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1989 - Nature - Conversion of MDX Myofibres From Dystrophin-Negative To - Positive by Injection of Normal Myoblasts
1989 - Nature - Conversion of MDX Myofibres From Dystrophin-Negative To - Positive by Injection of Normal Myoblasts
337 12 JANUA_R_Y_l~2
Significant differences in the amount of perinuclear a -mRN A 8. Fontaine, 8., Sassoon, D., Buckingham, M. & Changeux, J.-P. EMBO 1. 7, 603-609 ( l988).
9. Merlie, J. P. & Sanes, J. R. Nature 317, 66-68 (1985).
were evident even in a single ARIA-treated myotube. In Fig. 10. Buc-Caron, M.-H., Nystrom, P. & Fischbach, G. D. Devl Bioi. 95,378-386 (1983).
4a, one cluster of nuclei is heavily labelled whereas another 11. Hayward, L J. & Schwartz, R. J. J. Cell. Bioi. 102, 1485-1493 (1986).
12. Eldridge, J., Zehner, Z. & Paterson, B. M. Gene 36,55-63 (1985).
group, approximately 50 f.lm away in the same cell, is not label- 13. Nef. P.. Oncyser, C., Alliod. C.. Couturier. S. & Ballivet. M. EMBO J. 7, 595-601 ( 1988).
led above background. Previous studies have shown that high
density clusters of surface AChRs occur near myotube nuclei 5- 7 .
We have noted a correlation between the local concentration of
a-mRNA and the overall density of surface AChRs in the same
region, but the precise spatial relationship between these Conversion of mdx myofibres from
molecules remains to be determined.
Marked differences among nuclei in ARIA-treated cultures
dystrophin-negative to -positive by
were also evident after hybridization with a probe that detects injection of normal myoblasts
a partially spliced nuclear RNA encoding intron 6 of the a-
subunit gene 2 (Fig. 4b ). The striking heterogeneity in the distri- T. A. Partridge*, J. E. Morgan*, G. R. Coulton*,
bution of the exon probe is therefore probably due to different
rates of transcription of the a-subunit gene, and cannot be
E. P. Hoffmant & L. M. Kunkelt
attributed entirely to extra-nuclear factors such as the distribu- *Department of Histopathology, Charing Cross and Westminster
tion of rough endoplasmic reticulum. We have not yet reliably Medical School, Fulham Palace Road, London W6 8RF, UK
detected a signal from the intron probe in control cultures, t Division of Genetics, Childrens Hospital, Pediatrics, Harvard
probably because the level of intron 6-containing nuclear RNA Medical School and Howard Hughes Medical Institute, Boston,
is only 16% of that of mature a-mRNA 2 • Massachusetts 02115, USA
Our results indicate that ARIA does not activate all myotube
nuclei to the same degree. The distribution of grain densities in
ARIA-treated cultures was not obviously bimodal, but we An important corollary to the recent advances in our understanding
averaged grain counts over more than one nucleus in many of the primary cause of Duchenne muscular dystrophy 1 ~, is the
measurements, minimizing the distinction between responding validation of genuine genetic homologues as animal models of the
and non-responding nuclei. Likewise, the resolution of our disease 7 ' 8 in which potential therapies can be tested. The persistent
method does not allow us to determine if the distribution of skeletal muscle necrosis that characterizes human Duchenne mus-
responding nuclei is graded or multimodal. In addition, we do cular dystrophy9 is also seen in the mdx mouse 1{}-13 and is, in both,
not know if the nuclei labelled at background levels are a distinct a consequence of a deficiency of dystrophin6 ' 7 , probably within the
population, or part of the same distribution as nuclei labelled muscle fibres themselves 14- 16 • As injected muscle precursor cells
above background. These issues might be resolved if the signal- of one genotype can fuse with host muscle fibres of a different
to-noise ratio produced by the intron probe can be improved. genotype and express the donor genes 17•18, we decided to test grafts
We cannot at present account for the observed differences of normal muscle precursor cells to see if they could induce
among nuclei. No characteristic morphological features of synthesis of dystrophin in innately dystrophin-deficient mdx muscle
nuclei were noted that correlate with their level of expression fibres. We show that injected normal muscle precursor cells can
of a-mRNA. The ability to respond to inducing factors may be fuse with pre-existing or regenerating mdx muscle fibres to render
an intrinsic property of nuclei derived from a particular many of these fibres dystrophin-positive and so to partially or
myogenic lineage. Alternatively, the ability to respond may be wholly rescue them from their biochemical defect.
