Muscular Dystrophy

肌营养不良
  • 文章类型: Journal Article
    背景:长非编码RNA(lncRNA)是长度大于200个核苷酸的非编码RNA转录本,并且已知在调节涉及重要细胞功能的基因的转录中起作用。我们假设异常蛋白病中的疾病过程与lncRNAs和信使RNAs(mRNAs)的异常表达有关。
    目的:在本研究中,我们比较了野生型和dhyperlin缺陷鼠成肌细胞(C2C12细胞)的lncRNA和mRNA表达谱.
    方法:使用微阵列进行LncRNA和mRNA表达谱分析。使用定量实时聚合酶链反应验证了几种具有差异表达的lncRNA。进行基因本体论(GO)分析以了解差异表达的mRNA的功能作用。进一步的生物信息学分析用于探索潜在的功能,lncRNA-mRNA相关性,和差异表达lncRNAs的潜在靶标。
    结果:我们发现3195个lncRNAs和1966个mRNAs差异表达。差异表达的lncRNAs和mRNAs的染色体分布不相等,染色体2具有最高数量的lncRNAs和染色体7具有最高数量的差异表达的mRNA。对差异表达基因的通路分析表明,包括PI3K-Akt,河马,和调节干细胞多能性的途径。差异表达的基因也富集了GO术语,发育过程和肌肉系统过程。网络分析鉴定了来自上调的lncRNA的8个统计学上显著(P<.05)的网络对象和来自下调的lncRNA的3个统计学上显著的网络对象。
    结论:到目前为止,我们的结果暗示,异常蛋白病与多个lncRNAs的异常表达有关,其中许多可能在疾病过程中具有特定功能。GO术语和网络分析提示了这些lncRNA的肌肉特异性作用。为了阐明这些异常表达的非编码RNA的特定作用,需要进一步的研究工程他们的表达。
    BACKGROUND: Long noncoding RNAs (lncRNAs) are noncoding RNA transcripts greater than 200 nucleotides in length and are known to play a role in regulating the transcription of genes involved in vital cellular functions. We hypothesized the disease process in dysferlinopathy is linked to an aberrant expression of lncRNAs and messenger RNAs (mRNAs).
    OBJECTIVE: In this study, we compared the lncRNA and mRNA expression profiles between wild-type and dysferlin-deficient murine myoblasts (C2C12 cells).
    METHODS: LncRNA and mRNA expression profiling were performed using a microarray. Several lncRNAs with differential expression were validated using quantitative real-time polymerase chain reaction. Gene Ontology (GO) analysis was performed to understand the functional role of the differentially expressed mRNAs. Further bioinformatics analysis was used to explore the potential function, lncRNA-mRNA correlation, and potential targets of the differentially expressed lncRNAs.
    RESULTS: We found 3195 lncRNAs and 1966 mRNAs that were differentially expressed. The chromosomal distribution of the differentially expressed lncRNAs and mRNAs was unequal, with chromosome 2 having the highest number of lncRNAs and chromosome 7 having the highest number of mRNAs that were differentially expressed. Pathway analysis of the differentially expressed genes indicated the involvement of several signaling pathways including PI3K-Akt, Hippo, and pathways regulating the pluripotency of stem cells. The differentially expressed genes were also enriched for the GO terms, developmental process and muscle system process. Network analysis identified 8 statistically significant (P<.05) network objects from the upregulated lncRNAs and 3 statistically significant network objects from the downregulated lncRNAs.
    CONCLUSIONS: Our results thus far imply that dysferlinopathy is associated with an aberrant expression of multiple lncRNAs, many of which may have a specific function in the disease process. GO terms and network analysis suggest a muscle-specific role for these lncRNAs. To elucidate the specific roles of these abnormally expressed noncoding RNAs, further studies engineering their expression are required.
