Ferreira Lucio Gobbo, Marie Suely Kazue, Liu Enna Cristina, Resende Maria Bernadete Dutra, Carvalho Mary Souza, Scaff Milberto, Reed Umbertina Conti
Departamento de Neurologia, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brasil.
Arq Neuropsiquiatr. 2005 Sep;63(3B):791-800. doi: 10.1590/s0004-282x2005000500014. Epub 2005 Oct 18.
The congenital muscular dystrophies (CMD) are heterogeneous muscular diseases with early and dystrophic pattern on muscle biopsy. Many different subtypes have been genetically identified and most phenotypes not yet identified belong to the merosin-positive (MP) CMD subgroup.
To analyze the immunohistochemical expression of the main proteins of the dystrophin-glycoproteins associated complex in muscle biopsy of patients with different CMD phenotypes, for investigating a possible correlation with clinical and histopathological data.
Fifty-nine patients with CMD had clinical, histopathological and immunohistochemical data evaluated: 32 had MP-CMD, 23 CMD with merosin deficiency (MD-CMD), one Ullrich phenotype and three Walker-Warburg disease.
Dystrophin and dysferlin were normal in all; among the patients with MD-CMD, merosin deficiency was partial in nine who showed the same clinical severity as those with total deficiency; the reduced expression of alpha-sarcoglycan (SG) and alpha-dystroglycan (DG) showed statistically significant correlation with severe MD-CMD phenotype.
There is a greater relationship between merosin and the former proteins; among MP-CMD patients, no remarkable immunohistochemical/phenotypical correlations were found, although the reduced expression of beta-DG had showed statistically significant correlation with severe phenotype and marked fibrosis on muscular biopsy.
先天性肌营养不良(CMD)是一类异质性肌肉疾病,肌肉活检呈现早期和营养不良性模式。许多不同亚型已通过基因鉴定,大多数未鉴定的表型属于含肌纤膜蛋白阳性(MP)的CMD亚组。
分析不同CMD表型患者肌肉活检中肌营养不良蛋白 - 糖蛋白相关复合物主要蛋白的免疫组化表达,以研究其与临床和组织病理学数据之间可能的相关性。
对59例CMD患者的临床、组织病理学和免疫组化数据进行评估:32例为MP - CMD,23例为含肌纤膜蛋白缺乏的CMD(MD - CMD),1例为Ullrich表型,3例为Walker - Warburg病。
所有患者的肌营养不良蛋白和dysferlin均正常;在MD - CMD患者中,9例肌纤膜蛋白部分缺乏,其临床严重程度与完全缺乏者相同;α - 肌聚糖(SG)和α - 肌营养不良聚糖(DG)表达降低与严重的MD - CMD表型具有统计学显著相关性。
肌纤膜蛋白与前体蛋白之间存在更大的关联;在MP - CMD患者中,未发现显著的免疫组化/表型相关性,尽管β - DG表达降低与严重表型以及肌肉活检中明显纤维化具有统计学显著相关性。