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Lopes CP, Gonçalves GF, Paulino MFVM, Esquiaveto-Aun AM, de Mello MP, Pavin EJ, Breder ISS, Pu MZMH, de Lemos-Marini SHV, Guerra G. Insights from a Wolfram syndrome cohort: clinical and molecular findings from a specialized diabetes reference center. ARCHIVES OF ENDOCRINOLOGY AND METABOLISM 2024; 68:e240091. [PMID: 39420940 PMCID: PMC11460961 DOI: 10.20945/2359-4292-2024-0091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/02/2024] [Accepted: 06/06/2024] [Indexed: 10/19/2024]
Abstract
Objective Considering the rarity and clinical and molecular diversity of Wolfram syndrome (WS), the objective of this study was to identify patients with a clinical presentation suggestive of WS following up at a single Brazilian diabetes service and analyze their clinical and molecular characteristics. Subjects and methods The study included all patients with a clinical presentation of WS following up between 1991 and 2022 with early-onset diabetes mellitus and other WS signs and symptoms. A retrospective analysis was conducted, including patients' age, sex, consanguinity, age at symptom onset, diagnosis of diabetes mellitus, optic atrophy, diabetes insipidus, neurological and psychiatric disorders, hearing loss, urinary disorders, hypogonadism, and WFS1 molecular analysis. Results Eight patients were identified, all of whom were diagnosed with diabetes mellitus at an average age of 3.7 years. Optic atrophy, diabetes insipidus, and hearing loss were common, while psychiatric and neurological alterations were observed in some cases. Genetic analysis revealed pathogenic variants in homozygosity or compound heterozygosity. The most frequent variant was p. Val412Serfs29, present in five of the seven families. Conclusions This study represents the second-largest Brazilian sample of WS and is the first cohort from a single center in Southeast Brazil. The patients had an early, severe, and complete clinical presentation. The genetic variants identified were consistent with previous literature descriptions. The variant p. Val412Serfs29 was particularly common in this cohort, highlighting its relevance in the region.
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Affiliation(s)
- Carolina Paniago Lopes
- Universidade Estadual de CampinasFaculdade de Ciências Médicas e Hospital de ClínicasDepartamento de PediatriaCampinasSPBrasilDepartamento de Pediatria, Faculdade de Ciências Médicas e Hospital de Clínicas, Universidade Estadual de Campinas, Campinas, SP, Brasil
| | - Gentil Ferreira Gonçalves
- Universidade Estadual de CampinasFaculdade de Ciências Médicas e Hospital de ClínicasDepartamento de PediatriaCampinasSPBrasilDepartamento de Pediatria, Faculdade de Ciências Médicas e Hospital de Clínicas, Universidade Estadual de Campinas, Campinas, SP, Brasil
| | - Maria Fernanda Vanti Macedo Paulino
- Universidade Estadual de CampinasFaculdade de Ciências Médicas e Hospital de ClínicasDepartamento de PediatriaCampinasSPBrasilDepartamento de Pediatria, Faculdade de Ciências Médicas e Hospital de Clínicas, Universidade Estadual de Campinas, Campinas, SP, Brasil
| | - Adriana Mangue Esquiaveto-Aun
- Universidade Estadual de CampinasFaculdade de Ciências Médicas e Hospital de ClínicasDepartamento de PediatriaCampinasSPBrasilDepartamento de Pediatria, Faculdade de Ciências Médicas e Hospital de Clínicas, Universidade Estadual de Campinas, Campinas, SP, Brasil
| | - Maricilda Palandi de Mello
- Universidade Estadual de CampinasLaboratório de Genética Molecular Humana do Centro de Biologia Molecular e Engenharia GenéticaCampinasSPBrasilLaboratório de Genética Molecular Humana do Centro de Biologia Molecular e Engenharia Genética, Universidade Estadual de Campinas, Campinas, SP, Brasil
| | - Elizabeth João Pavin
- Universidade Estadual de CampinasFaculdade de Ciências Médicas e Hospital de ClínicasDepartamento de Clínica MédicaCampinasSPBrasilDepartamento de Clínica Médica, Faculdade de Ciências Médicas e Hospital de Clínicas, Universidade Estadual de Campinas, Campinas, SP, Brasil
| | - Ikaro Soares Santos Breder
- Universidade Estadual de CampinasFaculdade de Ciências Médicas e Hospital de ClínicasDepartamento de Clínica MédicaCampinasSPBrasilDepartamento de Clínica Médica, Faculdade de Ciências Médicas e Hospital de Clínicas, Universidade Estadual de Campinas, Campinas, SP, Brasil
| | - Mariana Zorron Mei Hsia Pu
- Universidade Estadual de CampinasFaculdade de Ciências Médicas e Hospital de ClínicasDepartamento de PediatriaCampinasSPBrasilDepartamento de Pediatria, Faculdade de Ciências Médicas e Hospital de Clínicas, Universidade Estadual de Campinas, Campinas, SP, Brasil
| | - Sofia Helena Valente de Lemos-Marini
- Universidade Estadual de CampinasFaculdade de Ciências Médicas e Hospital de ClínicasDepartamento de PediatriaCampinasSPBrasilDepartamento de Pediatria, Faculdade de Ciências Médicas e Hospital de Clínicas, Universidade Estadual de Campinas, Campinas, SP, Brasil
| | - Gil Guerra
- Universidade Estadual de CampinasFaculdade de Ciências Médicas e Hospital de ClínicasDepartamento de PediatriaCampinasSPBrasilDepartamento de Pediatria, Faculdade de Ciências Médicas e Hospital de Clínicas, Universidade Estadual de Campinas, Campinas, SP, Brasil
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2
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Caruso V, Raia A, Rigoli L. Wolfram Syndrome 1: A Neuropsychiatric Perspective on a Rare Disease. Genes (Basel) 2024; 15:984. [PMID: 39202345 PMCID: PMC11353439 DOI: 10.3390/genes15080984] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2024] [Revised: 07/18/2024] [Accepted: 07/23/2024] [Indexed: 09/03/2024] Open
Abstract
Wolfram syndrome 1 (WS1) is an uncommon autosomal recessive neurological disorder that is characterized by diabetes insipidus, early-onset non-autoimmune diabetes mellitus, optic atrophy, and deafness (DIDMOAD). Other clinical manifestations are neuropsychiatric symptoms, urinary tract alterations, and endocrinological disorders. The rapid clinical course of WS1 results in death by the age of 30. Severe brain atrophy leads to central respiratory failure, which is the main cause of death in WS1 patients. Mutations in the WFS1 gene, located on chromosome 4p16, account for approximately 90% of WS1 cases. The gene produces wolframin, a transmembrane glycoprotein widely distributed and highly expressed in retinal, neural, and muscular tissues. Wolframin plays a crucial role in the regulation of apoptosis, insulin signaling, and ER calcium homeostasis, as well as the ER stress response. WS1 has been designated as a neurodegenerative and neurodevelopmental disorder due to the numerous abnormalities in the ER stress-mediated system. WS1 is a devastating neurodegenerative disease that affects patients and their families. Early diagnosis and recognition of the initial clinical signs may slow the disease's progression and improve symptomatology. Moreover, genetic counseling should be provided to the patient's relatives to extend multidisciplinary care to their first-degree family members. Regrettably, there are currently no specific drugs for the therapy of this fatal disease. A better understanding of the etiology of WS1 will make possible the development of new therapeutic approaches that may enhance the life expectancy of patients. This review will examine the pathogenetic mechanisms, development, and progression of neuropsychiatric symptoms commonly associated with WS1. A thorough understanding of WS1's neurophysiopathology is critical for achieving the goal of improving patients' quality of life and life expectancy.
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Affiliation(s)
- Valerio Caruso
- Department of Neuroscience, Psychiatric Section, Azienda Ospedaliera Universitaria Pisana (A.U.O.P.), 56126 Pisa, Italy;
| | - Accursio Raia
- Department of Neuroscience, Psychiatric Section, Azienda Ospedaliera Universitaria Pisana (A.U.O.P.), 56126 Pisa, Italy;
| | - Luciana Rigoli
- Department of Human Pathology of Adulthood and Childhood G. Barresi, University of Messina, 98125 Messina, Italy
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3
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Borrelli E, Bandello F, Boon CJF, Carelli V, Lenaers G, Reibaldi M, Sadda SR, Sadun AA, Sarraf D, Yu-Wai-Man P, Barboni P. Mitochondrial retinopathies and optic neuropathies: The impact of retinal imaging on modern understanding of pathogenesis, diagnosis, and management. Prog Retin Eye Res 2024; 101:101264. [PMID: 38703886 DOI: 10.1016/j.preteyeres.2024.101264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2024] [Revised: 03/18/2024] [Accepted: 04/26/2024] [Indexed: 05/06/2024]
Abstract
Advancements in ocular imaging have significantly broadened our comprehension of mitochondrial retinopathies and optic neuropathies by examining the structural and pathological aspects of the retina and optic nerve in these conditions. This article aims to review the prominent imaging characteristics associated with mitochondrial retinopathies and optic neuropathies, aiming to deepen our insight into their pathogenesis and clinical features. Preceding this exploration, the article provides a detailed overview of the crucial genetic and clinical features, which is essential for the proper interpretation of in vivo imaging. More importantly, we will provide a critical analysis on how these imaging modalities could serve as biomarkers for characterization and monitoring, as well as in guiding treatment decisions. However, these imaging methods have limitations, which will be discussed along with potential strategies to mitigate them. Lastly, the article will emphasize the potential advantages and future integration of imaging techniques in evaluating patients with mitochondrial eye disorders, considering the prospects of emerging gene therapies.
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Affiliation(s)
- Enrico Borrelli
- Department of Surgical Sciences, University of Turin, Turin, Italy; Department of Ophthalmology, "City of Health and Science" Hospital, Turin, Italy.
| | - Francesco Bandello
- Vita-Salute San Raffaele University, Milan, Italy; IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Camiel J F Boon
- Department of Ophthalmology, Amsterdam University Medical Centers, Amsterdam, the Netherlands; Department of Ophthalmology, Leiden University Medical Center, Leiden, the Netherlands
| | - Valerio Carelli
- Dipartimento di Scienze Biomediche e Neuromotorie, Università di Bologna, Bologna, Italy; IRCCS Istituto delle Scienze Neurologiche di Bologna, Programma di Neurogenetica, Bologna, Italy
| | - Guy Lenaers
- Equipe MitoLab, Unité MitoVasc, INSERM U1083, Université d'Angers, 49933, Angers, France; Service de Neurologie, CHU d'Angers, 49100, Angers, France
| | - Michele Reibaldi
- Department of Surgical Sciences, University of Turin, Turin, Italy; Department of Ophthalmology, "City of Health and Science" Hospital, Turin, Italy
| | - Srinivas R Sadda
- Department of Ophthalmology, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA; Doheny Eye Institute, Los Angeles, CA, USA
| | - Alfredo A Sadun
- Department of Ophthalmology, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA; Doheny Eye Institute, Los Angeles, CA, USA
| | - David Sarraf
- Department of Ophthalmology, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA; Retinal Disorders and Ophthalmic Genetics Division, Stein Eye Institute, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | - Patrick Yu-Wai-Man
- John van Geest Centre for Brain Repair and MRC Mitochondrial Biology Unit, Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK; Cambridge Eye Unit, Addenbrooke's Hospital, Cambridge University Hospitals, Cambridge, UK; Moorfields Eye Hospital NHS Foundation Trust, London, UK; Institute of Ophthalmology, University College London, London, UK
| | - Piero Barboni
- IRCCS San Raffaele Scientific Institute, Milan, Italy; Studio Oculistico d'Azeglio, Bologna, Italy.
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Ravindren RK, Veettil RT, Athimannil S, Balaram N, Veedu PT, Veetil SA, Ayoor AK, Mathew S, Padinharath K, Balan S. Sequential Presentation of Obsessive-Compulsive Disorder and Narcolepsy in a 10-Year-Old Girl With Wolfram Syndrome 1. J Nerv Ment Dis 2024; 212:403-405. [PMID: 38949661 DOI: 10.1097/nmd.0000000000001784] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/02/2024]
Abstract
ABSTRACT Wolfram syndrome 1 (WS1) is a rare, autosomal recessive neurodegenerative disorder characterized by diabetes insipidus, insulin-dependent diabetes mellitus, optic atrophy, and deafness resulting from loss-of-function genetic variants in the WFS1 gene. Individuals with WS1 manifest a spectrum of neuropsychiatric disorders. Here, we report a pediatric case of WS1, which stemmed from a novel biallelic WFS1 loss-of-function genetic variant. The individual initially presented with obsessive-compulsive disorder, which was successfully managed by fluvoxamine. After 2 months, the child manifested excessive daytime sleepiness. Clinical evaluation and sleep recordings revealed a diagnosis of narcolepsy type 2. Excessive daytime sleepiness was improved with methylphenidate. To the best of our knowledge, this is the first report of narcolepsy in WS1, which possibly arose during a progressive neurodegenerative process. We emphasize the need for in-depth screening for neuropsychiatric phenotypes and sleep-related disorders in WS1, for clinical management, which significantly improves the quality of life.
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Affiliation(s)
| | - Rajesh Thaliyil Veettil
- Department of Paediatrics, Institute of Maternal and Child Health (IMCH), Government Medical College Kozhikode
| | - Shibila Athimannil
- Neuroscience Research Laboratory, Center for Interdisciplinary Brain Sciences, Institute of Mental Health and Neurosciences (IMHANS), Kozhikode
| | - Neetha Balaram
- Department of Neurology, Government Medical College Kozhikode
| | | | | | - Arun Kumar Ayoor
- Department of Ophthalmology, Government Medical College Kozhikode
| | | | | | - Shabeesh Balan
- Neuroscience Research Laboratory, Center for Interdisciplinary Brain Sciences, Institute of Mental Health and Neurosciences (IMHANS), Kozhikode
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5
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Scaravilli A, Tranfa M, Pontillo G, Brais B, De Michele G, La Piana R, Saccà F, Santorelli FM, Synofzik M, Brunetti A, Cocozza S. A Review of Brain and Pituitary Gland MRI Findings in Patients with Ataxia and Hypogonadism. CEREBELLUM (LONDON, ENGLAND) 2024; 23:757-774. [PMID: 37155088 DOI: 10.1007/s12311-023-01562-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 04/26/2023] [Indexed: 05/10/2023]
Abstract
The association of cerebellar ataxia and hypogonadism occurs in a heterogeneous group of disorders, caused by different genetic mutations often associated with a recessive inheritance. In these patients, magnetic resonance imaging (MRI) plays a pivotal role in the diagnostic workflow, with a variable involvement of the cerebellar cortex, alone or in combination with other brain structures. Neuroimaging involvement of the pituitary gland is also variable. Here, we provide an overview of the main clinical and conventional brain and pituitary gland MRI imaging findings of the most common genetic mutations associated with the clinical phenotype of ataxia and hypogonadism, with the aim of helping neuroradiologists in the identification of these disorders.
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Affiliation(s)
- Alessandra Scaravilli
- Department of Advanced Biomedical Sciences, University of Naples "Federico II", Via Pansini 5, 80131, Naples, Italy
| | - Mario Tranfa
- Department of Advanced Biomedical Sciences, University of Naples "Federico II", Via Pansini 5, 80131, Naples, Italy
| | - Giuseppe Pontillo
- Department of Advanced Biomedical Sciences, University of Naples "Federico II", Via Pansini 5, 80131, Naples, Italy
- Department of Electrical Engineering and Information Technology (DIETI), University of Naples "Federico II", Naples, Italy
| | - Bernard Brais
- Department of Neurology and Neurosurgery, Montreal Neurological Hospital and Institute, Montreal, Canada
| | - Giovanna De Michele
- Department of Neurosciences and Reproductive and Odontostomatological Sciences, University of Naples "Federico II", Naples, Italy
| | - Roberta La Piana
- Department of Neurology and Neurosurgery, Montreal Neurological Hospital and Institute, Montreal, Canada
| | - Francesco Saccà
- Department of Neurosciences and Reproductive and Odontostomatological Sciences, University of Naples "Federico II", Naples, Italy
| | | | - Matthis Synofzik
- German Center for Neurodegenerative Diseases (DZNE), Tubingen, Germany
- Division Translational Genomics of Neurodegenerative Diseases, Center for Neurology and Hertie Institute for Clinical Brain Research, University of Tübingen, Otfried-Müller-Strasse 27, 72076, Tubingen, Germany
| | - Arturo Brunetti
- Department of Advanced Biomedical Sciences, University of Naples "Federico II", Via Pansini 5, 80131, Naples, Italy
| | - Sirio Cocozza
- Department of Advanced Biomedical Sciences, University of Naples "Federico II", Via Pansini 5, 80131, Naples, Italy.
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6
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Kiely C, Douglas KAA, Douglas VP, Miller JB, Lizano P. Overlap between ophthalmology and psychiatry - A narrative review focused on congenital and inherited conditions. Psychiatry Res 2024; 331:115629. [PMID: 38029629 PMCID: PMC10842794 DOI: 10.1016/j.psychres.2023.115629] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Revised: 11/23/2023] [Accepted: 11/24/2023] [Indexed: 12/01/2023]
Abstract
A number of congenital and inherited diseases present with both ocular and psychiatric features. The genetic inheritance and phenotypic variants play a key role in disease severity. Early recognition of the signs and symptoms of those disorders is critical to earlier intervention and improved prognosis. Typically, the associations between these two medical subspecialties of ophthalmology and psychiatry are poorly understood by most practitioners so we hope to provide a narrative review to improve the identification and management of these disorders. We conducted a comprehensive review of the literature detailing the diseases with ophthalmic and psychiatric overlap that were more widely represented in the literature. Herein, we describe the clinical features, pathophysiology, molecular biology, diagnostic tests, and the most recent approaches for the treatment of these diseases. Recent studies have combined technologies for ocular and brain imaging such as optical coherence tomography (OCT) and functional imaging with genetic testing to identify the genetic basis for eye-brain connections. Additional work is needed to further explore these potential biomarkers. Overall, accurate, efficient, widely distributed and non-invasive tests that can help with early recognition of these diseases will improve the management of these patients using a multidisciplinary approach.
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Affiliation(s)
- Chelsea Kiely
- Department of Psychiatry, Beth Israel Deaconess Medical Center, 75 Fenwood Rd, 612, Boston, MA, United States
| | - Konstantinos A A Douglas
- Department of Psychiatry, Beth Israel Deaconess Medical Center, 75 Fenwood Rd, 612, Boston, MA, United States; Harvard Retinal Imaging Lab, Massachusetts Eye and Ear, Boston, MA, United States
| | | | - John B Miller
- Harvard Retinal Imaging Lab, Massachusetts Eye and Ear, Boston, MA, United States; Retina Service, Department of Ophthalmology, Massachusetts Eye and Ear, Boston, MA, United States; Department of Ophthalmology, Harvard Medical School, Boston, MA, United States
| | - Paulo Lizano
- Department of Psychiatry, Beth Israel Deaconess Medical Center, 75 Fenwood Rd, 612, Boston, MA, United States; Department of Psychiatry, Harvard Medical School, Boston, MA, United States; Division of Translational Neuroscience, Beth Israel Deaconess Medical Center, Boston, MA, United States.
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7
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Ateya R, Ciecierega T, Abusamra M, Abuawwad M, Abu-Libdeh A, Sultan M. Wolfram Syndrome-2, a Cause of Severe Gastrointestinal Bleeding: A Case Series and a Literature Review. JPGN REPORTS 2023; 4:e339. [PMID: 37600626 PMCID: PMC10435029 DOI: 10.1097/pg9.0000000000000339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Accepted: 04/27/2023] [Indexed: 08/22/2023]
Abstract
Background There are very few reports of Wolfram syndrome-2 (WFS2) in the literature, and understanding of involvement of the gastrointestinal (GI) tract in the syndrome is limited. Objectives: This study aims to describe the clinical presentations of a large number of WFS2 patients with specific focus on their GI manifestations. Methods This is a retrospective case series study. Patients who were homozygous for the CISD2 gene mutation were identified through the genetic department of Al-Makassed hospital. Their medical records were reviewed, and biometric data have been obtained. The data were collected and arranged on a data sheet, and descriptive analysis was done using SPSS. Results Thirteen patients from 9 families were identified; diabetes mellitus was present in 6 of them, optic atrophy in 5, diabetes insipidus (DI) in 5, and deafness in 2. All of the patients had GI manifestations with abnormal findings on upper endoscopy. Dysmorphic facial features and abnormal findings on brain MRI were present in 3 of our patients. The GI manifestations including GI bleeding and severe ulcerations were the first to appear in 9 of them, while anemia in the remaining 4. Conclusion This is the largest study to date describing patients with WFS2. This study's evidence shows the prominent presence of GI involvement, and the severe findings on endoscopy, including duodenal, gastric, and esophageal ulcerations and strictures. Unlike in the Jordanian report, some of the patients in our report also have DI.
