Nervenheilkunde 2004; 23(08): 442-446
DOI: 10.1055/s-0038-1626405
Original- und Übersichtsarbeiten - Original and Review Articles
Schattauer GmbH

Okulopharyngeale Muskeldystrophie

Oculopharyngeal muscular dystrophy
T. Müller
1   Klinik und Poliklinik für Neurologie, Martin-Luther-Universität Halle-Wittenberg
,
M. Deschauer
1   Klinik und Poliklinik für Neurologie, Martin-Luther-Universität Halle-Wittenberg
› Author Affiliations
Further Information

Publication History

Publication Date:
19 January 2018 (online)

Zusammenfassung

Die okulopharyngeale Muskeldystrophie (OPMD) ist eine autosomal-dominant vererbte Muskelerkrankung mit spätem Beginn, die klinisch durch eine Ptosis, Dysphagie und proximale Paresen gekennzeichnet ist. Die Erkrankung wird durch eine Trinukleotidvermehrung im Gen für das Poly-A-bindende Protein (PABPN1) verursacht. Hierdurch kommt es zu einer Verlängerung des Proteins um wenige Alanine, die zur Aggregation des Proteins führen. Diese Aggregate sind elektronenmikroskopisch als charakteristische intranukleäre Filamente nachweisbar. Der genaue pathogenetische Mechanismus, durch den es zum selektiven Befall der Muskelzellen und zur Ausbildung des typischen Phänotypes kommt, ist derzeit noch unklar.

Summary

Oculopharyngeal muscular dystrophy (OPMD) is a late onset myopathy with autosomal dominant inheritance. Clinical symptoms are eyelid drooping (ptosis), swallowing difficulties (dysphagia), and proximal limb weakness. Autosomal dominant OPMD is caused by an increased number of alanine coding trinukleotids in the PABPN1 gene leading to the expansion of a polyalanine stretch from 10 to 12-17 alanins in the N-terminal region of PABPN1. The expanded protein tends to form aggregates which are detectable as intranuclear filaments by electron microscopy. The definite pathogenetic mechanism leading to the selective damage of skeletal muscle cells and to the characteristic phenotype is presently unknown.

 
  • Literatur

  • 1 Taylor EW. Progressiv vagus-glossopharyngeal paralysis with ptosis: a contribution to the group of family diseaes. J Nerv Ment Dis 1915; 42: 129-39.
  • 2 Victor M, Hayes R, Adams RD. Oculopharyngeal muscular dystrophy; familial disease of late life characterized by dysphagia and progressive ptosis of the eyelids. N Engl J Med 1992; 267: 1267-72.
  • 3 Tome FMS, Fardeau M. Nuclear inclusions in oculopharyngeal dystrophy. Acta Neuropath 1980; 49: 85-7.
  • 4 Brais B, Xie YG, Sanson M, Morgan K, Weissenbach J, Korczyn AD, Blumen SC, Fardeau M, Tome FM, Bouchard JP. et al. The oculopharyngeal muscular dystrophy locus maps to the region of the cardiac alpha and beta myosin heavy chain genes on chromosome 14q11.2- q13. Hum Mol Genet 1995; 04: 429-34.
  • 5 Brais B, Bouchard JP, Xie YG, Rochefort DL, Chretien N, Tome FMS, Lafreniere RG, Rommens JM, Uyama E, Nohira O, Blumen S, Korcyn AD, Heutink P, Mathieu J, Duranceau A, Codere F, Fardeau M, Rouleau GA. Short GCG expansions in the PABP2 gene cause oculopharyngeal muscular dystrophy. Nature Genetics 1998; 18: 164-6.
  • 6 Blumen SC, Nisipeanu P, Sadeh M. et al. Clinical features of oculopharyngeal muscular dystrophy among Bukhara Jews. Neurology 1996; 46: 1324-8.
  • 7 Fuchs E. Ueber isolirte doppelseitige Ptosis. Graefes Arch. Ophthal 1890; 36: 234-59.
  • 8 Blumen SC, Brais B, Korczyn AD, Medinsky S, Chapman J, Asherov A, Nisipeanu P, Codere F, Bouchard JP, Fardeau M, Tome FM, Rouleau GA. Homozygotes for oculopharyngeal muscular dystrophy have a severe form of the disease. Ann Neurol 1999; 46: 115-8.
  • 9 Bouchard JP, Brais B, Tomé FMS. Oculopharyngeal muscular dystrophy. In: Emery AEH. (ed.). Neuromuscular disorders. Chichester: Wiley; 1998: 157-79.
  • 10 Muller T, Schroder R, Zierz S. GCG repeats and phenotype in oculopharyngeal muscular dystrophy. Muscle Nerve 2001; 24: 120-2.
  • 11 Satoyoshi E, Kinoshita M. Oculopharyngeal distal myopathy: report of four families. Arch Neurol 1977; 34: 89-92.
  • 12 Goto I, Kanazawa Y, Kobayashi T. Oculopharyngeal myopathy with distal and cardiomyopathy. J Neurol Neurosurg Psych 1977; 40: 600-7.
  • 13 Nakamoto M, Nakano S, Kawashima S, Ihara M, Nishimura Y, Shinde A, Kakizuka A. Unequal crossing-over in unique PABP2 mutations in Japanese patients: a possible cause of oculopharyngeal muscular dystrophy. Arch Neurol 2002; 59: 474-7.
  • 14 Wahle E. A novel poly(A)-binding protein acts as a specificity factor in the second phase of messenger RNA polyadenylation. Cell 1991; 66: 759-68.
  • 15 Wahle E. Poly(A) tail length control is caused by termination of processive synthesis. J Biol Chem 1995; 270: 2800-8.
  • 16 Fan X, Dion P, Laganiere J, Brais B, Rouleau GA. Oligomerization of polyalanine expanded PABPN1 facilitates nuclear protein aggregation that is associated with cell death. Hum Mol Genet 2001; 10: 2341-51.
  • 17 Calado A, Tome FM, Brais B, Rouleau GA, Kuhn U, Wahle E, Carmo-Fonseca M. Nuclear inclusions in oculopharyngeal muscular dystrophy consist of poly(A) binding protein 2 aggregates which sequester poly(A) RNA. Hum Mol Genet 2000; 09: 2321-8.
  • 18 Fan X, Rouleau GA. Progress in understanding the pathogenesis of oculopharyngeal muscular dystrophy. Can J Neurol Sci 2003; 30: 8-14.
  • 19 Kim YJ, Noguchi S, Hayashi YK, Tsukahara T, Shimizu T, Arahata K. The product of an oculopharyngeal muscular dystrophy gene, poly(A)- binding protein 2, interacts with SKIP and stimulates muscle-specific gene expression. Hum Mol Genet 2001; 10: 1129-39.
  • 20 Mirabella M, Silvestri G, de Rosa G, Di Giovanni S, Di Muzio A, Uncini A, Tonali P, Servidei S. GCG genetic expansions in Italian patients with oculopharyngeal muscular dystrophy. Neurology 2000; 54: 608-14.