determined by the cytoplasmic environment of the nuclei. It is Mononucleated cells were prepared by enzymatic dissociation
unlikely that the heterogeneity is related to the distribution of of normal neonatal mouse muscle 18 . Between 5 x 10 5 and 4 x 106
receptors for ARIA, because we have observed similar differen- cells were injected into the right extensor digitorum longus
ces among nuclei in a-mRNA expression following treatment (EDL) muscles of 5-27-day-old mdx hosts. Mice were killed
with tetrodotoxin (unpublished data). It may also be relevant after 20-99 days and the EDL and adjacent tibialis anterior and
in this regard that only a few nuclei in denervated chick muscle peroneus muscles removed from the injected and contralateral
(15-days after hatching) seem to be heavily labelled with an non-injected legs. Successful fusion of donor muscle precursor
a-subunit mRNA probe 8 . cells (mpc) into host (mdx) myofibres was verified by isoelectric
Northern blot and in situ hybridization experiments have focusing of allotypic isoenzymes of glucose 6-phosphate
shown that AChR subunit mRNAs are concentrated at synaptic isomerase (GPI EC 53-1-9) 17 (Fig. 1). Donor mpc, homozygous
sites in vivo (refs 8, 9, and unpublished results). Although it is for GPI-lsb (producing the BB isoenzyme) were injected into
clear that motor neurons induce the accumulation of receptors homozygous GPI-lsa hosts (producing the AA isoenzyme). The
in the postsynaptic membrane, our results indicate that myotube AB GPI heterodimer can be formed only in mosaic host/donor
nuclei are not equally susceptible to this trophic influence. A myofibres in which both types of myonucleus express their
subset of nuclei might be predisposed to participate in synapse individual GPI-1 alleles. 'Host' mdx strains (designated
formation even before the nerve arrives. mdx/ nude and M9) were bred to be homozygous for the GPI-1 sa
We thank Marc Ballivet for the AChR clones and Bruce allele and also to avoid immune rejection of the injected cells.
Paterson for the cardiac actin clone. We also acknowledge Cindy Athymic 'mdx/nude' double mutants accept a wide range of
Nettrour and Rebecca Dill-Devor for technical assistance. This allografts, whereas the M9 strain is MHC-compatible with the
work was supported by a Clinical Investigator Development donor strains and is readily made tolerant to these strains at
Award (D.A.H.) and a Physician Scientist Award (D.L.F.), both birth 19 .
from the NIH, and by grants from the NIH, the McKnight Of 70 mice analysed, 39 had the heterodimer AB GPI in one
Foundation, and the James S. McDonnell Foundation (G.D.F.). or more muscles, indicating fusion of the injected cells into host
(mdx) myofibres (Table 1; Fig. 1). In 18 muscles the proportion
Received 24 October; accepted 24 November 1988. of AB heterodimer exceeded that of the donor (BB) isoenzyme
1. Usdin, T. B. & Fischbach, G. D. J. Cell Bioi. 103,493-507 (1986).
(see for example Fig. 1b, c and e), indicating that the majority
2. Harris, D. A., Falls, D. L. , Dill-Devor, R. M. & Fischbach, G. D. Proc. natn. Acad. Sci. of surviving donor nuclei were resident in mosaic muscle fibres.
USA 85, 1983-1987 (1988). Grafts of normal mpc succeeded less frequently in young (5-7
3. Merlie, J.P. & Smith, M. M. J. Membrane Bioi. 91, 1-10 (1986).
4. Dubinsky, J. M., Morgan, M. & Fischbach, G. D. Devl Bioi. 130, 209-219 (1988). day) mouse muscles (3 of 17), in which myofibres should be
5. Fischbach, G. D. & Cohen, S. A. Devl Bioi. 31, 147-162 (1973). acquiring new myonuclei during rapid growth 20 , than in regen-
6. Bruner, J. M. & Bursztajn, S. Devl Bioi. 115, 35-43 (l986).
7. Englander, L L & Rubin. I L J. Cell Bioi. 104,87-95 (1987). erating muscle of 19-27 -day-old mice (36 of 53). ln the older
NATURE VOL. 337 12 JANUARY 1989
LETIERS TO NATURE
177
mdxl mdx2
-e .... -...
