title: RNA metabolism in myotonic dystrophy: patient muscle shows decreased insulin receptor RNA and protein consistent with abnormal insulin resistance.
abstract: Myotonic dystrophy is a dominantly inherited clinically variable multisystemic disorder, and has been found to be caused by heterozygosity for a trinucleotide repeat expansion mutation in the 3' untranslated region of a protein kinase gene (DM kinase). The mechanisms by which the expanded repeat in DNA results in a dominant biochemical defect and the varied clinical phenotype, is not known. We have recently proposed a model where disease pathogenesis may occur at the RNA level in myotonic dystrophy: the mutant DM kinase RNA with the expansion mutation may disrupt cellular RNA metabolism in some general manner, as evidenced by defects in RNA processing of the normal DM kinase gene in heterozygous patients (dominant negative RNA mutation). Here we further test this hypothesis by measuring RNA metabolism of other genes in patient muscle biopsies (nine adult onset myotonic dystrophy patients, two congenital muscular dystrophy patients, four normal controls, and four myopathic controls). We focused on the insulin receptor gene because of the documented insulin resistance of DM patients. We show that there is a significant decrease in insulin receptor RNA in both total RNA and RNA polyA+ pools relative to normal and myopathic control muscles (P < 0.002), measured relative to both dystrophin RNA and muscle sodium channel RNA. We also show reductions in insulin receptor protein. Our results reinforce the concept of a generalized RNA metabolism defect in myotonic dystrophy, and offer a possible molecular mechanism for the increased insulin resistance observed in many myotonic dystrophy patients.
authors.affiliation: Department of Molecular Genetics and Biochemistry, University of Pittsburgh School of Medicine, Pennsylvania 15261, USA.
authors.forename: A
authors.initials: A
authors.lastname: Morrone
authors.forename: E
authors.initials: E
authors.lastname: Pegoraro
authors.forename: C
authors.initials: C
authors.lastname: Angelini
authors.forename: E
authors.initials: E
authors.lastname: Zammarchi
authors.forename: G
authors.initials: G
authors.lastname: Marconi
authors.forename: E P
authors.initials: EP
authors.lastname: Hoffman
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D006801:Humans; D007223:Infant; D007333:Insulin Resistance; D008875:Middle Aged; D009132:Muscles / Q000378:metabolism*; D009223:Myotonic Dystrophy / Q000378:metabolism*; D065636:Myotonin-Protein Kinase; D017346:Protein Serine-Threonine Kinases / Q000235:genetics; D012313:RNA / Q000032:analysis / Q000378:metabolism*; D011972:Receptor, Insulin / Q000032:analysis / Q000235:genetics*
chemical_list: C585517:DMPK protein, human; D012313:RNA; D011972:Receptor, Insulin; D065636:Myotonin-Protein Kinase; D017346:Protein Serine-Threonine Kinases