Gene expression profiling of Duchenne muscular dystrophy skeletal muscle

The primary cause of Duchenne muscular dystrophy (DMD) is a mutation in the dystrophin gene, leading to absence of the corresponding protein, disruption of the dystrophin-associated protein complex, and substantial changes in skeletal muscle pathology. Although the primary defect is known and the histological pathology well documented, the underlying molecular pathways remain in question. To clarify these pathways, we used expression microarrays to compare individual gene expression profiles for skeletal muscle biopsies from DMD patients and unaffected controls. We have previously published expression data for the 12,500 known genes and full-length expressed sequence tags (ESTs) on the Affymetrix HG-U95Av2 chips. Here we present comparative expression analysis of the 50,000 EST clusters represented on the remainder of the Affymetrix HG-U95 set. Individual expression profiles were generated for biopsies from 10 DMD patients and 10 unaffected control patients. Two methods of statistical analysis were used to interpret the resulting data (t-test analysis to determine the statistical significance of differential expression and geometric fold change analysis to determine the extent of differential expression). These analyses identified 183 probe sets (59 of which represent known genes) that differ significantly in expression level between unaffected and disease muscle. This study adds to our knowledge of the molecular pathways that are altered in the dystrophic state. In particular, it suggests that signaling pathways might be substantially involved in the disease process. It also highlights a large number of unknown genes whose expression is altered and whose identity therefore becomes important in understanding the pathogenesis of muscular dystrophy. Electronic Supplementary Material Supplementary material is available for this article if you access the article at . A link in the frame on the left on that page takes you directly to the supplementary material.     

Isoprostanes in dystrophinopathy: Evidence of increased oxidative stress

Duchenne muscular dystrophy (DMD) and Becker muscular dystrophy (BMD) are degenerative disorders of muscle. Although the mechanisms underlying muscle degeneration are still uncertain, oxidative-damage has been proposed to play a key role. Isoprostanes are markers of free radical-catalyzed lipid peroxidation; the aim of our study was to evaluate plasma isoprostane levels in group of patients affected by Duchenne and Becker muscular dystrophies. PF₂-isoprostane levels were measured by colorimetric enzyme immunoassay in the plasma of 17 patients with DMD and 24 with BMD. When compared to a group of healthy controls, affected patients showed significantly higher plasma levels of isoprostanes (p = 0.001). When patients were stratified according to the clinical diagnosis, isoprostane levels were not statistically different between DMD and BMD patients. In conclusion whether the condition of oxidative stress found in plasma depends on the degenerative process occurring in muscles or on different mechanisms, such as the release of myoglobin in the blood, should be ascertained. However, our study confirms that oxidative stress findings in DMD/BMD patients are effectively present at the plasma levels. The condition of oxidative stress might act as an adjunctive cause of extra-muscular cell damage to which these patients are exposed for their entire life.     

Abnormal dystrophin expression in patients with limb girdle syndromes

Clinical differential diagnosis between Becker muscular dystrophy (BMD) and limb gridle muscular dystrophy (LGMD) may be difficult because the BMD clinical phenotype tends to overlap with other limb girdle syndromes, especially with LGMD. Therefore we studied the expression of dystrophin, the protein product of the Becker and Duchenne muscular dystrophy gene, in muscle biopsy specimens of 30 patients (18 males, of whom 15 represented spradic cases, and 12 females) diagnosed as having LGMD according to traditional clinical, electrophysiological and histological criteria. For dystrophin analysis, six different monoclonal antibodies directed against different epitopes of the dystrophin molecule were used. Immunocytochemically, five of the 30 LGMD patients (17%) showed abnormal dystrophin staining patterns diagnostic of BMD. Western blotting in these five patients, all sporadic cases, showed dystrophin of reduced size and/or abundance. Analysis of blood or muscle DNA using multiplex polymerase chain reaction revealed deletions in the dystrophin gene in three of the five. Thus, 5 of 15 (33%) sporadic male patients previously thought to have LGMD were identified as having BMD.     

