myopathy

先天性肌病
  • 文章类型: Journal Article
    BACKGROUND: Equine exercise-associated myopathies are prevalent, clinically heterogeneous, generally idiopathic disorders characterised by episodes of myofibre damage that occur in association with exercise. Episodes are intermittent and vary within and between affected horses and across breeds. The aetiopathogenesis is often unclear; there might be multiple causes. Poor phenotypic characterisation hinders genetic and other disease analyses.
    OBJECTIVE: The aim of this study was to characterise phenotypic patterns across exercise-associated myopathies in horses.
    METHODS: Historical cross-sectional study, with subsequent masked case-control validation study.
    METHODS: Historical clinical and histological features from muscle samples (n = 109) were used for k-means clustering and validated using principal components analysis and hierarchical clustering. For further validation, a blinded histological study (69 horses) was conducted comparing two phenotypic groups with selected controls and horses with histopathological features characterised by myofibrillar disruption.
    RESULTS: We identified two distinct broad phenotypes: a non-classic exercise-associated myopathy syndrome (EAMS) subtype was associated with practitioner-described signs of apparent muscle pain (p < 0.001), reluctance to move (10.85, p = 0.001), abnormal gait (p < 0.001), ataxia (p = 0.001) and paresis (p = 0.001); while a non-specific classic RER subtype was not uniquely associated with any particular variables. No histological differences were identified between subtypes in the validation study, and no identifying histopathological features for other equine myopathies identified in either subtype.
    CONCLUSIONS: Lack of an independent validation population; small sample size of smaller identified subtypes; lack of positive control myofibrillar myopathy cases; case descriptions derived from multiple independent and unblinded practitioners.
    CONCLUSIONS: This is the first study using computational clustering methods to identify phenotypic patterns in equine exercise-associated myopathies, and suggests that differences in patterns of presenting clinical signs support multiple disease subtypes, with EAMS a novel subtype not previously described. Routine muscle histopathology was not helpful in sub-categorising the phenotypes in our population.
    BACKGROUND: Les myopathies induites à l\'exercice demeurent fréquentes, hétérogènes cliniquement et représentent des désordres idiopathiques caractérisés par des épisodes de dommages myofibrillaires en lien avec l\'exercice. Les épisodes sont intermittents et varient à la fois chez le même cheval, entre chevaux et entre les différentes races. L\'étiopathogénie demeure obscure et pourrait être multifactorielle. La pauvre caractérisation phénotypique des myopathies ne simplifie pas les analyses génétiques ni celles d\'autres maladies.
    OBJECTIVE: Le but de cette étude est de caractériser les patrons phénotypiques en lien avec les myopathies induites à l\'exercice chez le cheval. TYPE D\'ÉTUDE: Étude transversale historique et étude subséquente de validation de cas témoins aveugle. MÉTHODES: Les facteurs clés cliniques et histologiques provenant d\'échantillons de muscles (n = 109) ont été utilisés pour l\'algorithme de K‐moyennes et validés par le biais d\'analyse des composantes principales et de classification hiérarchique. Pour validation additionnelle, une étude histologique à l\'aveugle (69 chevaux) a été faite comparant les deux groupes phénotypiques avec des contrôles sélectionnés et des chevaux avec éléments histopathologiques caractérisés par de la discontinuité myofibrillaire. RÉSULTATS: Deux phénotypes distincts ont été identifiés: un premier sous‐type de syndrome de myopathie induite à l\'exercice non‐classique (EAMS) associé à de la douleur musculaire telle que décrite par le praticien suivant le cheval (χ2 (df=1,n=109) = 19.33, p < 0.001), difficulté à se déplacer (χ2 (df=1,n=109) = 10.85, p = 0.001), démarche anormale (χ2 (df=1,n=109) = 34.61, p < 0.001), ataxie (χ2 (df=1,n=109) = 10.88, p = 0.001) et parésie (χ2 (df=1,n=109) = 10.88, p = 0.001); alors qu\'un sous‐type RER classique non‐spécifique n\'était associé à aucune variable en particulier. Aucune différente histologique n\'a été identifié entre les sous‐types dans l\'étude de validation et aucune caractéristique histopathologique d\'autres myopathies équines n\'a été identifiées dans les différents sous‐types.
