350 rub
Journal Technologies of Living Systems №8 for 2009 г.
Article in number:
LOCOMOTORY MUSCLE FIBER TYPE I AND TYPE II ATROPHY IN CHRONIC ALCOHOLIC PATIENTS. CLINICAL AND PHYSIOLOGICAL ANALYSIS
Keywords: alcoholism myopathy polyneuropathy immunohistochemistry muscle biopsy electromyography
Authors:
B.S. Shenkman, G.A. Maslova, Ju.V. Stogova, O.E. Zinovyeva, N.H. Yakhno
Abstract:
According to recent data, chronic alcoholic myopathy affects 4060 % of alcoholics. The type II muscle fibers (fast-twitch, anaerobic) are preferentially affected in this disease, whereas the type I fibers (slow-twitch, aerobic) are relatively spared. This pathology is also accompanied by reductions in the relative amounts of specific contractile proteins within the muscle itself, such as myosin, desmin, actin, and troponin. The most studies of molecular changes in chronic alcoholic myopathy were made on laboratory animal models. We have investigated neurophysiological and morphological changes in alcoholic myopathy in men. 25 chronic alcoholics were examined. Average age of 44,7±2 years, alcohol abuse duration was 15,9±2,1 years, with daily alcohol consumption 178±19 ml. Methods included: neurological examination, laboratory tests (serum CK, AST, ALT, γ-GT), nn. tibialis, peroneus, suralis, femoralis electroneuromyography, mm.vastus lateralis, tibialis anterior needle electromyography (EMG) and m. vastus lateralis biopsy. The undirect immunohistochemistry method was used to determine Type I and Type II fibers. Сross-sectional area of both type fibers was measured with Leica DC 300F and Leica Qwin Standart (Leica Microsystems, Germany) Based on morphological changes, we have divided all alcoholic patients into 3 groups: 1-patients without any structural changes in the muscle (n = 5), 2a-patients with selective Type II fiber atrophy (n = 10), 2b- alcoholics with Type I and II fiber atrophy (n = 10). Clinical signs of myopathy (weakness in proximal parts of limbs, loss of the skeletal muscle mass was obtained in 11 patients (44 %), 5 of them had morphological evidently Type II atrophy, 6 patients had both Type atrophy. There were no significant difference in age, daily alcohol intake, between these three groups. Significant difference in alcohol abuse duration was found - the longer is alcohol misuse the more severe is muscular fiber atrophy. Our results show, that chronic alcoholic myopathy may combine with chronic alcoholic poly-neuropathy, but they are two independent conditions. Chronic alcoholic myopathy has progressive clinical course, the longer is alcohol abuse, the more severe is muscular fiber atrophy. In the early stage patients have only type II muscle atrophy, in advanced stages of disease patients have both fiber type atrophy. According to our data, there are no specific needle electromyography findings in chronic alcoholic patients, these patients have mixed myopathic and neuropathic needle EMG changes.
Pages: 3-10
References
  1. Гехт Б.М., Касаткина Л.Ф., Самойлов М.И., Санадзе А.Г. Электромиография в диагностике нервно-мышечных заболеваний. Таганрог: Издательство ТРГУ. 1997. 370 с.
  2. Команцев В.Н., Архиреев А.Ю. Комплексная электронейромиографическая диагностика дермато- и полимиозитов // Неврологический журнал. 2008. Т. 13. № 4. С.19 - 25.
  3. Мак-Комас А.Дж. Скелетные мышцы. Киев: Олимпийская литература. 2001. 406 с.
  4. Amato A.A., Dumitru D., Zwarts M.J. Acquired myopathies. Electrodiagnostic medicine 2nd edition. Philadelphia: Hanley & Belfus: 2002. Р. 1265-1432.
  5. Estruch R., Sacanella E., Fernandez-Sola J., Nicolas J.M. et al. Natural history of alcoholic myopathy: 5-year study // Alcohol Clin. Exp. Res. 1998. V. 22. P. 2023-2028.
  6. Fernandez-Sola J., Sacanella E., Estruch R., Nicolas J.M. et al. Serum and muscle levels of alpha-tocopherol, ascorbic acid, and retinol are normal in chronic alcoholic myopathy // Alcohol. Clin. Exp. Res. 1998. V. 22. P. 422-427.
  7. Ferraz M.L., Gabbai A.A., Oliveira A.S., Ferrari A.P. et al. Histochemical study of the skeletal muscle in chronic alcoholism // Arq. Neuropsiquiatr. 1989. V. 47. P. 139-149.
  8. Fujita T., Adachi J., Ueno Y., Peters T.J. et al. Chronic ethanol feeding increases 7- hydroperoxycholesterol and oxysterols in rat skeletal muscle // Metabolism. 2002. V. 51. P.737-742.