Ataluren treatment of patients with nonsense mutation dystrophinopathy

Introduction: Dystrophinopathy is a rare, severe muscle disorder, and nonsense mutations are found in 13% of cases. Ataluren was developed to enable ribosomal readthrough of premature stop codons in nonsense mutation (nm) genetic disorders. Methods: Randomized, double‐blind, placebo‐controlled study; males ≥5 years with nm‐dystrophinopathy received study drug orally 3 times daily, ataluren 10, 10, 20 mg/kg (N = 57); ataluren 20, 20, 40 mg/kg (N = 60); or placebo (N = 57) for 48 weeks. The primary endpoint was change in 6‐Minute Walk Distance (6MWD) at Week 48. Results: Ataluren was generally well tolerated. The primary endpoint favored ataluren 10, 10, 20 mg/kg versus placebo; the week 48 6MWD Δ = 31.3 meters, post hoc P = 0.056. Secondary endpoints (timed function tests) showed meaningful differences between ataluren 10, 10, 20 mg/kg, and placebo. Conclusions: As the first investigational new drug targeting the underlying cause of nm‐dystrophinopathy, ataluren offers promise as a treatment for this orphan genetic disorder with high unmet medical need. Muscle Nerve 50 : 477–487, 2014     

Sub-cellular localisation of fukutin related protein in different cell lines and in the muscle of patients with MDC1C and LGMD2I

MDC1C and LGMD2I are two allelic forms of muscular dystrophies caused by mutations in the gene encoding for fukutin related protein (FKRP). FKRP encodes for a putative glycosyltransferase, the precise function of which is unknown. However, the marked reduction of -dystroglycan glycosylation in the muscle of MDC1C and LGMD2I patients suggests a role for FKRP in dystroglycan processing. Using a polyclonal antibody raised against FKRP we now show that endogenous FKRP locates to the Golgi apparatus of neuronal, oligodendroglial, and the cardiac muscle cell line H9c2. In differentiated C2C12 myotubes and in transverse sections of normal skeletal and cardiac muscle, endogenous FKRP surrounded the myonuclei. This localisation was unaffected in the skeletal muscle of patients with MDC1C and LGMD2I carrying various FKRP mutations. These observations imply a specific role for FKRP during striated muscle, neuronal and glial development and suggest that protein mis-localisation is not a common mechanism of disease in FKRP-related dystrophies.     

Different localization of dystrophin in developing and adult human skeletal muscle

Duchenne and Becker muscular dystrophy are caused by defects in dystrophin synthesis. Using affinity-purified polyclonal anti-dystrophin antibodies, we have studied immunohistochemically the subcellular localization of dystrophin in embryonic, fetal, and adult human skeletal muscle. In the embryonic stages dystrophin first appears in the sarcoplasm at the peripheral ends of the myotubes, immediately adjacent to the tendons, whereas in fetal stages dystrophin is found throughout the entire myofibers. In agreement with literature data, in adult muscle dystrophin expression was found to be restricted to the sarcolemma. The sarcoplasmic localization in embryonic and fetal tissue and the sarcolemmal localization of dystrophin in mature muscle suggests the accumulation of dystrophin in the cytoplasm prior to its integration into the membrane. These results increase our knowledge of the ontogenesis of dystrophin and may lead to a better understanding of the great diversity in pathological cases of Duchenne and Becker muscular dystrophy.     

Mdx小鼠骨骼肌中炎症反应和mpeg1的表达

目的探讨mdx小鼠不同时期骨骼肌的炎性病理改变,观察mpeg1在mdx小鼠及对照鼠中的表达。方法选取雄性C57BL/10ScSn-Dmdmdx/JNju鼠为实验组,对照组为雄性C57BL/6Sc Sn小鼠,根据年龄分为2 w、4 w、8 w、12 w 4个亚组。通过HE染色、MGT染色、ACP染色观察骨骼肌光镜下的形态学改变,总结mdx小鼠骨骼肌炎性病理变化。通过RNA提取,基因芯片的检测及mpegl的qRT-PCR检测,观察mpeg1的表达情况。结果常规组织染色中,2 w的mdx小鼠肌肉偶见高度浓染的肌纤维,未见肌细胞坏死,炎症细胞浸润,4 w可见巨噬细胞吞噬现象散在分布,8 w时炎细胞浸润灶融合成片,12 w时炎性病灶面积减小;利用基因芯片技术筛选出mdx小鼠中有关炎症反应的基因30余个,结果显示与2 w相比,炎症反应相关基因表达量均增加,在8 w时达到峰值,12 w有所下降,但较2 w时仍有升高;qRT-PCR结果显示从4 w开始,mdx小鼠中mpeg1的含量逐渐增加,8 w时含量最高。结论 (1)炎症反应参与mdx小鼠疾病的发生发展:从2 w开始出现,8 w达到高峰,12 w趋于平稳;(2)Mpeg1在mdx小鼠炎症反应中发挥了一定的作用。     

