What Is Myotonic Dystrophy Type 1?
Source: Genetic and Rare Diseases (GARD) Information Center
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Myotonic Dystrophy Type 1
Dystrophia Myotonica Type 1; DM1; Steinert Disease; Steinert Myotonic Dystrophy
Myotonic dystrophy type 2 is one of the two types of myotonic dystrophy. Type 2 particularly affects muscles farthest from the center of the body (distal muscles), such as those of the lower legs, hands, neck, and face. Explore symptoms, causes, and genetics of this rare condition.
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Small Molecule Drugs for the Treatment of Myotonic Dystrophy Type 1 (DM1)
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Source: Genetic and Rare Diseases (GARD) Information Center
Mutation
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MD1 is caused by a mutation called a CTG trinucleotide repeat in the DMPK gene. It is made up of three DNA building blocks (CTG stands for cytosine, thymine, and guanine) that appear multiple times in a row. If the number of CTG repeats is more than 34, it creates an unstable region in the gene. Repeats between 35 and 49 are considered premutations. Individuals with CTG repeats in this range do not have symptoms themselves, but their children are at increased risk of inheriting a larger repeat size and thus having symptoms.
The protein made by the DMPK gene is believed to play a role in communication and impulse transmission within and between cells. It appears to be important for the correct functioning of cells in the heart, brain, and skeletal muscles. The more than normal number of CTG repeats leads to the creation of longer and toxic RNA. This causes problems for cells mainly because it traps and disables important proteins. This prevents cells in muscles and other tissues from functioning normally, leading to the signs and symptoms of MD1.
Source: Genetic and Rare Diseases (GARD) Information Center
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The DMPK gene provides instructions for making a protein called myotonic dystrophy protein kinase. This protein appears to play an important role in muscle, heart, and brain cells. The protein may be involved in communication within cells. It also appears to regulate the production and function of important structures inside muscle cells by interacting with other proteins. For example, myotonic dystrophy protein kinase has been shown to turn off (inhibit) part of a muscle protein called myosin phosphatase. Myosin phosphatase is an enzyme that plays a role in muscle tensing (contraction) and relaxation.
One region of the DMPK gene contains a segment of three DNA building blocks (nucleotides) that is repeated multiple times. This sequence, which is written as CTG, is called a triplet or trinucleotide repeat. In most people, the number of CTG repeats in this gene ranges from 5 to 34.
Mutations in the DMPK gene cause a form of myotonic dystrophy known as myotonic dystrophy type 1. Myotonic dystrophy is characterized by progressive muscle wasting and weakness. The muscle weakness associated with type 1 particularly affects muscles farthest from the center of the body (distal muscles), such as those of the lower legs, hands, neck, and face. People with this disorder often have prolonged muscle contractions (myotonia) and are not able to relax certain muscles after use.
The type of mutation that causes myotonic dystrophy type 1 is known as a trinucleotide repeat expansion. This mutation increases the size of the repeated CTG segment in the DMPK gene. People with myotonic dystrophy type 1 have from 50 to 1,000 CTG repeats in most cells. The number of repeats may be even greater in certain types of cells, such as muscle cells.
The mutated DMPK gene produces an altered version of messenger RNA, which is a molecular blueprint of the gene that is normally used to guide the production of proteins. Researchers have found that the altered messenger RNA traps proteins to form clumps within the cell. The clumps interfere with the production of many other proteins. These changes prevent muscle cells and cells in other tissues from functioning properly, leading to muscle weakness and the other features of myotonic dystrophy type 1.
The size of the trinucleotide repeat expansion is associated with the severity of signs and symptoms. People with the classic features of myotonic dystrophy type 1, including muscle weakness and wasting beginning in adulthood, usually have between 100 and 1,000 CTG repeats in their cells. People born with the more severe, congenital form of myotonic dystrophy type 1 tend to have more than 1,000 CTG repeats in their cells. People with the mild form of the condition usually have between 50 and 150 CTG repeats in their cells.
As the altered DMPK gene is passed from one generation to the next, the size of the CTG repeat expansion often increases in size. People with 35 to 49 CTG repeats do not develop myotonic dystrophy type 1, but their children are at risk of having the disorder if the number of CTG repeats increases. Repeat lengths from 35 to 49 are called premutations.
Source: MedlinePlus Genetics
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Normal vision / Cataract
Source: Genetic and Rare Diseases (GARD) Information Center
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A medical illustration depicting normal eye. / A medical illustration depicting cataracts.
Source: Genetic and Rare Diseases (GARD) Information Center
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Source: Genetic and Rare Diseases (GARD) Information Center
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