  9. Hunter R.J., Neagoe C., Jarvelainen H.A., Martin C.R. et al. Alcohol affects the skeletal muscle proteins, titin and nebulin in male and female rats // J. Nutr. 2003. V. 133. P. 1154 -1157.
  10. Lang C.H., Frost R.A., Deshpande N, Kumar V., Thomas C., Vary T.C., Jefferson L.S., Scot R. 11.Kimball S.R. Alcohol impairs leucine-mediated phosphorylation of 4E-BP1, S6K1, eIF4G, and mTOR in skeletal muscle // Am J. Physiol. Endocrinol. Metab. 2003. V.285. P. E1205-E1215.
  11. Mantle D., Falkous G., Peters T.J., Preedy V.R. Effect of ethanol and acetaldehyde on intracellular protease activities in human liver, brain and muscle tissues in vitro // Clin Chim Acta. 1999. V. 281. P.101-108.
  12. Martin F., Ward K., Slavin G., Levi J., Peters T.J. Alcoholic skeletal myopathy, a clinical and pathological study // Q. J. Med. 1985. V. 55. P. 233 -251.
  13. Mills K.R., Ward K., Martin F., Peters T.J. Peripheral neuropathy and myopathy in chronic alcoholism // Alcohol. Alcohol. 1986. V. 21. P. 357 -362.
  14. Nicolas J.M., Garcia G., Fatjo F., Sacanella E. et al. Influence of nutritional status on alcoholic myopathy // American Journal of Clinical Nutrition. 2003. V. 78. № 2. P. 326 -333.
  15. Ohlendieck K., Harmon S., Koll M., Paice A.G. et al. Ca2+-regulatory muscle proteins in the alcohol-fed rat // Metabolism. 2003. V.52. № 9. P. 1102 -1112.
  16. Preedy V.R., Adachi J., Ueno Y., Ahmed S. et al. Alcoholic skeletal muscle myopathy: definitions, features, contribution of neuropathy, impact and diagnosis // European Journal of Neurology. 2001. V. 8. P. 677-687.
  17. Preedy V.R., Ohlendieck K., Adachi J., Koll M. et al. The importance of alcohol-induced muscle disease // J. Muscle Res Cell Motil. 2003. V. 24. № 1. P. 55 -63.
  18. Reilly M.E., Erylmaz E.I., Amir A, Peters T.J. et al. Skeletal muscle ribonuclease activities in chronically ethanol treated rats // Alcohol. Clin. Exp. Res. 1998. V. 22. P.876-883.
  19. Reilly M.E., Preedy V.R., Peters T.J. Investigations into the toxic effects of alcohol on skeletal muscle  // Adverse Drug. React. Toxicol. Rev. 1995. V. 14. P. 117 -150.
  20. Schiaffino S., Gorza L., Ausoni S., Bottinelli R. et al. The dynamic state of muscle fibers. Berlin: Walter de Gruyter. 1990. Р. 329 -341.
  21. Sharma S.C., Ray R.C., Banerjee A.K., Lakshmanan C. Chronic muscle wasting in alcoholics - a histochemical and biochemical study // Indian J. Pathol. Microbiol. 1990. V. 33. P. 244-249.
  22. Slavin G., Martin F., Ward P., Levi J. et al. Chronic alcohol excess is associated with selective bur reversible injury to type 2B muscle fibers // J. Clin. Pathol. 1983. V. 36. P. 772-777.
  23. Song S.K., Rubin E.Ethanol produces muscle damage in human volunteers // Science. 1972. V. 175. P. 327-328.
  24. Staron R.S., Hagerman F.C., Hikida R.S., Murray T.F. et al. Fiber type composition of the vastus lateralis muscle of young men and women // The Journal of Histochemistry & Cytochemistry. 2000. V. 48. P623 -629.
  25. Tiernan J.M., Ward L.C. Acute effects of ethanol on protein synthesis in the rat. // Alcohol. 1986. V. 21. P. 171-179.
  26. Urbano-Marquez A., Estruch R., Navarro-Lopez F.,
    Grau J.M.     et al. The effects of alcoholism on skeletal and cardiac muscle // N. Engl J. Med. 1989. V. 320. P. 409 -415.
  27. Walsh R.J., Amato A.A.Toxic myopathies // Neurol. Clin. 2005. V. 23. № 2. P. 397 -428.
  28. Ward R.J., Peters T.J.The antioxidant status of patients with either alcohol-induced liver damage or myopathy // Alcohol. Alcohol. 1992. V. 27. P. 359 -365.
  29. Wassif W.S., Preedy V.R., Summers B., Duane P. et al. The relationship between muscle fiber atrophy factor, plasma carnosinase activities and muscle RNA and protein composition in chronic alcoholic myopathy // Alcohol. 1993. V. 28. P.325-331.