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  • 文章类型: Case Reports
    肠囊虫肺炎(PCI)是一种罕见的疾病,其中空气积聚在肠浆膜下和粘膜下层,在胃肠壁内引起多个气态囊肿。虽然PCI有各种已知的危险因素,将肌肉疾病确定为一个因素的报告很少。这项研究的目的是阐明PCI在肌肉疾病中的临床特征。我们提出了一系列五个案例,包括2例Duchenne型肌营养不良症(DMD)和3例罕见的先天性肌病。所有病例均为男性患者,肠蠕动不良和便秘,通过气管造口术接受管饲和机械通气。他们没有严重并发症的迹象,如肠坏死,通过保守治疗,所有这些都得到了改善。病例1是一名患有DMD的23岁男子,在20岁时出现心肺骤停。行升结肠PCI术前3个月发生肺出血,通过保守的氧气治疗解决了。病例2是患有DMD的25岁男子,其在20岁时发展到需要气管造口术的不活动。他经历了持续的腹痛和恶心,在盲肠和升结肠检测到PCI。在保守治疗三个月后,他显示PCI几乎完全消退。病例3是一个六岁的男孩,患有减少的身体肌病。便秘在4岁时被诊断出来。他经历了间歇性的血便,导致6岁时偶然发现PCI。经过两个月的保守治疗,PCI缓解,无后续复发.病例4是一名33岁的婴儿严重肌管肌病。他出生后立即需要机械通气,后来因并发症接受了气管造口术和管饲。在27岁的时候,在腹部CT上偶然发现PCI。他有缓解和恶化的发作几年;然而,PCI在三年后完全解决。病例5是一名27岁的男性,患有线虫肌病。14岁时,他有持续的血泊。下消化道内镜检查后,他被诊断为PCI伴许多直肠囊肿.PCI不需要特定的治疗干预。有PCI和血便的自发消退。鉴于PCI缺乏特定症状,并且肌肉疾病的病例通常会出现腹部问题,许多病例容易被忽视或误诊。抱怨持续腹部症状的肌肉疾病患者应进行影像学检查以排除PCI。
    Pneumatosis cystoides intestinalis (PCI) is a rare disease wherein air accumulates in the intestinal subserosa and submucosa, causing multiple gaseous cysts within the gastrointestinal wall. While PCI has various known risk factors, reports identifying muscular diseases as a factor are scarce. The aim of this study is to elucidate the clinical characteristics of PCI in muscle disease. We present a case series of five cases, including two cases of Duchenne muscular dystrophy (DMD) and three cases of rare congenital myopathies. All cases are of male patients, with poor intestinal peristalsis and constipation, who underwent tube feeding and mechanical ventilation via tracheostomy. They had no signs of severe complications, such as intestinal necrosis, and all of them improved with conservative treatment. Case 1 is a 23-year-old man with DMD who developed cardiopulmonary arrest at the age of 20 years. Pulmonary hemorrhage occurred three months before the incidental detection of PCI in the ascending colon, which resolved with conservative oxygen treatment. Case 2 is a 25-year-old man with DMD who progressed to immobility necessitating tracheostomy at the age of 20 years. He experienced persistent abdominal pain and nausea, and PCI was detected in the cecum and ascending colon. He showed near-complete resolution of PCI after three months of conservative treatment. Case 3 is a six-year-old boy with reducing body myopathy. Constipation was diagnosed at four years of age. He experienced intermittent bloody stools, leading to the incidental detection of PCI at six years of age. After two months of conservative treatment, the PCI resolved with no subsequent recurrence. Case 4 is a 33-year-old man with infantile severe myotubular myopathy. He required mechanical ventilation immediately after birth and later underwent tracheostomy and tube feeding due to complications. At the age of 27 years, PCI was incidentally detected on abdominal CT. He had episodes of remission and worsening for a few years; however, PCI completely resolved after three years. Case 5 is a 27-year-old man with nemaline myopathy. At the age of 14 years, he had persistent bloody stools. After lower gastrointestinal endoscopy, he was diagnosed with PCI with numerous rectal cysts. PCI required no specific therapeutic intervention. There was spontaneous resolution of PCI and bloody stools. Given that PCI lacks specific symptoms and cases with muscular diseases often experience abdominal issues, many cases are liable to be overlooked or misdiagnosed. Cases with muscular diseases complaining of persistent abdominal symptoms should undergo radiographic imaging to rule out PCI.
