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Table 3 Primary and secondary protein abnormalities in muscular dystrophies

From: From proteins to genes: immunoanalysis in the diagnosis of muscular dystrophies

Disease

Gene(s)

Primary protein defect

Secondary changes

DMD

DMD

Dystrophin absent or very reduced with all antibodies

Utrophin overall upregulated

Sarcoglycans reduced/absent

Dystroglycan reduced/absent nNOS absent

BMD

DMD

Dystrophin reduced in size or amount or absent with at least one antibody

Utrophin overall upregulated

Sarcoglycans reduced/absent

Dystroglycan reduced/absent

nNOS may be absent

DMD/BMD carriers

DMD

Dystrophin patchy, mosaic pattern with at least one antibody

In fibres without dystrophin

Utrophin upregulated

Sarcoglycans reduced/absent

Dystroglycan reduced/absent

nNOS may be absent

EDMD1

EMD

Emerin absent

 

LGMD1A MFM

MYOT

Myotilin cytoplasmic aggregates

Desmin, αB-crystallin, VCP cytoplasmic aggregates

LGMD1B EDMD2 EDMD3

LMNA

Lamin A/C normally expressed

 

LGMD1C rippling muscle disease hyperCKemia

CAV3

Caveolin-3 absent/reduced

Dysferlin reduced at the sarcolemma

LGMD2A

CAPN3

Calpain 3 bands may be variably reduced on immunoblot, Iabelling may be absent or reduced on sections

Dysferlin reduced at the sarcolemma

LGMD2B Miyoshi myopathy

DYSF

Dysferlin absent or very reduced

Caveolin-3 reduced at the sarcolemma, calpain 3 bands may be reduced

LGMD2C-F

SGCG SGCA

SGCB

SGCD

Sarcoglycans variably reduced/absent

β-Dystroglycan may be reduced Dystrophin may be reduced

nNOS may be absent

LGMD2G

TCAP

Telethonin absent

 

LGMD2I, K, M-O, DG-pathies

FKRP POMT1 FKTN POMT2 POMGnT1 LARGE

Not applicable

Glycosylated α-dystroglycan very reduced/patchy

β-dystroglycan may be reduced

Laminin α2 may be reduced

MDC1A

LAMA2

Laminin α2 completely or partially absent

Laminin α5 overall upregulated

α-dystroglycan may be reduced

UCMD and Bethlem myopathy

COL6A1 COL6A2 COL6A3

Collagen VI very reduced in UCMD, usually normally expressed in BMD

 

MD with lipodystrophy

PTRF

PTRF-cavin absent/very reduced

Caveolin-3 reduced at the sarcolemma

MFM

DES

Desmin cytoplasmic aggregates

Myotilin, αB-crystallin, VCP cytoplasmic aggregates

MFM

CRYAB

αB-Crystallin cytoplasmic aggregates

Myotilin, desmin, VCP cytoplasmic aggregates

IBMPFD

VCP

VCP cytoplasmic aggregates

Myotilin, desmin, αB-crystallin cytoplasmic aggregates

  1. BMD = Becker muscular dystrophy; CK = creatine kinase; DG-pathies = dystroglycanopathies; DMD = Duchenne muscular dystrophy; EDMD = Emery-Dreifuss muscular dystrophy; IBMPFD = inclusion body myopathy with Paget's disease and frontotemporal dementia; LGMD = limb girdle muscular dystrophy; MD = muscular dystrophy; MDC = congenital muscular dystrophy; MFM = myofibrillar myopathy; nNOS = neuronal nitric oxide synthase; PTRF = polymerase I and transcript release factor; UCMD = Ulrich congenital muscular dystrophy; VCP = valosin-containing protein.