Diazacholesterol myotonia: accumulation of desmosterol and increased adenosine triphosphatase activity of sarcolemma.

Myotonia induced in rats by 20,25-diazacholesterol is accompanied by accumulation of desmosterol in serum, fragmented sarcoplasmic reticulum, and sarcolemma. Activities of (Na(+),K(+))- and Ca(2+)-stimulated adenosine triphosphatases of the sarcolemma are increased, but not the Mg(2+)-stimulated adenosine triphosphatase. The altered sterol composition of the sarcolemma may cause this type of myotonia by decreasing the chloride conductance of the membrane.

Adynamia episodica and paralysis periodica paramyotonica.

We studied hyperkalemic attacks in one family with adynamia episodica (AE) and one family with paralysis periodica paramyotonica (PPP). Under exercise, serum potassium increased as in healthy subjects. Thiazide did not affect this increase. Thirty minutes after exercise, a second potassium increase occurred, but could be prevented by thiazide and not by mexiletine. After cooling, muscle relaxation time was normal in AE but increased up to 100 times in PPP; this cooling effect was prevented by mexiletine. Although hyperkalemic attacks are similar in AE and in PPP, the membrane defect in PPP seems more complex.

Myotonic ADR-MDX mutant mice show less severe muscular dystrophy than MDX mice.

In Duchenne muscular dystrophy (DMD) and its murine model, the dystrophic mouse (MDX), the skeletal musculature lacks dystrophin. The presumed function of this cytoskeletal protein is to protect the sarcolemma against mechanical stress during muscle activity. To test this hypothesis in vivo, we bred a double mutant mouse that combines two genetic defects: the dystrophin-deficiency of the MDX mouse and the Cl- channel myotonia of the arrested development of righting response (ADR) mouse. We hypothesized that high mechanical muscle activity would aggravate muscular dystrophy in double mutant ADR-MDX mice. On the contrary, ADR-MDX mice showed fewer signs of muscle fiber necrosis and fibrosis than MDX mice at all ages. Plasma creatine kinase levels were slightly increased in ADR-MDX, but significantly lower when compared to MDX mice. Sections of ADR-MDX muscle showed a uniform pattern of oxidative muscle fibers. Similar findings have been obtained in dystrophin-positive ADR mice, they result from a complete fiber-type IIB to IIA transformation in myotonic muscle. Our results suggest that small, oxidative fibers of myotonic mice are less sensitive to dystrophin deficiency. Therefore, ADR-MDX mice develop less severe muscular dystrophy than MDX mice do, although their muscles are continually stressed. The new ADR-MDX double mutant mouse is the first animal model combining both a dystrophinopathy and a channelopathy. The results presented here give new insights into the pathomechanism of muscular dystrophy and may be helpful for the therapeutic management of DMD.

Erythrocyte membrane abnormalities in human myotonic dystrophy.

Membrane-bound enzyme activities and cardiac glycoside binding were determined in red blood cell membrane preparations from patients with myotonic dystrophy and in age matched controls. Na+-K+-activated ATPase activity was significantly increased in myotonic patients. [3H]Ouabain binding to erythrocyte membranes was also significantly increased in myotonic dystrophy patients. The Mg2+-ATPase (ouabain-insensitive) was, however, unchanged. The K+-stimulated paranitrophenyl phosphatase (KPNPPase) activity was markedly enhanced in myotonic patients as compared to controls. The kinetic analysis showed a marked change in Vmax of Na+-K+ ATPase with respect to the activation by Na+, K+ and ATP. However, the Km values were the same in control as well as in myotonic groups. The increased erythrocyte membrane Na+-K+-ATPase activity, KPNPPase and [3H]ouabain binding in myotonic patients supports the hypothesis that generalized membrane abnormality may be involved in pathogenesis of the human myotonic dystrophy.

Platelet aggregation in myotonia.

Platelet function tests were carried out on 21 patients with myotonic dystrophy (MyD) and 7 patients with myotonia congenita (MC) together with 22 healthy subjects. Compared to the controls, the MyD and MC patients showed significantly greater sensitivity to the calcium ionophore A23187 but not to adenosine diphosphate, collagen, ristocetin or adrenaline. In addition, with the MyD patients, a significantly higher concentration of chlorpromazine and lignocaine was required to inhibit aggregation induced by a standard dose of adrenaline. A similar trend was noted with the MC patients but because of the small numbers tested, statistical analysis was not possible. Plasma levels of betathromboglobulin were also significantly higher in MyD patients than in controls. Platelet adenine nucleotide levels were within the normal range in both groups of patients and were not significantly different from those in controls. These preliminary results support the view that there is a defect in calcium metabolism in myotonic dystrophy and suggest that it may be possible to use the blood platelet as a model with which to carry out further studies in this disorder.

Membrane fluidity and myotonia: effects of cholesterol and desmosterol on erythrocyte membrane fluidity in rats with 20,25-diazacholesterol-induced myotonia and on phospholipid liposomes.

Previous spin-label and electromyographic experiments with rats fed 20,25-diazacholesterol, an inhibitor of the biosynthetic conversion of desmosterol to cholesterol, demonstrated an increased erythrocyte membrane fluidity and myotonia, a prolonged muscle contraction upon stimulation. The current studies with rats showed normal erythrocyte fluidity in animals fed 20,25-diazacholesterol but maintained on a high-cholesterol diet and no myotonia. Studies of model membrane systems composed of phospholipid vesicles containing desmosterol, cholesterol, or both demonstrated that desmosterol increased membrane lipid fluidity relative to cholesterol, suggesting that in 20,25-diazacholesterol-induced myotonia, in which desmosterol accounts for 85% of the plasma sterol, the increased membrane fluidity previously observed in erythrocytes and sarcolemma in this animal model of human congenital myotonia may be due to desmosterol.

Serum parvalbumin, an indicator of muscle disease in murine dystrophy and myotonia.

The soluble Ca(++)-binding protein parvalbumin (PV) is highly concentrated in fast muscle fibers of the wild type mouse. Employing Sandwich ELISA, we have shown that PV is present in the serum of normal mice and that its level is indicative of the disease status of muscle. Elevated PV levels were found in mice with X-linked dystrophy (mdx) and reduced levels in myotonic (ADR) mice. Serum creatine kinase (CK) levels were elevated in mdx and normal in ADR mice. Because myotonic mouse muscle has a strongly reduced PV content, the reduced PV serum level in ADR mice indicated that serum PV is derived from skeletal muscle. Serum PV in mdx mice, in which muscle PV content is close to normal, is a measure of the necrosis of fast muscle fibers. Serum levels of PV and CK were not significantly elevated in heterozygous (mdx/+) carrier females. Serum PV in Duchenne patients was below the limit of detection.

Reversible nutritional myopathy with myotonia in the protein-deficient rat given methionine.

Rats fed a protein-deficient synthetic diet developed hind limb weakness caused by a myopathy with myotonic features on electromyography. Deficiency of vitamin E and selenium, known causes of nutritional myopathy, were excluded. Methionine supplementation of the diet reversed the clinical signs of weakness within 12 h.