The skeletal muscle has a remarkable regenerative capacity upon injury, due to the presence of the satellite cells, which remain quiescent in the tissue, but, when required, they are able to proliferate and form and/or repair myofibers. Moreover, satellite cells are important to muscle growth and maintenance. However, in many neuromuscular disorders, the amount, function, and proliferative capacity of these cells are impaired. Centronuclear myopathies (CNM) are a group of muscle diseases characterized by generalized muscle weakness and myofibers with central nuclei. The autosomal dominant form (AD-CNM) is caused by mutations in the DNM2 gene. Dynamin 2 protein is ubiquitously expressed and is involved in membrane remodeling, intracellular trafficking, and cytoskeleton dynamics. Therefore, the pathophysiological mechanisms are equally diverse e not completely understood, mainly the fact to be a muscle-specific disease. In the present Ph.D. thesis, we sought to investigate the satellite cells in the context of centronuclear myopathy. For this, we used the mouse model KI-Dnm2R465W, bearing the most frequent mutation found in human patients. Since in centronuclear myopathy there is no evident degenerative process ongoing, we induced muscle lesion by electrical shock, a protocol developed for this thesis, comparatively to cardiotoxin injection. We verified that the number of satellite cells in gastrocnemius muscle is reduced in the KI-Dnm2R465W mouse in relation to wild-type animals. As a result, the regenerative potential of the mutant mouse is decreased and the muscle is not able to fully recover. In addition, we investigated the functional consequences of two mutations, p.R465W and p.E650K, in immortalized myoblasts. We examined the myogenic potential in vitro, the migratory property, and the endocytosis capacity. We found that both mutations impact on the myogenic potential, but in different ways. We also show that both mutations impair the migratory capacity of myoblasts that justify, in parts, the alterations in their myogenic potential. Finally, we verified that the endocytosis capacity is affected in a mutation-dependent manner, which may also indirectly disturb the myogenic differentiation efficiency / O músculo esquelético possui grande capacidade regenerativa após sofrer lesões, por causa da presença das chamadas células-satélite, que permanecem no tecido em estado quiescente, mas que, na presença de uma lesão, são capazes de proliferar e formar e/ou reparar miofibras. As células-satélite são importantes para o crescimento e manutenção do músculo adulto. Porém, em diversas doenças neuromusculares, a quantidade, a função e a capacidade proliferativa destas células podem estar comprometidas. As miopatias centronucleares (CNM) são um grupo de doenças musculares caracterizadas por fraqueza muscular generalizada e o posicionamento dos núcleos na porção central da miofibra. A forma autossômica dominante (AD-CNM) é causada por mutações no gene DNM2. A proteína dinamina 2 é expressa ubiquamente e está envolvida no remodelamento de membranas, no tráfego intracelular e na dinâmica do citoesqueleto. Consequentemente, os mecanismos fisiopatológicos também são diversos e não completamente compreendidos, principalmente o fato de ser uma doença músculo-específica. Nesta tese de doutorado, buscamos investigar as células-satélite no contexto da miopatia centronuclear. Para isto, utilizamos o camundongo modelo KI-Dnm2R465W, portador da mutação mais frequente em pacientes humanos. Como na miopatia centronuclear não há um processo degenerativo em atividade, induzimos nos camundongos a lesão muscular por choque elétrico, em protocolo desenvolvido nesta tese, comparativamente a injeção de cardiotoxina. Verificamos que o número de células satélite no músculo gastrocnêmio do camundongo KI-Dnm2R465W é reduzido em relação aos animais selvagens. Em consequência disto, o potencial regenerativo do animal mutante é reduzido e o músculo não se recupera completamente. Investigamos também os efeitos funcionais de duas mutações, p.R465W e p.E650K, em mioblastos imortalizados. Examinamos o potencial miogênico in vitro, a propriedade migratória e a capacidade de endocitose. Verificamos que o potencial miogênico destas células é afetado pelas mutações, porém de maneiras distintas. Mostramos também que ambas as mutações impactam negativamente na capacidade migratória dos mioblastos, o que em parte justifica as alterações no potencial miogênico dos mesmos. Por fim, verificamos que a capacidade endocítica em mioblastos é alterada a depender da mutação, o que indiretamente também pode afetar a capacidade de diferenciação miogênica