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Affiliation(s)
- Rania Ateya
- Al-Quds University, East Jerusalem, Palestine
| | | | | | - Motee Abuawwad
- Makassed Hospital – Al-Quds University, Abu-Dies, East Jerusalem, Palestine
| | | | - Mutaz Sultan
- Makassed Hospital – Al-Quds University, Abu-Dies, East Jerusalem, Palestine
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8
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Jauregui R, Abreu NJ, Golan S, Panarelli JF, Sigireddi M, Nayak GK, Gold DM, Rucker JC, Galetta SL, Grossman SN. Neuro-Ophthalmologic Variability in Presentation of Genetically Confirmed Wolfram Syndrome: A Case Series and Review. Brain Sci 2023; 13:1030. [PMID: 37508961 PMCID: PMC10376978 DOI: 10.3390/brainsci13071030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Revised: 07/01/2023] [Accepted: 07/03/2023] [Indexed: 07/30/2023] Open
Abstract
Wolfram syndrome is a neurodegenerative disorder caused by pathogenic variants in the genes WFS1 or CISD2. Clinically, the classic phenotype is composed of optic atrophy, diabetes mellitus type 1, diabetes insipidus, and deafness. Wolfram syndrome, however, is phenotypically heterogenous with variable clinical manifestations and age of onset. We describe four cases of genetically confirmed Wolfram syndrome with variable presentations, including acute-on-chronic vision loss, dyschromatopsia, and tonic pupils. All patients had optic atrophy, only three had diabetes, and none exhibited the classic Wolfram phenotype. MRI revealed a varying degree of the classical features associated with the syndrome, including optic nerve, cerebellar, and brainstem atrophy. The cohort's genotype and presentation supported the reported phenotype-genotype correlations for Wolfram, where missense variants lead to milder, later-onset presentation of the Wolfram syndrome spectrum. When early onset optic atrophy and/or diabetes mellitus are present in a patient, a diagnosis of Wolfram syndrome should be considered, as early diagnosis is crucial for the appropriate referrals and management of the associated conditions. Nevertheless, the condition should also be considered in otherwise unexplained, later-onset optic atrophy, given the phenotypic spectrum.
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Affiliation(s)
- Ruben Jauregui
- Department of Neurology, New York University Grossman School of Medicine, New York, NY 10016, USA
| | - Nicolas J Abreu
- Department of Neurology, New York University Grossman School of Medicine, New York, NY 10016, USA
| | - Shani Golan
- Department of Ophthalmology, New York University Grossman School of Medicine, New York, NY 10016, USA
| | - Joseph F Panarelli
- Department of Ophthalmology, New York University Grossman School of Medicine, New York, NY 10016, USA
| | - Meenakshi Sigireddi
- Department of Medicine, New York University Grossman School of Medicine, New York, NY 10016, USA
- Department of Pediatrics, New York University Grossman School of Medicine, New York, NY 10016, USA
| | - Gopi K Nayak
- Department of Radiology, New York University Grossman School of Medicine, New York, NY 10016, USA
| | - Doria M Gold
- Department of Neurology, New York University Grossman School of Medicine, New York, NY 10016, USA
| | - Janet C Rucker
- Department of Neurology, New York University Grossman School of Medicine, New York, NY 10016, USA
- Department of Ophthalmology, New York University Grossman School of Medicine, New York, NY 10016, USA
| | - Steven L Galetta
- Department of Neurology, New York University Grossman School of Medicine, New York, NY 10016, USA
- Department of Ophthalmology, New York University Grossman School of Medicine, New York, NY 10016, USA
| | - Scott N Grossman
- Department of Neurology, New York University Grossman School of Medicine, New York, NY 10016, USA
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9
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Serbis A, Rallis D, Giapros V, Galli-Tsinopoulou A, Siomou E. Wolfram Syndrome 1: A Pediatrician's and Pediatric Endocrinologist's Perspective. Int J Mol Sci 2023; 24:ijms24043690. [PMID: 36835101 PMCID: PMC9960967 DOI: 10.3390/ijms24043690] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Revised: 01/21/2023] [Accepted: 02/10/2023] [Indexed: 02/15/2023] Open
Abstract
Wolfram syndrome 1 (WS1) is a rare autosomal recessive neurodegenerative disease caused by mutations in WFS1 and WFS2 genes that produce wolframin, a protein involved in endoplasmic reticulum calcium homeostasis and cellular apoptosis. Its main clinical features are diabetes insipidus (DI), early-onset non-autoimmune insulin-dependent diabetes mellitus (DM), gradual loss of vision due to optic atrophy (OA) and deafness (D), hence the acronym DIDMOAD. Several other features from different systems have been reported such as urinary tract, neurological, and psychiatric abnormalities. In addition, endocrine disorders that can appear during childhood and adolescence include primary gonadal atrophy and hypergonadotropic hypogonadism in males and menstrual cycle abnormalities in females. Further, anterior pituitary dysfunction with deficient GH and/or ACTH production have been described. Despite the lack of specific treatment for the disease and its poor life expectancy, early diagnosis and supportive care is important for timely identifying and adequately managing its progressive symptoms. The current narrative review focuses on the pathophysiology and the clinical features of the disease, with a special emphasis on its endocrine abnormalities that appear during childhood and adolescence. Further, therapeutic interventions that have been proven to be effective in the management of WS1 endocrine complications are discussed.
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Affiliation(s)
- Anastasios Serbis
- Department of Pediatrics, School of Medicine, University of Ioannina, 451 10 Ioannina, Greece
- Correspondence:
| | - Dimitrios Rallis
- Neonatal Intensive Care Unit, School of Medicine, University of Ioannina, 451 10 Ioannina, Greece
| | - Vasileios Giapros
- Neonatal Intensive Care Unit, School of Medicine, University of Ioannina, 451 10 Ioannina, Greece
| | - Assimina Galli-Tsinopoulou
- Second Department of Pediatrics, School of Medicine, Faculty of Health Sciences, AHEPA University General Hospital, Aristotle University of Thessaloniki, 541 24 Thessaloniki, Greece
| | - Ekaterini Siomou
- Department of Pediatrics, School of Medicine, University of Ioannina, 451 10 Ioannina, Greece
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Yuan F, Li Y, Hu R, Gong M, Chai M, Ma X, Cha J, Guo P, Yang K, Li M, Xu M, Ma Q, Su Q, Zhang C, Sheng Z, Wu H, Wang Y, Yuan W, Bian S, Shao L, Zhang R, Li K, Shao Z, Zhang ZN, Li W. Modeling disrupted synapse formation in wolfram syndrome using hESCs-derived neural cells and cerebral organoids identifies Riluzole as a therapeutic molecule. Mol Psychiatry 2023; 28:1557-1570. [PMID: 36750736 DOI: 10.1038/s41380-023-01987-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Revised: 01/18/2023] [Accepted: 01/30/2023] [Indexed: 02/09/2023]
Abstract
Dysregulated neurite outgrowth and synapse formation underlie many psychiatric disorders, which are also manifested by wolfram syndrome (WS). Whether and how the causative gene WFS1 deficiency affects synapse formation remain elusive. By mirroring human brain development with cerebral organoids, WFS1-deficient cerebral organoids not only recapitulate the neuronal loss in WS patients, but also exhibit significantly impaired synapse formation and function associated with reduced astrocytes. WFS1 deficiency in neurons autonomously delays neuronal differentiation with altered expressions of genes associated with psychiatric disorders, and impairs neurite outgrowth and synapse formation with elevated cytosolic calcium. Intriguingly, WFS1 deficiency in astrocytes decreases the expression of glutamate transporter EAAT2 by NF-κB activation and induces excessive glutamate. When co-cultured with wildtype neurons, WFS1-deficient astrocytes lead to impaired neurite outgrowth and increased cytosolic calcium in neurons. Importantly, disrupted synapse formation and function in WFS1-deficient cerebral organoids and impaired neurite outgrowth affected by WFS1-deficient astrocytes are efficiently reversed with Riluzole treatment, by restoring EAAT2 expression in astrocytes. Furthermore, Riluzole rescues the depressive-like behavior in the forced swimming test and the impaired recognition and spatial memory in the novel object test and water maze test in Wfs1 conditional knockout mice. Altogether, our study provides novel insights into how WFS1 deficiency affects synapse formation and function, and offers a strategy to treat this disease.
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Affiliation(s)
- Fei Yuan
- Translational Medical Center for Stem Cell Therapy and Institute for Regenerative Medicine, Shanghai East Hospital, Frontier Science Center for Stem Cell Research, School of Life Sciences and Technology, Tongji University, Shanghai, 200092, China.,Tsingtao Advanced Research Institute, Tongji University, Qingdao, 266071, China
| | - Yana Li
- CAS Key Laboratory of Computational Biology, Shanghai Institute of Nutrition and Health, Chinese Academy of Sciences, Shanghai, 200031, China.,University of Chinese Academy of Sciences, Beijing, 100049, China
| | - Rui Hu
- Translational Medical Center for Stem Cell Therapy and Institute for Regenerative Medicine, Shanghai East Hospital, Frontier Science Center for Stem Cell Research, School of Life Sciences and Technology, Tongji University, Shanghai, 200092, China.,Tsingtao Advanced Research Institute, Tongji University, Qingdao, 266071, China
| | - Mengting Gong
- Translational Medical Center for Stem Cell Therapy and Institute for Regenerative Medicine, Shanghai East Hospital, Frontier Science Center for Stem Cell Research, School of Life Sciences and Technology, Tongji University, Shanghai, 200092, China.,Tsingtao Advanced Research Institute, Tongji University, Qingdao, 266071, China
| | - Mengyao Chai
- Translational Medical Center for Stem Cell Therapy and Institute for Regenerative Medicine, Shanghai East Hospital, Frontier Science Center for Stem Cell Research, School of Life Sciences and Technology, Tongji University, Shanghai, 200092, China.,Tsingtao Advanced Research Institute, Tongji University, Qingdao, 266071, China
| | - Xuefei Ma
- QuietD Biotechnology, Ltd., Shanghai, 201210, China
| | - Jiaxue Cha
- Shanghai Key Laboratory of Signaling and Disease Research, School of Life Sciences and Technology, Tongji University, Shanghai, 200092, China
| | - Pan Guo
- Shanghai Key Laboratory of Signaling and Disease Research, School of Life Sciences and Technology, Tongji University, Shanghai, 200092, China
| | - Kaijiang Yang
- Translational Medical Center for Stem Cell Therapy and Institute for Regenerative Medicine, Shanghai East Hospital, Frontier Science Center for Stem Cell Research, School of Life Sciences and Technology, Tongji University, Shanghai, 200092, China.,Tsingtao Advanced Research Institute, Tongji University, Qingdao, 266071, China
| | - Mushan Li
- Department of Statistics, The Pennsylvania State University, University Park, PA, 16802, USA
| | - Minglu Xu
- Translational Medical Center for Stem Cell Therapy and Institute for Regenerative Medicine, Shanghai East Hospital, Frontier Science Center for Stem Cell Research, School of Life Sciences and Technology, Tongji University, Shanghai, 200092, China.,Tsingtao Advanced Research Institute, Tongji University, Qingdao, 266071, China
| | - Qing Ma
- Translational Medical Center for Stem Cell Therapy and Institute for Regenerative Medicine, Shanghai East Hospital, Frontier Science Center for Stem Cell Research, School of Life Sciences and Technology, Tongji University, Shanghai, 200092, China.,Tsingtao Advanced Research Institute, Tongji University, Qingdao, 266071, China
| | - Qiang Su
- Translational Medical Center for Stem Cell Therapy and Institute for Regenerative Medicine, Shanghai East Hospital, Frontier Science Center for Stem Cell Research, School of Life Sciences and Technology, Tongji University, Shanghai, 200092, China.,Tsingtao Advanced Research Institute, Tongji University, Qingdao, 266071, China
| | - Chuan Zhang
- School of Medicine, Tongji University, Shanghai, 200092, China
| | - Zhejin Sheng
- Translational Medical Center for Stem Cell Therapy and Institute for Regenerative Medicine, Shanghai East Hospital, Frontier Science Center for Stem Cell Research, School of Life Sciences and Technology, Tongji University, Shanghai, 200092, China.,Tsingtao Advanced Research Institute, Tongji University, Qingdao, 266071, China
| | - Heng Wu
- Department of Psychosomatic Medicine, Shanghai Tongji Hospital, Tongji University School of Medicine, Shanghai, 200092, China
| | - Yuan Wang
- Department of Neurology and Department of Neurosurgery, State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University and National Collaborative Innovation Center, Chengdu, Sichuan, 610041, China
| | - Wen Yuan
- Department of Stem Cell and Regenerative Biology, Harvard University, Cambridge, MA, 02138, USA
| | - Shan Bian
- Translational Medical Center for Stem Cell Therapy and Institute for Regenerative Medicine, Shanghai East Hospital, Frontier Science Center for Stem Cell Research, School of Life Sciences and Technology, Tongji University, Shanghai, 200092, China.,Tsingtao Advanced Research Institute, Tongji University, Qingdao, 266071, China
| | - Li Shao
- Department of VIP Clinic, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, 200092, China
| | - Ru Zhang
- Shanghai Key Laboratory of Signaling and Disease Research, School of Life Sciences and Technology, Tongji University, Shanghai, 200092, China
| | - Kaicheng Li
- QuietD Biotechnology, Ltd., Shanghai, 201210, China
| | - Zhen Shao
- CAS Key Laboratory of Computational Biology, Shanghai Institute of Nutrition and Health, Chinese Academy of Sciences, Shanghai, 200031, China.
| | - Zhen-Ning Zhang
- Translational Medical Center for Stem Cell Therapy and Institute for Regenerative Medicine, Shanghai East Hospital, Frontier Science Center for Stem Cell Research, School of Life Sciences and Technology, Tongji University, Shanghai, 200092, China. .,Tsingtao Advanced Research Institute, Tongji University, Qingdao, 266071, China.
| | - Weida Li
- Translational Medical Center for Stem Cell Therapy and Institute for Regenerative Medicine, Shanghai East Hospital, Frontier Science Center for Stem Cell Research, School of Life Sciences and Technology, Tongji University, Shanghai, 200092, China. .,Tsingtao Advanced Research Institute, Tongji University, Qingdao, 266071, China. .,Reg-Verse Therapeutics (Shanghai) Co. Ltd., Shanghai, 200120, China.
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11
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Chen Y, Zhang M, Zhou Y, Li P. Case Report: A novel mutation in WFS1 gene (c.1756G>A p.A586T) is responsible for early clinical features of cognitive impairment and recurrent ischemic stroke. Front Genet 2023; 14:1072978. [PMID: 36816038 PMCID: PMC9932685 DOI: 10.3389/fgene.2023.1072978] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Accepted: 01/06/2023] [Indexed: 02/05/2023] Open
Abstract
Wolfram syndrome 1 (WFS1) gene mutations can be dominantly or recessively inherited, and the onset of the clinical picture is highly heterogeneity in both appearance and degree of severity. Different types of WFS1 mutations have been identified. Autosomal recessive mutations in the WFS1 gene will underlie Wolfram syndrome 1 (WS1), a rare and severe neurodegenerative disease characterized by diabetes insipidus, diabetes mellitus, optic atrophy, deafness, and other neurological, urological and psychiatric abnormalities. Other WFS1-related disorders such as low-frequency sensorineural hearing impairment (LFSNHI) and Wolfram syndrome-like disease with autosomal dominant transmission have been described. It is difficult to establish genotype-phenotype correlations because of the molecular complexity of wolframin protein. In this report, we presented a case of WSF1 gene mutation-related disease with cognitive impairment as the initial symptom and recurrent cerebral infarction in the course of the disease. Brain structural imaging results suggested decreased intracranial volume, dramatically reduced in cerebral cortex and cerebellum regions. Multimodal molecular imaging results suggested Tau protein deposition in the corresponding brain regions without Aβ pathology changes. These pathological changes may indicate a role of WFS1 in neuronal vulnerability to tau pathology associated with neurodegeneration and ischemia-induced damage.
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Affiliation(s)
- Yuan Chen
- Department of Neurology, Tianjin Huanhu Hospital, Clinical College of Neurology, Neurosurgery, and Neurorehabilitation, Tianjin Medical University, Tianjin, China,Department of Neurology, Tianjin Huanhu Hospital affiliated to Nankai University, Tianjin University Huanhu Hospital, Tianjin, China,Tianjin Key Laboratory of Cerebral Vascular and Neurodegenerative Diseases, Tianjin Neurosurgery Institute, Tianjin Huanhu Hospital, Tianjin, China
| | - Miao Zhang
- Department of Neurology, Tianjin Huanhu Hospital, Clinical College of Neurology, Neurosurgery, and Neurorehabilitation, Tianjin Medical University, Tianjin, China,Department of Neurology, Tianjin Huanhu Hospital affiliated to Nankai University, Tianjin University Huanhu Hospital, Tianjin, China,Tianjin Key Laboratory of Cerebral Vascular and Neurodegenerative Diseases, Tianjin Neurosurgery Institute, Tianjin Huanhu Hospital, Tianjin, China
| | - Yuying Zhou
- Department of Neurology, Tianjin Huanhu Hospital, Clinical College of Neurology, Neurosurgery, and Neurorehabilitation, Tianjin Medical University, Tianjin, China,Department of Neurology, Tianjin Huanhu Hospital affiliated to Nankai University, Tianjin University Huanhu Hospital, Tianjin, China,Tianjin Key Laboratory of Cerebral Vascular and Neurodegenerative Diseases, Tianjin Neurosurgery Institute, Tianjin Huanhu Hospital, Tianjin, China
| | - Pan Li
- Department of Neurology, Tianjin Huanhu Hospital, Clinical College of Neurology, Neurosurgery, and Neurorehabilitation, Tianjin Medical University, Tianjin, China,Department of Neurology, Tianjin Huanhu Hospital affiliated to Nankai University, Tianjin University Huanhu Hospital, Tianjin, China,Tianjin Key Laboratory of Cerebral Vascular and Neurodegenerative Diseases, Tianjin Neurosurgery Institute, Tianjin Huanhu Hospital, Tianjin, China,*Correspondence: Pan Li,
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12
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Rossi G, Ordazzo G, Vanni NN, Castoldi V, Iannielli A, Di Silvestre D, Bellini E, Bernardo L, Giannelli SG, Luoni M, Muggeo S, Leocani L, Mauri P, Broccoli V. MCT1-dependent energetic failure and neuroinflammation underlie optic nerve degeneration in Wolfram syndrome mice. eLife 2023; 12:81779. [PMID: 36645345 PMCID: PMC9891717 DOI: 10.7554/elife.81779] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Accepted: 01/13/2023] [Indexed: 01/17/2023] Open
Abstract
Wolfram syndrome 1 (WS1) is a rare genetic disorder caused by mutations in the WFS1 gene leading to a wide spectrum of clinical dysfunctions, among which blindness, diabetes, and neurological deficits are the most prominent. WFS1 encodes for the endoplasmic reticulum (ER) resident transmembrane protein wolframin with multiple functions in ER processes. However, the WFS1-dependent etiopathology in retinal cells is unknown. Herein, we showed that Wfs1 mutant mice developed early retinal electrophysiological impairments followed by marked visual loss. Interestingly, axons and myelin disruption in the optic nerve preceded the degeneration of the retinal ganglion cell bodies in the retina. Transcriptomics at pre-degenerative stage revealed the STAT3-dependent activation of proinflammatory glial markers with reduction of the homeostatic and pro-survival factors glutamine synthetase and BDNF. Furthermore, label-free comparative proteomics identified a significant reduction of the monocarboxylate transport isoform 1 (MCT1) and its partner basigin that are highly enriched on retinal glia and myelin-forming oligodendrocytes in optic nerve together with wolframin. Loss of MCT1 caused a failure in lactate transfer from glial to neuronal cell bodies and axons leading to a chronic hypometabolic state. Thus, this bioenergetic impairment is occurring concurrently both within the axonal regions and cell bodies of the retinal ganglion cells, selectively endangering their survival while impacting less on other retinal cells. This metabolic dysfunction occurs months before the frank RGC degeneration suggesting an extended time-window for intervening with new therapeutic strategies focused on boosting retinal and optic nerve bioenergetics in WS1.