DMD、BMD患者骨骼肌、皮肤立毛肌肌营养不良蛋白同时欠损

目的研究、对比肌营养不良蛋白(dystrophin)在杜兴型肌营养不良(Duchenne muscular dystrophy,DMD)和贝克型肌营养不良(Becker muscular dystrophy,BMD)患者活检骨骼肌、皮肤立毛肌中的表达。方法用肌营养不良蛋白三个不同区域的单克隆抗体(Dystrophin-N、-C、-R)对11例DMD患者,5例BMD患者和3例其他神经肌病患者同时行活检骨骼肌、皮肤免疫组织化学染色分析。结果与对照例相比,11例DMD患者抗Dystro-phin-N、-C、-R单克隆抗体免疫组织化学染色显示:骨骼肌肌纤维膜Dystrophin-N、-C、-R呈完全欠损;皮肤立毛肌Dystrophin-N、-R完全欠损,Dystrophin-C轻微表达。5例BMD患者抗Dystrophin-N、-C、-R单克隆抗体免疫组织化学染色显示:肌营养不良蛋白在骨骼肌肌纤维膜和皮肤均呈不完全欠损。结论DMD和BMD患者肌营养不良蛋白在骨骼肌肌纤维膜、皮肤立毛肌呈完全/不完全欠损,与骨骼肌活检相同,皮肤活检也是分子病理学诊断DMD、BMD简便、易行、可靠的方法。     

Spatial distribution of β-spectrin in normal and dystrophic human skeletal muscle

Spectrin, a major component of the erythrocyte membrane skeleton, has previously been shown to form a two-dimensional lattice in erythrocytes, and in avian or chicken skeletal muscle. Those results were mainly obtained with antibodies against α-spectrin. Using immunofluorescence of semithin cryosections and single muscle fiber preparations, we show here that β-spectrin forms a costameric network which covers the plasma membrane of human skeletal muscle. These spectrin costameres are correlated with the Z-bands. They are longitudinally connected by fine strands and interrupted by myonuclear lacunae. Under mechanical stretching, the costameres retained their correlation to the Z-bands in normal and dystrophin-deficient muscle, up to the point at which the sarcolemma was disrupted. In stretched muscle, in some regions of the stretched fibers in which the costameres seemed to form double strands, the usually 1:1 correlation of spectrin to the Z-bands changed to a 2:1 relation. In dystrophin-deficient muscle, the costameric scaffold of spectrin in the well-preserved fibers appeared normal, indicating that spectrin can be correctly localized in the absence of dystrophin and that the subcellular spectrin organization does not primarily depend on dystrophin expression. The regular organization and the correlation of spectrin costameres to the Z-bands was notable even in stretched Duchenne muscular dystrophy (DMD) muscle. On the other hand, single teased muscle fibers of DMD muscle showed various degrees of morphological alterations of the costameric network, ranging from a focal disarray to complete loss of costameric organization. Because these findings indicate that the costameric spectrin scaffold undergoes secondary changes during the course of the dystrophic process in dystrophin-deficient muscle, spectrin staining of isolated muscle fibers may also serve as a tool to monitor the effect of gene therapy experiments at the single fiber level. Received: 13 March 1996 / Revised, accepted: 27 January 1997     

Heterogeneity of dystrophin expression in patients with Duchenne and Becker muscular dystrophy

Summary This report documents the results of an integrated biochemical and immunocytochemical investigation into the expression of dystrophin (the protein product of the Duchenne muscular dystrophy gene) in muscle biopsies from 226 patients. It is the first study in which dystrophin has been analysed on blots and on tissue sections in such a large number of patients using the same (monoclonal) antibody. The 140 patients with Xp21 muscular dystrophy who were included in this study represent a continuous spectrum of disease severity and this range was reflected in the heterogeneity of dystrophin expression which was observed with respect to abundance, size and the pattern of tissue localisation. Approximately 40% of biopsies obtained from patients diagnosed as having Duchenne muscular, dystrophy (DMD) contained isolated clearly positive fibres and a further 20% had very weak labelling on a large number of fibres. Biopsies from patients with Becker muscular dystrophy (BMD) showed labelling patterns which varied from weak labelling on the majority of fibres to clear labelling on all fibres. Typically, however, there was inter-and intra-fibre variation in labelling intensity. Approximately 85% of the 52 BMD and 54 DMD patients who had unequivocal labelling on blots demonstrated a protein of abnormal size. The remaining 15% had a protein of normal size but reduced abundance. Overall, the estimated abundance of dystrophin correlated well with clinical assessments of the disease severity expressed in patients: We conclude that dystrophin analysis is an essential and dependable technique for the differential diagnosis of patients with Xp21 muscular dystrophy.Supported by the University of Newcastle-upon-Tyne Research Committee, the Muscular Dystropy Group of Great Britain and the Medical Research Council     