'1:1 '1:1
....v -....s I -s... £7 -~
.. ••
·=- u= ·=-
<lj (II 0 (II <lj
z
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v
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=0
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.,
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Fig. 3 Immunofluorescent visualization of dystrophin in mdx
48.5 muscles injected with mpc derived from normal (C57Bl/IO)
donors. a, Muscle of M9 host mouse injected at 21 days with
1.5 x 106 mpc derived from a normal (C75Bl/IO) donor and
Fig. 2 Immunoblot detection of dystrophin in injected mdx examined 21 days later. Muscle fibre profiles exhibiting the charac-
muscles. Total muscle protein derived from the injected and non- teristic pattern of sarcolemmal dystrophin staining are found
injected (control) EDL muscles of two mdx mice was analysed for throughout the field. They are interspersed with typical mdx fibre
dystrophin content. The injected muscles have apparently normal profiles lacking this intense surface staining, and visible only by
virtue of background sarcoplasmic staining. In a few fibres (marked
dystrophin present at up to 30-40% of levels found in normal
mouse muscle. The immunoblot, after use for dystrophin detection, with an asterisk), some regions of the sarcolemmal profile are
was reprocessed for detection of a fast-twitch isoform of the weakly stained or unstained and others are brightly stained. This
Ca 2 +Mg2+ ATPase 41 as a control for the muscle protein content patchy pattern presumably reflects the restricted area of distribu-
of each lane. Relative molecular mass (M,) calibration is shown tion of dystrophin around myonuclei derived from injected normal
to the left. mpc. Stain is streptavidin-Texas Red and the final magnification
Methods. The portion of the ED L muscles remaining from the G PI is x 128. b, Muscle ofmdx/nude mouse injected at a time of muscle
growth (7 days) with 4 x I 06 mpc derived from a normal ( C57Bl/ I 0)
isoenzyme and dystrophin immunofluorescence analyses were
chipped out of the histological embedding medium at -20 oc and donor and examined 31 days later. This shows a mixture of com-
processed for electrophoresis on 3.5%-12.5% gradient SDS-poly- pletely stained, partially stained and unstained muscle fibres in
what appears to be an area of regeneration. It is uncertain whether
acrylamide gels and immunoblotted as previously described 6 ,
these donor cells entered the muscle fibres during growth, during
except that gels of 1.5 mm thickness were used and the bisacryl-
regeneration following the damage caused by the injection or
amide concentration in the 3.5% gel was 0.13%.
during the regeneration that follows the onset of mdx lesions at
around 21 days. The presence of some very small dystrophin-
ted cells, because these cells were entirely mononucleate 17 ·22 •27 positive fibres suggests that the latter mechanism is at least partially
and dystrophin is not expressed before the formation of multinu- responsible. Stain is streptavidin-Texas Red and the final mag-
nification is x200.
cleate myotubes 28 ·29 . These findings contrast markedly with ear- Methods. Cryostat cross-sections (5-8 J.Lm) of the muscles were
lier work on the inherited phosphorylase kinase deficiency in thawed on to gelatin-coated slides. PBS containing 5% horse serum
the ICR/IAn mouse 18 , where incorporation of grafted normal was used for blocking of the sections and for all reagent dilutions
mpc into host myofibres was poor and, even when successful, and washes. The primary antibody was a mixture of crude sheep-
resulted in only a marginal increase of phosphorylase kinase anti-mouse-dystrophin antisera directed against the dystrophin
above basal levels. This difference may reflect the lack ofmyone- antigens of molecular weight 30,000 and 60,000 and diluted I : 500.
crosis and regeneration in the ICR/IAn as compared with the The second antibody was a biotinylated donkey anti-sheep (Amer-
mdx myopathy. Law has studied the murine 'dy' dystrophi 0·3\ sham), diluted I: 250, followed by a streptavidin-Texas Red (BRL)
an autosomal recessive condition involving a major neuropathic or streptavidin-fluorescein (Amersham) diluted I: 40 or I: 250
respectively.
element 32 : the aetiology and pathogenesis of this disease are
uncertain 33 ·34 , so interpretation of the results is not straightfor-
ward. Nonetheless, the considerable functional improvement in the present study would not be applicable to man, although
achieved by injecting dy / dy muscles with normal mpc is the absence of class I MHC antigens on mature muscle fibres
encouraf!ing. in man 36 and in mouse 37 suggests that hosts and donors may
Before cell implantation can be considered as a means of require less stringent matching for muscle grafts than for other
therapy for DMD in man, a number of important problems tissues. It is also encouraging that long-term survival of muscle
must be addressed. First, it is important to establish whether allografts in the mouse has been achieved with cyclosporin
the introduction of dystrophin into mdx myofibres by this means A30·38 , but the demonstration of both class I (ref. 36) and class
will prevent their subsequent necrosis. Second, it is difficult to II (ref. 39) MHC antigens on muscle fibres in some circum-
see how the requirement for large numbers of human myogenic stances encourages caution. Fourth, there is the formidable
cells can be met, except by large-scale tissue culture and cell- problem of treating all the major muscle groups; as the migratory
sorting35. Third, the methods used to avoid immune rejection powers of mpc have not been shown to exceed a few mil-
- --LETIERSTONATURE
NATURE VOL 337 12 JANUA R:...:
Y-'-'19:...:8_.:_
9_ _ _ _ 179
limetres 22 •40 , injections would need to be spaced by not more 12. Camwat h, J. & Shotton, D. 1. Neural. Sci. 80, 39- 54 I 1987).
13. Coulton, G. R., Morgan, J. E., Pa nridge, T. A. & Sloper, J. C. Neuropath . appl. Ne!lrobiol.
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1. 411-420 11988).
We thank Dick Sullivan for help with histology and Ron 16. Morgan , 1. E., Co ulton , G. R. & Partridge, T. A. Muscle Nerve {i n th e press).
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