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Affiliation(s)
- Greta Rossi
- Division of Neuroscience, San Raffaele Scientific InstituteMilanoItaly
| | - Gabriele Ordazzo
- Division of Neuroscience, San Raffaele Scientific InstituteMilanoItaly
| | - Niccolò N Vanni
- Division of Neuroscience, San Raffaele Scientific InstituteMilanoItaly
| | - Valerio Castoldi
- Division of Neuroscience, San Raffaele Scientific InstituteMilanoItaly
- Experimental Neurophysiology Unit, Institute of Experimental Neurology (INSPE), San Raffaele Scientific InstituteMilanItaly
| | - Angelo Iannielli
- Division of Neuroscience, San Raffaele Scientific InstituteMilanoItaly
- National Research Council of Italy, Institute of NeuroscienceMilanoItaly
| | - Dario Di Silvestre
- National Research Council of Italy, Institute of Technologies in BiomedicineMilanItaly
| | - Edoardo Bellini
- Division of Neuroscience, San Raffaele Scientific InstituteMilanoItaly
| | - Letizia Bernardo
- National Research Council of Italy, Institute of Technologies in BiomedicineMilanItaly
| | | | - Mirko Luoni
- Division of Neuroscience, San Raffaele Scientific InstituteMilanoItaly
- National Research Council of Italy, Institute of NeuroscienceMilanoItaly
| | - Sharon Muggeo
- Division of Neuroscience, San Raffaele Scientific InstituteMilanoItaly
| | - Letizia Leocani
- Division of Neuroscience, San Raffaele Scientific InstituteMilanoItaly
- Experimental Neurophysiology Unit, Institute of Experimental Neurology (INSPE), San Raffaele Scientific InstituteMilanItaly
| | - PierLuigi Mauri
- National Research Council of Italy, Institute of Technologies in BiomedicineMilanItaly
| | - Vania Broccoli
- Division of Neuroscience, San Raffaele Scientific InstituteMilanoItaly
- National Research Council of Italy, Institute of NeuroscienceMilanoItaly
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13
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Wang Z, Wang X, Shi L, Cai Y, Hu B. Wolfram syndrome 1b mutation suppresses Mauthner-cell axon regeneration via ER stress signal pathway. Acta Neuropathol Commun 2022; 10:184. [PMID: 36527091 PMCID: PMC9758940 DOI: 10.1186/s40478-022-01484-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Accepted: 11/18/2022] [Indexed: 12/23/2022] Open
Abstract
Wolfram Syndrome (WS) is a fatal human inherited disease with symptoms of diabetes, vision decreasing, and neurodegeneration caused by mutations in the endoplasmic reticulum (ER)-resident protein WFS1. WFS1 has been reported to play an important role in glucose metabolism. However, the role of WFS1 in axonal regeneration in the central nervous system has so far remained elusive. Herein, we established a model of the wfs1b globally deficient zebrafish line. wfs1b deficiency severely impeded the Mauthner-cell (M-cell) axon regeneration, which was partly dependent on the ER stress response. The administration of ER stress inhibitor 4-Phenylbutyric acid (4-PBA) promoted M-cell axon regeneration in wfs1b-/- zebrafish larvae, while the ER stress activator Tunicamycin (TM) inhibited M-cell axon regeneration in wfs1b+/+ zebrafish larvae. Moreover, complementation of wfs1b at the single-cell level stimulated M-cell axon regeneration in the wfs1b-/- zebrafish larvae. Altogether, our results revealed that wfs1b promotes M-cell axon regeneration through the ER stress signal pathway and provide new evidence for a therapeutic target for WS and axon degeneration.
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Affiliation(s)
- Zongyi Wang
- grid.59053.3a0000000121679639Hefei National Research Center for Physical Sciences at the Microscale, Chinese Academy of Sciences Key Laboratory of Brain Function and Disease, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, 230026 China
| | - Xinliang Wang
- grid.59053.3a0000000121679639Hefei National Research Center for Physical Sciences at the Microscale, Chinese Academy of Sciences Key Laboratory of Brain Function and Disease, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, 230026 China
| | - Lingyu Shi
- grid.59053.3a0000000121679639Hefei National Research Center for Physical Sciences at the Microscale, Chinese Academy of Sciences Key Laboratory of Brain Function and Disease, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, 230026 China
| | - Yuan Cai
- grid.59053.3a0000000121679639Hefei National Research Center for Physical Sciences at the Microscale, Chinese Academy of Sciences Key Laboratory of Brain Function and Disease, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, 230026 China ,grid.59053.3a0000000121679639First Affiliated Hospital of USTC, School of Life Sciences, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, 230026 China
| | - Bing Hu
- grid.59053.3a0000000121679639Hefei National Research Center for Physical Sciences at the Microscale, Chinese Academy of Sciences Key Laboratory of Brain Function and Disease, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, 230026 China ,grid.59053.3a0000000121679639Research Institute of Frontier Cross Science and Biomedical Sciences, Hefei Comprehensive National Science Center, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, 230026 China
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14
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Rotsos T, Papakonstantinou E, Symeonidis C, Krassas A, Kamakari S. Wolfram Syndrome: A case report of two sisters Wolfram Syndrome: Case report of two sisters. Am J Ophthalmol Case Rep 2022; 26:101452. [PMID: 35252627 PMCID: PMC8892096 DOI: 10.1016/j.ajoc.2022.101452] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Revised: 02/17/2022] [Accepted: 02/22/2022] [Indexed: 02/08/2023] Open
Abstract
PURPOSE To present a case of two siblings with optic atrophy associated with Wolfram Syndrome. OBSERVATIONS Two young adult siblings presented with serious bilateral loss of vision and dyschromatopsia established in early adolescence. They were referred with a presumed diagnosis of Leber's Hereditary Optic Neuropathy. At baseline, visual acuity was 20/400 in the right eye and 20/200 in the left eye in patient A and 20/200 in both eyes in patient B, color perception tested with pseudo-isochromatic plates was 0/17 in each eye, optic discs were pale, visual field testing revealed diffuse scotomas bilaterally while electrophysiology showed delayed prominent positive deflection (P100) values in both patients. Personal history revealed Type 1 diabetes mellitus since early childhood. Patients were lost to follow-up and presented 4 years later with significant VA decrease (<20/400) and suspected hearing loss. At that point, genetic testing revealed a pathogenic variation in the WFS1 gene thus confirming the diagnosis of Wolfram syndrome. Treatment with idebenone was proposed, to which only one of the siblings agreed. The other patient remained under observation, as no known treatment for optic atrophy in Wolfram syndrome exists to date. CONCLUSIONS AND IMPORTANCE Wolfram syndrome is a rare neurodegenerative genetic disease associated with diabetes mellitus, optic atrophy and deafness. Careful and detailed medical and family history led to appropriate testing that confirmed the diagnosis of Wolfram syndrome. To this day, there is no definite treatment for this disease, but the experimental use of idebenone has been suggested to improve visual function. Genetic testing of family members and offspring of patients is strongly recommended.
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Affiliation(s)
- Tryfon Rotsos
- 1st Department of Ophthalmology, University of Athens, G. Gennimatas General Hospital, 154 Mesogion Av., 115 27, Athens, Greece
| | - Evangelia Papakonstantinou
- 1st Department of Ophthalmology, University of Athens, G. Gennimatas General Hospital, 154 Mesogion Av., 115 27, Athens, Greece
| | - Chrysanthos Symeonidis
- 2nd Department of Ophthalmology, Aristotle University of Thessaloniki, Thessaloniki Ring Road, 546 03, Thessaloniki, Greece
- Corresponding author. 44 Tsimiski str., 546 23, Thessaloniki, Greece.
| | - Augoustinos Krassas
- 1st Department of Ophthalmology, University of Athens, G. Gennimatas General Hospital, 154 Mesogion Av., 115 27, Athens, Greece
| | - Smaragda Kamakari
- Ophthalmic Genetics Unit, OMMA Institute, 74 Katechaki Str., 115 25, Athens, Greece
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15
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Barboni P, Amore G, Cascavilla ML, Battista M, Frontino G, Romagnoli M, Caporali L, Baldoli C, Gramegna LL, Sessagesimi E, Bonfanti R, Romagnoli A, Scotti R, Brambati M, Carbonelli M, Starace V, Fiorini C, Panebianco R, Parisi V, Tonon C, Bandello F, Carelli V, La Morgia C. The pattern of retinal ganglion cell loss in Wolfram syndrome is distinct from mitochondrial optic neuropathies. Am J Ophthalmol 2022; 241:206-216. [PMID: 35452662 DOI: 10.1016/j.ajo.2022.03.019] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2021] [Revised: 03/13/2022] [Accepted: 03/16/2022] [Indexed: 11/18/2022]
Abstract
PURPOSE To describe the clinical phenotype of a cohort of Wolfram syndrome (WS) patients, focusing on the pattern of optic atrophy correlated with brain MRI measurements, as compared to OPA1-associated mitochondrial optic neuropathy. DESIGN Retrospective, comparative cohort study METHODS: 25 WS patients and 33 age-matched patients affected by OPA1-related Dominant Optic Atrophy (DOA). Ophthalmological, neurological, endocrinological and MRI data from WS patients were retrospectively retrieved. Ophthalmological data were compared to OPA1-related DOA and further analyzed for age dependency dividing patients in age quartiles. In a subgroup of WS patients, we correlated the structural damage assessed by optical coherence tomography (OCT) with brain MRI morphological measurements. Visual acuity (VA), visual field mean defect (MD), retinal nerve fiber layer (RNFL) and ganglion cell layer (GCL) thickness assessed by OCT, MRI morphological measurements of anterior and posterior visual pathways. RESULTS In our cohort optic atrophy was present in 100% of WS patients. VA, MD and RNFL thickness loss were worse in WS patients with a faster decline since early age as compared to DOA patients, who displayed a more stable visual function over the years. Conversely, GCL sectors were overall thinner in DOA patients since early age compared to WS, in which GCL thickness started to decline later in life. The neuroradiological sub-analysis on 11 WS patients exhibited bilateral thinning of the anterior optic pathway, especially prechiasmatic optic nerves and optic tracts. Optic tract thinning was significantly correlated with the GCL thickness but not with RNFL parameters. CONCLUSIONS Our results showed a generally more severe and diffuse degeneration of both anterior and posterior visual pathways in WS, with fast deterioration of visual function and structural OCT parameters since early age. The pattern observed at OCT suggests that retinal ganglion cells axonal degeneration (i.e. RNFL) precedes of about a decade the cellular body atrophy (i.e. GCL). This differs substantially from DOA, in which a more stable visual function is evident with predominant early loss of GCL, indirectly supporting the lack of a primary mitochondrial dysfunction in WS.
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Affiliation(s)
- Piero Barboni
- From the Department of Ophthalmology (P.B., M.L.C., M.Ba., M.Br., V.S., F.B.), University Vita-Salute, IRCCS Ospedale San Raffaele, Milan, Italy; Studio Oculistico d'Azeglio (P.B.), Bologna, Italy.
| | - Giulia Amore
- Dipartimento di Scienze Biomediche e Neuromotorie (G.A., L.L.G., E.S., M.C., C.T., V.C.), Università di Bologna, Bologna, Italy
| | - Maria Lucia Cascavilla
- From the Department of Ophthalmology (P.B., M.L.C., M.Ba., M.Br., V.S., F.B.), University Vita-Salute, IRCCS Ospedale San Raffaele, Milan, Italy
| | - Marco Battista
- From the Department of Ophthalmology (P.B., M.L.C., M.Ba., M.Br., V.S., F.B.), University Vita-Salute, IRCCS Ospedale San Raffaele, Milan, Italy
| | - Giulio Frontino
- Department of Pediatrics (G.F., R.B., A.R.), IRCCS San Raffaele Hospital, Milan, Italy; Diabetes Research Institute (G.F., R.B., A.R.), IRCCS San Raffaele Hospital, Milan, Italy
| | - Martina Romagnoli
- IRCCS Istituto delle Scienze Neurologiche di Bologna (M.R., L.C., C.F., V.C., C.L.M.), Programma di Neurogenetica, Bologna, Italy
| | - Leonardo Caporali
- IRCCS Istituto delle Scienze Neurologiche di Bologna (M.R., L.C., C.F., V.C., C.L.M.), Programma di Neurogenetica, Bologna, Italy
| | - Cristina Baldoli
- Neuroradiology Unit (C.B., R.S.), IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Laura Ludovica Gramegna
- Dipartimento di Scienze Biomediche e Neuromotorie (G.A., L.L.G., E.S., M.C., C.T., V.C.), Università di Bologna, Bologna, Italy; IRCCS Istituto delle Scienze Neurologiche di Bologna (L.L.G., E.S., C.T.), Functional and Molecular Neuroimaging Unit, Bologna, Italy
| | - Elisa Sessagesimi
- Dipartimento di Scienze Biomediche e Neuromotorie (G.A., L.L.G., E.S., M.C., C.T., V.C.), Università di Bologna, Bologna, Italy; IRCCS Istituto delle Scienze Neurologiche di Bologna (L.L.G., E.S., C.T.), Functional and Molecular Neuroimaging Unit, Bologna, Italy
| | - Riccardo Bonfanti
- Department of Pediatrics (G.F., R.B., A.R.), IRCCS San Raffaele Hospital, Milan, Italy; Diabetes Research Institute (G.F., R.B., A.R.), IRCCS San Raffaele Hospital, Milan, Italy
| | - Andrea Romagnoli
- Department of Pediatrics (G.F., R.B., A.R.), IRCCS San Raffaele Hospital, Milan, Italy; Diabetes Research Institute (G.F., R.B., A.R.), IRCCS San Raffaele Hospital, Milan, Italy
| | - Roberta Scotti
- Neuroradiology Unit (C.B., R.S.), IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Maria Brambati
- From the Department of Ophthalmology (P.B., M.L.C., M.Ba., M.Br., V.S., F.B.), University Vita-Salute, IRCCS Ospedale San Raffaele, Milan, Italy
| | - Michele Carbonelli
- Dipartimento di Scienze Biomediche e Neuromotorie (G.A., L.L.G., E.S., M.C., C.T., V.C.), Università di Bologna, Bologna, Italy
| | - Vincenzo Starace
- From the Department of Ophthalmology (P.B., M.L.C., M.Ba., M.Br., V.S., F.B.), University Vita-Salute, IRCCS Ospedale San Raffaele, Milan, Italy
| | - Claudio Fiorini
- IRCCS Istituto delle Scienze Neurologiche di Bologna (M.R., L.C., C.F., V.C., C.L.M.), Programma di Neurogenetica, Bologna, Italy
| | - Roberta Panebianco
- Department of Ophthalmology (R.P.), University of Catania, Catania, Italy
| | | | - Caterina Tonon
- Dipartimento di Scienze Biomediche e Neuromotorie (G.A., L.L.G., E.S., M.C., C.T., V.C.), Università di Bologna, Bologna, Italy; IRCCS Istituto delle Scienze Neurologiche di Bologna (L.L.G., E.S., C.T.), Functional and Molecular Neuroimaging Unit, Bologna, Italy
| | - Francesco Bandello
- From the Department of Ophthalmology (P.B., M.L.C., M.Ba., M.Br., V.S., F.B.), University Vita-Salute, IRCCS Ospedale San Raffaele, Milan, Italy
| | - Valerio Carelli
- Dipartimento di Scienze Biomediche e Neuromotorie (G.A., L.L.G., E.S., M.C., C.T., V.C.), Università di Bologna, Bologna, Italy; IRCCS Istituto delle Scienze Neurologiche di Bologna (M.R., L.C., C.F., V.C., C.L.M.), Programma di Neurogenetica, Bologna, Italy
| | - Chiara La Morgia
- IRCCS Istituto delle Scienze Neurologiche di Bologna (M.R., L.C., C.F., V.C., C.L.M.), Programma di Neurogenetica, Bologna, Italy; IRCCS Istituto delle Scienze Neurologiche di Bologna (C.L.M.), UOC Clinica Neurologica, Bologna, Italy
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16
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Kabanovski A, Donaldson L, Margolin E. Neuro-ophthalmological manifestations of Wolfram syndrome: Case series and review of the literature. J Neurol Sci 2022; 437:120267. [DOI: 10.1016/j.jns.2022.120267] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Revised: 04/03/2022] [Accepted: 04/15/2022] [Indexed: 12/13/2022]
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Wolfram Syndrome 1: From Genetics to Therapy. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19063225. [PMID: 35328914 PMCID: PMC8949990 DOI: 10.3390/ijerph19063225] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/19/2021] [Revised: 02/24/2022] [Accepted: 02/25/2022] [Indexed: 02/01/2023]
Abstract
Wolfram syndrome 1 (WS1) is a rare neurodegenerative disease transmitted in an autosomal recessive mode. It is characterized by diabetes insipidus (DI), diabetes mellitus (DM), optic atrophy (OA), and sensorineural hearing loss (D) (DIDMOAD). The clinical picture may be complicated by other symptoms, such as urinary tract, endocrinological, psychiatric, and neurological abnormalities. WS1 is caused by mutations in the WFS1 gene located on chromosome 4p16 that encodes a transmembrane protein named wolframin. Many studies have shown that wolframin regulates some mechanisms of ER calcium homeostasis and therefore plays a role in cellular apoptosis. More than 200 mutations are responsible for WS1. However, abnormal phenotypes of WS with or without DM, inherited in an autosomal dominant mode and associated with one or more WFS1 mutations, have been found. Furthermore, recessive Wolfram-like disease without DM has been described. The prognosis of WS1 is poor, and the death occurs prematurely. Although there are no therapies that can slow or stop WS1, a careful clinical monitoring can help patients during the rapid progression of the disease, thus improving their quality of life. In this review, we describe natural history and etiology of WS1 and suggest criteria for a most pertinent approach to the diagnosis and clinical follow up. We also describe the hallmarks of new therapies for WS1.
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Rigoli L, Caruso V, Aloi C, Salina A, Maghnie M, d’Annunzio G, Lamacchia O, Salzano G, Lombardo F, Picca G. An Atypical Case of Late-Onset Wolfram Syndrome 1 without Diabetes Insipidus. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:2473. [PMID: 35206658 PMCID: PMC8872384 DOI: 10.3390/ijerph19042473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Revised: 02/15/2022] [Accepted: 02/17/2022] [Indexed: 12/04/2022]
Abstract
Wolfram syndrome 1, a rare autosomal recessive neurodegenerative disease, is caused by mutations in the WFS1 gene. It is characterized by diabetes insipidus, diabetes mellitus, optic atrophy, and deafness (DIDMOAD), and other clinical manifestations such as urological and neurological disorders. Here we described the case of a patient with an atypical late-onset Wolfram syndrome 1 without DI. Our WS1 patient was a c.1620_1622delGTG (p.Trp540del)/c.124 C > T (p.Arg42*) heterozygous compound. The p.Arg42* nonsense mutation was also found in heterozygosity in his sister and niece, both suffering from psychiatric disorders. The p.Arg42* nonsense mutation has never been found in WS1 and its pathogenicity is unclear so far. Our study underlined the need to study a greater number of WS1 cases in order to better understand the clinical significance of many WFS1 variants.
