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1From the Departments of Ophthalmology, 2Neurology, and 3Neurosciences, Case Western Reserve University and The Research Institute of University Hospitals of Cleveland, Cleveland, Ohio.
| Abstract |
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METHODS. Adult mouse EOM NMJ organization was examined by immunofluorescence and confocal microscopy. Differential cellular localization of components of two established synaptic signaling pathways, (1) neuregulin and erbB receptors 2, 3, and 4 and (2) agrin, MuSK, and rapsyn and select NMJ-associated structural proteins were studied for EOM SIF and MIF populations. Endplate topography and structure were also studied, using both confocal microscopy and transmission electron microscopy, with NMJ morphologic organization correlated with specific EOM fiber types.
RESULTS. Confocal fluorescence microscopy demonstrated that, for NMJs of both EOM SIFs and MIFs, components of neuregulin and agrin pathways and the major components of the junctional dystrophin-glycoprotein complex (DGC) colocalized with acetylcholine receptor (AChR) aggregates. However, EOM exhibited novel fiber-typespecific extrasynaptic localization of two key DGC signaling-related molecules:
-dystrobrevin 1 (global MIFs) and syntrophin ß1 (global MIFs and orbital MIFs and SIFs).
CONCLUSIONS. The data establish that the molecular organization of EOM SIF and MIF NMJs includes the same signaling and structural molecules previously characterized for other skeletal muscles. By contrast, divergence in other aspects of the synaptic and nonsynaptic sarcolemmal organization of EOM fiber types may underlie the unique responses of these muscles in a variety of neuromuscular disorders.
Activity and nonactivity-based mechanisms at the neuromuscular junction (NMJ) are key trophic determinants of skeletal muscle fiber properties. The nature of nerve-muscle interactions in EOM are likely to be more complex than in other muscles, because EOM contains singly innervated twitch fibers (SIFs), the standard for mammalian skeletal muscle, as well as atypical multiply innervated nontwitch fiber types (MIFs), that are rare in mammals but common in birds and amphibians. There are both general and fiber-typespecific differences in NMJs in EOM compared with other skeletal muscles, including the conspicuous sparseness of subjunctional folds, coexpression of adult and fetal acetylcholine receptor (AChR) isoforms, and increased susceptibility to the neurotransmission disorder, myasthenia gravis.9 Moreover, the nature of ocular motoneuronEOM communication has system-specific properties, including the requirement for innervation by appropriate motoneuron pools to mediate EOM primordia survival in an organotypic coculture model.10 In this context, the structural and functional properties of EOM NMJs are likely to exhibit both conserved and divergent features in comparison to those of more typical skeletal muscle.
Because of its accessibility, the NMJ represents the best-studied synapse (for review, see Sanes and Lichtman11 ). Presynaptic motoneuron axons enter a muscle, branch to innervate multiple muscle fibers, lose the myelin sheath immediately adjacent to each fiber, and then form a mitochondria and synaptic vesiclefilled expansion, or bouton, that closely contacts individual myofibers at one site only. The presynaptic boutons lie in deep synaptic gutters formed by invagination of the myofiber sarcolemma, thereby minimizing neurotransmitter diffusion distance and isolating the cellcell communication events from much of the extracellular milieu. Additional sarcolemmal specializations, the postjunctional folds, increase the surface area for synaptic interaction and segregate molecular events at the synapse. In contrast to this idealized synaptic profile, there is considerable variability at the NMJs. The presence of MIFs in EOM represents an extreme in variability of neuromuscular structural organization.
A generalized view of the molecular events controlling synapse induction, maturation, and maintenance has been constructed using data from a rather restricted subset of skeletal muscles (e.g., diaphragm and sternocleidomastoid; reviewed in Sanes and Lichtman12 ). Two principal motoneuron-derived signaling pathways mediate NMJ molecular organization: agrinMuSK and neuregulinerbB pathways.13 14 15 16 17 These are not independent, but rather are interlinked in regulating synaptogenesis. Nerve-derived agrin acts through a myotube sarcolemmal MuSK receptor complex to induce synthesis and aggregation of both MuSK and erbB receptors. MuSK activation by agrin, in turn, initiates focal clustering of AChRs and other synaptic proteins (e.g., utrophin and rapsyn) and, later, induces structural specializations of the postsynaptic apparatus. Rapsyn functions downstream of the agrin-MuSK pathway as a scaffold protein to cocluster AChRs, dystroglycan, utrophin, and erbB3 at the postsynaptic membrane. Neuregulin acts through agrin-recruited erbB receptors to accelerate AChR transcription by subsynaptic myonuclei. Synapse-mediated electrical activity is required to maintain the neuregulin- and agrin-dependent complex at the NMJ.