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  • 文章类型: Journal Article
    与Plectin病相关的疾病是由编码网蛋白的PLECTIN(PLEC)基因突变引起的。PLEC突变导致一系列由不同程度的体征定义的疾病,大多数患有单纯大疱性表皮松解症并伴有肌营养不良(EBS-MD)和与肌营养不良相关的疾病是2Q型肢带肌营养不良(LGMD2Q)。在这里,我们报告了3例EBS-MD和LGMD2Q疾病,通过外显子组测序分析,然后进行突变确认。
    由下一代遗传综合诊所的专家和临床遗传学家进行了完整的临床检查,马什哈德,伊朗(NGC,2020-2021年),.提取基因组DNA并通过全外显子组测序分析和随后的Sanger测序进行评估,用于PLEC候选变体的共分离分析。
    我们发现三例与plectinopathy相关的疾病,2例肢体带型肌营养不良2Q(LGMD2Q)患者,其他受影响的先证者患有单纯大疱性表皮松解症合并肌营养不良(EBS-MD),PLEC的接合性突变可变。运动发育障碍和肌营养不良症状在受影响的个体中具有不同的年龄发病。EBS患者表现出起泡等症状,皮肤疤痕,新生儿发病,和指甲营养不良。
    我们报告了与PLEC相关的疾病,以扩大不同类型PLEC相关疾病的临床表型。我们假设基于有关plectinopathy疾病遗传基础的全面知识,设计更组织良好的研究。
    UNASSIGNED: Plectinopathy-associated disorders are caused by mutations in the PLECTIN (PLEC) gene encoding Plectin protein. PLEC mutations cause a spectrum of diseases defined by varying degrees of signs, mostly with epidermolysis bullosa simplex with muscular dystrophy (EBS-MD) and plectinopathy-related disorder is limb-girdle muscular dystrophy type 2Q (LGMD2Q). Here we report three cases with EBS-MD and LGMD2Q disorders analyzed by exome sequencing followed by mutation confirmation.
    UNASSIGNED: A complete clinical examination was done by expert specialists and clinical geneticists in Next Generation Genetic polyclinic, Mashhad, Iran (NGC, years 2020_2021),. Genomic DNA was extracted and evaluated through whole-exome sequencing analysis followed by Sanger sequencing for co-segregation analysis of PLEC candidate variants.
    UNASSIGNED: We found three cases with the plectinopathy-related disease, two patients with limb-girdle muscular dystrophy type 2Q (LGMD2Q), and the other affected proband suffers from epidermolysis bullosa simplex combined with muscular dystrophy (EBS-MD) with variable zygosity mutations for PLEC. Motor development disorder and muscular dystrophy symptoms have different age onset in affected individuals. Patients with EBS demonstrated symptoms such as blistering, skin scars, neonatal-onset, and nail dystrophy.
    UNASSIGNED: We report plectinopathy-associated disorders to expand clinical phenotypes in different types of PLEC-related diseases. We suppose to design more well-organized research based on comprehensive knowledge about the genetic basis of plectinopathy diseases.