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Affiliation(s)
- Luciana Rigoli
- Department of Human Pathology of Adulthood and Childhood G. Barresi, University of Messina, 98125 Messina, Italy; (G.S.); (F.L.)
| | - Valerio Caruso
- Psychiatry 2 Unit, Clinical and Experimental Medicine Department, University of Pisa, 56126 Pisa, Italy;
| | - Concetta Aloi
- Pediatric Clinic, LABSIEM (Laboratory for the Study of Inborn Errors of Metabolism), IRCCS Institute Giannina Gaslini, 16147 Genoa, Italy; (C.A.); (A.S.); (M.M.); (G.d.)
| | - Alessandro Salina
- Pediatric Clinic, LABSIEM (Laboratory for the Study of Inborn Errors of Metabolism), IRCCS Institute Giannina Gaslini, 16147 Genoa, Italy; (C.A.); (A.S.); (M.M.); (G.d.)
| | - Mohamad Maghnie
- Pediatric Clinic, LABSIEM (Laboratory for the Study of Inborn Errors of Metabolism), IRCCS Institute Giannina Gaslini, 16147 Genoa, Italy; (C.A.); (A.S.); (M.M.); (G.d.)
| | - Giuseppe d’Annunzio
- Pediatric Clinic, LABSIEM (Laboratory for the Study of Inborn Errors of Metabolism), IRCCS Institute Giannina Gaslini, 16147 Genoa, Italy; (C.A.); (A.S.); (M.M.); (G.d.)
| | - Olga Lamacchia
- Unit of Endocrinology and Diabetology, Department of Medical and Surgical Sciences, University of Foggia, 71100 Foggia, Italy; (O.L.); (G.P.)
| | - Giuseppina Salzano
- Department of Human Pathology of Adulthood and Childhood G. Barresi, University of Messina, 98125 Messina, Italy; (G.S.); (F.L.)
| | - Fortunato Lombardo
- Department of Human Pathology of Adulthood and Childhood G. Barresi, University of Messina, 98125 Messina, Italy; (G.S.); (F.L.)
| | - Giuseppe Picca
- Unit of Endocrinology and Diabetology, Department of Medical and Surgical Sciences, University of Foggia, 71100 Foggia, Italy; (O.L.); (G.P.)
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19
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Crouzier L, Danese A, Yasui Y, Richard EM, Liévens JC, Patergnani S, Couly S, Diez C, Denus M, Cubedo N, Rossel M, Thiry M, Su TP, Pinton P, Maurice T, Delprat B. Activation of the sigma-1 receptor chaperone alleviates symptoms of Wolfram syndrome in preclinical models. Sci Transl Med 2022; 14:eabh3763. [PMID: 35138910 PMCID: PMC9516885 DOI: 10.1126/scitranslmed.abh3763] [Citation(s) in RCA: 31] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
The Wolfram syndrome is a rare autosomal recessive disease affecting many organs with life-threatening consequences; currently, no treatment is available. The disease is caused by mutations in the WSF1 gene, coding for the protein wolframin, an endoplasmic reticulum (ER) transmembrane protein involved in contacts between ER and mitochondria termed as mitochondria-associated ER membranes (MAMs). Inherited mutations usually reduce the protein's stability, altering its homeostasis and ultimately reducing ER to mitochondria calcium ion transfer, leading to mitochondrial dysfunction and cell death. In this study, we found that activation of the sigma-1 receptor (S1R), an ER-resident protein involved in calcium ion transfer, could counteract the functional alterations of MAMs due to wolframin deficiency. The S1R agonist PRE-084 restored calcium ion transfer and mitochondrial respiration in vitro, corrected the associated increased autophagy and mitophagy, and was able to alleviate the behavioral symptoms observed in zebrafish and mouse models of the disease. Our findings provide a potential therapeutic strategy for treating Wolfram syndrome by efficiently boosting MAM function using the ligand-operated S1R chaperone. Moreover, such strategy might also be relevant for other degenerative and mitochondrial diseases involving MAM dysfunction.
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Affiliation(s)
- Lucie Crouzier
- MMDN, Univ Montpellier, EPHE, INSERM, Montpellier, France
| | - Alberto Danese
- Department of Medical Sciences, Laboratory for Technologies of Advanced Therapies (LTTA), University of Ferrara, 44121 Ferrara, Italy
| | - Yuko Yasui
- Cellular Pathobiology Section, Integrative Neuroscience Research Branch, Intramural Research Program, National Institute on Drug Abuse, NIH, 333 Cassell Drive, Baltimore, MD 21224, USA
| | | | | | - Simone Patergnani
- Department of Medical Sciences, Laboratory for Technologies of Advanced Therapies (LTTA), University of Ferrara, 44121 Ferrara, Italy
| | - Simon Couly
- MMDN, Univ Montpellier, EPHE, INSERM, Montpellier, France
- Cellular Pathobiology Section, Integrative Neuroscience Research Branch, Intramural Research Program, National Institute on Drug Abuse, NIH, 333 Cassell Drive, Baltimore, MD 21224, USA
| | - Camille Diez
- MMDN, Univ Montpellier, EPHE, INSERM, Montpellier, France
| | - Morgane Denus
- MMDN, Univ Montpellier, EPHE, INSERM, Montpellier, France
| | - Nicolas Cubedo
- MMDN, Univ Montpellier, EPHE, INSERM, Montpellier, France
| | | | - Marc Thiry
- Laboratoire de Biologie Cellulaire, Université de Liège, GIGA-Neurosciences, Quartier Hopital, Avenue Hippocrate 15, 4000 Liege 1, Belgium
| | - Tsung-Ping Su
- Cellular Pathobiology Section, Integrative Neuroscience Research Branch, Intramural Research Program, National Institute on Drug Abuse, NIH, 333 Cassell Drive, Baltimore, MD 21224, USA
| | - Paolo Pinton
- Department of Medical Sciences, Laboratory for Technologies of Advanced Therapies (LTTA), University of Ferrara, 44121 Ferrara, Italy
| | - Tangui Maurice
- MMDN, Univ Montpellier, EPHE, INSERM, Montpellier, France
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20
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Crouzier L, Richard EM, Diez C, Alzaeem H, Denus M, Cubedo N, Delaunay T, Glendenning E, Baxendale S, Liévens JC, Whitfield TT, Maurice T, Delprat B. OUP accepted manuscript. Hum Mol Genet 2022; 31:2711-2727. [PMID: 35325133 PMCID: PMC9402244 DOI: 10.1093/hmg/ddac065] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Revised: 02/28/2022] [Accepted: 03/15/2022] [Indexed: 12/03/2022] Open
Abstract
Wolfram syndrome (WS) is a rare genetic disease characterized by diabetes, optic atrophy and deafness. Patients die at 35 years of age, mainly from respiratory failure or dysphagia. Unfortunately, there is no treatment to block the progression of symptoms and there is an urgent need for adequate research models. Here, we report on the phenotypical characterization of two loss-of-function zebrafish mutant lines: wfs1aC825X and wfs1bW493X. We observed that wfs1a deficiency altered the size of the ear and the retina of the fish. We also documented a decrease in the expression level of unfolded protein response (UPR) genes in basal condition and in stress condition, i.e. after tunicamycin treatment. Interestingly, both mutants lead to a decrease in their visual function measured behaviorally. These deficits were associated with a decrease in the expression level of UPR genes in basal and stress conditions. Interestingly, basal, ATP-linked and maximal mitochondrial respirations were transiently decreased in the wfs1b mutant. Taken together, these zebrafish lines highlight the critical role of wfs1a and wfs1b in UPR, mitochondrial function and visual physiology. These models will be useful tools to better understand the cellular function of Wfs1 and to develop novel therapeutic approaches for WS.
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Affiliation(s)
- Lucie Crouzier
- MMDN, Université Montpellier, EPHE, INSERM, Montpellier, France
| | | | - Camille Diez
- MMDN, Université Montpellier, EPHE, INSERM, Montpellier, France
| | - Hala Alzaeem
- MMDN, Université Montpellier, EPHE, INSERM, Montpellier, France
| | - Morgane Denus
- MMDN, Université Montpellier, EPHE, INSERM, Montpellier, France
| | - Nicolas Cubedo
- MMDN, Université Montpellier, EPHE, INSERM, Montpellier, France
| | | | - Emily Glendenning
- Development, Regeneration and Neurophysiology, School of Biosciences, University of Sheffield, Sheffield S10 2TN, UK
| | - Sarah Baxendale
- Development, Regeneration and Neurophysiology, School of Biosciences, University of Sheffield, Sheffield S10 2TN, UK
| | | | - Tanya T Whitfield
- Development, Regeneration and Neurophysiology, School of Biosciences, University of Sheffield, Sheffield S10 2TN, UK
| | - Tangui Maurice
- MMDN, Université Montpellier, EPHE, INSERM, Montpellier, France
| | - Benjamin Delprat
- To whom correspondence should be addressed: Tel: +33 467143623; Fax: +33 47149295;
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21
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Jagomäe T, Seppa K, Reimets R, Pastak M, Plaas M, Hickey MA, Kukker KG, Moons L, De Groef L, Vasar E, Kaasik A, Terasmaa A, Plaas M. Early Intervention and Lifelong Treatment with GLP1 Receptor Agonist Liraglutide in a Wolfram Syndrome Rat Model with an Emphasis on Visual Neurodegeneration, Sensorineural Hearing Loss and Diabetic Phenotype. Cells 2021; 10:cells10113193. [PMID: 34831417 PMCID: PMC8623088 DOI: 10.3390/cells10113193] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Revised: 11/11/2021] [Accepted: 11/14/2021] [Indexed: 01/11/2023] Open
Abstract
Wolfram syndrome (WS), also known as a DIDMOAD (diabetes insipidus, early-onset diabetes mellitus, optic nerve atrophy and deafness) is a rare autosomal disorder caused by mutations in the Wolframin1 (WFS1) gene. Previous studies have revealed that glucagon-like peptide-1 receptor agonist (GLP1 RA) are effective in delaying and restoring blood glucose control in WS animal models and patients. The GLP1 RA liraglutide has also been shown to have neuroprotective properties in aged WS rats. WS is an early-onset, chronic condition. Therefore, early diagnosis and lifelong pharmacological treatment is the best solution to control disease progression. Hence, the aim of this study was to evaluate the efficacy of the long-term liraglutide treatment on the progression of WS symptoms. For this purpose, 2-month-old WS rats were treated with liraglutide up to the age of 18 months and changes in diabetes markers, visual acuity, and hearing sensitivity were monitored over the course of the treatment period. We found that treatment with liraglutide delayed the onset of diabetes and protected against vision loss in a rat model of WS. Therefore, early diagnosis and prophylactic treatment with the liraglutide may also prove to be a promising treatment option for WS patients by increasing the quality of life.
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Affiliation(s)
- Toomas Jagomäe
- Laboratory Animal Centre, Institute of Biomedicine and Translational Medicine, University of Tartu, 14B Ravila Street, 50411 Tartu, Estonia; (K.S.); (R.R.); (K.G.K.); (A.T.)
- Department of Physiology, Institute of Biomedicine and Translational Medicine, University of Tartu, 19 Ravila Street, 50411 Tartu, Estonia;
- Correspondence: (T.J.); (M.P.)
| | - Kadri Seppa
- Laboratory Animal Centre, Institute of Biomedicine and Translational Medicine, University of Tartu, 14B Ravila Street, 50411 Tartu, Estonia; (K.S.); (R.R.); (K.G.K.); (A.T.)
| | - Riin Reimets
- Laboratory Animal Centre, Institute of Biomedicine and Translational Medicine, University of Tartu, 14B Ravila Street, 50411 Tartu, Estonia; (K.S.); (R.R.); (K.G.K.); (A.T.)
| | - Marko Pastak
- Eye Clinic of Tartu University Hospital, L. Puusepa 8 Street, 50406 Tartu, Estonia;
| | - Mihkel Plaas
- Ear Clinic of Tartu University Hospital, L. Puusepa 1a Street, 50406 Tartu, Estonia;
| | - Miriam A. Hickey
- Department of Pharmacology, Institute of Biomedicine and Translational Medicine, University of Tartu, 19 Ravila Street, 50411 Tartu, Estonia; (M.A.H.); (A.K.)
| | - Kaia Grete Kukker
- Laboratory Animal Centre, Institute of Biomedicine and Translational Medicine, University of Tartu, 14B Ravila Street, 50411 Tartu, Estonia; (K.S.); (R.R.); (K.G.K.); (A.T.)
| | - Lieve Moons
- Research Group Neural Circuit Development and Regeneration, Department of Biology, Belgium & Leuven Brain Institute, University of Leuven, Naamsestraat 61, Box 2464, 3000 Leuven, Belgium; (L.M.); (L.D.G.)
| | - Lies De Groef
- Research Group Neural Circuit Development and Regeneration, Department of Biology, Belgium & Leuven Brain Institute, University of Leuven, Naamsestraat 61, Box 2464, 3000 Leuven, Belgium; (L.M.); (L.D.G.)
| | - Eero Vasar
- Department of Physiology, Institute of Biomedicine and Translational Medicine, University of Tartu, 19 Ravila Street, 50411 Tartu, Estonia;
| | - Allen Kaasik
- Department of Pharmacology, Institute of Biomedicine and Translational Medicine, University of Tartu, 19 Ravila Street, 50411 Tartu, Estonia; (M.A.H.); (A.K.)
| | - Anton Terasmaa
- Laboratory Animal Centre, Institute of Biomedicine and Translational Medicine, University of Tartu, 14B Ravila Street, 50411 Tartu, Estonia; (K.S.); (R.R.); (K.G.K.); (A.T.)
| | - Mario Plaas
- Laboratory Animal Centre, Institute of Biomedicine and Translational Medicine, University of Tartu, 14B Ravila Street, 50411 Tartu, Estonia; (K.S.); (R.R.); (K.G.K.); (A.T.)
- Department of Physiology, Institute of Biomedicine and Translational Medicine, University of Tartu, 19 Ravila Street, 50411 Tartu, Estonia;
- Correspondence: (T.J.); (M.P.)
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22
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Urinary Tract Involvement in Wolfram Syndrome: A Narrative Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182211994. [PMID: 34831749 PMCID: PMC8624443 DOI: 10.3390/ijerph182211994] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 11/05/2021] [Accepted: 11/09/2021] [Indexed: 12/18/2022]
Abstract
Wolfram Syndrome (WS) is a rare neurodegenerative disease with autosomal recessive inheritance and characterized by juvenile onset, non-autoimmune diabetes mellitus and later followed by optic atrophy leading to blindness, diabetes insipidus, hearing loss, and other neurological and endocrine dysfunctions. A wide spectrum of neurodegenerative abnormalities affecting the central nervous system has been described. Among these complications, neurogenic bladder and urodynamic abnormalities also deserve attention. Urinary tract dysfunctions (UTD) up to end stage renal disease are a life-threatening complication of WS patients. Notably, end stage renal disease is reported as one of the most common causes of death among WS patients. UTD have been also reported in affected adolescents. Involvement of the urinary tract occurs in about 90% of affected patients, at a median age of 20 years and with peaks at 13, 21 and 33 years. The aim of our narrative review was to provide an overview of the most important papers regarding urological impairment in Wolfram Syndrome. A comprehensive search on PubMed including Wolfram Syndrome and one or more of the following terms: chronic renal failure, bladder dysfunction, urological aspects, and urinary tract dysfunction, was done. The exclusion criteria were studies not written in English and not including urinary tract dysfunction deep evaluation and description. Studies mentioning general urologic abnormalities without deep description and/or follow-up were not considered. Due to the rarity of the condition, we considered not only papers including pediatric patients, but also papers with pediatric and adult case reports
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Pourtoy-Brasselet S, Sciauvaud A, Boza-Moran MG, Cailleret M, Jarrige M, Polvèche H, Polentes J, Chevet E, Martinat C, Peschanski M, Aubry L. Human iPSC-derived neurons reveal early developmental alteration of neurite outgrowth in the late-occurring neurodegenerative Wolfram syndrome. Am J Hum Genet 2021; 108:2171-2185. [PMID: 34699745 DOI: 10.1016/j.ajhg.2021.10.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Accepted: 09/30/2021] [Indexed: 11/18/2022] Open
Abstract
Recent studies indicate that neurodegenerative processes that appear during childhood and adolescence in individuals with Wolfram syndrome (WS) occur in addition to early brain development alteration, which is clinically silent. Underlying pathological mechanisms are still unknown. We have used induced pluripotent stem cell-derived neural cells from individuals affected by WS in order to reveal their phenotypic and molecular correlates. We have observed that a subpopulation of Wolfram neurons displayed aberrant neurite outgrowth associated with altered expression of axon guidance genes. Selective inhibition of the ATF6α arm of the unfolded protein response prevented the altered phenotype, although acute endoplasmic reticulum stress response-which is activated in late Wolfram degenerative processes-was not detected. Among the drugs currently tried in individuals with WS, valproic acid was the one that prevented the pathological phenotypes. These results suggest that early defects in axon guidance may contribute to the loss of neurons in individuals with WS.
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Affiliation(s)
| | - Axel Sciauvaud
- INSERM UMR 861, I-STEM, AFM, Corbeil-Essonnes 91100, France; Université Paris-Saclay, INSERM, Univ Evry, Institut des Cellules Souches pour le Traitement et l'Étude des Maladies Monogéniques, Corbeil-Essonnes 91100, France
| | - Maria-Gabriela Boza-Moran
- INSERM UMR 861, I-STEM, AFM, Corbeil-Essonnes 91100, France; Université Paris-Saclay, INSERM, Univ Evry, Institut des Cellules Souches pour le Traitement et l'Étude des Maladies Monogéniques, Corbeil-Essonnes 91100, France
| | - Michel Cailleret
- INSERM UMR 861, I-STEM, AFM, Corbeil-Essonnes 91100, France; Université Paris-Saclay, INSERM, Univ Evry, Institut des Cellules Souches pour le Traitement et l'Étude des Maladies Monogéniques, Corbeil-Essonnes 91100, France
| | - Margot Jarrige
- INSERM UMR 861, I-STEM, AFM, Corbeil-Essonnes 91100, France; Université Paris-Saclay, INSERM, Univ Evry, Institut des Cellules Souches pour le Traitement et l'Étude des Maladies Monogéniques, Corbeil-Essonnes 91100, France; CECS/AFM, I-STEM, Corbeil-Essonnes 91100, France
| | | | | | - Eric Chevet
- INSERM U1242, Université Rennes 1, Rennes 35000, France; Centre de Lutte Contre le Cancer Eugène Marquis, Rennes 35000, France
| | - Cécile Martinat
- INSERM UMR 861, I-STEM, AFM, Corbeil-Essonnes 91100, France; Université Paris-Saclay, INSERM, Univ Evry, Institut des Cellules Souches pour le Traitement et l'Étude des Maladies Monogéniques, Corbeil-Essonnes 91100, France
| | - Marc Peschanski
- INSERM UMR 861, I-STEM, AFM, Corbeil-Essonnes 91100, France; Université Paris-Saclay, INSERM, Univ Evry, Institut des Cellules Souches pour le Traitement et l'Étude des Maladies Monogéniques, Corbeil-Essonnes 91100, France; CECS/AFM, I-STEM, Corbeil-Essonnes 91100, France
| | - Laetitia Aubry
- INSERM UMR 861, I-STEM, AFM, Corbeil-Essonnes 91100, France; Université Paris-Saclay, INSERM, Univ Evry, Institut des Cellules Souches pour le Traitement et l'Étude des Maladies Monogéniques, Corbeil-Essonnes 91100, France.
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24
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Abstract
Diabetes insipidus (DI) is a disorder characterized by a high hypotonic urinary output of more than 50ml per kg body weight per 24 hours, with associated polydipsia of more than 3 liters a day [1,2]. Central DI results from inadequate secretion and usually deficient synthesis of Arginine vasopressin (AVP) in the hypothalamus or pituitary gland. Besides central DI further underlying etiologies of DI can be due to other primary forms (renal origin) or secondary forms of polyuria (resulting from primary polydipsia). All these forms belong to the Polyuria Polydipsia Syndrom (PPS). In most cases central and nephrogenic DI are acquired, but there are also congenital forms caused by genetic mutations of the AVP gene (central DI) [3] or by mutations in the gene for the AVP V2R or the AQP2 water channel (nephrogenic DI) [4]. Primary polydipsia (PP) as secondary form of polyuria includes an excessive intake of large amounts of fluid leading to polyuria in the presence of intact AVP secretion and appropriate antidiuretic renal response. Differentiation between the three mentioned entities is difficult [5], especially in patients with Primary polydipsia or partial, mild forms of DI [1,6], but different tests for differential diagnosis, most recently based on measurement of copeptin, and a thorough medical history mostly lead to the correct diagnosis. This is important since treatment strategies vary and application of the wrong treatment can be dangerous [7]. Treatment of central DI consists of fluid management and drug therapy with the synthetic AVP analogue Desmopressin (DDAVP), that is used as nasal or oral preparation in most cases. Main side effect can be dilutional hyponatremia [8]. In this review we will focus on central diabetes insipidus and describe the prevalence, the clinical manifestations, the etiology as well as the differential diagnosis and management of central diabetes insipidus in the out- and inpatient setting.