Isolated noncompaction of the left ventricular myocardium (INVM) is characterized by the presence of numerous prominent trabeculations and deep intertrabecular recesses within the left ventricle, sometimes also affecting the right ventricle and interventricular septum. Familial occurrence of this disorder was described previously. We present a family in which 6 affected individuals demonstrated X-linked recessive inheritance of this trait. Affected relatives presented postnatally with left ventricular failure and arrhythmias, associated with the pathognomonic echocardiographic findings of INVM. The usual findings of Barth syndrome (neutropenia, growth retardation, elevated urinary organic acids, low carnitine levels, and mitochondrial abnormalities) were either absent or found inconsistently. Fetal echocardiograms obtained between 24-30 weeks of gestation in 3 of the affected males showed a dilated left ventricle in one heart, but were not otherwise diagnostic of INVM in any of the cases. Four of the affected individuals died during infancy, one is in cardiac failure at age 8 months, and one is alive following cardiac transplant at age 9 months. The hearts from infants who died or underwent transplantation appeared, on gross examination, to be enlarged, with coarse, deep ventricular trabeculations and prominent endocardial fibroelastosis. Histologically, there were loosely organized fascicles of myocytes in subepicardial and midmyocardial zones of both ventricles, and the myocytes showed thin, often angulated fibers with prominent central clearing and reduced numbers of filaments. Markedly elongated mitochondria were present in some ventricular myocytes from one specimen, but this finding was not reproducible. Genetic linkage analysis has localized INVM to the Xq28 region, where other myopathies with cardiac involvement have been located.

La myopathie centronucléaire (CNM) est un groupe de maladies génétiques caractérisées au niveau histologique par des noyaux au centre des myofibres au lieu de la périphérie. Des mutations dans trois gènes (MTM1, DNM2 et BIN1) sont associées à cette pathologie. Récemment, l’implication d’un nouveau gène a été révélée dans une myopathie congénitale, le gène PYROXD1. Cependant, la base moléculaire responsable du déséquilibre à l'intérieur de la cellule reste incertaine et la relation entre le niveau histologique et les symptômes chez les patients n'est pas comprise. De plus, aucun traitement n'est disponible pour ces maladies. Au cours de ma thèse, j'ai centré mon travail sur l'utilisation du modèle de levure S. cerevisiae pour comprendre trois protéines associées au CNM : la myotubularine Mtm1, l'oxydoréductase Pyroxd1 et la dynamine Dnm2. Ces données révèlent qu’il est possible d’utiliser une simple cellule eucaryote afin d'élucider certains aspects moléculaires de ces protéines impliquées dans des maladies humaines. / Centronuclear myopathy (CNM) is a group of genetic disorders characterized at the histological level by nuclei at the center of the myofibers instead of the periphery. Mutations in three genes (MTM1, DNM2 and BIN1) are associated with this pathology. Recently the implication of a new gene has been revealed in a congenital myopathy, the PYROXD1 gene.However, the molecular basis responsible for the imbalance inside the cell remains unclear and the relation between the histological level and the symptoms in patients is not understood. Moreover, there is no treatment available for these diseases.During my thesis I have focused my work on using yeast S. cerevisiae model to understand three proteins associated to CNM: the myotubularin Mtm1, the oxidoreductase Pyroxd1 and the dynamin Dnm2. These data reveal that it is possible to use a single eukaryote cell to elucidate some molecular aspects of these proteins implicated in human disorders.