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  • 文章类型: Journal Article
    Sarcospan(SSPN)是一种25kDa的跨膜蛋白,在许多组织的细胞表面广泛表达,包括,但不限于,骨骼肌和平滑肌的肌纤维,心肌细胞,脂肪细胞,肾上皮细胞,和神经元。SSPN是连接细胞内肌动蛋白细胞骨架与细胞外基质的肌营养不良蛋白-糖蛋白复合物(DGC)的核心成分。它还与整合素α7β1(骨骼肌中表达的主要整合素)相关。作为具有四个跨膜域的四跨膜蛋白样蛋白,SSPN充当支架以促进细胞膜上的蛋白质-蛋白质相互作用。杜氏肌营养不良症,Becker肌营养不良症,和X连锁扩张型心肌病是由肌细胞表面的肌营养不良蛋白的丢失以及伴随的整个DGC的丢失引起的,包括SSPN。SSPN过表达改善mdx小鼠模型中的Duchenne肌营养不良,这支持SSPN成为可行的治疗靶标。其他拯救研究支持SSPN作为DGC的正确组装和膜表达的生物标志物。SSPN拯救分子机制的基础研究需要针对SSPN的高度特异性和强大的抗体,临床前研究,和人类样本中的生物标志物评估。SSPN抗体的开发受到其四个跨膜结构域和有限的抗原表位的存在的挑战。为了解决有限的市售抗体带来的重大障碍,我们的目标是产生一组强大的SSPN特异性抗体,可以作为研究界的资源。我们创建了针对三个SSPN蛋白表位的抗体,包括细胞内N-和C-末端以及跨膜结构域3和4之间的大细胞外环(LEL)。我们开发了一组针对SSPNN末端肽片段的兔抗体(多抗体和单克隆抗体)。我们使用了几种测定法来显示兔抗体以高功能亲和力和特异性识别小鼠SSPN。我们开发了针对人SSPN的C末端肽和大细胞外环的小鼠单克隆抗体。这些抗体优于市售抗体,并在各种应用中胜过它们。包括免疫印迹,间接免疫荧光分析,免疫沉淀,和ELISA。这些新开发的抗体将显着提高SSPN检测的质量和易用性,用于基础和翻译研究。
    Sarcospan (SSPN) is a 25-kDa transmembrane protein that is broadly expressed at the cell surface of many tissues, including, but not limited to, the myofibers from skeletal and smooth muscles, cardiomyocytes, adipocytes, kidney epithelial cells, and neurons. SSPN is a core component of the dystrophin-glycoprotein complex (DGC) that links the intracellular actin cytoskeleton with the extracellular matrix. It is also associated with integrin α7β1, the predominant integrin expressed in skeletal muscle. As a tetraspanin-like protein with four transmembrane spanning domains, SSPN functions as a scaffold to facilitate protein-protein interactions at the cell membrane. Duchenne muscular dystrophy, Becker muscular dystrophy, and X-linked dilated cardiomyopathy are caused by the loss of dystrophin at the muscle cell surface and a concomitant loss of the entire DGC, including SSPN. SSPN overexpression ameliorates Duchenne muscular dystrophy in the mdx murine model, which supports SSPN being a viable therapeutic target. Other rescue studies support SSPN as a biomarker for the proper assembly and membrane expression of the DGC. Highly specific and robust antibodies to SSPN are needed for basic research on the molecular mechanisms of SSPN rescue, pre-clinical studies, and biomarker evaluations in human samples. The development of SSPN antibodies is challenged by the presence of its four transmembrane domains and limited antigenic epitopes. To address the significant barrier presented by limited commercially available antibodies, we aimed to generate a panel of robust SSPN-specific antibodies that can serve as a resource for the research community. We created antibodies to three SSPN protein epitopes, including the intracellular N- and C-termini as well as the large extracellular loop (LEL) between transmembrane domains 3 and 4. We developed a panel of rabbit antibodies (poly- and monoclonal) against an N-terminal peptide fragment of SSPN. We used several assays to show that the rabbit antibodies recognize mouse SSPN with a high functional affinity and specificity. We developed mouse monoclonal antibodies against the C-terminal peptide and the large extracellular loop of human SSPN. These antibodies are superior to commercially available antibodies and outperform them in various applications, including immunoblotting, indirect immunofluorescence analysis, immunoprecipitation, and an ELISA. These newly developed antibodies will significantly improve the quality and ease of SSPN detection for basic and translational research.