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25
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Cairns G, Burté F, Price R, O'Connor E, Toms M, Mishra R, Moosajee M, Pyle A, Sayer JA, Yu-Wai-Man P. A mutant wfs1 zebrafish model of Wolfram syndrome manifesting visual dysfunction and developmental delay. Sci Rep 2021; 11:20491. [PMID: 34650143 PMCID: PMC8516871 DOI: 10.1038/s41598-021-99781-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Accepted: 09/28/2021] [Indexed: 11/09/2022] Open
Abstract
Wolfram syndrome (WS) is an ultra-rare progressive neurodegenerative disorder defined by early-onset diabetes mellitus and optic atrophy. The majority of patients harbour recessive mutations in the WFS1 gene, which encodes for Wolframin, a transmembrane endoplasmic reticulum protein. There is limited availability of human ocular and brain tissues, and there are few animal models for WS that replicate the neuropathology and clinical phenotype seen in this disorder. We, therefore, characterised two wfs1 zebrafish knockout models harbouring nonsense wfs1a and wfs1b mutations. Both homozygous mutant wfs1a-/- and wfs1b-/- embryos showed significant morphological abnormalities in early development. The wfs1b-/- zebrafish exhibited a more pronounced neurodegenerative phenotype with delayed neuronal development, progressive loss of retinal ganglion cells and clear evidence of visual dysfunction on functional testing. At 12 months of age, wfs1b-/- zebrafish had a significantly lower RGC density per 100 μm2 (mean ± standard deviation; 19 ± 1.7) compared with wild-type (WT) zebrafish (25 ± 2.3, p < 0.001). The optokinetic response for wfs1b-/- zebrafish was significantly reduced at 8 and 16 rpm testing speeds at both 4 and 12 months of age compared with WT zebrafish. An upregulation of the unfolded protein response was observed in mutant zebrafish indicative of increased endoplasmic reticulum stress. Mutant wfs1b-/- zebrafish exhibit some of the key features seen in patients with WS, providing a versatile and cost-effective in vivo model that can be used to further investigate the underlying pathophysiology of WS and potential therapeutic interventions.
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Affiliation(s)
- G Cairns
- International Centre for Life, Institute of Genetic Medicine, Newcastle University, Newcastle upon Tyne, UK
- Interdisciplinary School of Health Science, Faculty of Health Sciences, University of Ottawa, Ottawa, Canada
| | - F Burté
- International Centre for Life, Institute of Genetic Medicine, Newcastle University, Newcastle upon Tyne, UK
| | - R Price
- International Centre for Life, Institute of Genetic Medicine, Newcastle University, Newcastle upon Tyne, UK
| | - E O'Connor
- Children's Hospital of Eastern Ontario Research Institute, University of Ottawa, Ottawa, Canada
| | - M Toms
- UCL Institute of Ophthalmology, University College London, London, UK
| | - R Mishra
- John van Geest Centre for Brain Repair and MRC Mitochondrial Biology Unit, Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK
| | - M Moosajee
- UCL Institute of Ophthalmology, University College London, London, UK
- Moorfields Eye Hospital NHS Foundation Trust, London, UK
- Great Ormond Street Hospital for Children NHS Foundation, Trust, London, UK
| | - A Pyle
- The Wellcome Centre for Mitochondrial Research, Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, UK
| | - J A Sayer
- International Centre for Life, Institute of Genetic Medicine, Newcastle University, Newcastle upon Tyne, UK
- Department of Renal Medicine, Freeman Hospital, The Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
- National Institute for Health Research Newcastle Biomedical Research Centre, Newcastle upon Tyne, UK
| | - P Yu-Wai-Man
- UCL Institute of Ophthalmology, University College London, London, UK.
- John van Geest Centre for Brain Repair and MRC Mitochondrial Biology Unit, Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK.
- Moorfields Eye Hospital NHS Foundation Trust, London, UK.
- Cambridge Eye Unit, Addenbrooke's Hospital, Cambridge University Hospitals, Cambridge, UK.
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Sabet SJ, Carey AR. Wolfram syndrome with vitelliform retinal deposits. Ophthalmic Genet 2021; 43:116-119. [PMID: 34425740 DOI: 10.1080/13816810.2021.1970195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
BACKGROUND : Wolfram Syndrome is a rare genetic disorder usually inherited in an autosomal recessive manner. The acronym DIDMOAD characterizes the classic constellation of findings: diabetes insipidus, diabetes mellitus, optic atrophy, and deafness. However, other ocular and systemic manifestations may also be present. The aim of this report is to present a patient with Wolfram Syndrome presenting with vitelliform changes in the retina - an association that has not been previously reported. MATERIALS AND METHODS : Case Report. RESULTS : Ophthalmologic examination and imaging studies showed bilateral optic neuropathy and scattered bilateral subretinal vitelliform deposits. Genetic testing was positive for Wolfram Syndrome. CONCLUSION : This patient showed optic atrophy with associated vitelliform retinal changes. The previously unreported association of these findings present possible associations in the molecular pathophysiology underlying both Wolfram syndrome and the spectrum of retinal disorders associated with vitelliform changes.
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Affiliation(s)
- Sina J Sabet
- Neuro-Ophthalmology Division, Wilmer Eye Institute, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | - Andrew R Carey
- Neuro-Ophthalmology Division, Wilmer Eye Institute, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
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27
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Yong J, Johnson JD, Arvan P, Han J, Kaufman RJ. Therapeutic opportunities for pancreatic β-cell ER stress in diabetes mellitus. Nat Rev Endocrinol 2021; 17:455-467. [PMID: 34163039 PMCID: PMC8765009 DOI: 10.1038/s41574-021-00510-4] [Citation(s) in RCA: 107] [Impact Index Per Article: 35.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/06/2021] [Indexed: 02/06/2023]
Abstract
Diabetes mellitus is characterized by the failure of insulin-secreting pancreatic β-cells (or β-cell death) due to either autoimmunity (type 1 diabetes mellitus) or failure to compensate for insulin resistance (type 2 diabetes mellitus; T2DM). In addition, mutations of critical genes cause monogenic diabetes. The endoplasmic reticulum (ER) is the primary site for proinsulin folding; therefore, ER proteostasis is crucial for both β-cell function and survival under physiological and pathophysiological challenges. Importantly, the ER is also the major intracellular Ca2+ storage organelle, generating Ca2+ signals that contribute to insulin secretion. ER stress is associated with the pathogenesis of diabetes mellitus. In this Review, we summarize the mutations in monogenic diabetes that play causal roles in promoting ER stress in β-cells. Furthermore, we discuss the possible mechanisms responsible for ER proteostasis imbalance with a focus on T2DM, in which both genetics and environment are considered important in promoting ER stress in β-cells. We also suggest that controlled insulin secretion from β-cells might reduce the progression of a key aspect of the metabolic syndrome, namely nonalcoholic fatty liver disease. Finally, we evaluate potential therapeutic approaches to treat T2DM, including the optimization and protection of functional β-cell mass in individuals with T2DM.
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Affiliation(s)
- Jing Yong
- Degenerative Diseases Program, Sanford-Burnham-Prebys Medical Discovery Institute, La Jolla, CA, USA
| | - James D Johnson
- Department of Cellular and Physiological Sciences & Life Sciences Institute, University of British Columbia, Vancouver, British Columbia, Canada
| | - Peter Arvan
- Division of Metabolism Endocrinology & Diabetes, University of Michigan Medical Center, Ann Arbor, MI, USA
| | - Jaeseok Han
- Soonchunhyang Institute of Medi-bio Science (SIMS), Soonchunhyang University, Cheonan-si, Choongchungnam-do, Republic of Korea.
| | - Randal J Kaufman
- Degenerative Diseases Program, Sanford-Burnham-Prebys Medical Discovery Institute, La Jolla, CA, USA.
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28
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Wilf-Yarkoni A, Shor O, Fellner A, Hellmann MA, Pras E, Yonath H, Shkedi-Rafid S, Basel-Salmon L, Bazak L, Eliahou R, Greenbaum L, Stiebel-Kalish H, Benninger F, Goldberg Y. Mild Phenotype of Wolfram Syndrome Associated With a Common Pathogenic Variant Is Predicted by a Structural Model of Wolframin. NEUROLOGY-GENETICS 2021; 7:e578. [PMID: 33763535 PMCID: PMC7983365 DOI: 10.1212/nxg.0000000000000578] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Accepted: 01/27/2021] [Indexed: 11/15/2022]
Abstract
Objective To describe the WFS1 c.1672C>T; p.R558C missense variant, found in 1.34% of Ashkenazi Jews, that has a relatively mild phenotype and to use computational normal mode analysis (NMA) to explain the genotype-phenotype relationship. Methods The clinical, laboratory, and genetic features of 8 homozygotes were collected. A model of the wolframin protein was constructed, and NMA was used to simulate the effect of the variant on protein thermodynamics. Results Mean age at Wolfram syndrome (WS) diagnosis among homozygotes was 30 years; diabetes (7/8) was diagnosed at mean age 19 years (15–21 years), and bilateral optic atrophy (with MRI evidence of optic/chiasm atrophy) (6/8) at mean age 29 years (15–48 years). The oldest patient (62 years) also had gait difficulties, memory problems, parietal and cerebellar atrophy, and white matter hyperintense lesions. All retained functional vision with independent ambulation and self-care; none had diabetes insipidus or hearing loss. The p.R558C variant caused less impairment of protein entropy than WFS1 variants associated with a more severe phenotype. Conclusions The p.R558C variant causes a milder, late-onset phenotype of WS. We report a structural model of wolframin protein based on empirical functional studies and use NMA modeling to show a genotype-phenotype correlation across all homozygotes. Clinicians should be alert to this condition in patients with juvenile diabetes and patients of any age with a combination of diabetes and optic atrophy. Computational NMA has potential benefit for prediction of the genotype-phenotype relationship.
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Affiliation(s)
- Adi Wilf-Yarkoni
- Neuro-Immunology Unit (A.W-.Y., M.A.H.), Department of Neurology (O.S., A.F., F.B.), Department of Radiology (R.E.), and Neuro-Ophthalmology Unit, Department of Ophthalmology (H.S.K.), Rabin Medical Center-Beilinson Hospital, Petach Tikva, Israel; Sackler Faculty of Medicine (O.S., E.P., H.Y., L.B.-S., L.G., H.S.-K., F.B., Y.G.), Tel Aviv University, Tel Aviv, Israel; The Raphael Recanati Genetic Institute (A.F., Y.G., L.B.-S., L.B.), Rabin Medical Center-Beilinson Hospital, Petach Tikva, Israel; The Danek Gertner Institute of Human Genetics (E.P., H.Y., L.G.), Sheba Medical Center, Tel Hashomer, Israel; The Joseph Sagol Neuroscience Center (E.P., L.G.), Sheba Medical Center, Tel Hashomer, Israel; Department of Internal Medicine A (H.Y.), Sheba Medical Center, Tel Hashomer, Israel; Department of Genetics and Faculty of Medicine (S.S.-R.), Hadassah-Hebrew University Hospital, Jerusalem, Israel; Felsenstein Medical Research Center (O.S., L.B.-S., F.B.), Petach Tikva, Israel
| | - Oded Shor
- Neuro-Immunology Unit (A.W-.Y., M.A.H.), Department of Neurology (O.S., A.F., F.B.), Department of Radiology (R.E.), and Neuro-Ophthalmology Unit, Department of Ophthalmology (H.S.K.), Rabin Medical Center-Beilinson Hospital, Petach Tikva, Israel; Sackler Faculty of Medicine (O.S., E.P., H.Y., L.B.-S., L.G., H.S.-K., F.B., Y.G.), Tel Aviv University, Tel Aviv, Israel; The Raphael Recanati Genetic Institute (A.F., Y.G., L.B.-S., L.B.), Rabin Medical Center-Beilinson Hospital, Petach Tikva, Israel; The Danek Gertner Institute of Human Genetics (E.P., H.Y., L.G.), Sheba Medical Center, Tel Hashomer, Israel; The Joseph Sagol Neuroscience Center (E.P., L.G.), Sheba Medical Center, Tel Hashomer, Israel; Department of Internal Medicine A (H.Y.), Sheba Medical Center, Tel Hashomer, Israel; Department of Genetics and Faculty of Medicine (S.S.-R.), Hadassah-Hebrew University Hospital, Jerusalem, Israel; Felsenstein Medical Research Center (O.S., L.B.-S., F.B.), Petach Tikva, Israel
| | - Avi Fellner
- Neuro-Immunology Unit (A.W-.Y., M.A.H.), Department of Neurology (O.S., A.F., F.B.), Department of Radiology (R.E.), and Neuro-Ophthalmology Unit, Department of Ophthalmology (H.S.K.), Rabin Medical Center-Beilinson Hospital, Petach Tikva, Israel; Sackler Faculty of Medicine (O.S., E.P., H.Y., L.B.-S., L.G., H.S.-K., F.B., Y.G.), Tel Aviv University, Tel Aviv, Israel; The Raphael Recanati Genetic Institute (A.F., Y.G., L.B.-S., L.B.), Rabin Medical Center-Beilinson Hospital, Petach Tikva, Israel; The Danek Gertner Institute of Human Genetics (E.P., H.Y., L.G.), Sheba Medical Center, Tel Hashomer, Israel; The Joseph Sagol Neuroscience Center (E.P., L.G.), Sheba Medical Center, Tel Hashomer, Israel; Department of Internal Medicine A (H.Y.), Sheba Medical Center, Tel Hashomer, Israel; Department of Genetics and Faculty of Medicine (S.S.-R.), Hadassah-Hebrew University Hospital, Jerusalem, Israel; Felsenstein Medical Research Center (O.S., L.B.-S., F.B.), Petach Tikva, Israel
| | - Mark Andrew Hellmann
- Neuro-Immunology Unit (A.W-.Y., M.A.H.), Department of Neurology (O.S., A.F., F.B.), Department of Radiology (R.E.), and Neuro-Ophthalmology Unit, Department of Ophthalmology (H.S.K.), Rabin Medical Center-Beilinson Hospital, Petach Tikva, Israel; Sackler Faculty of Medicine (O.S., E.P., H.Y., L.B.-S., L.G., H.S.-K., F.B., Y.G.), Tel Aviv University, Tel Aviv, Israel; The Raphael Recanati Genetic Institute (A.F., Y.G., L.B.-S., L.B.), Rabin Medical Center-Beilinson Hospital, Petach Tikva, Israel; The Danek Gertner Institute of Human Genetics (E.P., H.Y., L.G.), Sheba Medical Center, Tel Hashomer, Israel; The Joseph Sagol Neuroscience Center (E.P., L.G.), Sheba Medical Center, Tel Hashomer, Israel; Department of Internal Medicine A (H.Y.), Sheba Medical Center, Tel Hashomer, Israel; Department of Genetics and Faculty of Medicine (S.S.-R.), Hadassah-Hebrew University Hospital, Jerusalem, Israel; Felsenstein Medical Research Center (O.S., L.B.-S., F.B.), Petach Tikva, Israel
| | - Elon Pras
- Neuro-Immunology Unit (A.W-.Y., M.A.H.), Department of Neurology (O.S., A.F., F.B.), Department of Radiology (R.E.), and Neuro-Ophthalmology Unit, Department of Ophthalmology (H.S.K.), Rabin Medical Center-Beilinson Hospital, Petach Tikva, Israel; Sackler Faculty of Medicine (O.S., E.P., H.Y., L.B.-S., L.G., H.S.-K., F.B., Y.G.), Tel Aviv University, Tel Aviv, Israel; The Raphael Recanati Genetic Institute (A.F., Y.G., L.B.-S., L.B.), Rabin Medical Center-Beilinson Hospital, Petach Tikva, Israel; The Danek Gertner Institute of Human Genetics (E.P., H.Y., L.G.), Sheba Medical Center, Tel Hashomer, Israel; The Joseph Sagol Neuroscience Center (E.P., L.G.), Sheba Medical Center, Tel Hashomer, Israel; Department of Internal Medicine A (H.Y.), Sheba Medical Center, Tel Hashomer, Israel; Department of Genetics and Faculty of Medicine (S.S.-R.), Hadassah-Hebrew University Hospital, Jerusalem, Israel; Felsenstein Medical Research Center (O.S., L.B.-S., F.B.), Petach Tikva, Israel
| | - Hagit Yonath
- Neuro-Immunology Unit (A.W-.Y., M.A.H.), Department of Neurology (O.S., A.F., F.B.), Department of Radiology (R.E.), and Neuro-Ophthalmology Unit, Department of Ophthalmology (H.S.K.), Rabin Medical Center-Beilinson Hospital, Petach Tikva, Israel; Sackler Faculty of Medicine (O.S., E.P., H.Y., L.B.-S., L.G., H.S.-K., F.B., Y.G.), Tel Aviv University, Tel Aviv, Israel; The Raphael Recanati Genetic Institute (A.F., Y.G., L.B.-S., L.B.), Rabin Medical Center-Beilinson Hospital, Petach Tikva, Israel; The Danek Gertner Institute of Human Genetics (E.P., H.Y., L.G.), Sheba Medical Center, Tel Hashomer, Israel; The Joseph Sagol Neuroscience Center (E.P., L.G.), Sheba Medical Center, Tel Hashomer, Israel; Department of Internal Medicine A (H.Y.), Sheba Medical Center, Tel Hashomer, Israel; Department of Genetics and Faculty of Medicine (S.S.-R.), Hadassah-Hebrew University Hospital, Jerusalem, Israel; Felsenstein Medical Research Center (O.S., L.B.-S., F.B.), Petach Tikva, Israel
| | - Shiri Shkedi-Rafid
- Neuro-Immunology Unit (A.W-.Y., M.A.H.), Department of Neurology (O.S., A.F., F.B.), Department of Radiology (R.E.), and Neuro-Ophthalmology Unit, Department of Ophthalmology (H.S.K.), Rabin Medical Center-Beilinson Hospital, Petach Tikva, Israel; Sackler Faculty of Medicine (O.S., E.P., H.Y., L.B.-S., L.G., H.S.-K., F.B., Y.G.), Tel Aviv University, Tel Aviv, Israel; The Raphael Recanati Genetic Institute (A.F., Y.G., L.B.-S., L.B.), Rabin Medical Center-Beilinson Hospital, Petach Tikva, Israel; The Danek Gertner Institute of Human Genetics (E.P., H.Y., L.G.), Sheba Medical Center, Tel Hashomer, Israel; The Joseph Sagol Neuroscience Center (E.P., L.G.), Sheba Medical Center, Tel Hashomer, Israel; Department of Internal Medicine A (H.Y.), Sheba Medical Center, Tel Hashomer, Israel; Department of Genetics and Faculty of Medicine (S.S.-R.), Hadassah-Hebrew University Hospital, Jerusalem, Israel; Felsenstein Medical Research Center (O.S., L.B.-S., F.B.), Petach Tikva, Israel
| | - Lina Basel-Salmon
- Neuro-Immunology Unit (A.W-.Y., M.A.H.), Department of Neurology (O.S., A.F., F.B.), Department of Radiology (R.E.), and Neuro-Ophthalmology Unit, Department of Ophthalmology (H.S.K.), Rabin Medical Center-Beilinson Hospital, Petach Tikva, Israel; Sackler Faculty of Medicine (O.S., E.P., H.Y., L.B.-S., L.G., H.S.-K., F.B., Y.G.), Tel Aviv University, Tel Aviv, Israel; The Raphael Recanati Genetic Institute (A.F., Y.G., L.B.-S., L.B.), Rabin Medical Center-Beilinson Hospital, Petach Tikva, Israel; The Danek Gertner Institute of Human Genetics (E.P., H.Y., L.G.), Sheba Medical Center, Tel Hashomer, Israel; The Joseph Sagol Neuroscience Center (E.P., L.G.), Sheba Medical Center, Tel Hashomer, Israel; Department of Internal Medicine A (H.Y.), Sheba Medical Center, Tel Hashomer, Israel; Department of Genetics and Faculty of Medicine (S.S.-R.), Hadassah-Hebrew University Hospital, Jerusalem, Israel; Felsenstein Medical Research Center (O.S., L.B.-S., F.B.), Petach Tikva, Israel
| | - Lili Bazak
