Aberrant insulin receptor expression is associated with insulin resistance and skeletal muscle atrophy in myotonic dystrophies

PLoS One. 2019 Mar 22;14(3):e0214254. doi: 10.1371/journal.pone.0214254. eCollection 2019.

Abstract

Myotonic dystrophy type 1 (DM1) and type 2 (DM2) are autosomal dominant multisystemic disorders linked to two different genetic loci and characterized by several features including myotonia, muscle atrophy and insulin resistance. The aberrant alternative splicing of insulin receptor (IR) gene and post-receptor signalling abnormalities have been associated with insulin resistance, however the precise molecular defects that cause metabolic dysfunctions are still unknown. Thus, the aims of this study were to investigate in DM skeletal muscle biopsies if beyond INSR missplicing, altered IR protein expression could play a role in insulin resistance and to verify if the lack of insulin pathway activation could contribute to skeletal muscle wasting. Our analysis showed that DM skeletal muscle exhibits a lower expression of the insulin receptor in type 1 fibers which can contribute to the defective activation of the insulin pathway. Moreover, the aberrant insulin signalling activation leads to a lower activation of mTOR and to an increase in MuRF1 and Atrogin-1/MAFbx expression, possible explaining DM skeletal muscle fiber atrophy. Taken together our data indicate that the defective insulin signalling activation can contribute to skeletal muscle features in DM patients and are probably linked to an aberrant specific-fiber type expression of the insulin receptor.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Antigens, CD / analysis*
  • Female
  • Humans
  • Insulin Resistance*
  • Male
  • Middle Aged
  • Muscle, Skeletal / pathology*
  • Muscular Atrophy / pathology*
  • Myotonic Dystrophy / pathology*
  • Receptor, Insulin / analysis*
  • Young Adult

Substances

  • Antigens, CD
  • INSR protein, human
  • Receptor, Insulin

Grants and funding

This study was supported by MDF-Myotonic Dystrophy Foundation and Wyck Foundation Postdoctoral Research Award to LVR and by FMM-Fondazione Malattie Miotoniche to RC. This study was partially supported by Ricerca Corrente funding from Italian Ministry of Health to IRCCS-Policlinico San Donato. The Italian Registry for Myotonic Dystrophy Type 1 and Type 2 is funded by the Italian Ministry of Health (RF-2010-2314711) to GM. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.