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  • 文章类型: Case Reports
    LMNA中的致病变体与广泛的肌肉疾病有关:层蛋白病。LMNA相关的先天性肌营养不良是一种以早期症状为特征的层肌病,通常在年轻时导致致命的结果。儿童面临恶性心律失常的风险增加。没有建立的儿科方案来管理这种情况。我们回顾了已发表的病例,并提供了两个患有LMNA相关肌营养不良的双胞胎姐妹的疾病进展的见解。我们的目标是提出专门为儿科患者量身定制的心脏监测和管理计划。我们介绍了一个有五个成员的家庭,包括两个患有LMNA相关肌营养不良的双胞胎姐妹。对所有家庭成员进行了全面的神经肌肉和心脏检查。使用大规模测序技术对两个双胞胎进行了遗传分析。临床评估显示,只有双胞胎诊断出LMNA相关的肌营养不良。随访显示早期出现症状和危及生命的心律失常,尽管两个双胞胎都去世了,但疾病进展不同。遗传分析确定了LMNA基因中的从头罕见的错义有害变体。在与肌无力综合征相关的基因中发现了其他其他罕见变异。早发性神经肌肉症状可能与LMNA相关肌营养不良中危及生命的心律失常的预后有关。作为其他罕见变体的载体可能是表型进展的修饰因素,虽然还需要进一步的研究。迫切需要针对儿科人群的特定心脏建议,以减轻恶性心律失常的风险。
    Pathogenic variants in LMNA have been associated with a wide spectrum of muscular conditions: the laminopathies. LMNA-related congenital muscular dystrophy is a laminopathy characterised by the early onset of symptoms and often leads to a fatal outcome at young ages. Children face a heightened risk of malignant arrhythmias. No established paediatric protocols for managing this condition are available. We review published cases and provide insights into disease progression in two twin sisters with LMNA-related muscular dystrophy. Our objective is to propose a cardiac surveillance and management plan tailored specifically for paediatric patients. We present a family of five members, including two twin sisters with LMNA-related muscular dystrophy. A comprehensive neuromuscular and cardiac work-up was performed in all family members. Genetic analysis using massive sequencing technology was performed in both twins. Clinical assessment showed that only the twins showed diagnoses of LMNA-related muscular dystrophy. Follow-up showed an early onset of symptoms and life-threatening arrhythmias, with differing disease progressions despite both twins passing away. Genetic analysis identified a de novo rare missense deleterious variant in the LMNA gene. Other additional rare variants were identified in genes associated with myasthenic syndrome. Early-onset neuromuscular symptoms could be related to a prognosis of worse life-threatening arrhythmias in LMNA related muscular dystrophy. Being a carrier of other rare variants may be a modifying factor in the progression of the phenotype, although further studies are needed. There is a pressing need for specific cardiac recommendations tailored to the paediatric population to mitigate the risk of malignant arrhythmias.
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  • 文章类型: Journal Article
    肌糖病包括四种不同形式的肢体带肌营养不良(LGMD),表示为LGMDR3-R6,由SGCA内的突变引起,SGCB,SGCG,和SGCD基因。全球的肌糖病患病率很低,使得研究这些疾病具有挑战性。这项研究的主要目的是探索一组俄罗斯肌糖病患者的突变谱,并确定这些疾病在俄罗斯联邦的发生频率。我们对49例俄罗斯sarcogycan基因变异患者的临床和分子遗传学数据进行了回顾性分析。结果表明,在71.4%的病例中发现了SGCA基因的变异,SGCB和SGCG基因在12.2%的患者中都表现出变异。在4.1%的病例中检测到SGCD基因变异。在49例肌糖病中的46例中发现了双等位基因致病性和可能的致病性变异:LGMDR3(n=34),LGMDR4(n=4),LGMDR5(n=6),和LGMDR6(n=2)。总共鉴定了31种不同的变体,包含25个先前报道的和6个新的变体。两个主要的变体,c.229C>T和c.271G>A,在SGCA中检测到,占俄罗斯LGMDR3患者所有突变等位基因的61.4%。两个LGMDR6病例均由SGCD基因中的纯合无义变体c.493C>Tp。(Arg165Ter)引起。据估计,俄罗斯联邦的肌糖病发病率至少为4,115,039人中有1人,低于其他人群的报告发病率。
    Sarcoglycanopathies encompass four distinct forms of limb-girdle muscular dystrophies (LGMD), denoted as LGMD R3-R6, arising from mutations within the SGCA, SGCB, SGCG, and SGCD genes. The global prevalence of sarcoglycanopathies is low, making it challenging to study these diseases. The principal objective of this study was to explore the spectrum of mutations in a cohort of Russian patients with sarcoglycanopathies and to ascertain the frequency of these conditions in the Russian Federation. We conducted a retrospective analysis of clinical and molecular genetic data from 