- Neuro-Immunology Unit (A.W-.Y., M.A.H.), Department of Neurology (O.S., A.F., F.B.), Department of Radiology (R.E.), and Neuro-Ophthalmology Unit, Department of Ophthalmology (H.S.K.), Rabin Medical Center-Beilinson Hospital, Petach Tikva, Israel; Sackler Faculty of Medicine (O.S., E.P., H.Y., L.B.-S., L.G., H.S.-K., F.B., Y.G.), Tel Aviv University, Tel Aviv, Israel; The Raphael Recanati Genetic Institute (A.F., Y.G., L.B.-S., L.B.), Rabin Medical Center-Beilinson Hospital, Petach Tikva, Israel; The Danek Gertner Institute of Human Genetics (E.P., H.Y., L.G.), Sheba Medical Center, Tel Hashomer, Israel; The Joseph Sagol Neuroscience Center (E.P., L.G.), Sheba Medical Center, Tel Hashomer, Israel; Department of Internal Medicine A (H.Y.), Sheba Medical Center, Tel Hashomer, Israel; Department of Genetics and Faculty of Medicine (S.S.-R.), Hadassah-Hebrew University Hospital, Jerusalem, Israel; Felsenstein Medical Research Center (O.S., L.B.-S., F.B.), Petach Tikva, Israel
| | - Ruth Eliahou
- Neuro-Immunology Unit (A.W-.Y., M.A.H.), Department of Neurology (O.S., A.F., F.B.), Department of Radiology (R.E.), and Neuro-Ophthalmology Unit, Department of Ophthalmology (H.S.K.), Rabin Medical Center-Beilinson Hospital, Petach Tikva, Israel; Sackler Faculty of Medicine (O.S., E.P., H.Y., L.B.-S., L.G., H.S.-K., F.B., Y.G.), Tel Aviv University, Tel Aviv, Israel; The Raphael Recanati Genetic Institute (A.F., Y.G., L.B.-S., L.B.), Rabin Medical Center-Beilinson Hospital, Petach Tikva, Israel; The Danek Gertner Institute of Human Genetics (E.P., H.Y., L.G.), Sheba Medical Center, Tel Hashomer, Israel; The Joseph Sagol Neuroscience Center (E.P., L.G.), Sheba Medical Center, Tel Hashomer, Israel; Department of Internal Medicine A (H.Y.), Sheba Medical Center, Tel Hashomer, Israel; Department of Genetics and Faculty of Medicine (S.S.-R.), Hadassah-Hebrew University Hospital, Jerusalem, Israel; Felsenstein Medical Research Center (O.S., L.B.-S., F.B.), Petach Tikva, Israel
| | - Lior Greenbaum
- Neuro-Immunology Unit (A.W-.Y., M.A.H.), Department of Neurology (O.S., A.F., F.B.), Department of Radiology (R.E.), and Neuro-Ophthalmology Unit, Department of Ophthalmology (H.S.K.), Rabin Medical Center-Beilinson Hospital, Petach Tikva, Israel; Sackler Faculty of Medicine (O.S., E.P., H.Y., L.B.-S., L.G., H.S.-K., F.B., Y.G.), Tel Aviv University, Tel Aviv, Israel; The Raphael Recanati Genetic Institute (A.F., Y.G., L.B.-S., L.B.), Rabin Medical Center-Beilinson Hospital, Petach Tikva, Israel; The Danek Gertner Institute of Human Genetics (E.P., H.Y., L.G.), Sheba Medical Center, Tel Hashomer, Israel; The Joseph Sagol Neuroscience Center (E.P., L.G.), Sheba Medical Center, Tel Hashomer, Israel; Department of Internal Medicine A (H.Y.), Sheba Medical Center, Tel Hashomer, Israel; Department of Genetics and Faculty of Medicine (S.S.-R.), Hadassah-Hebrew University Hospital, Jerusalem, Israel; Felsenstein Medical Research Center (O.S., L.B.-S., F.B.), Petach Tikva, Israel
| | - Hadas Stiebel-Kalish
- Neuro-Immunology Unit (A.W-.Y., M.A.H.), Department of Neurology (O.S., A.F., F.B.), Department of Radiology (R.E.), and Neuro-Ophthalmology Unit, Department of Ophthalmology (H.S.K.), Rabin Medical Center-Beilinson Hospital, Petach Tikva, Israel; Sackler Faculty of Medicine (O.S., E.P., H.Y., L.B.-S., L.G., H.S.-K., F.B., Y.G.), Tel Aviv University, Tel Aviv, Israel; The Raphael Recanati Genetic Institute (A.F., Y.G., L.B.-S., L.B.), Rabin Medical Center-Beilinson Hospital, Petach Tikva, Israel; The Danek Gertner Institute of Human Genetics (E.P., H.Y., L.G.), Sheba Medical Center, Tel Hashomer, Israel; The Joseph Sagol Neuroscience Center (E.P., L.G.), Sheba Medical Center, Tel Hashomer, Israel; Department of Internal Medicine A (H.Y.), Sheba Medical Center, Tel Hashomer, Israel; Department of Genetics and Faculty of Medicine (S.S.-R.), Hadassah-Hebrew University Hospital, Jerusalem, Israel; Felsenstein Medical Research Center (O.S., L.B.-S., F.B.), Petach Tikva, Israel
| | - Felix Benninger
- Neuro-Immunology Unit (A.W-.Y., M.A.H.), Department of Neurology (O.S., A.F., F.B.), Department of Radiology (R.E.), and Neuro-Ophthalmology Unit, Department of Ophthalmology (H.S.K.), Rabin Medical Center-Beilinson Hospital, Petach Tikva, Israel; Sackler Faculty of Medicine (O.S., E.P., H.Y., L.B.-S., L.G., H.S.-K., F.B., Y.G.), Tel Aviv University, Tel Aviv, Israel; The Raphael Recanati Genetic Institute (A.F., Y.G., L.B.-S., L.B.), Rabin Medical Center-Beilinson Hospital, Petach Tikva, Israel; The Danek Gertner Institute of Human Genetics (E.P., H.Y., L.G.), Sheba Medical Center, Tel Hashomer, Israel; The Joseph Sagol Neuroscience Center (E.P., L.G.), Sheba Medical Center, Tel Hashomer, Israel; Department of Internal Medicine A (H.Y.), Sheba Medical Center, Tel Hashomer, Israel; Department of Genetics and Faculty of Medicine (S.S.-R.), Hadassah-Hebrew University Hospital, Jerusalem, Israel; Felsenstein Medical Research Center (O.S., L.B.-S., F.B.), Petach Tikva, Israel
| | - Yael Goldberg
- Neuro-Immunology Unit (A.W-.Y., M.A.H.), Department of Neurology (O.S., A.F., F.B.), Department of Radiology (R.E.), and Neuro-Ophthalmology Unit, Department of Ophthalmology (H.S.K.), Rabin Medical Center-Beilinson Hospital, Petach Tikva, Israel; Sackler Faculty of Medicine (O.S., E.P., H.Y., L.B.-S., L.G., H.S.-K., F.B., Y.G.), Tel Aviv University, Tel Aviv, Israel; The Raphael Recanati Genetic Institute (A.F., Y.G., L.B.-S., L.B.), Rabin Medical Center-Beilinson Hospital, Petach Tikva, Israel; The Danek Gertner Institute of Human Genetics (E.P., H.Y., L.G.), Sheba Medical Center, Tel Hashomer, Israel; The Joseph Sagol Neuroscience Center (E.P., L.G.), Sheba Medical Center, Tel Hashomer, Israel; Department of Internal Medicine A (H.Y.), Sheba Medical Center, Tel Hashomer, Israel; Department of Genetics and Faculty of Medicine (S.S.-R.), Hadassah-Hebrew University Hospital, Jerusalem, Israel; Felsenstein Medical Research Center (O.S., L.B.-S., F.B.), Petach Tikva, Israel
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Reschke F, Rohayem J, Maffei P, Dassie F, Schwandt A, de Beaufort C, Toni S, Szypowska A, Cardona-Hernandez R, Datz N, Klee K, Danne T. Collaboration for rare diabetes: understanding new treatment options for Wolfram syndrome. Endocrine 2021; 71:626-633. [PMID: 33527330 DOI: 10.1007/s12020-021-02622-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Accepted: 01/09/2021] [Indexed: 12/18/2022]
Abstract
BACKGROUND Wolfram Syndrome is a very rare genetic disease causing diabetes mellitus, blindness, deafness, diabetes insipidus, and progressive brainstem degeneration. Neurologic symptoms of affected patients include ataxia, sleep apnea, loss of bladder control, dysphagia, loss of taste, and accompanying psychiatric symptoms as a sign of progressive neurodegeneration. Its genetic cause is mainly biallelic mutations of the Wolframin endoplasmatic reticulum transmembrane glycoprotein gene Wfs1. These result in increased ER stress, which in turn induces apoptosis and leads to the depletion of the corresponding cells and a loss of their physiological functions. Though diabetes mellitus is mostly treated by insulin, there is still no proven cure for the disease in general. It leads to premature death in affected individuals-usually within the 4th decade of live. CURRENT RESEARCH AND TREATMENT TRIALS Clinical studies are currently being conducted at various locations worldwide to test a therapy for the disease using various approaches. POTENTAIL OF VIRTUAL NETOWRKING As rare diseases in general represent a major challenge for individual clinicians and researchers due to the rarity of diagnosis, the lack of evidence and of value of existing research, international cooperation, coordination and networking leading to an alignment of different stakeholders is necessary to support patients and increase knowledge about these diseases, like wolfram syndrome. CONCLUSION ENDO-ERN and EURRECA are two EU-funded networks that aim to promote knowledge sharing, education and research on rare endocrine diseases.
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Affiliation(s)
- Felix Reschke
- Diabetes Center, Children's Hospital AUF DER BULT, Hannover, Germany.
| | - Julia Rohayem
- Centre of Reproductive Medicine and Andrology, Department of Clinical and Surgical Andrology, University of Münster, Muenster, Germany
| | - Pietro Maffei
- Department of Medicine (DIMED), Padua University Hospital, Padua, Italy.
| | - Francesca Dassie
- Department of Medicine (DIMED), Padua University Hospital, Padua, Italy
| | - Anke Schwandt
- Institute of Epidemiology and Medical Biometry, ZIBMT, Ulm University, Ulm, Germany
- German Center for Diabetes Research (DZD), Munich-Neuherberg, Germany
| | - Carine de Beaufort
- Pediatric Clinic, DECCP/Center Hospitalier de Luxembourg, Luxembourg, Grand-Duché de Luxembourg
| | - Sonia Toni
- Ospedale Pediatrico Meyer Firenze, Florence, Italy
| | | | | | - Nicolin Datz
- Diabetes Center, Children's Hospital AUF DER BULT, Hannover, Germany
| | - Katharina Klee
- Diabetes Center, Children's Hospital AUF DER BULT, Hannover, Germany
| | - Thomas Danne
- Diabetes Center, Children's Hospital AUF DER BULT, Hannover, Germany
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30
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Gaines CH, Snyder AE, Ervin RB, Farrington J, Walsh K, Schoenrock SA, Tarantino LM. Behavioral characterization of a novel Cisd2 mutant mouse. Behav Brain Res 2021; 405:113187. [PMID: 33610659 DOI: 10.1016/j.bbr.2021.113187] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Revised: 02/11/2021] [Accepted: 02/12/2021] [Indexed: 12/11/2022]
Abstract
Wolfram syndrome (WFS) is a rare autosomal recessive disorder characterized by diabetes mellitus and insipidus, progressive optic atrophy and sensorineural deafness. An increased incidence of psychiatric disorders has also been reported in WFS patients. There are two subtypes of WFS. Type 1 (WFS1) is caused by mutations in the WFS1 gene and type 2 (WFS2) results from mutations in the CISD2 gene. Existing Wfs1 knockout mice exhibit many WFS1 cardinal symptoms including diabetic nephropathy, metabolic disruptions and optic atrophy. Far fewer studies have examined loss of Cisd2 function in mice. We identified B6.DDY-Cisd2m1Lmt, a mouse model with a spontaneous mutation in the Cisd2 gene. B6.DDY-Cisd2m1Lmt mice were initially identified based on the presence of audible sonic vocalizations as well as decreased body size and weight compared to unaffected wildtype littermates. Although Wfs1 knockout mice have been characterized for numerous behavioral phenotypes, similar studies have been lacking for Cisd2 mutant mice. We tested B6.DDY-Cisd2m1Lmt mice in a battery of behavioral assays that model phenotypes related to neurological and psychiatric disorders including anxiety, sensorimotor gating, stress response, social interaction and learning and memory. B6.DDY-Cisd2m1Lmt mice displayed hypoactivity across several behavioral tests, exhibited increased stress response and had deficits in spatial learning and memory and sensorimotor gating compared to wildtype littermates. Our data indicate that the B6.DDY-Cisd2m1Lmt mouse strain is a useful model to investigate potential mechanisms underlying the neurological and psychiatric symptoms observed in WFS.
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Affiliation(s)
- Christiann H Gaines
- Department of Genetics, University of North Carolina at Chapel Hill, NC, United States; Neuroscience Curriculum, University of North Carolina at Chapel Hill, NC, United States
| | - Angela E Snyder
- Department of Genetics, University of North Carolina at Chapel Hill, NC, United States
| | - Robin B Ervin
- Psychiatry Department, School of Medicine, University of North Carolina at Chapel Hill, NC, United States
| | - Joseph Farrington
- Department of Genetics, University of North Carolina at Chapel Hill, NC, United States
| | - Kenneth Walsh
- Department of Genetics, University of North Carolina at Chapel Hill, NC, United States
| | - Sarah A Schoenrock
- Department of Genetics, University of North Carolina at Chapel Hill, NC, United States; Neuroscience Curriculum, University of North Carolina at Chapel Hill, NC, United States
| | - Lisa M Tarantino
- Department of Genetics, University of North Carolina at Chapel Hill, NC, United States; Division of Pharmacotherapy and Experimental Therapeutics, Eshelman School of Pharmacy, University of North Carolina at Chapel Hill, NC, United States.
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Liraglutide, 7,8-DHF and their co-treatment prevents loss of vision and cognitive decline in a Wolfram syndrome rat model. Sci Rep 2021; 11:2275. [PMID: 33500541 PMCID: PMC7838169 DOI: 10.1038/s41598-021-81768-6] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Accepted: 01/11/2021] [Indexed: 12/13/2022] Open
Abstract
Wolfram syndrome (WS) is a monogenic progressive neurodegenerative disease and is characterized by various neurological symptoms, such as optic nerve atrophy, loss of vision, cognitive decline, memory impairment, and learning difficulties. GLP1 receptor agonist liraglutide and BDNF mimetic 7,8-dihydroxyflavone (7,8-DHF) have had protective effect to visual pathway and to learning and memory in different rat models of neurodegenerative disorders. Although synergistic co-treatment effect has not been reported before and therefore the aim of the current study was to investigate liraglutide, 7,8-DHF and most importantly for the first time their co-treatment effect on degenerative processes in WS rat model. We took 9 months old WS rats and their wild-type (WT) control animals and treated them daily with liraglutide, 7,8-DHF or with the combination of liraglutide and 7,8-DHF up to the age of 12.5 months (n = 47, 5-8 per group). We found that liraglutide, 7,8-DHF and their co-treatment all prevented lateral ventricle enlargement, improved learning in Morris Water maze, reduced neuronal inflammation, delayed the progression of optic nerve atrophy, had remyelinating effect on optic nerve and thereby improved visual acuity in WS rats compared to WT controls. Thus, the use of the liraglutide, 7,8-DHF and their co-treatment could potentially be used as a therapeutic intervention to induce neuroprotection or even neuronal regeneration.
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Pasquesoone T, Chergui I, Satour H, Kaaloul N. [Wolfram Syndrome: Report of 2 hereditary cases]. J Fr Ophtalmol 2021; 44:e245-e248. [PMID: 33487451 DOI: 10.1016/j.jfo.2020.05.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Revised: 05/18/2020] [Accepted: 05/25/2020] [Indexed: 11/29/2022]
Affiliation(s)
- T Pasquesoone
- CHU Amiens Picardie, service d'ophtalmologie, 1, rond-point du Professeur Christian Cabrol, 80054 Amiens cedex 1.
| | - I Chergui
- CH Saint Quentin, 1, avenue Michel de l'Hospital BP 608, 02321 Saint-Quentin.
| | - H Satour
- CH Saint Quentin, 1, avenue Michel de l'Hospital BP 608, 02321 Saint-Quentin.
| | - N Kaaloul
- CH Saint Quentin, 1, avenue Michel de l'Hospital BP 608, 02321 Saint-Quentin.
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Mishra R, Chen BS, Richa P, Yu-Wai-Man P. Wolfram syndrome: new pathophysiological insights and therapeutic strategies. THERAPEUTIC ADVANCES IN RARE DISEASE 2021; 2:26330040211039518. [PMID: 37181110 PMCID: PMC10032446 DOI: 10.1177/26330040211039518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Accepted: 07/23/2021] [Indexed: 05/16/2023]
Abstract
Wolfram Syndrome (WS) is an ultra-rare, progressive neurodegenerative disease characterized by early-onset diabetes mellitus and irreversible loss of vision, secondary to optic nerve degeneration. Visual loss in WS is an important cause of registrable blindness in children and young adults and the pathological hallmark is the preferential loss of retinal ganglion cells within the inner retina. In addition to optic atrophy, affected individuals frequently develop variable combinations of neurological, endocrinological, and psychiatric complications. The majority of patients carry recessive mutations in the WFS1 (4p16.1) gene that encodes for a multimeric transmembrane protein, wolframin, embedded within the endoplasmic reticulum (ER). An increasingly recognised subgroup of patients harbor dominant WFS1 mutations that usually cause a milder phenotype, which can be limited to optic atrophy. Wolframin is a ubiquitous protein with high levels of expression in retinal, neuronal, and muscle tissues. It is a multifunctional protein that regulates a host of cellular functions, in particular the dynamic interaction with mitochondria at mitochondria-associated membranes. Wolframin has been implicated in several crucial cellular signaling pathways, including insulin signaling, calcium homeostasis, and the regulation of apoptosis and the ER stress response. There is currently no cure for WS; management remains largely supportive. This review will cover the clinical, genetic, and pathophysiological features of WS, with a specific focus on disease models and the molecular pathways that could serve as potential therapeutic targets. The current landscape of therapeutic options will also be discussed in the context of the latest evidence, including the pipeline for repurposed drugs and gene therapy. Plain language summary Wolfram syndrome - disease mechanisms and treatment options Wolfram syndrome (WS) is an ultra-rare genetic disease that causes diabetes mellitus and progressive loss of vision from early childhood. Vision is affected in WS because of damage to a specialized type of cells in the retina, known as retinal ganglion cells (RGCs), which converge at the back of the eye to form the optic nerve. The optic nerve is the fast-conducting cable that transmits visual information from the eye to the vision processing centers within the brain. As RGCs are lost, the optic nerve degenerates and it becomes pale in appearance (optic atrophy). Although diabetes mellitus and optic atrophy are the main features of WS, some patients can develop more severe problems because the brain and other organs, such as the kidneys and the bladder, are also affected. The majority of patients with WS carry spelling mistakes (mutations) in the WFS1 gene, which is located on the short arm of chromosome 4 (4p16.1). This gene is highly expressed in the eye and in the brain, and it encodes for a protein located within a compartment of the cell known as the endoplasmic reticulum. For reasons that still remain unclear, WFS1 mutations preferentially affect RGCs, accounting for the prominent visual loss in this genetic disorder. There is currently no effective treatment to halt or slow disease progression and management remains supportive, including the provision of visual aids and occupational rehabilitation. Research into WS has been limited by its relative rarity and the inability to get access to eye and brain tissues from affected patients. However, major advances in our understanding of this disease have been made recently by making use of more accessible cells from patients, such as skin cells (fibroblasts), or animal models, such as mice and zebrafish. This review summarizes the mechanisms by which WFS1 mutations affect cells, impairing their function and eventually leading to their premature loss. The possible treatment strategies to block these pathways are also discussed, with a particular focus on drug repurposing (i.e., using drugs that are already approved for other diseases) and gene therapy (i.e., replacing or repairing the defective WFS1 gene).