    UNASSIGNED: Aucune population indépendante pour validation; petite taille d\'échantillon pour les sous‐types peu nombreux identifiés; aucun cas contrôles positifs de myopathie fibrillaire; description des cas provenant de multiples praticiens indépendants et non‐aveugles.
    CONCLUSIONS: Cette étude est la première utilisant des méthodes de regroupement informatique pour identifier des patrons phénotypiques de myopathies équines induites à l\'exercice et suggère que des différences existent dans les patrons de signes cliniques en faveur de multiples sous‐types de maladie, incluant EAMS qui représente un nouveau sous‐type non décrit jusqu\'à maintenant. L\'histopathologie musculaire de routine n\'a pas permis de sous‐catégoriser les phénotypes dans cette population.
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  • 文章类型: Journal Article
    Hutchinson-Gilford早衰综合征(HGPS)是一种罕见的早衰疾病,由层粘连蛋白A基因的从头突变引起。患有HGPS的儿童通常在青少年时期由于动脉粥样硬化等心血管疾病而去世,心肌梗塞,心力衰竭,和中风。在这项研究中,我们对G608GHGPS小鼠模型进行了表征,并探索了心肌和骨骼肌功能,以及成纤维细胞中衰老相关的表型。纯合G608GHGPS小鼠表现出心脏功能障碍,包括心输出量和每搏输出量下降,左心室舒张功能受损.此外,骨骼肌表现出降低的等距强直扭矩,肌肉萎缩,纤维化增加。HGPS成纤维细胞显示核异常,减少增殖,和衰老标志物的表达增加。这些发现为G608GHGPS小鼠模型的病理生理学提供了见解,并为HGPS的潜在治疗策略提供了信息。
    Hutchinson-Gilford progeria syndrome (HGPS) is a rare premature aging disorder resulting from de novo mutations in the lamin A gene. Children with HGPS typically pass away in their teenage years due to cardiovascular diseases such as atherosclerosis, myocardial infarction, heart failure, and stroke. In this study, we characterized the G608G HGPS mouse model and explored cardiac and skeletal muscle function, along with senescence-associated phenotypes in fibroblasts. Homozygous G608G HGPS mice exhibited cardiac dysfunction, including decreased cardiac output and stroke volume, and impaired left ventricle relaxation. Additionally, skeletal muscle exhibited decreased isometric tetanic torque, muscle atrophy, and increased fibrosis. HGPS fibroblasts showed nuclear abnormalities, decreased proliferation, and increased expression of senescence markers. These findings provide insights into the pathophysiology of the G608G HGPS mouse model and inform potential therapeutic strategies for HGPS.
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  • 文章类型: Editorial
    暂无摘要。
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  • 文章类型: Journal Article
    这篇综述是家禽科学协会研讨会的摘要,该研讨会讨论了肉鸡胸肉中的肌病,专注于遗传学之间的相互作用,营养,畜牧业,和肉类加工。描述了胸大肌主要肌病(木质乳房[WB];白色条纹[WS];意大利面条[SM])和胸小肌(“羽毛”),然后讨论它们的患病率,潜在原因,当前和未来的缓解方法,以及检测方法(在活禽和肉中)以及利用受影响肉的方法。总的来说,乳腺肌病仍然是整个家禽业的重要焦点,同时收集了大量的数据和知识,很明显,还有很多东西需要理解。由于有多种因素影响乳腺肌病的发生,它们的减少依赖于整体方法。家禽育种者正在进行的平衡育种策略针对的是长期遗传因素,但理解非遗传因素(短期解决方案,如营养)的重大影响仍然是机会的关键领域。因此,通过鸟类的生命了解肌肉的生理和生物学需求对于减少肌病至关重要(例如,尽量减少氧化应激),并更深入地了解它们的病因。
    This review is a summary of a Poultry Science Association symposium addressing myopathies in broilers\' breast meat, focusing on the interactions between genetics, nutrition, husbandry, and meat processing. The Pectoralis major myopathies (woody breast [WB]; white striping [WS]; spaghetti meat [SM]) and Pectoralis minor (\"feathering\") are described, followed by discussing their prevalence, potential causes, current and future ways to mitigate, as well as detection methods (in live birds and meat) as well as ways to utilize affected meat. Overall, breast myopathies remain an important focus across the poultry industry and whilst a lot of data and knowledge has been gathered, it is clear that there is still a lot to understand. As there are multiple factors impacting the occurrence of breast myopathies, their reduction relies on a holistic approach. Ongoing balanced breeding strategies by poultry breeders is targeting the longer-term genetic component but comprehending the significant influence from nongenetic factors (short-term solutions such as nutrition) remains a key area of opportunity. Consequently, understanding the physiology and biological needs of the muscle through the life of the bird is critical to reduce the myopathies (e.g., minimizing oxidative stress) and gain more insight into their etiology.