Expression of myoglobin gene in skeletal muscle of patients with neuromuscular diseases

Expression of the myoglobin (Mb) gene in skeletal muscle was studied in patients with Duchenne muscular dystrophy (DMD), polymyositis (PM), or amyotrophic lateral sclerosis (ALS) by measuring Mb concentration by radioimmunoassay and Mb messenger ribonucleic acid (RNA) (MbmRNA) levels by Northern blot analysis. Mb concentrations in the muscle cells (Mb/noncollagenous protein) were decreased in patients with DMD, PM, or ALS. However, while Mb concentrations per MbmRNA content (Mb/MbmRNA) were decreased in DMD and PM patients, these values were normal in ALS patients. These results suggest that Mb synthesis is increased in muscles of DMD and PM patients, but is not sufficient to compensate for the excessive loss of Mb from the affected muscles, and that the synthesis is decreased in the muscles of ALS patients. © 1994 John Wiley & Sons, Inc.     

Light and electron microscopic studies on localization of myoglobin in skeletal muscle cells in neuromuscular diseases

The localizations of myoglobin in skeletal muscle cells of patients with Duchenne muscular dystrophy (DMD), myotonic dystrophy (MyD), and amyotrophic lateral sclerosis (ALS) were studied by immunohistochemistry and immunoelectron microscopy. In normal skeletal muscle cells, myoglobin was localized mainly in the I-band region. In degenerating muscle cells of patients with DMD and MyD, myoglobin was also demonstrated in the distended lumen of the internal membrane system and in the intermyofibrillar space, through which it seemed to pass into the extracellular space. No myoglobin was detected in opaque fibers or in some of small-sized fibers in DMD muscle. In patients with ALS the staining intensities of myoglobin varied in different muscle cells, but myoglobin was restricted to the I-band region in many muscle cells. These findings suggest that changes in the localization of myoglobin in skeletal muscle cell sensitively reflect the pathologic status of muscle cells.     

肌营养不良蛋白在假肥大肌营养不良症肌组织中的表达研究

目的检测假肥大肌营养不良症肌组织中肌营养不良蛋白（ｄｙｓｔｒｏｐｈｉｎ）的表达。方法用针对ｄｙｓｔｒｏｐｈｉｎ棒状区第１５～１８重复区域的多克隆抗血清Ａｎｔｉ５～７，对２２例Ｄｕｃｈｅｎｎｅ型（ＤＭＤ）和４例Ｂｅｃｋｅｒ型肌营养不良症（ＢＭＤ）患者及１１例无神经肌肉疾病的急诊外伤患者（作为对照）的肌组织进行免疫组化分析。结果在对照组肌细胞中ｄｙｓｔｒｏｐｈｉｎ存在着可达检测水平的表达，并特异地定位于肌细胞膜上。１９例ＤＭＤ没有可达检测水平的ｄｙｓｔｒｏｐｈｉｎ表达，３例ＤＭＤ存在着ｄｙｓｔｒｏｐｈｉｎ表达。４例ＢＭＤ肌细胞膜上则呈现出斑片状、不连续ｄｙｓｔｒｏｐｈｉｎ弱阳性表达。结论ｄｙｓ－ｔｒｏｐｈｉｎ的缺乏是造成ＤＭＤ／ＢＭＤ表型的基本生化因素，此方法为临床上对ＤＭＤ／ＢＭＤ患者作出确诊提供了直接的特异生化测试指标。     

