Sarkozi E, Askanas V, Engel W K
Department of Neurology, University of Southern California School of Medicine, Los Angeles.
Am J Pathol. 1994 Dec;145(6):1280-4.
Sporadic inclusion-body myositis is the most common progressive muscle disease of older patients. The muscle biopsy demonstrates mononuclear cell inflammation and vacuolated muscle fibers containing paired helical filaments and 6 to 10-nm fibrils, both resembling those of Alzheimer brain, and Congo-red positivity. Hereditary inclusion-body myopathy designates patients cytopathologically similar but without inflammation. In both muscle diseases, prion, and several proteins characteristic of Alzheimer brain--eg, beta-amyloid protein and hyperphosphorylated tau (which normally are expressed mainly in neurons), and apolipoprotein E--are abnormally accumulated in vacuolated muscle fibers, by unknown mechanisms. We now demonstrate in both muscle diseases that prion mRNA is strongly expressed in the vacuolated muscle fibers, which suggests that their accumulated prion protein results, at least partly, from increased gene expression. This, to our knowledge, is the first demonstration of abnormally increased prion mRNA in human disease. Another novel finding is the increased prion mRNA in human muscle macrophages, and both increased prion protein and prion mRNA in regenerating muscle fibers. The latter indicates that prion may play a role in human muscle development.
散发性包涵体肌炎是老年患者中最常见的进行性肌肉疾病。肌肉活检显示单核细胞炎症以及含有双螺旋丝和6至10纳米原纤维的空泡化肌纤维,二者均类似于阿尔茨海默病大脑中的结构,且刚果红呈阳性。遗传性包涵体肌病指的是细胞病理学表现相似但无炎症的患者。在这两种肌肉疾病中,朊病毒以及几种阿尔茨海默病大脑特有的蛋白质——例如β-淀粉样蛋白和高度磷酸化的tau蛋白(通常主要在神经元中表达),还有载脂蛋白E——通过未知机制在空泡化肌纤维中异常蓄积。我们现在在这两种肌肉疾病中均证实,朊病毒mRNA在空泡化肌纤维中强烈表达,这表明其蓄积的朊病毒蛋白至少部分是基因表达增加的结果。据我们所知,这是人类疾病中朊病毒mRNA异常增加的首次证明。另一个新发现是人类肌肉巨噬细胞中朊病毒mRNA增加,以及再生肌纤维中朊病毒蛋白和朊病毒mRNA均增加。后者表明朊病毒可能在人类肌肉发育中起作用。