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  • 文章类型: Journal Article
    目的:在患有神经肌肉疾病(NMD)和脑瘫(CP)的儿童中经常报告睡眠不良,但睡眠中的呼吸障碍通常是临床重点。在患有NMD的成年人中,周期性肢体运动(PLM)的患病率增加,并且可能导致该人群的睡眠障碍。我们评估了患有NMD或CP的儿童中PLM的患病率。
    方法:对1-18岁患有NMD(包括Duchenne型肌营养不良症,强直性肌营养不良,脊髓性肌萎缩)或CP在2004-2022年儿科睡眠中心进行。
    结果:在239名儿童中至少有1例PSG可进行腿部肌电图检查(125NMD,114CP),和105名儿童的2个PSG(73个NMD,32CP)。在最初的PSG,72(30%)为女性,中位年龄为9岁,呼吸紊乱指数为3.5/h(四分位距1.3-9.9/h)。在每个CP和NMD组中,有9.6%的PLM指数(PLMI;>5/h)升高,通过初始PSG量化。总的来说,PLMI从基线(中位数0,最大值33/h)到随访(中位数0,最大值55.8/h;p<0.05)增加。在那些PLMI升高的人中,归因于PLM的觉醒百分比高达25%(中位数7.5%).
    结论:NMD和CP患儿的PLMI升高发生率高于其他临床转诊儿科人群。重要的是不要忽视PLM,因为识别和治疗可能有助于改善睡眠结果。需要进一步的研究来了解PLM特别是在该人群中的病理生理学和后果。
    OBJECTIVE: Poor sleep is frequently reported in children with neuromuscular diseases (NMD) and cerebral palsy (CP) however breathing disorders during sleep are often the clinical focus. Periodic limb movements (PLMs) have an increased prevalence in adults with NMD and may contribute to sleep disturbance in this population. We assessed the prevalence of PLMs in children with NMD or CP.
    METHODS: Retrospective review of polysomnography (PSG) with leg electromyography in children age 1-18 years with NMD (including Duchenne muscular dystrophy, myotonic dystrophy, spinal muscular atrophy) or CP performed at a paediatric sleep centre 2004-2022.
    RESULTS: Leg electromyography was available in at least 1 PSG in 239 children (125 NMD, 114 CP), and in 2 PSGs in 105 children (73 NMD, 32 CP). At initial PSG, 72 (30 %) were female with a median age 9y and respiratory disturbance index 3.5/h (interquartile range 1.3-9.9/h). Elevated PLM index (PLMI; >5/h) occurred in 9.6 % of each of the CP and NMD groups, quantified by initial PSG. Overall, PLMI increased from baseline (median 0, maximum 33/h) to follow-up (median 0, maximum 55.8/h; p < 0.05). In those with an elevated PLMI, arousal percentage attributable to PLMs was up to 25 % (median 7.5 %).
    CONCLUSIONS: Elevated PLMI occurred at a higher prevalence in children with NMD and CP than reported in other clinic-referred paediatric populations. It is important that PLMs are not overlooked as identification and treatment may help improve sleep outcomes. Further research is required to understand the pathophysiology and consequences of PLMs specifically in this population.