Cytoskeletal and basal lamina components, particularly the dystrophin-glycoprotein complex (DGC), s-laminin (ß2 laminin), spectrin, and ankyrinG, also are critical for the stabilization and maintenance of the AChR clusters and maturation of postsynaptic structure, including the formation of postsynaptic folds.18 19 20 21 22 23 Except for retention of developmental AChR isoforms24 25 26 and the localization of some components of the dystrophin-glycoprotein complex (dystrophin, utrophin, the dystroglycans, and the sarcoglycans),27 nothing is known of the molecular organization of EOM NMJs.
On the basis of established morphologic divergences between EOM and typical skeletal muscles, and novel differences between SIF and MIF NMJs, we hypothesized that EOM may use distinctive synaptic signaling and structural proteins. Such differences are important, in that they may account for the differential susceptibility of EOMs to neuromuscular disorders, such as myasthenia gravis and muscular dystrophy.
In the current study, we examined the cellular localization of established neuromuscular synaptic cell signaling and structural proteins at EOM NMJs, differentiating the synaptic organization of the SIF and MIF types. We first correlated endplate topography and structure with the distinctive EOM fiber types. Next, we established that the EOMs share the basic postsynaptic molecular architecture described for the other skeletal muscles. Finally, we identified EOM-specific features of the DGC.
| Methods |
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-bungarotoxin (TR-
Btx 1 µg/mL; Molecular Probes, Eugene, OR) overnight at 4°C. Muscles then were washed with PBS and mounted in antifade reagent in glycerol (SlowFade; Molecular Probes), coverslipped, and sealed with nail enamel for observation under a confocal fluorescence microscope.
Immunohistochemistry
Frozen sections were air dried, hydrated for 30 minutes with PBS, and then blocked with 10% goat serum in 1% bovine serum albumin (BSA) for 30 minutes. Primary antibodies were diluted in 1% BSA/PBS and applied to the sections overnight at 4°C. The sections were washed three times for 5 minutes each with PBS. The appropriate secondary antibody was then applied, along with 5 µg/mL TR-
Btx, for 1.5 hours at room temperature. Sections were washed and coverslipped with antifade reagent in glycerol (SlowFade; Molecular Probes) and sealed with nail enamel.
Antibodies
NMJ proteins were detected with primary monoclonal and polyclonal antibodies specific for ankyrinG (RDI-ANKYRGabmX; Research Diagnostics, Inc., Flanders, NJ); utrophin (NCL-DRP2; Novocastra/Vector Laboratories, Burlingame, CA);
1-syntrophin (SYN258), ß1-syntrophin (SYN37), ß2-syntrophin (SYN28), rapsyn (1234),
-dystrobrevins DB-1 (670), and DB-2 (DB2) (all gifts from Marvin Adams and Stanley Froehner, University of Washington, Seattle, WA); s-laminin (D7; Joshua Sanes, Washington University, St. Louis, MO); nNOS (DiaSorin, Stillwater, MN); neuregulin (NDF; Jeffrey A. Loeb, Wayne State University, Detroit, MI); erbB2 (Neu:sc-284; Santa Cruz Biotechnologies, Santa Cruz, CA); erbB3 and erbB4 (05-390 and 06-572; Upstate Biotechnology, Lake Placid, NY); agrin (anti-agrin 4, 8 (606051); Regeneron Pharmaceuticals, Tarrytown, NY); and MuSK (Markus Ruegg, University of Basel, Switzerland). The antibody to slow myosin heavy chain (NCL-MHC slow) was obtained from Novocastra/Vector Laboratories. The secondary antibodies, anti-mouse and anti-rabbit IgGs, were obtained from Molecular Probes, Inc.
Confocal Microscopy
Confocal microscopy was performed with a laser scanning microscope (model LSM 410; Carl Zeiss, Göttingen, Germany). For cross-sectional studies, images were acquired with the 40x objective (1.3 numeric aperture; Plan-NeoFluar; Carl Zeiss), with a constant pinhole setting used to preserve the thickness of the confocal plane. For dual color imaging, TR-
Btx and green-fluorescenceconjugated secondary antibody labels were excited sequentially using the 568-nm and the 488-nm excitation lines of the krypton/argon laser. The laser intensity and gain settings were adjusted on a per-image basis.
