sporadic inclusion body myositis (sIBM), dermatomyositis (DM), polymyositis), amyotrophic lateral sclerosis (neurogenic control), and normal controls. The number of eosinophils/mm² was significantly higher in LGMD2A, PM, DM, and sIBM compared to controls but not significantly higher than other myopathies. A large overlap in the number of eosinophils/mm2 between all groups was seen. In all disease groups eosinophils were mainly found endomysially (46- 88%) and intra- and perivascularly (4-37%). There was no correlation between the numbers of eosinophils/mm² and (i) age at biopsy and (ii) the duration of the disease. The extent of myopathic, fibrotic, and inflammatory changes did not differ in samples with high and low eosinophil count. Eosinophils seem to represent an unspecific histological finding in hereditary and inflammatory myopathies, but also amyotrophic lateral sclerosis.
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Affiliation(s)
- THOMAS SCHRöDER
- Department of Neurology, Martin-Luther-University Halle-Wittenberg, Halle (Saale), Germany
| | - JOHANN FUCHSS
- Department of Neurology, Martin-Luther-University Halle-Wittenberg, Halle (Saale), Germany
| | - ILKA SCHNEIDER
- Department of Neurology, Martin-Luther-University Halle-Wittenberg, Halle (Saale), Germany
| | | | - FRANK HANISCH
- Department of Neurology, Martin-Luther-University Halle-Wittenberg, Halle (Saale), Germany;,Address for correspondence: Frank Hanisch, Department of Neurology, Martin-Luther-University Halle-Wittenberg, Ernst-Grube-Str. 40, D-06120 Halle (Saale), Germany. Tel. +49 345 557 3337. Fax +49 345 557 3335.
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Jethwa H, Jacques TS, Gunny R, Wedderburn LR, Pilkington C, Manzur AY. Limb girdle muscular dystrophy type 2B masquerading as inflammatory myopathy: case report. Pediatr Rheumatol Online J 2013; 11:19. [PMID: 23641709 PMCID: PMC3652784 DOI: 10.1186/1546-0096-11-19] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2012] [Accepted: 04/23/2013] [Indexed: 11/24/2022] Open
Abstract
Limb girdle muscular dystrophy type 2B is a rare subtype of muscular dystrophy, the predominant feature of which is muscle weakness. The disease is caused by an autosomal recessively inherited reduction/absence of muscle dysferlin due to a mutation in dysferlin gene at 2p12-14. We report a 10 year old boy who presented with severe non-transient right knee pain and swelling, which later became bilateral. His pain was worst in the morning and during rest. Blood tests revealed markedly raised creatine kinase values (highest 22, 297 U/l), raising the possibility of an inflammatory myositis. MRI showed bilateral asymmetrical muscle involvement of thighs and calves with oedematous changes mimicking the imaging appearances of inflammatory myositis. CRP and ESR levels were consistently within normal limits. Over several months his knee pain worsened and limited walking. Muscle biopsy revealed a severe reduction of dysferlin immunostaining, indicating the diagnosis, which was confirmed by 2 compound heterozygous pathogenic mutations in the dysferlin gene. It is not unusual for this subtype of the disease to mimic myositis: however, significant pain is a rare presenting symptom. Given the significant overlap between this form of muscular dystrophy and inflammatory myopathies, a high index of suspicion is needed to ensure an accurate and timely diagnosis. Furthermore, characteristic inflammatory-related morning pain should not rule out consideration of non-inflammatory causes.
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Affiliation(s)
- Hannah Jethwa
- Dubowitz Neuromuscular Centre, 30 Guilford Street, London, WC1N 1EH, UK.
