Physiology, pathophysiology and diagnostic significance of autophagic changes in skeletal muscle tissue--towards the enigma of rimmed and round vacuoles.

Autophagic vacuoles are the morphological hallmark in a wide variety of human skeletal muscle disorders. The present review summarizes recent novel insights in the physiology and pathophysiology of autophagic vacuole formation in skeletal muscle. Special emphasis will be given to the relationship between vacuolar changes and lysosomal and non-lysosomal protein degradation pathways, the diagnostic significance of rimmed and round vacuoles and novel therapeutic options related to autophagic pathways.