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  • 文章类型: Journal Article
    目的:聚葡聚糖贮积障碍是神经退行性疾病和神经肌肉疾病中的一个新兴领域,包括Lafora病(EPM2A,EPM2B),成人聚葡聚糖体病(APBD,GBE1),与RBCK1缺乏症(PGBM1,RBCK1)或糖原-1缺乏症(PGBM2,GYG1)相关的聚葡聚糖体肌病。虽然储存材料主要包括聚糖,这项研究旨在通过对糖原-1缺乏症中的储存物质进行蛋白质组学分析,对蛋白质成分有更深入的了解。
    方法:我们采用了分子遗传分析,激光显微解剖聚葡聚糖体和肌肉匀浆的定量质谱,对一名45岁患者的肌肉组织进行免疫组织化学和蛋白质印迹分析,该患者患有由于聚葡聚糖贮积性肌病而导致的青少年晚期近端肌无力。
    结果:由于GYG1中的一种新型纯合深内含子变体(c.7992T>G),肌肉组织表现出完全不存在糖原蛋白-1,引入假外显子导致移码和提前终止密码子。聚葡聚糖体中积累的蛋白质构成糖原代谢的组成部分,蛋白质质量控制途径和结蛋白。含有聚葡聚糖体的肌纤维经常表现出正常糖原的消耗。
    结论:糖原-1是一种对糖原合成启动很重要的蛋白质,导致聚葡聚糖的储存,显示几种蛋白质的积累,包括糖原合成所必需的,隔离体1/p62和desmin,反映RBCK1缺乏症的发现。这些结果表明,不同疾病之间存在共同的致病途径,表现出聚葡聚糖的储存。这些见解对这些罕见但破坏性和目前无法治愈的疾病的治疗具有意义。
    OBJECTIVE: Polyglucosan storage disorders represent an emerging field within neurodegenerative and neuromuscular conditions, including Lafora disease (EPM2A, EPM2B), adult polyglucosan body disease (APBD, GBE1), polyglucosan body myopathies associated with RBCK1 deficiency (PGBM1, RBCK1) or glycogenin-1 deficiency (PGBM2, GYG1). While the storage material primarily comprises glycans, this study aimed to gain deeper insights into the protein components by proteomic profiling of the storage material in glycogenin-1 deficiency.
    METHODS: We employed molecular genetic analyses, quantitative mass spectrometry of laser micro-dissected polyglucosan bodies and muscle homogenate, immunohistochemistry and western blot analyses in muscle tissue from a 45-year-old patient with proximal muscle weakness from late teenage years due to polyglucosan storage myopathy.
    RESULTS: The muscle tissue exhibited a complete absence of glycogenin-1 due to a novel homozygous deep intronic variant in GYG1 (c.7+992T>G), introducing a pseudo-exon causing frameshift and a premature stop codon. Accumulated proteins in the polyglucosan bodies constituted components of glycogen metabolism, protein quality control pathways and desmin. Muscle fibres containing polyglucosan bodies frequently exhibited depletion of normal glycogen.
    CONCLUSIONS: The absence of glycogenin-1, a protein important for glycogen synthesis initiation, causes storage of polyglucosan that displays accumulation of several proteins, including those essential for glycogen synthesis, sequestosome 1/p62 and desmin, mirroring findings in RBCK1 deficiency. These results suggest shared pathogenic pathways across different diseases exhibiting polyglucosan storage. Such insights have implications for therapy in these rare yet devastating and presently untreatable disorders.
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  • 文章类型: Case Reports
    特发性炎性肌病(IIM)代表一组罕见的自身免疫性疾病,导致肌肉无力,包括多发性肌炎,皮肌炎,免疫介导性坏死性肌病(IMNM),重叠肌炎,和包涵体肌炎。抗3-羟基-3-甲基戊二酰辅酶A还原酶(HMGCR)抗体IMNM代表了一种罕见但日益被认可的IIM亚型。在这里,我们报告一例65岁女性服用瑞舒伐他汀,出现两个月的进行性近端肌无力,显著的躯干无力,肌酸激酶升高与横纹肌溶解和炎性肌病有关。在延迟测试该特定肌病之后,患者最终在她住院的第8天被诊断为抗HMGCR抗体IMNM。增加了对这种IIM亚型的认识,以及其风险因素和呈现特征,如果在急诊科或住院早期考虑诊断,可能会提高检测速度并缩短住院时间。
    Idiopathic inflammatory myopathy (IIM) represents a rare group of autoimmune conditions resulting in muscle weakness and includes polymyositis, dermatomyositis, immune-mediated necrotizing myopathy (IMNM), overlap myositis, and inclusion body myositis. Anti-3-hydroxy-3-methylglutaryl-CoA reductase (HMGCR) antibody IMNM represents a rare but increasingly recognized subtype of IIM. Here we report a case of a 65-year-old woman on rosuvastatin who presented with two months of progressive proximal muscle weakness, significant truncal weakness, and elevated creatine kinase concerning for rhabdomyolysis and inflammatory myopathy. The patient was eventually diagnosed on day 8 of her hospital stay with anti-HMGCR antibody IMNM after delayed testing for this specific myopathy. Increased awareness of this IIM subtype, as well as its risk factors and presenting features, might improve rapidity of testing and shorten hospital stays if the diagnosis is considered in the emergency department or early in the hospital course.
