Giorgio, Roberto De

ABSTRACT Background Visceral myopathy (VSCM) is an ultra‐rare life‐threatening condition characterized by severe impairment of gastrointestinal (GI), genitourinary, and uterine smooth muscle. This disorder represents a significant clinical challenge due to variable presentation and the lack of standardized diagnostic and therapeutic protocols. Methods To discuss advances in the field, scientists and clinicians with a special interest in VSCM met in Arenzano, Genova, Italy in October 2024 for the second International Forum on Visceral Myopathy 2024 (IFVM2024) ( https://ifvm2024.ge.ibf.cnr.it/ ). Key Results As in the previous edition of the event ( https://poic‐e‐dintorni.org/efvm‐2022/ ), attendees included clinicians and researchers from around the world who study this disease, representatives from support organizations, patients affected by VSCM and their families, and companies that co‐funded the event. The present manuscript aims to summarize knowledge shared during the IFVM2024 conference, thus providing an updated state‐of‐the‐art summary of VSCM biology and disease management. Conclusions Here, we pay particular attention to the epidemiology of the disease, histopathology, genetics, novel treatments, advances in molecular and cell biology, experimental models, and the lived experiences and impact of this disorder on families.

AbstractBackgroundRAD21 is a double‐strand‐break repair protein and component of the cohesin complex with key roles in cellular functions. A RAD21 loss‐of‐function mutation was found in cases of chronic intestinal pseudo‐obstruction (CIPO) with associated enteric neuronal loss. Analysis of RAD21 expression in the enteric nervous system is lacking, thus we aimed to characterize RAD21 immunoreactivity (IR) in myenteric ganglia.MethodsDouble labeling immunofluorescence in mouse and human jejunum was used to determine colocalization of RAD21 with HuC/D, PGP9.5, neuronal nitric oxide synthase (nNOS), neuropeptide Y (NPY), choline acetyl transferase (ChAT), Kit, platelet‐derived growth factor receptor‐α (PDGFRα), and glial fibrillary acid protein (GFAP) IRs.ResultsA subset of PGP9.5‐ and HuC/D‐IR neuronal cell bodies and nerve fibers in the myenteric plexus of human and mouse small intestine also displayed cytoplasmic RAD21‐IR Cytoplasmic RAD21‐IR was found in 43% of HuC/D‐IR neurons in adult and neonatal mice but did not colocalize with nNOS. A subset of ChAT‐positive neurons had cytoplasmic RAD21‐IR Punctate RAD21‐IR was restricted to the nucleus in most cell types consistent with labeling of the cohesin complex. Cytoplasmic RAD21‐IR was not detected in interstitial cells of Cajal, fibroblast‐like cells or glia. Subsets of neurons in primary culture exhibited cytoplasmic RAD21‐IR Suppression of RAD21 expression by shRNA knockdown abolished RAD21‐IR in cultured neurons.ConclusionsOur data showing cytoplasmic RAD21 expression in enteric neurons provide a basis toward understanding how mutations of this gene may contribute to altered neuronal function/survival thus leading to gut‐motor abnormalities.