Title Clinical findings and autophagic pathology in neutral lipid storage disease with myopathy
Authors Hong, Daojun
Zheng, Junjun
Xin, Ling
Xiang, Yining
Luan, Xinghua
Cao, Li
Cong, Lu
Fang, Pu
Zhang, Jun
Affiliation Peking Univ, Peoples Hosp, Dept Neurol, 11 Xizhimen South Ave, Beijing 100044, Peoples R China
Nanchang Univ, Affiliated Hosp 1, Dept Neurol, Nanchang, Jiangxi, Peoples R China
Univ Mississippi, Dept Hlth Exercise Sci & Recreat Management, Oxford, MS USA
Guiyang Med Univ, Affiliated Hosp, Dept Pathol, Guiyang, Guizhou, Peoples R China
Shanghai Jiao Tong Univ, Ruijin Hosp, Dept Neurol, Shanghai, Peoples R China
Keywords neutral lipid storage disease with myopathy
adipose triglyceride lipases
PNPLA2 gene
autophagy
lysosomes
Issue Date 2019
Publisher CLINICAL NEUROPATHOLOGY
Abstract Neutral lipid storage disease with myopathy (NLSDM) is a triglyceride metabolic disorder caused by defects of adipose triglyceride lipases (ATGL). The coexistence of lipid vacuoles and rimmed vacuoles in the myofibers is a characteristic pathological change in some NLSDM cases. However, it has not been explored whether autophagic abnormalities exist in the NLSDM myofibers with rimmed vacuole. Herein, we report that 5 patients with NLSDM initially presented with muscle weakness in the right arm related to long-term physical efforts, then developed muscle weakness of other limbs. Pathogenic mutations in the PNPLA2 gene were identified in all patients. Myopathological analysis showed a coexistence of massive lipid vacuoles and rimmed vacuoles, which was not associated with the age of onset or mutation sites, but closely related to the severity of muscle degeneration. The rimmed vacuoles showed strong immunopositivity to autophagic markers, but were negative to apoptotic markers. Significant immunoreactivity of p62 was observed in the rimmed vacuoles, while the lysosomal marker LAMP1 was severely decreased. Our study expanded the clinical and genetic spectrum of NLSDM. Loss of ATGL activity in muscle fibers with rimmed vacuoles induced a marked increase in autophagic formation, but lowered down the turnover of autolysosomes due to malfunction of lysosomes.
URI http://hdl.handle.net/20.500.11897/547174
ISSN 0722-5091
DOI 10.5414/NP301159
Indexed SCI(E)
Appears in Collections: 人民医院

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