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Affiliation(s)
- Ratnakar Mishra
- Cambridge Centre for Brain Repair and MRC
Mitochondrial Biology Unit, Department of Clinical Neurosciences, University
of Cambridge, Cambridge, UK
| | - Benson S. Chen
- Cambridge Centre for Brain Repair and MRC
Mitochondrial Biology Unit, Department of Clinical Neurosciences, University
of Cambridge, Cambridge, UK
- Cambridge Eye Unit, Addenbrooke’s Hospital,
Cambridge University Hospitals, Cambridge, UK
| | - Prachi Richa
- Department of Physiology, Development and
Neuroscience, University of Cambridge, Cambridge, UK
| | - Patrick Yu-Wai-Man
- Cambridge Centre for Brain Repair and MRC
Mitochondrial Biology Unit, Department of Clinical Neurosciences, University
of Cambridge, ED Adrian Building, Robinson Way, Cambridge, CB2 0PY, UK
- Cambridge Eye Unit, Addenbrooke’s Hospital,
Cambridge University Hospitals, Cambridge, UK
- Moorfields Eye Hospital, London, UK
- UCL Institute of Ophthalmology, University
College London, London, UK
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Abstract
Although type 1 diabetes mellitus and, to a lesser extent, type 2 diabetes mellitus, are the prevailing forms of diabetes in youth, atypical forms of diabetes are not uncommon and may require etiology-specific therapies. By some estimates, up to 6.5% of children with diabetes have monogenic forms. Mitochondrial diabetes and cystic fibrosis related diabetes are less common but often noted in the underlying disease. Atypical diabetes should be considered in patients with a known disorder associated with diabetes, aged less than 25 years with nonautoimmune diabetes and without typical characteristics of type 2 diabetes mellitus, and/or with comorbidities associated with atypical diabetes.
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Affiliation(s)
- Jaclyn Tamaroff
- Division of Endocrinology and Diabetes, Children's Hospital of Philadelphia, 3500 Civic Center Boulevard, 12th Floor, Philadelphia, PA 19104, USA.
| | - Marissa Kilberg
- Division of Endocrinology and Diabetes, Children's Hospital of Philadelphia, 3500 Civic Center Boulevard, 12th Floor, Philadelphia, PA 19104, USA
| | - Sara E Pinney
- Division of Endocrinology and Diabetes, Children's Hospital of Philadelphia, 3500 Civic Center Boulevard, 12th Floor, Philadelphia, PA 19104, USA
| | - Shana McCormack
- Division of Endocrinology and Diabetes, Children's Hospital of Philadelphia, 3500 Civic Center Boulevard, 12th Floor, Philadelphia, PA 19104, USA
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Abu-El-Haija A, McGowan C, Vanderveen D, Bodamer O. Autosomal-dominant WFS1-related disorder-Report of a novel WFS1 variant and review of the phenotypic spectrum of autosomal recessive and dominant forms. Am J Med Genet A 2020; 185:528-533. [PMID: 33179441 DOI: 10.1002/ajmg.a.61945] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2020] [Revised: 10/04/2020] [Accepted: 10/12/2020] [Indexed: 12/17/2022]
Abstract
Wolfram syndrome was initially reported as an autosomal recessive (AR), progressive neurodegenerative disorder that leads to diabetes insipidus, childhood onset diabetes mellitus (DM), optic atrophy, and deafness (D) also known as DIDMOAD. However, heterozygous dominant pathogenic variants in Wolfram syndrome type 1 (WFS1) may lead to distinct, allelic conditions, described as isolated sensorineural hearing loss (SNHL), syndromic SNHL, congenital cataracts, or early onset DM. We report a family with a novel dominant, likely pathogenic variant in WFS1 (NM_006005.3) c.2605_2616del12 (p.Ser869_His872del), resulting in cataracts, SNHL, and DM in a female and her mother. A maternal aunt had cataracts, DM, and SNHL but was not tested for the familial WFS1 mutation. Both the mother and maternal aunt had early menopause by age 43 years and infertility which may be a coincidental finding that has not been associated with autosomal dominant AD WFS1-related disorder to the best of our knowledge. Screening at risk individuals in families with the AR Wolfram syndrome, for DM, SNHL, and for cataracts is indicated.
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Affiliation(s)
- Aya Abu-El-Haija
- Division of Genetics and Genomics, Department of Pediatrics, Boston Children's Hospital, Boston, MA, USA.,Department of Medical Oncology, Dana Farber Cancer Institute, Boston, MA, USA
| | - Caroline McGowan
- Division of Genetics and Genomics, Department of Pediatrics, Boston Children's Hospital, Boston, MA, USA
| | - Deborah Vanderveen
- Department of Ophthalmology, Boston Children's Hospital, Boston, MA, USA
| | - Olaf Bodamer
- Division of Genetics and Genomics, Department of Pediatrics, Boston Children's Hospital, Boston, MA, USA
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Samara A, Lugar HM, Hershey T, Shimony JS. Longitudinal Assessment of Neuroradiologic Features in Wolfram Syndrome. AJNR Am J Neuroradiol 2020; 41:2364-2369. [PMID: 33122205 DOI: 10.3174/ajnr.a6831] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Accepted: 08/06/2020] [Indexed: 12/11/2022]
Abstract
BACKGROUND AND PURPOSE Wolfram syndrome is a rare genetic disease with characteristic brain involvement. We reviewed the brain MR images of patients with Wolfram syndrome to determine the frequency and characteristics of common neuroradiologic findings. MATERIALS AND METHODS We retrospectively reviewed the imaging data of patients with genetically-confirmed Wolfram syndrome who had been recruited to the Washington University Wolfram Syndrome Research Clinic. These patients were evaluated between 2010 and 2019 with annual MRIs, along with other measures. MR images were assessed for clinical neuroradiologic signs at each individual's first and last follow-up visits to characterize the frequency, rate of progression, and clinical correlations of these signs. RESULTS We included 30 patients (13 males/17 females; average age at first visit, 14 years; average age at last visit, 19 years). The median duration of follow-up was 5 years (range, 2-9 years). The most common findings were an absent or diminished posterior pituitary bright spot (first, 53%; last, 70%), T1/T2 pons signal abnormalities (first, 53%; last, 67%), optic nerve atrophy (first, 30%; last, 80%), white matter T2 hyperintensities (first, 27%; last, 35%), and cerebellar atrophy (first, 23%; last, 70%). CONCLUSIONS Patients with Wolfram syndrome present characteristic neuroradiologic findings that involve the posterior pituitary gland, optic nerves, white matter, brain stem, and cerebellum. These abnormal findings appear at an early age and tend to increase in frequency with time. However, the neurologic significance and neuropathologic mechanisms of each sign require more investigation. Neuroradiologists should be aware of the pattern of these features in Wolfram syndrome.
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Affiliation(s)
- A Samara
- From the Department of Psychiatry (A.S., H.M.L.)
| | - H M Lugar
- From the Department of Psychiatry (A.S., H.M.L.)
| | - T Hershey
- From the Department of Psychiatry (A.S., H.M.L.) .,Neurology (T.H.).,Mallinckrodt Institute of Radiology (T.H., J.S.S.), Washington University School of Medicine, St. Louis, Missouri
| | - J S Shimony
- Mallinckrodt Institute of Radiology (T.H., J.S.S.), Washington University School of Medicine, St. Louis, Missouri
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Li L, Venkataraman L, Chen S, Fu H. Function of WFS1 and WFS2 in the Central Nervous System: Implications for Wolfram Syndrome and Alzheimer's disease. Neurosci Biobehav Rev 2020; 118:775-783. [PMID: 32949681 DOI: 10.1016/j.neubiorev.2020.09.011] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2020] [Revised: 08/25/2020] [Accepted: 09/10/2020] [Indexed: 12/14/2022]
Abstract
L.P. Li, L. Venkataraman, S. Chen, and H.J. Fu. Function of WFS1 and WFS2 in the Central Nervous System: Implications for Wolfram Syndrome and Alzheimer's Disease. NEUROSCI BIOBEHAV REVXXX-XXX,2020.-Wolfram syndrome (WS) is a rare monogenetic spectrum disorder characterized by insulin-dependent juvenile-onset diabetes mellitus, diabetes insipidus, optic nerve atrophy, hearing loss, progressive neurodegeneration, and a wide spectrum of psychiatric manifestations. Most WS patients belong to Wolfram Syndrome type 1 (WS1) caused by mutations in the Wolfram Syndrome 1 (WFS1/Wolframin) gene, while a small fraction of patients belongs to Wolfram Syndrome type 2 (WS2) caused by pathogenic variants in the CDGSH Iron Sulfur Domain 2 (CISD2/WFS2) gene. Although currently there is no treatment for this life-threatening disease, the molecular mechanisms underlying the pathogenesis of WS have been proposed. Interestingly, Alzheimer's disease (AD), an age-dependent neurodegenerative disease, shares some common mechanisms with WS. In this review, we focus on the function of WFS1 and WFS2 in the central nervous system as well as their implications in WS and AD. We also propose three future directions for elucidating the role of WFS1 and WFS2 in WS and AD.
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Affiliation(s)
- Liangping Li
- Department of Neuroscience, Chronic Brain Injury, Discovery Themes, The Ohio State University, Columbus, OH, USA
| | - Lalitha Venkataraman
- Department of Neuroscience, Chronic Brain Injury, Discovery Themes, The Ohio State University, Columbus, OH, USA
| | - Shuo Chen
- Department of Neuroscience, Chronic Brain Injury, Discovery Themes, The Ohio State University, Columbus, OH, USA
| | - Hongjun Fu
- Department of Neuroscience, Chronic Brain Injury, Discovery Themes, The Ohio State University, Columbus, OH, USA.
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Abstract
In the majority of cases, hereditary neurohypophyseal diabetes insipidus (DI) is a monogenic disorder caused by mutations in the AVP gene. Dominant transmission is by far the most common form. In these patients, symptoms develop gradually at various ages during childhood, progressing with complete penetrance to polyuria and polydipsia that is usually severe. In autosomal dominant neurohypophyseal DI (ADNDI), the mutant prohormone is folding deficient and consequently retained in the ER, where it forms amyloid-like fibrillar aggregates. Degradation by proteasomes occurs, but their clearance capacity appears to be insufficient. Postmortem studies in affected individuals suggest a neurodegenerative process confined to vasopressinergic neurons. Other forms of genetic neurohypophyseal DI include the very rare autosomal recessive type, also caused by mutations in the AVP gene, and complex multiorgan disorders, such as Wolfram syndrome. In all individuals where a congenital form of DI is suspected, including nephrogenic types, genetic analysis should be performed.
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Affiliation(s)
- Martin Spiess
- University of Basel, Biozentrum, Klingelbergstrasse 50/70, CH-4056 Basel, Switzerland.
| | - Nicole Beuret
- University of Basel, Biozentrum, Klingelbergstrasse 50/70, CH-4056 Basel, Switzerland.
| | - Jonas Rutishauser
- University of Basel, Biozentrum, Klingelbergstrasse 50/70, CH-4056 Basel, Switzerland; Kantonsspital Baden, Clinical Trial Unit, Im Ergel 1, CH-5405 Baden, Switzerland.
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Abreu D, Asada R, Revilla JMP, Lavagnino Z, Kries K, Piston DW, Urano F. Wolfram syndrome 1 gene regulates pathways maintaining beta-cell health and survival. J Transl Med 2020; 100:849-862. [PMID: 32060407 PMCID: PMC7286786 DOI: 10.1038/s41374-020-0408-5] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2019] [Revised: 02/03/2020] [Accepted: 02/04/2020] [Indexed: 12/17/2022] Open
Abstract
Wolfram Syndrome 1 (WFS1) protein is an endoplasmic reticulum (ER) factor whose deficiency results in juvenile-onset diabetes secondary to cellular dysfunction and apoptosis. The mechanisms guiding β-cell outcomes secondary to WFS1 function, however, remain unclear. Here, we show that WFS1 preserves normal β-cell physiology by promoting insulin biosynthesis and negatively regulating ER stress. Depletion of Wfs1 in vivo and in vitro causes functional defects in glucose-stimulated insulin secretion and insulin content, triggering Chop-mediated apoptotic pathways. Genetic proof of concept studies coupled with RNA-seq reveal that increasing WFS1 confers a functional and a survival advantage to β-cells under ER stress by increasing insulin gene expression and downregulating the Chop-Trib3 axis, thereby activating Akt pathways. Remarkably, WFS1 and INS levels are reduced in type-2 diabetic (T2DM) islets, suggesting that WFS1 may contribute to T2DM β-cell pathology. Taken together, this work reveals essential pathways regulated by WFS1 to control β-cell survival and function primarily through preservation of ER homeostasis.
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Affiliation(s)
- Damien Abreu
- Department of Medicine, Division of Endocrinology, Metabolism, and Lipid Research, Washington University School of Medicine, St. Louis, MO 63110, USA,Medical Scientist Training Program, Washington University School of Medicine, St. Louis, MO 63110, U.S.A
| | - Rie Asada
- Department of Medicine, Division of Endocrinology, Metabolism, and Lipid Research, Washington University School of Medicine, St. Louis, MO 63110, USA,Department of Biochemistry, Institute of Biomedical & Health Science, Hiroshima University, Hiroshima 734-8553, Japan
| | - John M. P. Revilla
- Department of Medicine, Division of Endocrinology, Metabolism, and Lipid Research, Washington University School of Medicine, St. Louis, MO 63110, USA
| | - Zeno Lavagnino
- Department of Cell Biology and Physiology, Washington University School of Medicine, St. Louis, MO 63110, USA,Experimental Imaging Center DIBIT, IRCCS Ospedale San Raffaele, 20132, Milan, Italy
| | - Kelly Kries
- Department of Medicine, Division of Endocrinology, Metabolism, and Lipid Research, Washington University School of Medicine, St. Louis, MO 63110, USA
| | - David W. Piston
- Department of Cell Biology and Physiology, Washington University School of Medicine, St. Louis, MO 63110, USA
| | - Fumihiko Urano
- Department of Medicine, Division of Endocrinology, Metabolism, and Lipid Research, Washington University School of Medicine, St. Louis, MO, 63110, USA. .,Department of Pathology and Immunology, Washington University School of Medicine, St. Louis, MO, 63110, USA.
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40
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Calcium mishandling in absence of primary mitochondrial dysfunction drives cellular pathology in Wolfram Syndrome. Sci Rep 2020; 10:4785. [PMID: 32179840 PMCID: PMC7075867 DOI: 10.1038/s41598-020-61735-3] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2019] [Accepted: 02/18/2020] [Indexed: 02/06/2023] Open
Abstract
Wolfram syndrome (WS) is a recessive multisystem disorder defined by the association of diabetes mellitus and optic atrophy, reminiscent of mitochondrial diseases. The role played by mitochondria remains elusive, with contradictory results on the occurrence of mitochondrial dysfunction. We evaluated 13 recessive WS patients by deep clinical phenotyping, including optical coherence tomography (OCT), serum lactic acid at rest and after standardized exercise, brain Magnetic Resonance Imaging, and brain and muscle Magnetic Resonance Spectroscopy (MRS). Finally, we investigated mitochondrial bioenergetics, network morphology, and calcium handling in patient-derived fibroblasts. Our results do not support a primary mitochondrial dysfunction in WS patients, as suggested by MRS studies, OCT pattern of retinal nerve fiber layer loss, and, in fibroblasts, by mitochondrial bioenergetics and network morphology results. However, we clearly found calcium mishandling between endoplasmic reticulum (ER) and mitochondria, which, under specific metabolic conditions of increased energy requirements and in selected tissue or cell types, may turn into a secondary mitochondrial dysfunction. Critically, we showed that Wolframin (WFS1) protein is enriched at mitochondrial-associated ER membranes and that in patient-derived fibroblasts WFS1 protein is completely absent. These findings support a loss-of-function pathogenic mechanism for missense mutations in WFS1, ultimately leading to defective calcium influx within mitochondria.
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Lusk L, Black E, Vengoechea J. Segregation of two variants suggests the presence of autosomal dominant and recessive forms of WFS1-related disease within the same family: expanding the phenotypic spectrum of Wolfram Syndrome. J Med Genet 2020; 57:121-123. [PMID: 31363008 DOI: 10.1136/jmedgenet-2018-105782] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2018] [Revised: 05/29/2019] [Accepted: 06/22/2019] [Indexed: 01/06/2023]
Abstract
BACKGROUND WFS1 was initially described as causative agent of autosomal recessive (AR) Wolfram syndrome, a childhood-onset disorder involving diabetes, optic atrophy, hearing loss and neurodegenerative features. However, the discovery of autosomal dominant (AD) disorders caused by this gene has resulted in clinical counselling and result interpretation challenges. OBJECTIVE We seek to report a family that appears to segregate dominant and recessive forms of WFS1-related disease. METHODS/RESULTS A 19-year-old woman presented with progressive childhood sensorineural hearing loss and recent optic atrophy, with biallelic mutations in WFS1: c.2486T>C (likely pathogenic) and c.2470G>A (uncertain significance). Her A1C was normal. Her sister carried the same variants and had a similar phenotype. Their father carried c.2486T>C and was found to have mild-moderate hearing loss but no optic atrophy or neurological symptoms. The mother carried c.2470G>A and had a normal audiogram and ophthalmological exam. Providing anticipatory guidance for this family was difficult given the phenotypic variability of WFS1-related disorders and the uncertainty surrounding whether the inheritance pattern was AR or AD. CONCLUSION The clinical correlation of the variants identified in this family suggests an AR Wolfram-like syndrome, without the typical diabetes mellitus or diabetes insipidus nor neurological decline. To our knowledge, this is a novel WFS1-related phenotype.
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Affiliation(s)
- Laina Lusk
- Department of Human Genetics, Emory University, Atlanta, Georgia, USA
| | - Emily Black
- Department of Human Genetics, Emory University, Atlanta, Georgia, USA
| | - Jaime Vengoechea
- Department of Human Genetics, Emory University, Atlanta, Georgia, USA
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Eljamel S, Ghosh W, De Stone S, Griffiths A, Barrett T, Thompson R. A cost of illness study evaluating the burden of Wolfram syndrome in the United Kingdom. Orphanet J Rare Dis 2019; 14:185. [PMID: 31366393 PMCID: PMC6670179 DOI: 10.1186/s13023-019-1149-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2018] [Accepted: 06/26/2019] [Indexed: 01/21/2023] Open
Abstract
Background Wolfram syndrome is a rare genetic, progressive, neurodegenerative disorder characterised by childhood-onset diabetes mellitus, diabetes insipidus, optic atrophy and deafness. To date, the economic burden of Wolfram syndrome has not been well-studied or reported. The aim of this study was to evaluate the cost of illness (COI) of all people with Wolfram syndrome in the UK and to identify major determinants of cost from a service provider perspective (National Health Service, NHS). Methods A prevalence-based approach was used to model the UK Wolfram syndrome specialist service. Model inputs were informed by a pragmatic literature review and UK reference costs, in conjunction with patient interviews and expert opinion. A deterministic sensitivity analysis (DSA) was run at 10% to identify major cost drivers. Results The total COI of all people with Wolfram syndrome to the NHS was £1,055,899 per year, with an average annual cost per person with Wolfram syndrome of £16,498. Costs associated with diabetes mellitus care, late-stage diabetes mellitus complications and hearing impairment contributed most to the COI (18.9, 21.4 and 15.8% of the COI, respectively). The DSA identified costs associated with hearing impairment, diabetes mellitus care and end-stage renal disease (a diabetes mellitus complication) as major model drivers. Conclusions The annual cost of Wolfram syndrome to the NHS was found to be substantial, with areas of potential cost savings identified, such as diabetes mellitus management. This model provides crucial information to facilitate economic evaluation of prospective therapies for this disease.