| | | | - Roxanna Gunny
- Radiology Department, Great Ormond Street Hospital, London, UK
| | | | | | - Adnan Y Manzur
- Dubowitz Neuromuscular Centre, 30 Guilford Street, London, WC1N 1EH, UK
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Renjini R, Gayathri N, Nalini A, Bharath MS. Analysis of calpain-3 protein in muscle biopsies of different muscular dystrophies from India. Indian J Med Res 2012; 135:878-86. [PMID: 22825607 PMCID: PMC3410215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND & OBJECTIVES Calpain-3, a Ca [2]+ -dependent protease has been implicated in the pathology of neuromuscular disorders (NMDs). The current study aimed to analyze calpain-3 expression in cases diagnosed as muscular dystrophy from the Indian population. METHODS Calpain-3 Western blot analysis in muscle biopsies of immunohistochemically confirmed cases of Duchenne muscular dystrophy (DMD) (n=10), dysferlinopathy (n=30) and sarcoglycanopathy (n=8) was carried out. Calpain-3 Western blotting was also used in a blinded study to identify cases of calpain-3 deficiency in 28 NMD patients with potential muscular dystrophy. RESULTS Calpain-3 appeared as a full length 94 kDa band with an autolytic product (~60 kDa) on Western blots with antibody NCL-CALP-12A2 (Ab-2). Eight of the 10 DMD samples showed absence of 94 kDa band but presence of 60 kDa band while one case of sarcoglycanopathy showed absence of both. Twenty one of the 30 dysferlinopathy samples showed both bands while six showed only the 60 kDa band and three showed absence of both. In the blinded study, five NMD cases with potential muscular dystrophy that showed complete absence of both bands in retrospect exhibited clinical features of limb girdle muscular dystrophy 2A (LGMD2A). INTERPRETATION & CONCLUSIONS While the study revealed a consistent pattern of calpain-3 in DMD, one sarcoglycanopathy and three dysferlinopathy samples exhibited secondary reduction in calpain-3. It was recognized that both calpain-3 bands should be considered to confirm calpain deficiency. Further, western blot offers an economical and fast preliminary screening method for LGMD2A especially in cases of complete absence of calpain-3 prior to conclusive diagnosis by genetic testing.
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Affiliation(s)
- R. Renjini
- Department of Neurochemistry, National Institute of Mental Health & Neuro Sciences, Bangalore, India
| | - N. Gayathri
- Department of Neuropathology, National Institute of Mental Health & Neuro Sciences, Bangalore, India
| | - A. Nalini
- Department of Neurology, National Institute of Mental Health & Neuro Sciences, Bangalore, India
| | - M.M. Srinivas Bharath
- Department of Neurochemistry, National Institute of Mental Health & Neuro Sciences, Bangalore, India,Reprint requests: Dr M.M. Srinivas Bharath, National Institute of Mental Health & Neuro Sciences, P.B # 2900, Hosur Road, Bangalore 560 029, India e-mail: bharath@ nimhans.kar.nic.in
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26
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Abstract
Driven by increasing numbers of newly identified genetic defects and new insights into the field of inherited muscle diseases, neuromuscular imaging in general and magnetic resonance imaging (MRI) in particular are increasingly being used to characterise the severity and pattern of muscle involvement. Although muscle biopsy is still the gold standard for the establishment of the definitive diagnosis, muscular imaging is an important diagnostic tool for the detection and quantification of dystrophic changes during the clinical workup of patients with hereditary muscle diseases. MRI is frequently used to describe muscle involvement patterns, which aids in narrowing of the differential diagnosis and distinguishing between dystrophic and non-dystrophic diseases. Recent work has demonstrated the usefulness of muscle imaging for the detection of specific congenital myopathies, mainly for the identification of the underlying genetic defect in core and centronuclear myopathies. Muscle imaging demonstrates characteristic patterns, which can be helpful for the differentiation of individual limb girdle muscular dystrophies. The aim of this review is to give a comprehensive overview of current methods and applications as well as future perspectives in the field of neuromuscular imaging in inherited muscle diseases. We also provide diagnostic algorithms that might guide us through the differential diagnosis in hereditary myopathies.
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Affiliation(s)
- Mike P Wattjes
- Department of Radiology, VU University Medical Center, De Boelelaan 1117, 1081, HV, Amsterdam, the Netherlands.
