1
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Morrison K, Koshiya H, Safier R, Brown A, May C, Vockley J, Ghaloul-Gonzalez L. Clinical case report of intractable paroxysmal sympathetic hyperactivity in TANGO2 deficiency disorder. Am J Med Genet A 2024; 194:e63633. [PMID: 38634641 PMCID: PMC11315627 DOI: 10.1002/ajmg.a.63633] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Revised: 03/27/2024] [Accepted: 04/05/2024] [Indexed: 04/19/2024]
Abstract
TANGO2 deficiency disorder (TDD) is a neurodegenerative disease characterized by a broad and variable spectrum of clinical manifestations, even among individuals sharing the same pathogenic variants. Here, we report a severely affected individual with TDD presenting with intractable paroxysmal sympathetic hyperactivity (PSH). While progressive brain atrophy has been observed in TDD, PSH has not been reported. Despite comprehensive workup for an acute trigger, no definite cause was identified, and pharmacological interventions were ineffective to treat PSH. Ultimately care was redirected to comfort measures. This article expands the clinical phenotype of patients with TDD, highlights the possibility of PSH in these patients, and the need for continued research for better treatments of TDD.
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Affiliation(s)
- Kaitlin Morrison
- Division of Genetic and Genomic Medicine, Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Hitoshi Koshiya
- Division of Child Neurology, Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Robert Safier
- Division of Child Neurology, Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Amanda Brown
- Division of Palliative Medicine and Supportive Care, Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Carol May
- Division of Palliative Medicine and Supportive Care, Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Jerry Vockley
- Division of Genetic and Genomic Medicine, Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
- Department of Human Genetics, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA
| | - Lina Ghaloul-Gonzalez
- Division of Genetic and Genomic Medicine, Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
- Department of Human Genetics, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA
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2
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Mehranfar M, Asadi P, Shokohi R, Milev MP, Gamberi C, Sacher M. Lipidomic analysis of human TANGO2-deficient cells suggests a lipid imbalance as a cause of TANGO2 deficiency disease. Biochem Biophys Res Commun 2024; 717:150047. [PMID: 38718569 DOI: 10.1016/j.bbrc.2024.150047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2024] [Revised: 04/17/2024] [Accepted: 05/01/2024] [Indexed: 05/21/2024]
Abstract
TANGO2 deficiency disease (TDD) is a multisystem disease caused by variants in the TANGO2 gene. Symptoms include neurodevelopmental delays, seizures and potentially lethal metabolic crises and cardiac arrhythmias. While the function of TANGO2 remains elusive, vitamin B5/pantothenic acid supplementation has been shown to alleviate symptoms in a fruit fly model and has also been used with success to treat individuals suffering from TDD. Since vitamin B5 is the precursor to the lipid activator coenzyme A (CoA), we hypothesized that TANGO2-deficient cells would display changes in the lipid profile compared to control and that these changes would be rescued by vitamin B5 supplementation. In addition, the specific changes seen might point to a pathway in which TANGO2 functions. Indeed, we found profound changes in the lipid profile of human TANGO2-deficient cells as well as an increased pool of free fatty acids in both human cells devoid of TANGO2 and Drosophila harboring a previously described TANGO2 loss of function allele. All these changes were reversed upon vitamin B5 supplementation. Pathway analysis showed significant increases in triglyceride as well as in lysophospholipid levels as the top enriched pathways in the absence of TANGO2. Consistent with a defect in triglyceride metabolism, we found changes in lipid droplet numbers and sizes in the absence of TANGO2 compared to control. Our data will allow for comparison between other model systems of TDD and the homing in on critical lipid imbalances that lead to the disease state.
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Affiliation(s)
- Mahsa Mehranfar
- Concordia University, Department of Chemistry and Biochemistry, Canada
| | - Paria Asadi
- Concordia University, Department of Biology, Canada
| | | | | | - Chiara Gamberi
- Coastal Carolina University, Department of Biology, United States
| | - Michael Sacher
- Concordia University, Department of Biology, Canada; McGill University, Department of Anatomy and Cell Biology, Canada.