For endplate topography, whole muscle mounts were labeled for AChR with TR-
Btx and imaged using the 568-nm excitation line and a 100x objective (1.3 numeric aperture; Plan-NeoFluar; Carl Zeiss), with a zoom setting of 2x. For endplates that were in the plane of observation, z-sectioning was performed to view the entire thickness of the junction. For each NMJ, the final image was obtained by combining 6 to 16 images taken every 0.6 µm along the z-axis into a single projected view, using the software provided by the manufacturer. Approximately 100 NMJs were examined by confocal microscopy. All digital images were then processed (Photoshop; Adobe, Mountain View, CA).
Electron Microscopy
For ultrastructural analyses, mice were perfused with physiological saline followed by 1% paraformaldehyde/2% glutaraldehyde fixative solution in 0.1 M phosphate buffer. EOMs were removed, postfixed in 4% glutaraldehyde fixative solution, followed by 1% osmium tetroxide in 0.1 M phosphate buffer, and processed into plastic resin, according to standard procedures.28 Sections were photographed by electron microscopes (Zeiss; or JEOL, Tokyo, Japan). Delineation of fiber-typespecific NMJ properties relied on recognition of fiber types by the criteria of Spencer and Porter,9 which include distinctive differences in myofibril size and in the number, size, and distribution of mitochondria.
| Results |
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Btx, showed a single distinct innervation band, similar to those found in other skeletal muscles. Singly innervated fiber types (SIF; Fig. 1A ) had single en plaque junctions (Fig. 1B) , and all were localized in the common endplate zone in the muscle midbelly (Fig. 1D) . In contrast to other skeletal muscles, EOMs also exhibited small-diameter, MIFs (Fig. 1A) with multiple en grappe endplates (Fig. 1C) scattered along the length of the fibers. MIF NMJs were found both proximal and distal to the central endplate zone. Cross-sections through the midbelly of rectus muscles labeled with TR-
Btx showed numerous endplates (Fig. 1D) . The morphology of most of the NMJs was typical of en plaque endplates. The slow fibers (identified by immunoreactivity to slow myosin heavy chain antibody5 ) showed much smaller punctate labeling with TR-
Btx, representative of the en grappe morphology. En grappe endplates were concentrated in sections from the proximal and distal ends of the EOM (Fig. 1E) .
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Btx. We identified four distinctive NMJ types in EOM (Figs. 2A 2B 2C 2D) . The synaptic gutters of all en plaque endings exhibited the continuous, branched morphology typical of skeletal muscles, with uniform labeling of AChRs within the gutters. Most of the en plaque endplates were large and oval, approximately 20 µm in width, with length varying from 35 to 45 µm (Fig. 2C) . Less typical junctions associated with SIFs were smaller and more rounded (Fig. 2B) . Some SIFs had unusually long (
65 µm) junctions (Fig. 2D) . These usually curved around the circumference of the fiber (these typically were associated with small myofibers approximately 25 µm in diameter). This last type was not seen in the accessory EOMs (retractor bulbi and levator palpebrae superioris). All rectus muscle en plaque endplates were more intricately branched than those of levator (Fig. 2E) and retractor bulbi muscles (Figs. 2F 2G) . Rectus muscle en grappe junctions were small, approximately 10 µm, and their substructure was not complex, as viewed by confocal microscopy (Fig. 2A) . This endplate type was not found in the accessory EOMs.
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Cellular Localization of Synaptic Signaling Proteins at SIF and MIF Endplates
The neuregulin/erbB receptor and agrin/MuSK pathways are critical for the establishment and maintenance of the communication between nerve, muscle, and perisynaptic Schwann cell that lies behind the precise topological arrangement at typical skeletal NMJs (for review see Sanes and Lichtman12 ). ErbB2, erbB3, and erbB4, as well as neuregulin, agrin, and MuSK and rapsyn, are concentrated at the limb, diaphragm, and sternocleidomastoid NMJs. To determine whether these same molecules may be involved in the maintenance of the synapse in the phenotypically unique EOMs, with attention to potential differences in the NMJs of the MIFs and SIFs, we examined the localization of synaptic proteins in EOM.
