Coley William, Rayavarapu Sree, Pandey Gouri S, Sabina Richard L, Van der Meulen Jack H, Ampong Beryl, Wortmann Robert L, Rawat Rashmi, Nagaraju Kanneboyina
Children's National Medical Center, Washington, DC, USA.
Arthritis Rheum. 2012 Nov;64(11):3750-9. doi: 10.1002/art.34625.
It is generally believed that muscle weakness in patients with polymyositis and dermatomyositis is due to autoimmune and inflammatory processes. However, it has been observed that there is a poor correlation between the suppression of inflammation and a recovery of muscle function in these patients. This study was undertaken to examine whether nonimmune mechanisms also contribute to muscle weakness. In particular, it has been suggested that an acquired deficiency of AMP deaminase 1 (AMPD1) may be responsible for muscle weakness in myositis.
We performed comprehensive functional, behavioral, histologic, molecular, enzymatic, and metabolic assessments before and after the onset of inflammation in a class I major histocompatibility complex (MHC)-transgenic mouse model of autoimmune inflammatory myositis.
Muscle weakness and metabolic disturbances were detectable in the mice prior to the appearance of infiltrating mononuclear cells. Force contraction analysis of muscle function revealed that weakness was correlated with AMPD1 expression and was myositis specific. Decreasing AMPD1 expression resulted in decreased muscle strength in healthy mice. Fiber typing suggested that fast-twitch muscles were converted to slow-twitch muscles as myositis progressed, and microarray results indicated that AMPD1 and other purine nucleotide pathway genes were suppressed, along with genes essential to glycolysis.
These data suggest that an AMPD1 deficiency is acquired prior to overt muscle inflammation and is responsible, at least in part, for the muscle weakness that occurs in the mouse model of myositis. AMPD1 is therefore a potential therapeutic target in myositis.
人们普遍认为,多发性肌炎和皮肌炎患者的肌肉无力是由自身免疫和炎症过程引起的。然而,据观察,在这些患者中,炎症抑制与肌肉功能恢复之间的相关性较差。本研究旨在探讨非免疫机制是否也会导致肌肉无力。特别是,有人提出,腺苷酸脱氨酶1(AMPD1)后天缺乏可能是肌炎患者肌肉无力的原因。
我们在自身免疫性炎性肌炎的I类主要组织相容性复合体(MHC)转基因小鼠模型中,在炎症发作前后进行了全面的功能、行为、组织学、分子、酶学和代谢评估。
在浸润性单核细胞出现之前,小鼠中就可检测到肌肉无力和代谢紊乱。肌肉功能的力收缩分析表明,无力与AMPD1表达相关,且具有肌炎特异性。降低健康小鼠的AMPD1表达会导致肌肉力量下降。纤维类型分析表明,随着肌炎的进展,快肌纤维转变为慢肌纤维,微阵列结果表明,AMPD1和其他嘌呤核苷酸途径基因以及糖酵解必需基因均受到抑制。
这些数据表明,在明显的肌肉炎症之前就出现了AMPD1缺乏,这至少部分导致了肌炎小鼠模型中出现的肌肉无力。因此,AMPD1是肌炎的一个潜在治疗靶点。