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27
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MURAKAMI T, HAYASHI YK, OGAWA M, NOGUCHI S, CAMPBELL KP, TOGAWA M, INOUE T, OKA A, OHNO K, NONAKA I, NISHINO I. A novel POMT2 mutation causes mild congenital muscular dystrophy with normal brain MRI. Brain Dev 2009; 31:465-8. [PMID: 18804929 PMCID: PMC2702532 DOI: 10.1016/j.braindev.2008.08.005] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2008] [Revised: 07/18/2008] [Accepted: 08/06/2008] [Indexed: 10/21/2022]
Abstract
We report a patient harboring a novel homozygous mutation of c.604T>G (p.F202V) in POMT2. He showed delayed psychomotor development but acquired the ability to walk at the age of 3 years and 10 months. His brain MRI was normal. No ocular abnormalities were seen. Biopsied skeletal muscle revealed markedly decreased but still detectable glycosylated forms of alpha-dystroglycan (alpha-DG). Our results indicate that mutations in POMT2 can cause a wide spectrum of clinical phenotypes as observed in other genes associated with alpha-dystroglycanopathy. Presence of small amounts of partly glycosylated alpha-DG may have a role in reducing the clinical symptoms of alpha-dystroglycanopathy.
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Affiliation(s)
- Terumi MURAKAMI
- Department of Neuromuscular Research, National Institute of Neuroscience, National Center of Neurology and Psychiatry, Tokyo, Japan,Department of Pediatrics, Tokyo Women’s Medical University, Tokyo, Japan
| | - Yukiko K. HAYASHI
- Department of Neuromuscular Research, National Institute of Neuroscience, National Center of Neurology and Psychiatry, Tokyo, Japan,Address correspondence to: Yukiko K. HAYASHI, MD, PhD National Institute of Neuroscience, National Center of Neurology and Psychiatry (NCNP), 4-1-1 Ogawa-Higashi, Kodaira, Tokyo 187-8502, Japan Tel: +81 42 341 2711 FAX: +81 42 346 1742
| | - Megumu OGAWA
- Department of Neuromuscular Research, National Institute of Neuroscience, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Satoru NOGUCHI
- Department of Neuromuscular Research, National Institute of Neuroscience, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Kevin P. CAMPBELL
- Howard Hughes Medical Institute, Department of Molecular Physiology and Biophysics, Internal Medicine, and Neurology, University of Iowa Carver College of Medicine, Iowa City, Iowa, U.S.A
| | - Masami TOGAWA
- Department of Child Neurology, Institute of Neurological Sciences, Tottori University Faculty of Medicine, Tottori, Japan
| | - Takehiko INOUE
- Department of Child Neurology, Institute of Neurological Sciences, Tottori University Faculty of Medicine, Tottori, Japan
| | - Akira OKA
- Department of Child Neurology, Institute of Neurological Sciences, Tottori University Faculty of Medicine, Tottori, Japan
| | - Kousaku OHNO
- Department of Child Neurology, Institute of Neurological Sciences, Tottori University Faculty of Medicine, Tottori, Japan
| | - Ikuya NONAKA
- Department of Neuromuscular Research, National Institute of Neuroscience, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Ichizo NISHINO
- Department of Neuromuscular Research, National Institute of Neuroscience, National Center of Neurology and Psychiatry, Tokyo, Japan
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28
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Abstract
Limb girdle muscular dystrophy type 2A (LGMD2A) is caused by mutations in the calpain 3 gene. In a large family affected by LGMD2A with four severely affected members, three additional asymptomatic relatives had very high serum creatine kinase concentrations. All were homozygous for the R110X mutation and showed a total absence of calpain 3 in the muscle. Histological analysis of muscle in these three rare preclinical cases showed a consistent but unusual pattern, with isolated fascicles of degenerating fibres in an almost normal muscle. This pattern was also seen in one patient with early stage LGMD2A who had a P82L missense mutation and a partial deficiency of calpain 3 in the muscle, but was not seen in early stage patients affected by other forms of LGMD. These findings suggest that a peculiar pattern of focal degeneration occurs in calpainopathy, independently of the type of mutation or the amount of calpain 3 in the muscle.
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Affiliation(s)
- M Vainzof
- Human Genome Research Centre, Department of Biology, IBUSP, University of São Paulo, São Paulo, Sao Paulo - CEP, 05508-900, SP Brazil
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