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3
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Xu W, Cao Y, Stephens SB, Arredondo MJ, Chen Y, Perez W, Sun L, Yu AC, Kim JJ, Lalani SR, Li N, Horrigan FT, Altamirano F, Wehrens XH, Miyake CY, Zhang L. Folate as a potential treatment for lethal ventricular arrhythmias in TANGO2-deficiency disorder. JCI Insight 2024; 9:e171005. [PMID: 38855866 PMCID: PMC11382877 DOI: 10.1172/jci.insight.171005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Accepted: 04/23/2024] [Indexed: 06/11/2024] Open
Abstract
TANGO2-deficiency disorder (TDD) is an autosomal-recessive genetic disease caused by biallelic loss-of-function variants in the TANGO2 gene. TDD-associated cardiac arrhythmias are recalcitrant to standard antiarrhythmic medications and constitute the leading cause of death. Disease modeling for TDD has been primarily carried out using human dermal fibroblast and, more recently, in Drosophila by multiple research groups. No human cardiomyocyte system has been reported, which greatly hinders the investigation and understanding of TDD-associated arrhythmias. Here, we established potentially novel patient-derived induced pluripotent stem cell differentiated cardiomyocyte (iPSC-CM) models that recapitulate key electrophysiological abnormalities in TDD. These electrophysiological abnormalities were rescued in iPSC-CMs with either adenoviral expression of WT-TANGO2 or correction of the pathogenic variant using CRISPR editing. Our natural history study in patients with TDD suggests that the intake of multivitamin/B complex greatly diminished the risk of cardiac crises in patients with TDD. In agreement with the clinical findings, we demonstrated that high-dose folate (vitamin B9) virtually abolishes arrhythmias in TDD iPSC-CMs and that folate's effect was blocked by the dihydrofolate reductase inhibitor methotrexate, supporting the need for intracellular folate to mediate antiarrhythmic effects. In summary, data from TDD iPSC-CM models together with clinical observations support the use of B vitamins to mitigate cardiac crises in patients with TDD, providing potentially life-saving treatment strategies during life-threatening events.
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Affiliation(s)
- Weiyi Xu
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, Texas, USA
| | - Yingqiong Cao
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, Texas, USA
| | - Sara B Stephens
- Department of Pediatrics, Division of Pediatric Cardiology, Texas Children's Hospital and Baylor College of Medicine, Houston, Texas, USA
| | - Maria Jose Arredondo
- Department of Pediatrics, Division of Pediatric Cardiology, Texas Children's Hospital and Baylor College of Medicine, Houston, Texas, USA
| | - Yifan Chen
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, Texas, USA
| | - William Perez
- Department of Cardiovascular Sciences, Houston Methodist Research Institute, Houston, Texas, USA
| | - Liang Sun
- Department of Integrative Physiology
| | - Andy C Yu
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, Texas, USA
| | - Jean J Kim
- Department of Molecular and Cellular Biology
- Human Stem Cell Core, Advanced Technology Cores
| | - Seema R Lalani
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, Texas, USA
| | - Na Li
- Department of Medicine (Section of Cardiovascular Research), and
- Cardiovascular Research Institute, Baylor College of Medicine, Houston, Texas, USA
| | | | - Francisco Altamirano
- Department of Cardiovascular Sciences, Houston Methodist Research Institute, Houston, Texas, USA
- Department of Cardiothoracic Surgery, Weill Cornell Medical College, Cornell University, Ithaca, New York, USA
| | - Xander Ht Wehrens
- Department of Integrative Physiology
- Department of Medicine (Section of Cardiovascular Research), and
- Cardiovascular Research Institute, Baylor College of Medicine, Houston, Texas, USA
- Department of Neuroscience
- Department of Pediatrics
- Center for Space Medicine, and
| | - Christina Y Miyake
- Department of Pediatrics, Division of Pediatric Cardiology, Texas Children's Hospital and Baylor College of Medicine, Houston, Texas, USA
- Department of Molecular Physiology and Biophysics, Baylor College of Medicine, Houston, Texas, USA
| | - Lilei Zhang
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, Texas, USA
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4
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Owlett LD, Zapanta B, Sandkuhler SE, Ames EG, Hickey SE, Mackenzie SJ, Meisner JK. Multicenter appraisal of comorbid TANGO2 deficiency disorder in patients with 22q11.2 deletion syndrome. Am J Med Genet A 2024:e63778. [PMID: 38829177 DOI: 10.1002/ajmg.a.63778] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Revised: 05/16/2024] [Accepted: 05/19/2024] [Indexed: 06/05/2024]
Abstract
TANGO2 deficiency disorder (TDD) is a rare, autosomal recessive condition caused by pathogenic variants in TANGO2, a gene residing within the region commonly deleted in 22q11.2 deletion syndrome (22q11.2DS). Although patients with 22q11.2DS are at substantially higher risk for comorbid TDD, it remains underdiagnosed within 22q11.2DS, likely due to overlapping symptomatology and a lack of knowledge about TDD. Initiation of B-vitamin supplementation may provide therapeutic benefit in TDD, highlighting the need for effective screening methods to improve diagnosis rates in this at-risk group. In this retrospective, multicenter study, we evaluated two cohorts of patients with 22q11.2DS (total N = 435) for possible comorbid TDD using two different symptom-based screening methods (free text-mining and manual chart review versus manual chart review alone). The methodology of the cohort 1 screening method successfully identified a known 22q11.2DS patient with TDD. Combined, these two cohorts identified 21 living patients meeting the consensus recommendation for TANGO2 testing for suspected comorbid TDD. Of the nine patients undergoing TANGO2 sequencing with del/dup analysis, none were ultimately diagnosed with TDD. Of the 12 deaths in the suspected comorbid TDD cohort, some of these patients exhibited symptoms (rhabdomyolysis, cardiac arrhythmia, or metabolic crisis) suspicious of comorbid TDD contributing to their death. Collectively, these findings highlight the need for robust prospective screening tools for diagnosing comorbid TDD in patients with 22q11.2DS.
