# Proteomic analysis of nemaline myopathy in infants reveals distinct common dysregulated proteins and cellular pathways

**Authors:** Carola Hedberg-Oldfors, Ali Zeki Bedir, Kittichate Visuttijai, Eva Michael, Anders Oldfors

PMC · DOI: 10.3389/fneur.2025.1661747 · Frontiers in Neurology · 2025-10-03

## TL;DR

This study identifies key proteins and pathways involved in infantile nemaline myopathy, a rare muscle disorder, using proteomic analysis.

## Contribution

The study reveals shared molecular mechanisms in nemaline myopathy across different genetic subtypes through proteomic profiling.

## Key findings

- 183 proteins were significantly dysregulated in nemaline myopathy muscle tissue.
- Nine upregulated, muscle-specific proteins were identified, including NRAP, FBXO40, and TRIM63.
- Dysregulated pathways include protein synthesis, proteasomal degradation, and reduced glycolysis.

## Abstract

Nemaline myopathy is a rare congenital muscle disorder characterized by the presence of nemaline rods, protein aggregates, in muscle fibers. Pathogenic variants in several genes, most commonly NEB and ACTA1, which encode thin filament proteins of the sarcomere, have been implicated in its etiology. Currently, there is no cure for nemaline myopathy, underscoring the need to identify disease-modifying targets for therapeutic development.

In this study, we employed quantitative nanoscale liquid chromatography–tandem mass spectrometry (LC-MS3) with labeled protein analysis on muscle tissue from five normal controls and seven infants diagnosed with nemaline myopathy due to NEB or ACTA1 pathogenic variants.

We identified and quantified 4,846 proteins across all samples, with 183 proteins showing significant dysregulation. Protein–protein interaction analysis revealed nine upregulated, muscle-specific proteins: NRAP, FBXO40, TRIM63, TRIM54, ALPK3, XIRP1, ANKRD2, LMOD2, and CSRP3. Further pathway analysis indicated upregulation of protein synthesis and proteasomal degradation processes, alongside downregulation of glycolysis. Notably, the dysregulated proteins and pathways were consistent across both genetic subtypes, suggesting shared molecular mechanisms underlying the disease.

This proteomic profiling study has identified key dysregulated proteins and pathways in infantile nemaline myopathy. These findings advance our understanding of the disease’s molecular basis and highlight candidate targets for future therapeutic intervention.

## Linked entities

- **Genes:** NEB (nebulin) [NCBI Gene 4703], ACTA1 (actin alpha 1, skeletal muscle) [NCBI Gene 58]
- **Proteins:** NRAP (nebulin related anchoring protein), FBXO40 (F-box protein 40), TRIM63 (tripartite motif containing 63), TRIM54 (tripartite motif containing 54), ALPK3 (alpha kinase 3), XIRP1 (xin actin binding repeat containing 1), ANKRD2 (ankyrin repeat domain 2), LMOD2 (leiomodin 2), CSRP3 (cysteine and glycine rich protein 3)
- **Diseases:** nemaline myopathy (MONDO:0018958)

## Full-text entities

- **Genes:** ALPK3 (alpha kinase 3) [NCBI Gene 57538] {aka CMH27, MAK, MIDORI}, LMOD2 (leiomodin 2) [NCBI Gene 442721] {aka C-LMOD, CLMOD, CMD2G}, ACTA1 (actin alpha 1, skeletal muscle) [NCBI Gene 58] {aka ACTA, ASMA, CFTD, CFTD1, CFTDM, CMYO2A}, CSRP3 (cysteine and glycine rich protein 3) [NCBI Gene 8048] {aka CLP, CMD1M, CMH12, CRP3, MLP}, TRIM63 (tripartite motif containing 63) [NCBI Gene 84676] {aka CMH31, IRF, MURF1, MURF2, RNF28, SMRZ}, ANKRD2 (ankyrin repeat domain 2) [NCBI Gene 26287] {aka ARPP}, NEB (nebulin) [NCBI Gene 4703] {aka AMC6, NEB177D, NEM2}, TRIM54 (tripartite motif containing 54) [NCBI Gene 57159] {aka MURF, MURF-3, RNF30, muRF3}, FBXO40 (F-box protein 40) [NCBI Gene 51725] {aka FBX40}, XIRP1 (xin actin binding repeat containing 1) [NCBI Gene 165904] {aka CMYA1, Xin}, NRAP (nebulin related anchoring protein) [NCBI Gene 4892] {aka CMD2N, N-RAP}
- **Diseases:** Nemaline myopathy (MESH:D017696), congenital muscle disorder (MESH:D009135)

## Full text

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## Figures

9 figures with captions in the complete paper: https://tomesphere.com/paper/PMC12531377/full.md

## References

40 references — full list in the complete paper: https://tomesphere.com/paper/PMC12531377/full.md

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Source: https://tomesphere.com/paper/PMC12531377