49 Russian patients with sarcoglycan genes variants. The results indicated that variants in the SGCA gene were found in 71.4% of cases, with SGCB and SGCG genes each exhibiting variants in 12.2 % of patients. SGCD gene variants were detected in 4.1% of cases. Bi-allelic pathogenic and likely pathogenic variants were identified in 46 of the 49 cases of sarcoglycanopathies: LGMD R3 (n = 34), LGMD R4 (n = 4), LGMD R5 (n = 6), and LGMD R6 (n = 2). A total of 31 distinct variants were identified, comprising 25 previously reported and 6 novel variants. Two major variants, c.229C>T and c.271G>A, were detected within the SGCA, constituting 61.4% of all mutant alleles in Russian patients with LGMD R3. Both LGMD R6 cases were caused by the homozygous nonsense variant c.493C>T p.(Arg165Ter) in the SGCD gene. The incidence of sarcoglycanopathies in the Russian Federation was estimated to be at least 1 in 4,115,039, which is lower than the reported incidence in other populations.
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  • 文章类型: Journal Article
    杜氏肌营养不良症(DMD)的特征是呼吸肌损伤,炎症,纤维化和虚弱,最终导致呼吸衰竭.DMD(mdx)的肌营养不良蛋白缺陷小鼠模型显示了呼吸肌重塑和功能障碍导致呼吸系统性能受损的证据。抗氧化剂N-乙酰半胱氨酸(NAC)已被证明可以发挥抗炎和抗纤维化作用,从而在一系列肌肉功能障碍的动物模型中改善呼吸肌的性能。包括MDX老鼠,短期给药(2周)后。我们试图通过探索慢性NAC给药(3个月)对mdx小鼠呼吸系统性能的影响来建立先前的工作。一个月大的雄性mdx小鼠随机接受正常饮用水(n=30)或饮用水中的1%NAC(n=30)3个月。在4个月大的时候,我们通过体积描记术评估清醒小鼠的呼吸,然后通过离体评估膈肌力产生能力.此外,进行膈肌组织学检查.在单独的研究中,在麻醉的老鼠身上,确定了一系列行为的呼吸肌电图(EMG)活动和吸气压力,包括峰值吸气压力产生能力的评估。NAC处理不影响mdx隔膜的力产生能力。与mdx隔膜相比,mdxNAC中的胶原蛋白含量和免疫细胞浸润没有变化。此外,NAC对呼吸没有显著影响,通气反应性,从基础条件到峰值系统性能的行为范围内的吸气EMG活动或吸气压力。我们得出的结论是,在DMD的mdx小鼠模型中,慢性NAC治疗对呼吸系统性能没有明显的有益作用,这表明仅NAC治疗对人DMD的潜力有限。
    Duchenne muscular dystrophy (DMD) is characterised by respiratory muscle injury, inflammation, fibrosis and weakness, ultimately culminating in respiratory failure. The dystrophin-deficient mouse model of DMD (mdx) shows evidence of respiratory muscle remodelling and dysfunction contributing to impaired respiratory system performance. The antioxidant N-acetylcysteine (NAC) has been shown to exert anti-inflammatory and anti-fibrotic effects leading to improved respiratory muscle performance in a range of animal models of muscle dysfunction, including mdx mice, following short-term administration (2 weeks). We sought to build on previous work by exploring the effects of chronic NAC administration (3 months) on respiratory system performance in mdx mice. One-month-old male mdx mice were randomised to receive normal drinking water (n = 30) or 1% NAC in the drinking water (n = 30) for 3 months. At 4 months of age, we assessed breathing in conscious mice by plethysmography followed by ex vivo assessment of diaphragm force-generating capacity. Additionally, diaphragm histology was performed. In separate studies, in anaesthetised mice, respiratory electromyogram (EMG) activity and inspiratory pressure across a range of behaviours were determined, including assessment of peak inspiratory pressure-generating capacity. NAC treatment did not affect force-generating capacity of the mdx diaphragm. Collagen content and immune cell infiltration were unchanged in mdx + NAC compared with mdx diaphragms. Additionally, there was no significant effect of NAC on breathing, ventilatory responsiveness, inspiratory EMG activity or inspiratory pressure across the range of behaviours from basal conditions to peak system performance. We conclude that chronic NAC treatment has no apparent beneficial effects on respiratory system performance in the mdx mouse model of DMD suggesting limited potential of NAC treatment alone for human DMD.
