Ryanodine receptor 1-related disorders: an historical perspective and proposal for a unified nomenclature
Ryanodine receptor 1-related disorders: an historical perspective and proposal for a unified nomenclature
AbstractTheRYR1gene, which encodes the sarcoplasmic reticulum calcium release channel or type 1 ryanodine receptor (RyR1) of skeletal muscle, was sequenced in 1988 andRYR1variations that impair calcium homeostasis and increase susceptibility to malignant hyperthermia were first identified in 1991. Since then,RYR1-related myopathies (RYR1-RM) have been described as rare, histopathologically and clinically heterogeneous, and slowly progressive neuromuscular disorders.RYR1variants can lead to dysfunctional RyR1-mediated calcium release, malignant hyperthermia susceptibility, elevated oxidative stress, deleterious post-translational modifications, and decreased RyR1 expression.RYR1-RM-affected individuals can present with delayed motor milestones, contractures, scoliosis, ophthalmoplegia, and respiratory insufficiency.Historically,RYR1-RM-affected individuals were diagnosed based on morphologic features observed in muscle biopsies including central cores, cores and rods, central nuclei, fiber type disproportion, and multi-minicores. However, these histopathologic features are not always specific toRYR1-RM and often change over time. As additional phenotypes were associated withRYR1variations (including King-Denborough syndrome, exercise-induced rhabdomyolysis, lethal multiple pterygium syndrome, adult-onset distal myopathy, atypical periodic paralysis with or without myalgia, mild calf-predominant myopathy, and dusty core disease) the overlap among diagnostic categories is ever increasing. With the continuing emergence of new clinical subtypes along theRYR1disease spectrum and reports of adult-onset phenotypes, nuanced nomenclatures have been reported (RYR1- [related, related congenital, congenital] myopathies). In this narrative review, we provide historical highlights ofRYR1research, accounts of the main diagnostic disease subtypes and proposeRYR1-related disorders (RYR1-RD) as a unified nomenclature to describe this complex and evolving disease spectrum.
- National Institutes of Health United States
- University of Toronto Canada
- BAYLOR COLLEGE OF MEDICINE
- National Institute of Health Pakistan
- Baylor College of Medicine United States
History, Medical Sciences, Myopathy, Biophysics, 610, Skeletal muscle, Diseases of the musculoskeletal system, Review, Biochemistry, Ion channel defects, Terminology as Topic, Medical Specialties, Medicine and Health Sciences, Animals, Humans, Biology, Integrative Medicine, Life Sciences, Ryanodine Receptor Calcium Release Channel, Neuromuscular Diseases, Neuromuscular disease, Phenotype, RC925-935, Clinical neurology, and Structural Biology
History, Medical Sciences, Myopathy, Biophysics, 610, Skeletal muscle, Diseases of the musculoskeletal system, Review, Biochemistry, Ion channel defects, Terminology as Topic, Medical Specialties, Medicine and Health Sciences, Animals, Humans, Biology, Integrative Medicine, Life Sciences, Ryanodine Receptor Calcium Release Channel, Neuromuscular Diseases, Neuromuscular disease, Phenotype, RC925-935, Clinical neurology, and Structural Biology
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