As a positive control, we first examined sections of adult rat gastrocnemius-soleus muscle to confirm that the antibodies used revealed the expected enrichment of neuregulin, the erbBs, agrin, rapsyn, and MuSK at the NMJ. NMJs were identified by colabeling with TR-
Btx. Consistent with previous results, these proteins were enriched at the NMJ (data not shown). There was no evidence for extrajunctional sarcolemmal localization of any of the synaptic molecules in the gastrocnemius and soleus.
Cross-sections of adult mouse EOM were evaluated for components of the neuregulin/erbB and agrin/MuSK signaling pathways. NMJs were identified by AChR labeling with TR-
Btx. For the EOM SIF en plaque endplates, clear colocalization of agrin/MuSK and NDF/erbB pathway proteins with AChR receptors, was noted (Figs. 4 and 5) . MIF en grappe endplates were identified in cross-section by their small size compared with the en plaque endplates and their localization on the slow fibers, often distal and proximal to the endplate zone (Fig. 1E) . Observations confirmed the presence of all components of agrin/MuSK and NDF/erbB pathway proteins at en grappe endplates (Figs. 4 5) . Thus, the major synaptic signaling pathway molecules previously identified in other skeletal muscles were conserved for EOM SIF and MIF types.
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and ß1, and
-dystrobrevin 2 are present throughout the sarcolemma, with enrichment at the synapse, utrophin, syntrophin ß2, and
-dystrobrevin-1 are largely restricted to synaptic sites. Deletions of the various junctional DGC components alter skeletal muscle postsynaptic specializations, including postsynaptic folds and AChR distribution.18 19 20 21
Here, we studied the localization of select DGC components at EOM endplates by immunohistochemistry. As shown in Figures 6 and 7 , EOM SIF and MIF NMJs showed the presence of important elements of the DGCnamely, utrophin,
-dystrobrevin-1 and -2,
-syntrophin, ß1- and ß2-syntrophin, and a signaling molecule related to
-syntrophin, neuronal nitric oxide synthase (nNOS). This localization pattern is identical with that in other skeletal muscles. We also evaluated the distribution of the basal lamina protein s-laminin (ß2-laminin) and the cytoskeletal molecule ankyrinG. Laminin ß2 is involved in the differentiation and maturation of the presynaptic apparatus.31 We noted laminin localization at both the MIF and SIF junctions. AnkyrinG is a cytoskeletal protein that binds voltage-gated sodium channels and is important in organizing the secondary folds at the junction.23 EOM SIFs and MIFs showed localization of ankyrinG along the entire sarcolemma with enrichment at the synapse, as is typical of other skeletal muscles (data not shown).
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| Discussion |
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NMJ Morphology
Acetylcholinesterase histochemistry has been used in conjunction with light and electron microscopy to identify two principal morphologic motor endplates types in EOM fibers35 36 : single and multiple. Moreover, additional junctional adaptations are correlated with the various EOM fiber types.9 37 38 39 40 Our data closely paralleled these prior studies in demonstrating the endplate structural variability that is associated with EOM. AChR visualization and confocal optical sectioning of entire endplates allowed reconstruction of projected surface views that were comparable with prior scanning electron microscopic studies. By this approach, we identified one small en grappe type and three principal en plaque types, differing mainly in size, shape, and branching pattern of the synaptic gutter. Correlation of confocal-generated projected images with ultrastructure enabled us to associate NMJ morphology with identified EOM fiber types.
The orbital SIFs exhibited highly branched endplates, leading to a distinctive appearance with several synaptic profiles distributed around the perimeter of individual myofibers in transverse sections (Fig. 3B) . This morphology was consistent with the elongated, encircling NMJ profiles seen with confocal microscopy (Fig. 2D) . Our data also confirmed that EOM endplates show a notable absence or paucity of postjunctional folds in all fiber types. Only the global pale SIFs exhibited NMJs with significant postjunctional folding (Fig. 3G) . Postjunctional folds are thought to increase synaptic area and segregate postjunctional structural and signaling proteins. The absence of postjunctional folds at most EOM NMJs, however, alters synaptic organization by eliminating the spatial segregation of molecules normally found in the depths of the folds (e.g., ankyrinG, dystrophin, DB-2, and syntrophin
1 and ß1) from those that usually occupy the fold crests (e.g., AChR;
- and ß-dystroglycan;
-, ß-,
-, and
-sarcoglycan; MuSK; and erbB).