MTM1 et MTMR2 sont 2 phosphatases de phosphoinositides appartenant à la famille des myotubularines, conservée pendant l’évolution. Bien qu’étant très similaires, des mutations dans MTM1 entraînent la sévère myopathie XLCNM alors que les mutations dans MTMR2 entraînent la neuropathie CMT4B. On ne comprend pas encore les bases moléculaires de cette spécificité de tissu, et il n’existe aucun traitement spécifique pour ces maladies. J’ai tout d’abord caractérisé l’activité des 2 isoformes endogènes de MTMR2, nommés MTMR2-L et MTMR2-S. J’ai démontré que la différence fonctionnelle entre MTM1 et MTMR2 s’explique principalement par l’extension N-terminale de MTMR2, et que l’isoforme MTMR2-S dépourvu de cette extension entraîne les mêmes phénotypes que MTM1. Ensuite, grâce à l’injection d’AAV dans les souris Mtm1 KO, j’ai démontré que l’expression exogène des isoformes de MTMR2, et surtout de MTMR2-S, améliore grandement l’atrophie musculaire, la force musculaire et les marqueurs histologiques de ces souris myopathiques. Ces résultats révèlent une première base moléculaire expliquant les spécificités fonctionnelles de MTM1 et MTMR2, et montrent que MTMR2 est une cible thérapeutique potentielle pour la myopathie XLCNM. / MTM1 and MTMR2 are 2 phosphatases of phosphoinositides that belong to the myotubularin family conserved through evolution. Despite their high level of similarity, mutations in MTM1 lead to the severe XLCNM myopathy while mutations in MTMR2 lead to the CMT4B neuropathy. The molecular bases for the surprising tissue-specific functions of these ubiquitously expressed proteins was unclear. Moreover, there is no specific therapy for these diseases.I first characterized the activity of the two naturally occurring isoforms of MTMR2, that we named MTMR2-L (long) and MTMR2-S (short). I found that the functional differences between MTM1 and MTMR2 reside mostly in the N-terminal extension of MTMR2-L, and that the endogenous MTMR2-S isoform lacking this N-terminal extension behaves similarly as MTM1. Then, using the myopathic Mtm1 KO mouse and AAV-mediated expression, I showed that exogenous expression of MTMR2 isoforms, and specifically of MTMR2-S, strongly improved the muscle atrophy, muscle force and the histological hallmarks of the myopathic mice. These data reveal a first molecular basis for the functional specificities of MTM1 and MTMR2, and highlight MTMR2 as a therapeutic target for XLCNM myopathy.

Le couplage excitation-contraction (EC) du muscle squelettique correspond à l’efflux de Ca2+ par le réticulum sarcoplasmique (RS) suite à une dépolarisation sarcolemmale. Des mutations dans les gènes MTM1 et DNM2 sont responsables respectivement de la forme sévère et modérée de la myopathie centronucléaire (CNM). Chez la souris Mtm1 KO, l’absence de la (PtdInsP) 3-phosphatase MTM1 est associée à une altération du couplage EC, propablement la cause majeure de la faiblesse musculaire. Le rôle du PdtIns(4,5)P2 dans la régulation du couplage EC a été étudié dans des fibres musculaires exprimant une PtdInsP phosphatase sensible au potentiel. Grâce à une combinaison d’électrophysiologie et d’imagerie confocale, nous avons montré une altération de l’efflux calcique en réponse à de fortes dépolarisations déplétant les stocks de PdtIns(4,5)P2 à la membrane.Dans un deuxième temps, une caractérisation complète des défauts de signalisation calcique et du couplage EC a été réalisée dans les fibres musculaires isolées de souris Mtm1 KO. Nos résultats indiquent que l’efflux calcique est d’amplitude réduite, est retardé et est spatialement hétérogène. L’inhibition pharmacologique de l’activité PtdInsP 3-kinase améliore ces défauts in vitro et la survie des souris in vivo, suggérant que l’accumulation des substrats