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  • 文章类型: Journal Article
    杜氏肌营养不良症(DMD)是一种致命的遗传性神经肌肉疾病,其特征是由于肌营养不良蛋白缺乏的继发性后果而导致骨骼肌功能逐渐下降。虚弱延伸到呼吸肌肉组织,和心肺功能衰竭是男性DMD的主要死亡原因。间歇性缺氧已成为一种潜在的疗法,可通过引起长期呼吸促进来抵消通气功能不全。在动物模型中已经很好地描述了感觉和运动促进呼吸的机制。已经在人体试验中设计并实施了间歇性缺氧的各种范例,最终在脊髓损伤和肌萎缩性侧索硬化症患者中进行了临床试验。考虑了治疗性间歇性缺氧对DMD的应用,并讨论了由于这种破坏性疾病的复杂性而导致的潜在进展障碍。尽管间歇性低氧治疗DMD存在相当大的挑战和潜在的缺陷,我们建议研究界有责任探索临床前模型的潜在益处.应实施间歇性缺氧范例,以探索表达呼吸可塑性的倾向,并以维持和增强临床前模型和DMD患者的通气为长期目标。
    Duchenne muscular dystrophy (DMD) is a fatal genetic neuromuscular disorder, characterised by progressive decline in skeletal muscle function due to the secondary consequences of dystrophin deficiency. Weakness extends to the respiratory musculature, and cardiorespiratory failure is the leading cause of death in men with DMD. Intermittent hypoxia has emerged as a potential therapy to counteract ventilatory insufficiency by eliciting long-term facilitation of breathing. Mechanisms of sensory and motor facilitation of breathing have been well delineated in animal models. Various paradigms of intermittent hypoxia have been designed and implemented in human trials culminating in clinical trials in people with spinal cord injury and amyotrophic lateral sclerosis. Application of therapeutic intermittent hypoxia to DMD is considered together with discussion of the potential barriers to progression owing to the complexity of this devastating disease. Notwithstanding the considerable challenges and potential pitfalls of intermittent hypoxia-based therapies for DMD, we suggest it is incumbent on the research community to explore the potential benefits in pre-clinical models. Intermittent hypoxia paradigms should be implemented to explore the proclivity to express respiratory plasticity with the longer-term aim of preserving and potentiating ventilation in pre-clinical models and people with DMD.
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  • 文章类型: Journal Article
    聚合层粘连蛋白是多结构域基底膜(BM)糖蛋白,其自组装成细胞锚定的平面晶格以建立初始BM支架。Nidogens,然后,胶原蛋白IV和蛋白聚糖在不同的结构域基因座处与支架结合以产生成熟的BM。相邻层粘连蛋白的LN结构域彼此结合形成聚合物节点,而LG结构域连接到细胞骨架锚定整合素和营养不良聚糖,以及硫酸盐和硫酸乙酰肝素。聚合物节点,聚合物支架的重复单元,被组织成一个近乎对称的triskelion.结构,最近通过冷冻电子显微镜结合AlphaFold2建模和生化研究解决,揭示了LN表面残基如何相互作用,以及突变如何导致一组新兴疾病中的自组装失败,LN-层粘连蛋白病,包括LAMA2相关的营养不良和Pierson综合征。
    Polymerizing laminins are multi-domain basement membrane (BM) glycoproteins that self-assemble into cell-anchored planar lattices to establish the initial BM scaffold. Nidogens, collagen-IV and proteoglycans then bind to the scaffold at different domain loci to create a mature BM. The LN domains of adjacent laminins bind to each other to form a polymer node, while the LG domains attach to cytoskeletal-anchoring integrins and dystroglycan, as well as to sulfatides and heparan sulfates. The polymer node, the repeating unit of the polymer scaffold, is organized into a near-symmetrical triskelion. The structure, recently solved by cryo-electron microscopy in combination with AlphaFold2 modeling and biochemical studies, reveals how the LN surface residues interact with each other and how mutations cause failures of self-assembly in an emerging group of diseases, the LN-lamininopathies, that include LAMA2-related dystrophy and Pierson syndrome.