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Affiliation(s)
- Laura D Owlett
- Department of Neurology, Division of Child Neurology, University of Rochester, Rochester, New York, USA
| | - Bianca Zapanta
- Department of Pediatrics, Section of Genetic and Genomic Medicine, Nationwide Children's Hospital, Columbus, Ohio, USA
| | - Sarah E Sandkuhler
- Department of Pathology, University of Rochester, Rochester, New York, USA
| | - Elizabeth G Ames
- Department of Pediatrics, Division of Genetics, Metabolism & Genomic Medicine, University of Michigan, Ann Arbor, Michigan, USA
| | - Scott E Hickey
- Department of Pediatrics, Section of Genetic and Genomic Medicine, Nationwide Children's Hospital, Columbus, Ohio, USA
| | - Samuel J Mackenzie
- Department of Neurology, Division of Child Neurology, University of Rochester, Rochester, New York, USA
| | - Joshua K Meisner
- Department of Pediatrics, Division of Pediatric Cardiology, University of Michigan, Ann Arbor, Michigan, USA
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5
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Sacher M, DeLoriea J, Mehranfar M, Casey C, Naaz A, Gamberi C. TANGO2 deficiency disease is predominantly caused by a lipid imbalance. Dis Model Mech 2024; 17:dmm050662. [PMID: 38836374 PMCID: PMC11179719 DOI: 10.1242/dmm.050662] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2024] Open
Abstract
TANGO2 deficiency disease (TDD) is a rare genetic disorder estimated to affect ∼8000 individuals worldwide. It causes neurodegeneration often accompanied by potentially lethal metabolic crises that are triggered by diet or illness. Recent work has demonstrated distinct lipid imbalances in multiple model systems either depleted for or devoid of the TANGO2 protein, including human cells, fruit flies and zebrafish. Importantly, vitamin B5 supplementation has been shown to rescue TANGO2 deficiency-associated defects in flies and human cells. The notion that vitamin B5 is needed for synthesis of the lipid precursor coenzyme A (CoA) corroborates the hypothesis that key aspects of TDD pathology may be caused by lipid imbalance. A natural history study of 73 individuals with TDD reported that either multivitamin or vitamin B complex supplementation prevented the metabolic crises, suggesting this as a potentially life-saving treatment. Although recently published work supports this notion, much remains unknown about TANGO2 function, the pathological mechanism of TDD and the possible downsides of sustained vitamin supplementation in children and young adults. In this Perspective, we discuss these recent findings and highlight areas for immediate scientific attention.