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Affiliation(s)
| | | | | | | | - Timothy Barrett
- Institute of Cancer and Genomic Sciences, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
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Pallotta MT, Tascini G, Crispoldi R, Orabona C, Mondanelli G, Grohmann U, Esposito S. Wolfram syndrome, a rare neurodegenerative disease: from pathogenesis to future treatment perspectives. J Transl Med 2019; 17:238. [PMID: 31337416 PMCID: PMC6651977 DOI: 10.1186/s12967-019-1993-1] [Citation(s) in RCA: 78] [Impact Index Per Article: 15.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2019] [Accepted: 07/17/2019] [Indexed: 02/06/2023] Open
Abstract
Background Wolfram syndrome (WS), a rare genetic disorder, is considered the best prototype of endoplasmic reticulum (ER) diseases. Classical WS features are childhood-onset diabetes mellitus, optic atrophy, deafness, diabetes insipidus, neurological signs, and other abnormalities. Two causative genes (WFS1 and WFS2) have been identified. The transmission of the disease takes place in an autosomal recessive mode but autosomal dominant mutations responsible for WS-related disorders have been described. Prognosis is poor, death occurs at the median age of 39 years with a major cause represented by respiratory failure as a consequence of brain stem atrophy and neurodegeneration. The aim of this narrative review is to focus on etiology, pathogenesis and natural history of WS for an adequate patient management and for the discussion of future therapeutic interventions. Main body WS requires a multidisciplinary approach in order to be successfully treated. A prompt diagnosis decreases morbidity and mortality through prevention and treatment of complications. Being a monogenic pathology, WS represents a perfect model to study the mechanisms of ER stress and how this condition leads to cell death, in comparison with other prevalent diseases in which multiple factors interact to produce the disease manifestations. WS is also an important disease prototype to identify drugs and molecules associated with ER homeostasis. Evidence indicates that specific metabolic diseases (type 1 and type 2 diabetes), neurodegenerative diseases, atherosclerosis, inflammatory pathologies and also cancer are closely related to ER dysfunction. Conclusions Therapeutic strategies in WS are based on drug repurposing (i.e., investigation of approved drugs for novel therapeutic indications) with the aim to stop the progression of the disease by reducing the endoplasmic reticulum stress. An extensive understanding of WS from pathophysiology to therapy is fundamental and more studies are necessary to better manage this devastating disease and guarantee the patients a better quality of life and longer life expectancy.
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Affiliation(s)
- Maria Teresa Pallotta
- Pharmacology Section, Department of Experimental Medicine, Università degli Studi di Perugia, Perugia, Italy
| | - Giorgia Tascini
- Pediatric Clinic, Department of Surgical and Biomedical Sciences, Università degli Studi di Perugia, Piazza Menghini 1, 06129, Perugia, Italy
| | - Roberta Crispoldi
- Pediatric Clinic, Department of Surgical and Biomedical Sciences, Università degli Studi di Perugia, Piazza Menghini 1, 06129, Perugia, Italy
| | - Ciriana Orabona
- Pharmacology Section, Department of Experimental Medicine, Università degli Studi di Perugia, Perugia, Italy
| | - Giada Mondanelli
- Pharmacology Section, Department of Experimental Medicine, Università degli Studi di Perugia, Perugia, Italy
| | - Ursula Grohmann
- Pharmacology Section, Department of Experimental Medicine, Università degli Studi di Perugia, Perugia, Italy
| | - Susanna Esposito
- Pediatric Clinic, Department of Surgical and Biomedical Sciences, Università degli Studi di Perugia, Piazza Menghini 1, 06129, Perugia, Italy.
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Evidence for altered neurodevelopment and neurodegeneration in Wolfram syndrome using longitudinal morphometry. Sci Rep 2019; 9:6010. [PMID: 30979932 PMCID: PMC6461605 DOI: 10.1038/s41598-019-42447-9] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2018] [Accepted: 04/01/2019] [Indexed: 12/11/2022] Open
Abstract
Wolfram syndrome is a rare disease caused by mutations in the WFS1 gene leading to symptoms in early to mid-childhood. Brain structural abnormalities are present even in young children, but it is not known when these abnormalities arise. Such information is critical in determining optimal outcome measures for clinical trials and in understanding the aberrant neurobiological processes in Wolfram syndrome. Using voxel-wise and regional longitudinal analyses, we compared brain volumes in Wolfram patients (n = 29; ages 5–25 at baseline; mean follow-up = 3.6 years), to age and sex-equivalent controls (n = 52; ages 6–26 at baseline; mean follow-up = 2.0 years). Between groups, white and gray matter volumes were affected differentially during development. Controls had uniformly increasing volume in white matter, whereas the Wolfram group had stable (optic radiations) or decreasing (brainstem, ventral pons) white matter volumes. In gray matter, controls had stable (thalamus, cerebellar cortex) or decreasing volumes (cortex), whereas the Wolfram group had decreased volume in thalamus and cerebellar cortex. These patterns suggest that there may be early, stalled white matter development in Wolfram syndrome, with additional degenerative processes in both white and gray matter. Ideally, animal models could be used to identify the underlying mechanisms and develop specific interventions.
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Bansal V, Boehm BO, Darvasi A. Identification of a missense variant in the WFS1 gene that causes a mild form of Wolfram syndrome and is associated with risk for type 2 diabetes in Ashkenazi Jewish individuals. Diabetologia 2018; 61:2180-2188. [PMID: 30014265 DOI: 10.1007/s00125-018-4690-3] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2018] [Accepted: 06/15/2018] [Indexed: 12/26/2022]
Abstract
AIMS/HYPOTHESIS Wolfram syndrome is a rare, autosomal recessive syndrome characterised by juvenile-onset diabetes and optic atrophy and is caused by bi-allelic mutations in the WFS1 gene. In a recent sequencing study, an individual with juvenile-onset diabetes was observed to be homozygous for a rare missense variant (c.1672C>T, p.R558C) in the WFS1 gene. The aim of this study was to perform the genetic characterisation of this variant and to determine whether it is causal for young-onset diabetes and Wolfram syndrome. METHODS We analysed the allele frequency of the missense variant in multiple variant databases. We genotyped the variant in 475 individuals with type 1 diabetes and 2237 control individuals of Ashkenazi Jewish ancestry and analysed the phenotypes of homozygotes. We also investigated the association of this variant with risk for type 2 diabetes using genotype and sequence data for type 2 diabetes cases and controls. RESULTS The missense variant demonstrated an allele frequency of 1.4% in individuals of Ashkenazi Jewish ancestry, 60-fold higher than in other populations. Genotyping of this variant in 475 individuals diagnosed with type 1 diabetes identified eight homozygotes compared with none in 2237 control individuals (genotype relative risk 135.3, p = 3.4 × 10-15). The age at diagnosis of diabetes for these eight individuals (17.8 ± 8.3 years) was several times greater than for typical Wolfram syndrome (5 ± 4 years). Further, optic atrophy was observed in only one of the eight individuals, while another individual had the Wolfram syndrome-relevant phenotype of neurogenic bladder. Analysis of sequence and genotype data in two case-control cohorts of Ashkenazi ancestry demonstrated that this variant is also associated with an increased risk of type 2 diabetes in heterozygotes (OR 1.81, p = 0.004). CONCLUSIONS/INTERPRETATION We have identified a low-frequency coding variant in the WFS1 gene that is enriched in Ashkenazi Jewish individuals and causes a mild form of Wolfram syndrome characterised by young-onset diabetes and reduced penetrance for optic atrophy. This variant should be considered for genetic testing in individuals of Ashkenazi ancestry diagnosed with young-onset non-autoimmune diabetes and should be included in Ashkenazi carrier screening panels.
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Affiliation(s)
- Vikas Bansal
- Department of Pediatrics, University of California San Diego, 9500 Gilman Drive, La Jolla, CA, 92093, USA.
| | - Bernhard O Boehm
- Department of Internal Medicine I, Ulm University Medical Centre, Ulm, Germany
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
- Imperial College London, London, UK
| | - Ariel Darvasi
- Department of Genetics, The Institute of Life Sciences, The Hebrew University of Jerusalem, Givat Ram, Jerusalem, Israel
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Genetic and clinical aspects of Wolfram syndrome 1, a severe neurodegenerative disease. Pediatr Res 2018; 83:921-929. [PMID: 29774890 DOI: 10.1038/pr.2018.17] [Citation(s) in RCA: 55] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2017] [Accepted: 12/31/2017] [Indexed: 12/14/2022]
Abstract
Wolfram syndrome 1 (WS1) is a rare autosomal recessive neurodegenerative disease characterized by diabetes insipidus, diabetes mellitus, optic atrophy, deafness, and other abnormalities. WS1 usually results in death before the age of 50 years. The pathogenesis of WS1 is ascribed to mutations of human WFS1 gene on chromosome 4p encoding a transmembrane protein called wolframin, which has physiological functions in membrane trafficking, secretion, processing, and/or regulation of ER calcium homeostasis. Different types of WFS1 mutations have been identified, and some of these have been associated with a dominant, severe type of WS. Mutations of CISD2 gene cause autosomal recessive Wolfram syndrome 2 (WS2) characterized by the absence of diabetes insipidus and psychiatric disorders, and by bleeding upper intestinal ulcer and defective platelet aggregation. Other WFS1-related disorders such as DFNA6/14/38 nonsyndromic low-frequency sensorineural hearing loss and Wolfram syndrome-like disease with autosomal dominant transmission have been described. WS1 is a devastating disease for the patients and their families. Thus, early diagnosis is imperative to enable proper prognostication, prevent complications, and reduce the transmission to further progeny. Although there is currently no effective therapy, potential new drugs have been introduced, attempting to improve the progression of this fatal disease.
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Wolfram Syndrome: A Case Report and Review of Clinical Manifestations, Genetics Pathophysiology, and Potential Therapies. Case Rep Endocrinol 2018; 2018:9412676. [PMID: 29850290 PMCID: PMC5932515 DOI: 10.1155/2018/9412676] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2018] [Revised: 02/25/2018] [Accepted: 03/06/2018] [Indexed: 02/06/2023] Open
Abstract
Background Classical Wolfram syndrome (WS) is a rare autosomal recessive disorder caused by mutations in WFS1, a gene implicated in endoplasmic reticulum (ER) and mitochondrial function. WS is characterized by insulin-requiring diabetes mellitus and optic atrophy. A constellation of other features contributes to the acronym DIDMOAD (Diabetes Insipidus, Diabetes Mellitus, Optic Atrophy, and Deafness). This review seeks to raise awareness of this rare form of diabetes so that individuals with WS are identified and provided with appropriate care. Case We describe a woman without risk factors for gestational or type 2 diabetes who presented with gestational diabetes (GDM) at the age of 39 years during her first and only pregnancy. Although she had optic atrophy since the age of 10 years, WS was not considered as her diagnosis until she presented with GDM. Biallelic mutations in WFS1 were identified, supporting a diagnosis of classical WS. Conclusions The distinct natural history, complications, and differences in management reinforce the importance of distinguishing WS from other forms of diabetes. Recent advances in the genetics and pathophysiology of WS have led to promising new therapeutic considerations that may preserve β-cell function and slow progressive neurological decline. Insight into the pathophysiology of WS may also inform strategies for β-cell preservation for individuals with type 1 and 2 diabetes.
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Li M, Liu J, Yi H, Xu L, Zhong X, Peng F. A novel mutation of WFS1 gene in a Chinese patient with Wolfram syndrome: a case report. BMC Pediatr 2018; 18:116. [PMID: 29549887 PMCID: PMC5857142 DOI: 10.1186/s12887-018-1091-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2017] [Accepted: 03/07/2018] [Indexed: 12/03/2022] Open
Abstract
Background Wolfram syndrome (WS), caused by mutations of the Wolfram syndrome 1 (WFS1) gene on chromosome 4p16.1, is an autosomal recessive disorder characterized by diabetes insipidus (DI), neuro-psychiatric disorders, hearing deficit, and urinary tract anomalies. Case presentation Here we report a 11-year-old Chinese boy who presented with visual loss, was suspected with optic neuritis (ON) or neuromyelitis optica (NMO) and referred to our department for further diagnosis. Finally he was diagnosed with WS because of diabetes mellitus (DM) and optic atrophy (OA). Eight exons and flanking introns of WFS1 gene were analyzed by sequencing. A novel mutation c.1760G > A in WFS1 gene of exon 8 was identified. Conclusion This report reviews a case of WS associated with a novel mutation, c.1760G > A in WFS1 gene of exon 8, and emphasizes that WS should be taken into account for juveniles with visual loss and diabetes mellitus.
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Affiliation(s)
- Min Li
- Multiple Sclerosis Center, Department of Neurology, the Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong, 510630, China
| | - Jia Liu
- Multiple Sclerosis Center, Department of Neurology, the Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong, 510630, China
| | - Huan Yi
- Multiple Sclerosis Center, Department of Neurology, the Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong, 510630, China
| | - Li Xu
- Multiple Sclerosis Center, Department of Neurology, the Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong, 510630, China
| | - Xiufeng Zhong
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen Univeristy, Guangzhou, Guangdong, 510060, China.
| | - Fuhua Peng
- Multiple Sclerosis Center, Department of Neurology, the Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong, 510630, China.
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Ivask M, Pajusalu S, Reimann E, Kõks S. Hippocampus and Hypothalamus RNA-sequencing of WFS1-deficient Mice. Neuroscience 2018; 374:91-103. [PMID: 29406269 DOI: 10.1016/j.neuroscience.2018.01.039] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2017] [Revised: 11/26/2017] [Accepted: 01/18/2018] [Indexed: 01/08/2023]
Abstract
Wolfram syndrome is caused by mutations in the WFS1 gene. WFS1 protein dysfunction results in a range of neuroendocrine syndromes and is mostly characterized by juvenile-onset diabetes mellitus and optic atrophy. WFS1 has been shown to participate in membrane trafficking, protein processing and Ca2+ homeostasis in the endoplasmic reticulum. Aim of the present study was to find the transcriptomic changes influenced by WFS1 in the hypothalamus and hippocampus using RNA-sequencing. The WFS1-deficient mice were used as a model system to analyze the changes in transcriptional networks. The number of differentially expressed genes between hypothalami of WFS1-deficient (Wfs1KO) and wild-type (WT) mice was 43 and between hippocampi 311 with False Discovery Rate (FDR) <0.05. Avpr1a and Avpr1b were significantly upregulated in the hypothalamus and hippocampus of Wfs1KO mice respectively. Trpm8 was the most upregulated gene in the hippocampus of Wfs1KO mice. The functional analysis revealed significant enrichment of networks and pathways associated with protein synthesis, cell-to-cell signaling and interaction, molecular transport, metabolic disease and nervous system development and function. In conclusion, the transcriptomic profiles of WFS1-deficient hypothalamus and hippocampus do indicate the activation of degenerative molecular pathways causing the clinical occurrences typical to Wolfram syndrome.
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Affiliation(s)
- Marilin Ivask
- Department of Pathophysiology, Institute of Biomedicine and Translational Medicine, University of Tartu, Tartu, Estonia.
| | - Sander Pajusalu
- Department of Clinical Genetics, United Laboratories, Tartu University Hospital, Tartu, Estonia; Department of Clinical Genetics, Institute of Clinical Medicine, University of Tartu, Tartu, Estonia
| | - Ene Reimann
- Department of Pathophysiology, Institute of Biomedicine and Translational Medicine, University of Tartu, Tartu, Estonia
| | - Sulev Kõks
- Department of Pathophysiology, Institute of Biomedicine and Translational Medicine, University of Tartu, Tartu, Estonia
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Sakakibara Y, Sekiya M, Fujisaki N, Quan X, Iijima KM. Knockdown of wfs1, a fly homolog of Wolfram syndrome 1, in the nervous system increases susceptibility to age- and stress-induced neuronal dysfunction and degeneration in Drosophila. PLoS Genet 2018; 14:e1007196. [PMID: 29357349 PMCID: PMC5794194 DOI: 10.1371/journal.pgen.1007196] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2016] [Revised: 02/01/2018] [Accepted: 01/09/2018] [Indexed: 01/08/2023] Open
Abstract
Wolfram syndrome (WS), caused by loss-of-function mutations in the Wolfram syndrome 1 gene (WFS1), is characterized by juvenile-onset diabetes mellitus, bilateral optic atrophy, and a wide spectrum of neurological and psychiatric manifestations. WFS1 encodes an endoplasmic reticulum (ER)-resident transmembrane protein, and mutations in this gene lead to pancreatic β-cell death induced by high levels of ER stress. However, the mechanisms underlying neurodegeneration caused by WFS1 deficiency remain elusive. Here, we investigated the role of WFS1 in the maintenance of neuronal integrity in vivo by knocking down the expression of wfs1, the Drosophila homolog of WFS1, in the central nervous system. Neuronal knockdown of wfs1 caused age-dependent behavioral deficits and neurodegeneration in the fly brain. Knockdown of wfs1 in neurons and glial cells resulted in premature death and significantly exacerbated behavioral deficits in flies, suggesting that wfs1 has important functions in both cell types. Although wfs1 knockdown alone did not promote ER stress, it increased the susceptibility to oxidative stress-, excitotoxicity- or tauopathy-induced behavioral deficits, and neurodegeneration. The glutamate release inhibitor riluzole significantly suppressed premature death phenotypes induced by neuronal and glial knockdown of wfs1. This study highlights the protective role of wfs1 against age-associated neurodegeneration and furthers our understanding of potential disease-modifying factors that determine susceptibility and resilience to age-associated neurodegenerative diseases. Wolfram syndrome (WS), a neurodegenerative disorder with an autosomal recessive inheritance pattern, has a variable clinical presentation that includes diabetes mellitus, optic atrophy, and a wide spectrum of neurological and psychiatric manifestations. Homozygous mutations in WFS1 are causative for WS. The prognosis of WS is poor, and most patients die prematurely with respiratory failure due to brain stem atrophy. However, the mechanisms underlying the neurological manifestations of WS remain elusive. In this study, we used the fruit fly Drosophila to examine the neurological features of WS by generating genetically modified flies harboring knockdown of wfs1, the fly homolog of WFS1, in the central nervous system. These flies developed age-dependent behavioral deficits, neurodegeneration and premature death. wfs1-deficient flies were vulnerable to various age-related stressors such as oxidative stress and excitotoxicity, and to neurodegeneration caused by Alzheimer’s disease-related toxic proteins. The premature death phenotype in wfs1-deficient flies was ameliorated by administration of riluzole, which inhibits glutamate-induced excitotoxicity. This study provides insight into the mechanisms underlying neurodegeneration not only in WS, but also in age-associated neurodegenerative diseases such as Alzheimer’s disease.
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Affiliation(s)
- Yasufumi Sakakibara
- Department of Alzheimer’s Disease Research, Center for Development of Advanced Medicine for Dementia, National Center for Geriatrics and Gerontology, Obu, Aichi, Japan
| | - Michiko Sekiya
- Department of Alzheimer’s Disease Research, Center for Development of Advanced Medicine for Dementia, National Center for Geriatrics and Gerontology, Obu, Aichi, Japan
| | - Naoki Fujisaki
- Department of Alzheimer’s Disease Research, Center for Development of Advanced Medicine for Dementia, National Center for Geriatrics and Gerontology, Obu, Aichi, Japan
- Department of Experimental Gerontology, Graduate School of Pharmaceutical Sciences, Nagoya City University, 3–1 Tanabe-dori, Mizuho-ku, Nagoya, Japan
| | - Xiuming Quan
- Department of Alzheimer’s Disease Research, Center for Development of Advanced Medicine for Dementia, National Center for Geriatrics and Gerontology, Obu, Aichi, Japan
| | - Koichi M. Iijima
- Department of Alzheimer’s Disease Research, Center for Development of Advanced Medicine for Dementia, National Center for Geriatrics and Gerontology, Obu, Aichi, Japan
- Department of Experimental Gerontology, Graduate School of Pharmaceutical Sciences, Nagoya City University, 3–1 Tanabe-dori, Mizuho-ku, Nagoya, Japan
- * E-mail:
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