Despite the paucity of postjunctional folds, EOM en plaque endplates are relatively large in relationship to myofiber diameter, when compared with those of the accessory EOMs and other nonocular skeletal muscles. The long axon terminalmyofiber contact zones may offset the need for augmentation of synaptic area with postjunctional folds. Endplate morphology and branching pattern have been correlated with fiber types of typical skeletal muscle (diaphragm). NMJ structural complexity typically increases from type I to type IIB fibers.41 NMJ cytoarchitecture also has been linked to motor unit properties and to selective recruitment patterns that are responsible for various motor behavior. Thus, the fiber type differences in EOM NMJ morphology may relate to the unique properties of the fibers and their innervating motoneurons.
Agrin- and Neuregulin-Based Signaling Molecules in EOM
Based on the novel physiology, fiber types, gene expression profile, innervation pattern, and endplate morphology of EOM (present data),1 2 3 4 we hypothesized that the synapse signaling molecules that play essential roles at skeletal muscle NMJs, agrin/MuSK and neuregulin/erbB, may not be fully shared by the oculomotor motoneuron/EOM system. Recent findings42 support this notion by showing that NMJ synaptogenesis may have muscle-groupspecific adaptations not suggested by current models. In particular, the unusual EOM MIFs may require novel molecular architecture at the synapse. Yet, there have been no studies to establish the presence of the NMJ agrin- and neuregulin-based signal transduction molecules at any mammalian, avian, or amphibian multiply innervated, muscle fiber type.
Because EOM possesses a unique combination of SIF/twitch and MIF/tonic muscle fiber types and distinct oculomotor motoneuron classes innervate SIFs and MIFs,43 differences in synaptic signaling molecules were anticipated for these two major muscle fiber classes. By contrast, our data establish that the molecular framework for the principal NMJ signal transduction pathways, agrin/MuSK and neuregulin/erbB, is conserved in EOM. We did not detect differences in signaling pathway components between either EOM SIFs and MIFs or between EOM SIFs and published skeletal muscle data. These findings establish that the fundamental skeletal muscle synaptic organization molecules are essential, even in the highly divergent EOM fiber types.
Our data have bearing on the nature of the signals necessary to initiate and maintain the neuregulin-dependent signaling complex at the NMJ. EOM MIFs present an interesting dilemma for models of synaptogenesis. In allowing the formation of distributed synaptic sites along the entire length of individual myotubes, MIFs ignore skeletal muscle mechanisms that normally exclude NMJs from other sarcolemmal sites once the initial synapse is formed. Recent evidence in skeletal muscle suggests uninnervated myotubes are not passive in synaptogenesis, but rather that synaptic sites may be preordained by myotube MuSK expression patterns.44 45 46 The formation and maintenance of the NMJ requires both myofiber MuSK expression and the secretion of agrin from motor nerve terminals. Lack of action potential propagation in MIFs may be mechanistic in allowing the formation of multiple synaptic sites. Thus, EOM MIFs represent an excellent model to test NMJ synaptogenesis concepts. During synaptogenesis, both the motoneuron and the myotube exhibit considerable molecular heterogeneity,47 48 that could determine whether a particular myotube is destined as an MIF or SIF, and bidirectional cues at the developing NMJ may favor contacts between appropriate partners.
Divergence of the EOM DGC
The DGC plays essential roles in the structural and functional organization of the sarcolemma and its NMJ postjunctional specializations.30 Although we have shown that many DGC components are conserved in EOM,27 our present study is the first to describe a muscle-groupspecific pattern in the extrasynaptic DGC. In most skeletal muscles, syntrophin ß1 is distributed along the entire sarcolemma at birth, but rapidly becomes concentrated at the NMJs in all fiber types and at the sarcolemma in type IIB myofibers.32 49 In the current study, we identified adult preservation of the embryonic expression pattern of sarcolemmal syntrophin ß1 for both orbital fiber types and the global MIF (notably, these do not expresses IIB myosin5 ). Prior studies suggest that syntrophin may not function in the mechanical role of the DGC, but rather may serve as a scaffold to recruit signaling complexes to the sarcolemma. Because of the relatively low homology among syntrophin isoforms and variations in isoform binding partner preferences,32 EOM fiber type differences in syntrophin expression probably reflect the recruitment of distinct subsets of signal transduction molecules. Consistent with this view, studies in two muscular dystrophy models, dystrophin-deficient mdx and dystrophin/utrophindeficient double-knockout mice,50 suggest that the three EOM fiber types identified herein with atypical syntrophin ß1 distribution may have substantial plasticity in DGC expression.