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Affiliation(s)
- Michael Sacher
- Department of Biology, Concordia University, Montreal H4B 1R6, Canada
- Department of Anatomy and Cell Biology, McGill University, Montreal H3A 0C7, Canada
| | - Jay DeLoriea
- Department of Biology, Coastal Carolina University, Conway, SC 29526, USA
| | - Mahsa Mehranfar
- Department of Chemistry and Biochemistry, Concordia University, Montreal H4B 1R6, Canada
| | - Cody Casey
- Department of Biology, Coastal Carolina University, Conway, SC 29526, USA
| | - Aaliya Naaz
- Department of Biology, Concordia University, Montreal H4B 1R6, Canada
| | - Chiara Gamberi
- Department of Biology, Coastal Carolina University, Conway, SC 29526, USA
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6
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Hardiyanti W, Djabir YY, Fatiah D, Pratama MR, Putri TZA, Chaeratunnisa R, Latada NP, Mudjahid M, Asri RM, Nainu F. Evaluating the Impact of Vitamin D 3 on NF-κB and JAK/STAT Signaling Pathways in Drosophila melanogaster. ACS OMEGA 2024; 9:20135-20141. [PMID: 38737056 PMCID: PMC11079875 DOI: 10.1021/acsomega.4c00134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/04/2024] [Revised: 04/12/2024] [Accepted: 04/16/2024] [Indexed: 05/14/2024]
Abstract
This study delved into the consequences of prolonged administration of vitamin D3 on innate immune systems, particularly NF-κB and JAK/STAT, in Drosophila melanogaster. The outcomes indicated that vitamin D3 treatment exhibited a notable capacity to improve the survival of adult flies with compromised immune functions, a condition induced by the loss of PGRP-LB, particularly when the flies were exposed to heat-killed Escherichia coli. The PGRP-LBΔ mutant line that was treated with heat-killed E. coli experienced reduced survival. Treatment of heat-killed E. coli-treated PGRP-LBΔ with vitamin D3 resulted in improved survival, and this phenotypic feature might be due to the downregulation of gene expression in the NF-κB and JAK/STAT pathways. However, a higher concentration of vitamin D3 was associated with decreased survival, potentially linked to intricate immunological responses. The research also underscored the influence of vitamin D3 on the expression of antioxidant genes, sod1 and sod2, indicating an augmented resistance to oxidative stress. Further, this study revealed the effect of vitamin D3 on the reproductive status of the autoinflammatory model, showing an increase in pupae and adult flies with a treatment of 10 mM vitamin D3, suggesting the potential benefits of vitamin D3 on the reproductive profile. Overall, this study provides preliminary insights into the complex interactions between vitamin D3, immune pathways, oxidative responses in the cell, and reproduction in Drosophila.
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Affiliation(s)
- Widya Hardiyanti
- Postgraduate
Program in Pharmacy, Faculty of Pharmacy, Hasanuddin University, Tamalanrea, Makassar 90245, Indonesia
| | - Yulia Yusrini Djabir
- Department
of Pharmacy, Faculty of Pharmacy, Hasanuddin
University, Tamalanrea, Makassar 90245, Indonesia
| | - Dewita Fatiah
- Postgraduate
Program in Pharmacy, Faculty of Pharmacy, Hasanuddin University, Tamalanrea, Makassar 90245, Indonesia
| | - Muhammad Rasul Pratama
- Postgraduate
Program in Pharmacy, Faculty of Pharmacy, Hasanuddin University, Tamalanrea, Makassar 90245, Indonesia
| | - Tenri Zulfa Ayu
Dwi Putri
- Postgraduate
Program in Pharmacy, Faculty of Pharmacy, Hasanuddin University, Tamalanrea, Makassar 90245, Indonesia
| | - Rizkya Chaeratunnisa
- Undergraduate
Program in Pharmacy, Faculty of Pharmacy, Hasanuddin University, Tamalanrea, Makassar 90245, Indonesia
| | - Nadila Pratiwi Latada
- Unhas
Fly Research Group, Faculty of Pharmacy, Hasanuddin University, Tamalanrea, Makassar 90245, Indonesia
| | - Mukarram Mudjahid
- Department
of Pharmacy, Faculty of Pharmacy, Hasanuddin
University, Tamalanrea, Makassar 90245, Indonesia
| | - Rangga Meidianto Asri
- Department
of Pharmaceutical Science and Technology, Faculty of Pharmacy, Hasanuddin University, Tamalanrea, Makassar 90245, Indonesia
| | - Firzan Nainu
- Department
of Pharmacy, Faculty of Pharmacy, Hasanuddin
University, Tamalanrea, Makassar 90245, Indonesia
- Unhas
Fly Research Group, Faculty of Pharmacy, Hasanuddin University, Tamalanrea, Makassar 90245, Indonesia
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7
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Walters B, McConkey N, Imundo JR. TANGO2: A Rare but Important Mutation. J Innov Card Rhythm Manag 2024; 15:5871-5875. [PMID: 38808169 PMCID: PMC11129830 DOI: 10.19102/icrm.2024.15054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Accepted: 01/29/2024] [Indexed: 05/30/2024] Open
Abstract
We report the case of a 7-year-old boy who presented with post-viral myositis, rhabdomyolysis, and hepatitis, who was later readmitted due to a seizure-like activity and ultimately found to have episodes of recalcitrant polymorphic ventricular tachycardia secondary to simultaneous QT prolongation and severe hypothyroidism. Temporary transvenous atrial pacing was successful at controlling the ventricular arrhythmias in the intensive care unit. With levothyroxine therapy and cessation of QT-prolonging medications, the corrected QT (QTc) normalized. A comprehensive arrhythmia panel identified a pathogenic mutation in KCNQ1, consistent with long QT syndrome (LQTS) type 1. After the patient experienced progressive neurodegeneration and seizures, he was referred to a genetics clinic to rule out genetic epilepsy. On the epilepsy panel of genetic testing, he was found to have two pathogenic variants in TANGO2. TANGO2 deficiency explains the initial presentation of myositis, rhabdomyolysis, hypothyroidism, and life-threatening arrhythmias surrounding a viral illness more so than the initial diagnosis of mere LQTS. However, the TANGO2 gene is not included in most comprehensive arrhythmia and cardiomyopathy panels. TANGO2 deficiency is a rare condition that often presents with arrhythmias but may be unfamiliar to many cardiologists and electrophysiologists. This case describes management strategies and caveats, which could aid in the successful diagnosis and treatment of TANGO2 deficiency at the time of presentation.