Duchenne肌营养不良模型鼠基因型及肌肉病理的研究

目的研究Duchenne肌营养不良(DMD)模型鼠mdx基因型及肌肉病理改变。方法分别采用光镜、免疫荧光、EvansBlue染料、电镜等方法研究mdx小鼠与正常对照组C57/BL6小鼠腓肠肌病理改变,并检测mdx小鼠的基因型。结果经Dys-3、δ-sarcoglican抗体染色后mdx小鼠肌膜基本未见绿色荧光,正常对照组C57/BL6小鼠肌膜呈明显网状绿色荧光;荧光显微镜观察EvansBlue红色荧光染料,mdx小鼠肌纤维呈明显红色荧光,而肌膜完整的正常对照组C57/BL6小鼠肌纤维不摄取红色荧光染料。mdx模型鼠肌丝排列紊乱,方向不一,肌细胞核位于肌纤维中央,Z盘模糊,肌膜局部不连续,C57/BL6小鼠肌丝排列整齐,Z盘清晰可见。结论mdx小鼠以肌纤维变性、坏死为特征,肌细胞膜缺损是mdx小鼠主要病理改变之一。mdx小鼠dystrophin基因缺陷同时伴有dystrophin相关蛋白缺失,mdx小鼠肌肉病理为DMD进一步治疗研究奠定了基础。     

Spin-lock magnetic resonance imaging of muscle in patients with autosomal recessive limb girdle muscular dystrophy.

Spin-lock imaging is a new magnetic resonance imaging (MRI) technique used to reflect the microstructural integrity of muscle. The purpose of this study was to characterize spin-lock contrast (SLC) of calf muscles in limb girdle muscular dystrophy (LGMD). The calf muscles of 5 patients with LGMD and 10 healthy volunteers were imaged with an off-resonance magnetic resonance (MR) spin-lock suppression pulse. Spin-lock suppression ratios were calculated for anterior tibialis, posterior tibialis, soleus, and gastrocnemius muscles. Clinical assessments of muscle strength were compared to the spin-lock suppression ratios in the LGMD group. Strong SLC was observed in healthy muscles, with mean (+/- SD) suppression ratios ranging from 51.2% (+/- 3.6%) to 56.3% (+/- 1.3%). In diseased muscle, spin-lock signal suppression was reduced by 8%-70%, demonstrating an inverse correlation between symptom duration and suppression ratios. Spin-lock contrast in the patients with LGMD, as a reflection of tissue integrity, was best preserved in posterior tibialis, anterior tibialis, soleus, and gastrocnemius muscles in descending order. Clinical assessments did a poorer job of differentiating than SLC did and were in poor agreement with spin-lock suppression ratios. Spin-lock MRI can quantify microstructural changes in LGMD and appears to provide information not obtainable from clinical evaluations. This suggests that this noninvasive technique may be useful in evaluating the extent, progression, and response to therapy of LGMD.     

Prednisolone enhances myogenesis and dystrophin-related protein in skeletal muscle cell cultures from mdx mouse

The differentiation of skeletal muscle cells from mdx mice which lack dystrophin expression was examined after glucocorticoid treatment, namely α-methylprednisolone (PDN). Primary skeletal muscle cell cultures were established from newborn mdx, congenic C57BL/10, and allogenic BALB/C mice. We show that PDN promotes the myogenesis of both mdx- and control mice-derived cultures as determined by (1) the number of myotubes, (2) acetylcholine receptors, and (3) dystrophin and dystrophin-related protein levels. These results support the hypothesis that PDN could enhance the myogenesis of satellite cells and increase dystrophin-related protein expression in DMD treated patients. © 1993 Wiley-Liss, Inc.     

Blockade of TNF in vivo using cV1q antibody reduces contractile dysfunction of skeletal muscle in response to eccentric exercise in dystrophic mdx and normal mice

This study evaluated the contribution of the pro-inflammatory cytokine, tumour necrosis factor (TNF) to the severity of exercise-induced muscle damage and subsequent myofibre necrosis in mdx mice. Adult mdx and non-dystrophic C57 mice were treated with the mouse-specific TNF antibody cV1q before undergoing a damaging eccentric contraction protocol performed in vivo on a custom built mouse dynamometer. Muscle damage was quantified by (i) contractile dysfunction (initial torque deficit) immediately after the protocol, (ii) subsequent myofibre necrosis 48 h later. Blockade of TNF using cV1q significantly reduced contractile dysfunction in mdx and C57 mice compared with mice injected with the negative control antibody (cVaM) and un-treated mice. Furthermore, cV1q treatment significantly reduced myofibre necrosis in mdx mice. This in vivo evidence that cV1q reduces the TNF-mediated adverse response to exercise-induced muscle damage supports the use of targeted anti-TNF treatments to reduce the severity of the functional deficit and dystropathology in DMD.