Recurring Weakness in Rhabdomyolysis Following Pfizer–BioNTech Coronavirus Disease 2019 mRNA Vaccination

Rhabdomyolysis is a well-known clinical syndrome of muscle injury. Rhabdomyolysis following coronavirus disease 2019 (COVID-19) vaccination has recently been reported. The patients’ weakness gradually subsided and did not recur. Rhabdomyolysis associated with COVID-19 vaccination has not been assessed by repeated magnetic resonance imaging (MRI) within a short time. We report a rare case of an older woman who developed recurring weakness with rhabdomyolysis after COVID-19 vaccination. A 76-year-old woman presented with myalgia 2 days after receiving a third dose of the COVID-19 vaccine. A physical examination showed weakness of the bilateral iliopsoas muscles. Her creatine kinase concentration was 9816 U/L. MRI showed hyperintensity of multiple limb muscles. She was treated with intravenous normal saline. Her symptoms disappeared within 3 days. However, MRI on day 4 of hospitalization showed exacerbation of the hyperintensity in the left upper limb muscles. On day 5 of hospitalization, weakness of the left supraspinatus and deltoid muscles appeared. MRI on day 8 of hospitalization showed attenuation of the hyperintensity in all muscles. Her weakness and elevated creatine kinase concentration disappeared by day 10. Repeated MRI over a short time may be useful to predict potential weakness and monitor the course of COVID-19 vaccine-induced rhabdomyolysis

Disease-associated marked hyperalphalipoproteinemia

Marked hyperalphalipoproteinemia (HAL) is a heterogeneous syndrome. To clarify the pathophysiological significance of HAL, we compared clinical profiles between marked HAL subjects with and without cholesteryl ester transfer protein (CETP) deficiency. CETP deficiency was associated with cardiovascular diseases and strokes in the HAL population, particularly in female. HAL women without CETP deficiency tended to have higher prevalence with cancer history. HAL may not always be a longevity marker, but be sometimes accompanied with pathological conditions

Dorfin-CHIP chimeric proteins potently ubiquitylate and degrade familial ALS-related mutant SOD1 proteins and reduce their cellular toxicity

The ubiquitin-proteasome system (UPS) is involved in the pathogenetic mechanisms of neurodegenerative disorders, including amyotrophic lateral sclerosis (ALS). Dorfin is a ubiquitin ligase (E3) that degrades mutant SOD1 proteins, which are responsible for familial ALS. Although Dorfin has potential as an anti-ALS molecule, its life in cells is short. To improve its stability and enhance its E3 activity, we developed chimeric proteins containing the substrate-binding hydrophobic portion of Dorfin and the U-box domain of the carboxyl terminus of Hsc70-interacting protein (CHIP), which has strong E3 activity through the U-box domain. All the Dorfin-CHIP chimeric proteins were more stable in cells than was wild-type Dorfin (Dorfin(WT)). One of the Dorfin-CHIP chimeric proteins, Dorfin-CHIP(L), ubiquitylated mutant SOD1 more effectively than did Dorfin(WT) and CHIP in vivo, and degraded mutant SOD1 protein more rapidly than Dorfin(WT) does. Furthermore, Dorfin-CHIP(L) rescued neuronal cells from mutant SOD1-associated toxicity and reduced the aggresome formation induced by mutant SOD1 more effectively than did Dorfin(WT)

Testosterone Reduction Prevents Phenotypic Expression in a Transgenic Mouse Model of Spinal and Bulbar Muscular Atrophy

AbstractSpinal and bulbar muscular atrophy (SBMA) is a polyglutamine disease caused by the expansion of a CAG repeat in the androgen receptor (AR) gene. We generated a transgenic mouse model carrying a full-length AR containing 97 CAGs. Three of the five lines showed progressive muscular atrophy and weakness as well as diffuse nuclear staining and nuclear inclusions consisting of the mutant AR. These phenotypes were markedly pronounced in male transgenic mice, and dramatically rescued by castration. Female transgenic mice showed only a few manifestations that markedly deteriorated with testosterone administration. Nuclear translocation of the mutant AR by testosterone contributed to the phenotypic difference with gender and the effects of hormonal interventions. These results suggest the therapeutic potential of hormonal intervention for SBMA

Tissue-Specific Somatic Mosaicism in Spinal and Bulbar Muscular Atrophy Is Dependent on CAG-Repeat Length and Androgen Receptor–Gene Expression Level

The factors influencing the tissue-specific pattern of somatic mosaicism in CAG-repeat diseases have not yet been fully resolved. We performed a detailed analysis of the degree of somatic mosaicism in various tissues from 20 patients with spinal and bulbar muscular atrophy (SBMA), including 4 who were deceased. The most outstanding feature was the prominent somatic mosaicism observed in the cardiac and skeletal muscles, composed predominantly of postmitotic cells, and in the skin, prostate, and testis. The CNS tissues, liver, and spleen showed the least mosaicism. The tissue distribution of somatic mosaicism in patients with SBMA was markedly different from that in patients with Huntington disease (HD) and from that in patients with dentatorubral-pallidoluysian atrophy (DRPLA). The degree of somatic mosaicism correlated with the CAG-repeat number but not with age at examination. Furthermore, tissues with a higher mosaicism level corresponded well to those with a higher expression level of androgen receptor protein. The tissue-specific pattern of somatic mosaicism related not only to cell composition with different cell turnover rates but to repeat size and gene expression levels, and postnatal cell division is unlikely to be a major cause of somatic mosaicism probably because of the relative stability of CAG repeat in SBMA