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Affiliation(s)
- Benjamin Walters
- Pennsylvania State University School of Medicine, Hershey, PA, USA
| | - Nathan McConkey
- Heart and Vascular Institute, Penn State Milton S. Hershey Medical Center, Hershey, PA, USA
| | - Jason R. Imundo
- Division of Pediatric Cardiology, Penn State Health Children’s Hospital, Hershey, PA, USA
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8
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Miyake CY, Mackenzie SJ, Zhang L. Top Stories on arrhythmias in TANGO2 deficiency disorder. Heart Rhythm 2024; 21:707-709. [PMID: 38692818 DOI: 10.1016/j.hrthm.2024.03.229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2024] [Revised: 03/21/2024] [Accepted: 03/22/2024] [Indexed: 05/03/2024]
Affiliation(s)
- Christina Y Miyake
- Department of Pediatrics, Division of Pediatric Cardiology, Texas Children's Hospital and Baylor College of Medicine, Houston, Texas; Department of Molecular Physiology and Biophysics, Baylor College of Medicine, Houston, Texas.
| | - Samuel J Mackenzie
- Department of Neurology, University of Rochester Medical Center, Rochester, New York
| | - Lilei Zhang
- Department of Molecular Physiology and Biophysics, Baylor College of Medicine, Houston, Texas; Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, Texas
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9
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Wedman JJ, Sibon OCM, Mastantuono E, Iuso A. Impaired coenzyme A homeostasis in cardiac dysfunction and benefits of boosting coenzyme A production with vitamin B5 and its derivatives in the management of heart failure. J Inherit Metab Dis 2024. [PMID: 38591231 DOI: 10.1002/jimd.12737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2024] [Revised: 03/25/2024] [Accepted: 03/27/2024] [Indexed: 04/10/2024]
Abstract
Coenzyme A (CoA) is an essential cofactor required for over a hundred metabolic reactions in the human body. This cofactor is synthesized de novo in our cells from vitamin B5, also known as pantothenic acid, a water-soluble vitamin abundantly present in vegetables and animal-based foods. Neurodegenerative disorders, cancer, and infectious diseases have been linked to defects in de novo CoA biosynthesis or reduced levels of this coenzyme. There is now accumulating evidence that CoA limitation is a critical pathomechanism in cardiac dysfunction too. In the current review, we will summarize our current knowledge on CoA and heart failure, with emphasis on two primary cardiomyopathies, phosphopantothenoylcysteine synthetase and phosphopantothenoylcysteine decarboxylase deficiency disorders biochemically characterized by a decreased level of CoA in patients' samples. Hence, we will discuss the potential benefits of CoA restoration in these diseases and, more generally, in heart failure, by vitamin B5 and its derivatives pantethine and 4'-phosphopantetheine.
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Affiliation(s)
- J J Wedman
- Department of Biomedical Sciences, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - O C M Sibon
- Department of Biomedical Sciences, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - E Mastantuono
- Regenerative Medicine in Cardiovascular Diseases, First Department of Medicine, Klinikum Rechts der Isar, Technical University of Munich, School of Medicine and Health, Munich, Germany
- First Department of Medicine, Cardiology, Klinikum Rechts der Isar, Technical University of Munich, School of Medicine and Health, Munich, Germany
| | - A Iuso
- Institute of Neurogenomics, Helmholtz Zentrum München, Neuherberg, Germany
- Institute of Human Genetics, Technical University of Munich, School of Medicine and Health, Munich, Germany
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10
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DeLoriea J, Millet-Boureima C, Gamberi C. Protocol to build a drug-testing pipeline using large populations of Drosophila melanogaster. STAR Protoc 2023; 4:102747. [PMID: 38103197 PMCID: PMC10751569 DOI: 10.1016/j.xpro.2023.102747] [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: 08/08/2023] [Revised: 10/05/2023] [Accepted: 11/13/2023] [Indexed: 12/18/2023] Open
Abstract
As a small animal that recapitulates many fundamental aspects of human disease, Drosophila lends itself to probing the biological activity of molecules and drug candidates. Here, we present a protocol to build a drug-testing pipeline in Drosophila. We describe steps for generating synchronous populations of Bicaudal C mutants by genetic crossing and wild-type fly culturing for controlled compound administration and exemplary phenotypic assays. For complete details on the use and execution of this protocol, please refer to Millet-Boureima et al.,1 Millet-Boureima et al.,2 and Gamberi et al.3.
