AUTHOR=Yang Meng-Ge , Zhang Qing , Wang Hong , Ma Xue , Ji Suqiong , Li Yue , Xu Li , Bi Zhuajin , Bu Bitao TITLE=The accumulation of muscle RING finger-1 in regenerating myofibers: Implications for muscle repair in immune-mediated necrotizing myopathy JOURNAL=Frontiers in Neurology VOLUME=Volume 13 - 2022 YEAR=2022 URL=https://www.frontiersin.org/journals/neurology/articles/10.3389/fneur.2022.1032738 DOI=10.3389/fneur.2022.1032738 ISSN=1664-2295 ABSTRACT=Background: Muscle RING finger-1 (MuRF-1) plays a key role in the degradation of skeletal muscle proteins. We hypothesize the involvement of MuRF-1 in immune-mediated necrotizing myopathy (IMNM). Methods: Muscle biopsies from patients with IMNM (n=37) were analyzed and compared to biopsies from patients with dermatomyositis (DM, n=13), limb-girdle muscular dystrophy (LGMD, n=10) and controls (n=7) using immunostaining. Results: MuRF-1 staining could be observed in IMNM, DM and LGMD biopsies, whereas the percentage of MuRF-1 positive myofibers was significantly higher in IMNM than in LGMD (p = 0.0309), and correlated with muscle weakness and disease activity in IMNM and DM. Surprisingly, MuRF-1 staining predominantly presented in regenerating fibers but not in atrophic fibers. Moreover, MuRF-1-positive fibers tended to be distributed around necrotic myofibers and myofibers with sarcolemma membrane attack complex deposition. Abundant MuRF-1 expression in IMNM and DM was associated with rapid activation of myogenesis after muscle injury, whereas relatively low expression of MuRF-1 in LGMD may be attributed to damaged muscle regeneration. Conclusions: MuRF-1 accumulated in regenerating myofibers, which may contribute to muscle injury repair in IMNM and DM. MuRF-1 staining may help clinicians differentiate IMNM and LGMD.