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  • 文章类型: Journal Article
    在神经肌肉疾病的临床试验中建议测量肌肉力量和运动功能,但运动功能受到影响的手的力量损失没有记录。
    要建立手部力量与功能之间的关系,并确定区分Duchenne肌营养不良(DMD)或脊髓性肌萎缩(SMA)个体的正常和异常手功能的力量阈值。
    用MyoGrip和MyoPinch测力计测量了最大的握力和钥匙捏合强度,分别。使用MoviPlate评估手功能,上肢远端运动功能测量项目(MFM-D3-UL)和Cochin手部功能量表(CHFS)。
    来自168名参与者的数据(91DMD和77SMA,年龄6-31岁)进行分析。强度和功能之间的关系显着(P<0.001)。当强度高于接收器工作特性(ROC)分析确定的强度阈值时,通常会保留手功能:对于MFM-D3-UL,对于健康受试者,计算出的握力阈值为预测强度的41%和13%(%pred),对于DMD和SMA,键捏力阈值为42%和26%pred,分别。对于MoviPlate,对于DMD和SMA,握力阈值分别为11%和8%pred,键捏力阈值分别为21%和11%pred,分别。对于强度低于阈值的参与者,手功能评分随着力量的降低而降低。在相同的%pred强度下,SMA患者的功能评分优于DMD患者.
    对于大多数运动任务,手的功能取决于强度。只有当力量低于疾病特异性阈值时,它才会下降。因此,能够将力量保持在该阈值以上的疗法应保留手功能。
    UNASSIGNED: Measurement of muscle strength and motor function is recommended in clinical trials of neuromuscular diseases, but the loss of hand strength at which motor function is impacted is not documented.
    UNASSIGNED: To establish the relationship between hand strength and function, and to determine the strength threshold that differentiates normal and abnormal hand function in individuals with Duchenne Muscular Dystrophy (DMD) or Spinal Muscular Atrophy (SMA).
    UNASSIGNED: Maximal handgrip and key pinch strength were measured with the MyoGrip and MyoPinch dynamometers, respectively. Hand function was assessed using the MoviPlate, the Motor Function Measure items for distal upper limb (MFM-D3-UL) and the Cochin Hand Function Scale (CHFS).
    UNASSIGNED: Data from 168 participants (91 DMD and 77 SMA, age 6-31 years) were analyzed. Relationships between strength and function were significant (P < 0.001). Hand function was generally preserved when strength was above the strength threshold determined by Receiver-Operating Characteristic (ROC) analysis: For MFM-D3-UL, the calculated handgrip strength thresholds were 41 and 13% of the predicted strength for a healthy subject (% pred) and the key pinch strength thresholds were 42 and 26% pred for DMD and SMA, respectively. For the MoviPlate, handgrip strength thresholds were 11 and 8% pred and key pinch strength thresholds were 21 and 11% pred for DMD and SMA, respectively. For participants with sub-threshold strength, hand function scores decreased with decreasing strength. At equal % pred strength, individuals with SMA had better functional scores than those with DMD.
    UNASSIGNED: Hand function is strength-dependent for most motor tasks. It declines only when strength falls below a disease-specific threshold. Therefore, therapies capable of maintaining strength above this threshold should preserve hand function.
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