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Affiliation(s)
- Jay DeLoriea
- Department of Biology, Coastal Carolina University, Conway, SC 29526, USA
| | | | - Chiara Gamberi
- Department of Biology, Coastal Carolina University, Conway, SC 29526, USA.
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11
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Sandkuhler SE, Youngs KS, Owlett L, Bandora MB, Naaz A, Kim ES, Wang L, Wojtovich AP, Gupta VA, Sacher M, Mackenzie SJ. Haem's relevance genuine? Re-visiting the roles of TANGO2 homologues including HRG-9 and HRG-10 in C. elegans. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2023:2023.11.29.569072. [PMID: 38106020 PMCID: PMC10723261 DOI: 10.1101/2023.11.29.569072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/19/2023]
Abstract
Mutations in the TANGO2 gene cause severe illness in humans, including life-threatening metabolic crises; however, the function of TANGO2 protein remains unknown. In a recent publication in Nature, Sun et al. proposed that TANGO2 helps transport haem within and between cells, from areas with high haem concentrations to those with lower concentrations. Caenorhabditis elegans has two versions of TANGO2 that Sun et al. called HRG-9 and HRG-10. They demonstrated that worms deficient in these proteins show increased survival upon exposure to a toxic haem analog, which Sun et al. interpreted as evidence of decreased haem uptake from intestinal cells into the rest of the organism. We repeated several experiments using the same C. elegans strain as Sun et al. and believe that their findings are better explained by reduced feeding behavior in these worms. We demonstrate that hrg-9 in particular is highly responsive to oxidative stress, independent of haem status. Our group also performed several experiments in yeast and zebrafish models of TANGO2 deficiency and was unable to replicate key findings from these models reported in Sun et al.'s original study. Overall, we believe there is insufficient evidence to support haem transport as the primary function for TANGO2.
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Affiliation(s)
- Sarah E. Sandkuhler
- Department of Pathology, University of Rochester Medical Center, Rochester, NY
| | - Kayla S. Youngs
- Department of Neurology, University of Rochester Medical Center, Rochester, NY
| | - Laura Owlett
- Department of Neurology, University of Rochester Medical Center, Rochester, NY
| | | | - Aaliya Naaz
- Department of Anatomy and Cell Biology, Concordia, Montreal, Canada
| | - Euri S. Kim
- Department of Medicine, Brigham and Women’s Hospital Harvard Medical School, Boston, MA
| | - Lili Wang
- Department of Pharmacology, Vanderbilt University, Nashville, TN
| | - Andrew P. Wojtovich
- Department of Anesthesiology and Perioperative Medicine, University of Rochester Medical Center, Rochester, NY
| | - Vandana A. Gupta
- Department of Medicine, Brigham and Women’s Hospital Harvard Medical School, Boston, MA
| | - Michael Sacher
- Department of Anatomy and Cell Biology, Concordia, Montreal, Canada
- Department of Biology, McGill University, Montreal, Canada
| | - Samuel J. Mackenzie
- Department of Neurology, University of Rochester Medical Center, Rochester, NY
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12
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Yılmaz-Gümüş E, Elcioglu NH, Genç E, Arıcı Ş, Öztürk G, Yapıcı Ö, Akalın F, Öztürk-Hişmi B. Management of acute metabolic crisis in TANGO2 deficiency: a case report. J Pediatr Endocrinol Metab 2023; 36:983-987. [PMID: 37381587 DOI: 10.1515/jpem-2023-0172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Accepted: 06/20/2023] [Indexed: 06/30/2023]
Abstract
OBJECTIVES TANGO2 deficiency is a rare inborn error of metabolism, with distinct clinical features. The clinical presentations of TANGO2 deficiency are developmental delay, speech difficulties, intellectual disability, non-life-threatening paroxysmal neurologic episodes (TANGO2 spells), acute metabolic crises, cardiac crises, seizures and hypothyroidism. Patients may die in acute metabolic crises. Here we report our experience in the management of an acute metabolic crisis in TANGO2 deficiency. CASE PRESENTATION A 9-year-old patient diagnosed with TANGO2 deficiency was admitted with fever, fatigue, unable to walk. In follow up, encephalopathy, rhabdomyolysis and arrhythmia were detected. Vitamin B-complex was started. Our patient's mental status and rhabdomyolysis improved dramatically, and cardiac crises ended without Torsades de pointes, ventricular tachycardia and/or fibrillation or myocardial dysfunction. CONCLUSIONS With this report, we aimed to show the effectiveness of vitamin B-complex in the management of acute metabolic crises.