de MTM1 participe au défaut du couplage EC. Ces résultats montrent le bénéfice thérapeutique d’une approche pharmacologique aux inhibiteurs d’activité PtdInsP 3-kinase.Enfin, nous avons montré que les fibres musculaires d’un modèle murin de la forme modérée de CNM (KI-Dnm2R465W) partagent certaines altérations du couplage EC avec le modèle Mtm1 KO (retard de l’efflux calcique) pouvant contribuer à la faiblesse musculaire. Cependant, d’autres défauts (altérations structurales, réduction de l’efflux calcique) affectent plus sévèrement le modèle Mtm1 KO, et pourraient être déterminants dans la différence de sévérité entre les deux formes de CNM / Excitation-contraction (EC) coupling is the process whereby a membrane depolarization leads to an increased cytosolic Ca2+ content, allowing contraction. Mutations in the genes MTM1 and DNM2 are responsible respectively for severe and moderate forms of centronuclear myopathy (CNM). In Mtm1 KO mouse model, MTM deficiency is associated with defective EC coupling, which makes probably the major contribution to muscle meakness.PdtIns(4,5)P2 involvement in regulating EC coupling has been investigated in muscle fibers expressing a voltage sensing PtdInsP phosphatase. Thanks to a combination of electrophysiology and confocal imaging techniques, we showed a reduction of SR Ca2+ release amplitude in response to strong depolarizations activating PdtIns(4,5)P2 depletion at plasma membrane.Secondly, we made a complete characterization of calcium signaling and EC coupling properties in isolated muscle fibers from Mtm1 KO mice. Our results demonstrate that SR Ca2+ release is depressed, delayed and spatially heterogeneous in diseased fibers. Moreover, we showed that pharmacological inhibition of PtdInsP 3-kinase activity improves these defects in vitro and mice survival in vivo, suggesting that accumulation of MTM1 substrates may participate to defective EC coupling. Overall, these results provide proof of concept for the use of PtdIns 3-kinase inhibitors in severe form of CNM.Finally, we showed that muscle fibers from murine model of moderate CNM form (KI-Dnm2R465W) share some of EC coupling defects with Mtm1 KO model (delayed SR Ca2+ release) that may contribute to muscle weakness. However, other defects (structural alterations, depressed SR Ca2+ release) affect more severely Mtm1 KO model, and may be critical in determining the severity of CNM

Centronuclear myopathy (CNM) is a genetically heterogeneous disorder associated with general skeletal muscle weakness, type I fiber predominance and atrophy, and abnormally centralized nuclei. Autosomal dominant CNM is due to mutations in the large GTPase dynamin 2 (DNM2), a mechanochemical enzyme regulating cytoskeleton and membrane trafficking in cells. To date, 40 families with CNM-related DNM2 mutations have been described, and here we report 60 additional families encompassing a broad genotypic and phenotypic spectrum. In total, 18 different mutations are reported in 100 families and our cohort harbors nine known and four new mutations, including the first splice-site mutation. Genotype-phenotype correlation hypotheses are drawn from the published and new data, and allow an efficient screening strategy for molecular diagnosis. In addition to CNM, dissimilar DNM2 mutations are associated with Charcot-Marie-Tooth (CMT) peripheral neuropathy (CMTD1B and CMT2M), suggesting a tissue-specific impact of the mutations. In this study, we discuss the possible clinical overlap of CNM and CMT, and the biological significance of the respective mutations based on the known functions of dynamin 2 and its protein structure. Defects in membrane trafficking due to DNM2 mutations potentially represent a common pathological mechanism in CNM and CMT.