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  • 文章类型: Journal Article
    突变的骨骼肌ryanodine受体1(RYR1)基因与一系列具有广泛表型的常染色体显性和隐性RyR1相关疾病有关。本报告描述了与以前未报道的RYR1移码致病变异相关的可变表型,(NM_000540.2)c.12815_12825del;p.Ala4272Glyfs*307,在利比亚犹太人中常见。收集了来自8个无关家庭的14个携带者的临床和遗传特征。共有12个杂合子和2个复合杂合子。六个杂合子(中位年龄49.8岁)无症状,和6(中位年龄24.5)表现为肌病(n=3)或严重的关节病样特征,严重脊柱侧弯,pesplanus,麻醉后恶性高热,或囊性水瘤(在胎儿中)(每个n=1)。没有异常的超声心动图研究或肌酸磷酸激酶(CPK)水平升高。一个双等位基因携带者具有严重的骨骼表型和肌病;另一个是患有囊性水瘤的胎儿。对447名因无关原因接受外显子组测试的利比亚犹太人的变异频率进行评估,得出的患病率为1:55。RYR1p.Ala4272Glyfs*307变体在利比亚犹太人中很常见。它与广泛的表型谱有关,在杂合子中可能存在。进一步的基因型-表型研究对于描述单等位基因和双等位基因携带者中变体的临床意义至关重要。
    Mutated skeletal muscle ryanodine receptor-1 (RYR1) gene is associated with a spectrum of autosomal dominant and recessive RyR1-related disorders with a wide phenotype. This report describes a variable phenotype associated with a previously unreported RYR1 frameshift pathogenic variant, (NM_000540.2) c.12815_12825del; p.Ala4272Glyfs*307, common in Libyan Jews. Clinical and genetic features of 14 carriers from 8 unrelated families were collected. There were 12 heterozygotes and 2 compound heterozygotes. Six heterozygotes (median age 49.8) were asymptomatic, and six (median age 24.5) presented with myopathy (n = 3) or severe arthrogryposis-like features, severe scoliosis, pes planus, post-anesthesia malignant hyperthermia, or cystic hygroma (in a fetus) (n = 1 each). None had an abnormal echocardiogram study or elevated creatine phosphokinase (CPK) levels. One bi-allelic carrier had a severe skeletal phenotype and myopathy; the other was a fetus with a cystic hygroma. Assessment of variant frequency in 447 Libyan Jews who underwent exome testing for unrelated reason yielded a prevalence of 1:55. The RYR1 p.Ala4272Glyfs*307 variant is common in Libyan Jews. It is associated with a broad phenotypic spectrum, with possible presentation among heterozygotes. Further genotype-phenotype studies are essential to delineate the clinical significance of the variant in mono- and bi-allelic carriers.
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  • 文章类型: Case Reports
    奥希替尼,第三代EGFR酪氨酸激酶抑制剂,是晚期NSCLC和EGFR致敏突变患者的治疗标准。在奥希替尼关键试验和上市后阶段,已报道无症状肌酐磷酸激酶升高和临床相关的肌肉损伤.然而,这些疾病的潜在机制尚不清楚.在这里,我们报告了奥希替尼诱导的肌病的首次肌肉活检描述,并假设支持肌肉毒性的机制可能是由再生机制和线粒体功能障碍引起的,随后代谢耐力降低。两者都与抑制肌肉细胞中EGFR介导的下游分子途径直接相关。
    Osimertinib, a third-generation EGFR tyrosine kinase inhibitor, is the standard of care for patients with advanced NSCLC and EGFR-sensitizing mutations. Both in osimertinib pivotal trials and in the post-marketing phase, asymptomatic creatinine phosphokinase elevation and clinically relevant muscle damage have been reported. However, the mechanisms underlying these conditions remain unclear. Herein, we report the first muscle biopsy description of osimertinib-induced myopathy and hypothesize that the mechanisms underpinning muscle toxicity could be driven by hyporegenerative mechanisms and mitochondrial dysfunction with subsequent reduced metabolic endurance, both directly linked to the inhibition of downstream molecular pathways mediated by EGFR in muscle cells.
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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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