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Affiliation(s)
- Emel Yılmaz-Gümüş
- Department of Pediatrics, Division of Pediatric Metabolic Diseases, Marmara University School of Medicine, Istanbul, Türkiye
| | - Nursel H Elcioglu
- Department of Pediatrics, Division of Pediatric Genetics, Marmara University School of Medicine, Istanbul, Türkiye
- Eastern Mediterranean University School of Medicine, Famagusta, Türkiye
| | - Emine Genç
- Department of Pediatrics, Division of Pediatric Metabolic Diseases, Marmara University School of Medicine, Istanbul, Türkiye
| | - Şule Arıcı
- Department of Pediatrics, Division of Pediatric Cardiology, Marmara University School of Medicine, Istanbul, Türkiye
| | - Gülten Öztürk
- Department of Pediatrics, Division of Pediatric Neurology, Marmara University School of Medicine, Istanbul, Türkiye
| | - Özge Yapıcı
- Department of Pediatric Radiology, Marmara University School of Medicine, Istanbul, Türkiye
| | - Figen Akalın
- Department of Pediatrics, Division of Pediatric Cardiology, Marmara University School of Medicine, Istanbul, Türkiye
| | - Burcu Öztürk-Hişmi
- Department of Pediatrics, Division of Pediatric Metabolic Diseases, Marmara University School of Medicine, Istanbul, Türkiye
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Kim ES, Casey JG, Tao BS, Mansur A, Mathiyalagan N, Wallace ED, Ehrmann BM, Gupta VA. Intrinsic and extrinsic regulation of rhabdomyolysis susceptibility by Tango2. Dis Model Mech 2023; 16:dmm050092. [PMID: 37577943 PMCID: PMC10499024 DOI: 10.1242/dmm.050092] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Accepted: 08/09/2023] [Indexed: 08/15/2023] Open
Abstract
Rhabdomyolysis is a clinical emergency characterized by severe muscle damage, resulting in the release of intracellular muscle components, which leads to myoglobinuria and, in severe cases, acute kidney failure. Rhabdomyolysis is caused by genetic factors linked to increased disease susceptibility in response to extrinsic triggers. Recessive mutations in TANGO2 result in episodic rhabdomyolysis, metabolic crises, encephalopathy and cardiac arrhythmia. The underlying mechanism contributing to disease onset in response to specific triggers remains unclear. To address these challenges, we created a zebrafish model of Tango2 deficiency. Here, we demonstrate that the loss of Tango2 in zebrafish results in growth defects, early lethality and increased susceptibility of skeletal muscle defects in response to extrinsic triggers, similar to TANGO2-deficient patients. Using lipidomics, we identified alterations in the glycerolipid pathway in tango2 mutants, which is critical for membrane stability and energy balance. Therefore, these studies provide insight into key disease processes in Tango2 deficiency and have increased our understanding of the impacts of specific defects on predisposition to environmental triggers in TANGO2-related disorders.