La Myotubularine (MTM1) est une 3-phosphatase à phosphoinositides (PI) mutée dans la myopathie centronucléaire liée au chromosome X (XLCNM), caractérisée par une faiblesse musculaire et un positionnement anormal des noyaux dans les fibres musculaires. MTM1 définit une grande famille de phosphatases, exprimées dans tous les tissus, et qui englobent des phosphatases catalytiquement actives et inactives. Les myotubularines actives dephosphorylent le phosphatidylinositol 3 monophosphate [PtdIns3P] et le 3,5-bisphosphate [PtdIns(3,5)P2] en PtdIns et PtdIns5P, respectivement. Le rôle de MTM1 et son activité phosphatase à lipide dans le muscle restaient peu connus. L’étude approfondie de la protéine a révélé une association de MTM1 au réticulum sarcoplasmique des triades, un sous-compartiment impliqué dans la régulation calcique. La caractérisation de la souris Mtm1 KO, qui reproduit la XLCNM, a témoigné d’une anomalie de l’organisation et de la forme du réticulum sarcoplasmique. Afin d’explorer l’implicationde l’activité phosphatase de MTM1 dans l’organisation de réticulum sarcoplasmique, j’ai utilisé une approche in vivo avec des virus adéno-associé (AAV) pour moduler l’activité phosphatase en sur-exprimant MTM1 et sa forme phosphatase-inactive (MTM1-C375S) dans un muscle sauvage. L’observation des muscles transduits a dévoilé une implication de MTM1 dans le remodelage du réticulum sarcoplasmique et un rôle potentiel de PtdIns3P avec MTM1 dans la courbure des membranes du réticulum sarcoplasmique. Afin de comprendre l’importance de l’activité phosphatase dans le maintien du phénotype XLCNM, les muscles de souris Mtm1 KO ont été injectés avec ces AAVs contenant la forme active et inactive de MTM1 au moment de l’apparition des premiers signes de XLCNM. Étonnamment, la forme phosphatase-inactive(MTM1-C375S) a sauvé le phénotype de la souris Mtm1 KO de la même façon que la forme active, suggérant que l'activité de phosphatase de MTM1 n’est pas nécessaire pour le maintien de la structure intracellulaire des fibres du muscle adulte. Ces données suggèrent que MTM1 exerce une fonction phosphatase-indépendante dans le maintien de la structure musculaire, certainement via des interactions protéine-protéine, et une fonction phosphatase-dépendente dans le remodelage de la forme du réticulum sarcoplasmique dans le muscle squelettique. / Myotubularin (MTM1) is a phosphoinositide (PI) 3-phosphatase mutated in X-linked centronuclear myopathy (XLCNM), a rare congenital myopathy characterized by muscle weakness and abnormal positioning of nuclei in muscle fibers. MTM1 defines a large family of ubiquitously expressed catalytically active and inactive phosphatases. Active myotubularins dephosphorylate both phosphatidylinositol 3-phosphate [PtdIns3P] and 3,5-bisphosphate [PtdIns(3,5)P2] to PtdIns andPtdIns5P, respectively. The specific role of MTM1 and its PI phosphatase activity in muscle remains unknown. Comprehensive analysis of the protein unveiled the association of MTM1 with the sarcoplasmic reticulum (SR) at the triads. Characterization of Mtm1-KO mouse, which reproduce the XLCNM phenotype, revealed a defect of SR organization and shape. In order to gain insight into the involvement of MTM1 phosphatase activity on SR shape and organization, we employed an in vivo approach using Adeno-Associated Virus (AAV) to modulate the phosphatase activity by overexpressingMTM1 and its phosphatase inactive mutant in wild type muscle. The analysis of transduced muscle revealed the involvement of MTM1 in the SR remodeling and its potential role together with PtdIns3P in modulating membrane curvature. In order to understand the importance of the phosphatase activity in the generation of the XLCNM phenotype, Mtm1 KO mice were injected with AAV expressing the active form and the phosphatase inactive form. Surprisingly, both, the phosphatase active and the phosphatase inactive mutant corrected the Mtm1-KO mouse phenotype to a similar extent, thus suggesting that the PI-phosphatase activity of MTM1 is not essential for adult skeletal muscle maintenance. Our data indicates that MTM1 has a phosphatase-independent function in adult muscle structure maintenance and a phosphatase-dependent function in sarcoplasmic reticulum remodeling and shape in skeletal muscle.