The diagnostic and pathophysiological challenges of toxic vacuolar myopathies

Clinician and researchers from the Institute of Myology, in collaboration with international researchers, have investigated myopathies induced by chloroquine (and its derivatives, referred to by the acronym HCQ/CQ) and by colchicine:

• clinical, histological, immunological and transcriptomic data from nine patients were compiled and analysed (five with colchicine-induced myopathy and four with HCQ/CQ-related myopathy)
• whilst vacuoles, whether rimmed or not, were characteristic of HCQ/CQ-related myopathies, myofibrillar disorganisation was more common in cases of colchicine-related myopathy,
• however, the mechanisms of autophagy, immune system activation and disturbances in muscular homeostasis were comparable in both groups.

The authors emphasise the importance of the role of autophagy in the process of direct toxicity.