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Affiliation(s)
- Euri S. Kim
- Division of Genetics, Department of Medicine, Brigham and Women's Hospital Harvard Medical School, Boston, MA 02115, USA
| | - Jennifer G. Casey
- Division of Genetics, Department of Medicine, Brigham and Women's Hospital Harvard Medical School, Boston, MA 02115, USA
| | - Brian S. Tao
- Division of Genetics, Department of Medicine, Brigham and Women's Hospital Harvard Medical School, Boston, MA 02115, USA
| | - Arian Mansur
- Division of Genetics, Department of Medicine, Brigham and Women's Hospital Harvard Medical School, Boston, MA 02115, USA
| | - Nishanthi Mathiyalagan
- Division of Genetics, Department of Medicine, Brigham and Women's Hospital Harvard Medical School, Boston, MA 02115, USA
| | - E. Diane Wallace
- Department of Chemistry, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
| | - Brandie M. Ehrmann
- Department of Chemistry, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
| | - Vandana A. Gupta
- Division of Genetics, Department of Medicine, Brigham and Women's Hospital Harvard Medical School, Boston, MA 02115, USA
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Miyake CY, Ehsan SA, Zhang L, Mackenzie SJ, Azamian MS, Scott DA, Hernandez-Garcia A, Lalani SR. Early initiation of B-vitamin supplementation may reduce symptoms and explain intrafamilial variability: Insights from two sibling pairs from the TANGO2 natural history study. Am J Med Genet A 2023; 191:2433-2439. [PMID: 37421366 PMCID: PMC10612108 DOI: 10.1002/ajmg.a.63331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2023] [Revised: 05/07/2023] [Accepted: 05/26/2023] [Indexed: 07/10/2023]
Abstract
TANGO2-deficiency disorder (TDD) is an autosomal recessive condition arising from pathogenic biallelic variants in the TANGO2 gene. TDD is characterized by symptoms typically beginning in late infancy including delayed developmental milestones, cognitive impairment, dysarthria, expressive language deficits, and gait abnormalities. There is wide phenotypic variability where some are severely affected while others have mild symptoms. This variability has been documented even among sibling pairs who share the same genotype, but reasons for this variability have not been well understood. Emerging data suggest a potential link between B-complex or multivitamin supplementation and decreased metabolic crises in TDD. In this report, we describe two sibling pairs from unreladiagnosed with TDD with marked differences in symptoms. In both families, the older siblings suffered multiple metabolic crises and are clinically more affected than their younger siblings who have very mild to no symptoms; they are the least impaired among 70 other patients in our ongoing international natural history study. Unlike their older siblings, the two younger siblings started taking B-complex vitamins early between 9 and 16 months. This report delineates the mildest presentation of TDD in two families. These data may support a role for early diagnosis and initiation of vitamin supplementation to not only prevent metabolic crises but also improve neurologic outcomes in this life-threatening disorder.
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Affiliation(s)
- Christina Y. Miyake
- Department of Pediatrics, Division of Cardiology, Texas Children’s Hospital, Houston, TX, 77030, USA
- Department of Molecular Physiology and Biophysics, Baylor College of Medicine, Houston, TX, 77030, USA
- Department of Pediatrics, Baylor College of Medicine, Houston, TX, 77030, USA
| | - Saad A. Ehsan
- Baylor College School of Medicine, Houston, TX, 77030, USA
| | - Lilei Zhang
- Department of Molecular Physiology and Biophysics, Baylor College of Medicine, Houston, TX, 77030, USA
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, Texas, 77030, USA
| | - Samuel J. Mackenzie
- Department of Neurology, University of Rochester Medical Center, Rochester, NY USA, 14642, USA
| | - Mahshid S. Azamian
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, Texas, 77030, USA
| | - Daryl A. Scott
- Department of Molecular Physiology and Biophysics, Baylor College of Medicine, Houston, TX, 77030, USA
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, Texas, 77030, USA
| | - Andres Hernandez-Garcia
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, Texas, 77030, USA
| | - Seema R. Lalani
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, Texas, 77030, USA
- Department of Pediatrics, Baylor College of Medicine, Houston, TX, 77030, USA
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Chen C, Hamza I. Notes from the Underground: Heme Homeostasis in C. elegans. Biomolecules 2023; 13:1149. [PMID: 37509184 PMCID: PMC10377359 DOI: 10.3390/biom13071149] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Revised: 07/13/2023] [Accepted: 07/14/2023] [Indexed: 07/30/2023] Open
Abstract
Heme is an iron-containing tetrapyrrole that plays a critical role in various biological processes, including oxygen transport, electron transport, signal transduction, and catalysis. However, free heme is hydrophobic and potentially toxic to cells. Organisms have evolved specific pathways to safely transport this essential but toxic macrocycle within and between cells. The bacterivorous soil-dwelling nematode Caenorhabditis elegans is a powerful animal model for studying heme-trafficking pathways, as it lacks the ability to synthesize heme but instead relies on specialized trafficking pathways to acquire, distribute, and utilize heme. Over the past 15 years, studies on this microscopic animal have led to the identification of a number of heme-trafficking proteins, with corresponding functional homologs in vertebrates. In this review, we provide a comprehensive overview of the heme-trafficking proteins identified in C. elegans and their corresponding homologs in related organisms.
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Affiliation(s)
- Caiyong Chen
- MOE Key Laboratory of Biosystems Homeostasis and Protection, College of Life Sciences, Zhejiang University, Hangzhou 310058, China
| | - Iqbal Hamza
- Center for Blood Oxygen Transport and Hemostasis, Department of Pediatrics, School of Medicine, University of Maryland, Baltimore, MD 21201, USA
- Department of Animal and Avian Sciences, University of Maryland, College Park, MD 20742, USA
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