In addition, we showed in the current study that EOM extrasynaptic DB-1 does not fit the established skeletal muscle pattern. Instead of localization to the sarcolemma of all fiber types, as in other skeletal muscles,33 51 DB-1 consistently localized to the sarcolemma of EOM global MIFs only. Dystrobrevin complexes contain dystrophin and syntrophin ß1,32 a finding that may explain the colocalization of syntrophin ß1 and the syntrophin-binding protein DB-1, at the MIF sarcolemma. Knockout mouse studies suggest that dystrobrevin is likely to play signaling, rather than structural, roles at the sarcolemma.20 Together with present data, this suggests that dystrobrevin-mediated signaling mechanisms are tailored to the requirements of the various EOM fiber types. The absence of both dystrophin and utrophin, which displaces all DGC components from the membrane, leads to a maturational arrest of select EOM myofibers and their NMJs at an early myotube stage50 that does not occur in other EOM fiber types and in other skeletal muscles.52 53 These findings suggest that DGC functional roles are, at least in part, different for EOM and may relate to the complete sparing of the EOMs in the DGC-based muscular dystrophies.50 54 55 56 57 58
Finally, the DGC is known to play a key role in maturation of the skeletal muscle NMJ. Deletion of any one of several DGC components alters synaptic properties including formation of postjunctional folds.18 19 20 59 60 Because EOM NMJs generally lack postjunctional folds, particularly those three fiber types with sarcolemmal distribution of syntrophin ß1, the DGC organizational differences between EOM and other skeletal muscles identified here may contribute toward the distinctive morphology and function of NMJs.
Developmental Traits in EOM
A prevalent theme in EOM biology is adult retention of traits generally considered to be embryonic or neonatal in most other skeletal muscles (e.g., embryonic and perinatal myosin heavy chain isoforms).5 61 62 The fiber-typespecific sarcolemmal localization of syntrophin ß1 shown herein contributes to this pattern. One interpretation of adult muscle retention of developmental traits is the partial developmental arrest of some EOM myofiber types. An alternative explanation is that EOM requires the full range of plasticity available to skeletal muscle to execute its complex and diverse range of tasks.63 Known NMJ properties further reflect the utilization of ontogenic or phylogenetically primitive traits in adult EOM.
The embryonic pattern of sarcolemmal syntrophin ß1 was noted in EOM orbital layer fiber types that also retain embryonic myosin heavy chain, express both embryonic (
2ß
) and adult (
2ß
) AChRs, and retain the embryonic neural cell adhesion molecule (NCAM) distribution pattern at the sarcolemma.24 25 26 64 Global layer MIFs share some of these same traits and, in our data, were the only fiber type exhibiting sarcolemmal DB-1. The global layer MIFs exhibit simple NMJs, with small synaptic boutons, shallow to absent synaptic gutters, absent postjunctional folds, and AChRs that are exclusively of the embryonic type.25 That these same developmentally primitive traits are found at NMJs of other skeletal muscles in AChR
-subunitknockout mice65 supports the operation of either common or coordinated mechanisms in determining NMJ properties. These data further suggest that absence of the requisite signal for the
-to-
AChR subunit switch, possibly an as yet uncharacterized neurotrophic factor,66 underlies the novel properties of the MIF NMJ. This signaling difference may not reside solely in the agrin or neuregulin axis, because we have shown in this study that MIFs use both of these pathways. Collectively, our data advance the concept that select EOM fiber types have a very different developmental program than either other EOM fiber types or traditional skeletal muscle types.
| Summary |
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| Acknowledgements |
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| Footnotes |
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Submitted for publication August 30, 2002; revised October 16 and November 11, 2002; accepted November 26, 2002.
Disclosure: S. Khanna, None; C.R. Richmonds, None; H.J. Kaminski, None; J.D. Porter, None
The publication costs of this article were defrayed in part by page charge payment. This article must therefore be marked "advertisement" in accordance with 18 U.S.C.
1734 solely to indicate this fact.
Corresponding author: Sangeeta Khanna, Department of Ophthalmology, University Hospitals of Cleveland, 11100 Euclid Avenue, Cleveland, OH 44106-5068; sxk128{at}po.cwru.edu.
| References |
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-dystrobrevin in muscle J Cell Sci 111,2595-2605[Abstract]
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