1
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Teng XY, Hu P, Zhang CM, Zhang QX, Yang G, Zang YY, Liu ZX, Chen G, Shi YS. OPALIN is an LGI1 receptor promoting oligodendrocyte differentiation. Proc Natl Acad Sci U S A 2024; 121:e2403652121. [PMID: 39083419 PMCID: PMC11317624 DOI: 10.1073/pnas.2403652121] [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: 02/23/2024] [Accepted: 07/02/2024] [Indexed: 08/02/2024] Open
Abstract
Leucine-rich glioma-inactivated protein 1 (LGI1), a secretory protein in the brain, plays a critical role in myelination; dysfunction of this protein leads to hypomyelination and white matter abnormalities (WMAs). Here, we hypothesized that LGI1 may regulate myelination through binding to an unidentified receptor on the membrane of oligodendrocytes (OLs). To search for this hypothetic receptor, we analyzed LGI1 binding proteins through LGI1-3 × FLAG affinity chromatography with mouse brain lysates followed by mass spectrometry. An OL-specific membrane protein, the oligodendrocytic myelin paranodal and inner loop protein (OPALIN), was identified. Conditional knockout (cKO) of OPALIN in the OL lineage caused hypomyelination and WMAs, phenocopying LGI1 deficiency in mice. Biochemical analysis revealed the downregulation of Sox10 and Olig2, transcription factors critical for OL differentiation, further confirming the impaired OL maturation in Opalin cKO mice. Moreover, virus-mediated re-expression of OPALIN successfully restored myelination in Opalin cKO mice. In contrast, re-expression of LGI1-unbound OPALIN_K23A/D26A failed to reverse the hypomyelination phenotype. In conclusion, our study demonstrated that OPALIN on the OL membrane serves as an LGI1 receptor, highlighting the importance of the LGI1/OPALIN complex in orchestrating OL differentiation and myelination.
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Affiliation(s)
- Xiao-Yu Teng
- Guangdong Institute of Intelligence Science and Technology, 519031Hengqin, Zhuhai, China
- Ministry of Education Key Laboratory of Model Animal for Disease Study, Model Animal Research Center, Jiangsu Key Laboratory of Molecular Medicine, Medical School, Nanjing University, 210032Nanjing, China
| | - Ping Hu
- Department of Prenatal Diagnosis, State Key Laboratory of Reproductive Medicine, Women’s Hospital of Nanjing Medical University, Nanjing Women and Children’s Healthcare Hospital, 210004Nanjing, China
| | - Cai-Ming Zhang
- Department of Thoracic Surgery, Integrated Hospital of Traditional Chinese Medicine, Southern Medical University, 510315Guangzhou, China
| | - Qin-Xin Zhang
- Department of Prenatal Diagnosis, State Key Laboratory of Reproductive Medicine, Women’s Hospital of Nanjing Medical University, Nanjing Women and Children’s Healthcare Hospital, 210004Nanjing, China
| | - Guolin Yang
- Ministry of Education Key Laboratory of Model Animal for Disease Study, Model Animal Research Center, Jiangsu Key Laboratory of Molecular Medicine, Medical School, Nanjing University, 210032Nanjing, China
| | - Yan-Yu Zang
- Ministry of Education Key Laboratory of Model Animal for Disease Study, Model Animal Research Center, Jiangsu Key Laboratory of Molecular Medicine, Medical School, Nanjing University, 210032Nanjing, China
| | - Zhi-Xiong Liu
- Guangdong Institute of Intelligence Science and Technology, 519031Hengqin, Zhuhai, China
| | - Guiquan Chen
- Ministry of Education Key Laboratory of Model Animal for Disease Study, Model Animal Research Center, Jiangsu Key Laboratory of Molecular Medicine, Medical School, Nanjing University, 210032Nanjing, China
| | - Yun Stone Shi
- Guangdong Institute of Intelligence Science and Technology, 519031Hengqin, Zhuhai, China
- Ministry of Education Key Laboratory of Model Animal for Disease Study, Model Animal Research Center, Jiangsu Key Laboratory of Molecular Medicine, Medical School, Nanjing University, 210032Nanjing, China
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2
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Lee S, Kim S, Kim BJ, Jang H. Morvan Syndrome Associated With Anti-LGI1 Antibodies and Thymoma. J Clin Neurol 2024; 20:103-105. [PMID: 38179640 PMCID: PMC10782085 DOI: 10.3988/jcn.2023.0230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Revised: 07/21/2023] [Accepted: 08/22/2023] [Indexed: 01/06/2024] Open
Affiliation(s)
- Suin Lee
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Seongmi Kim
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Byoung Joon Kim
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Hyemin Jang
- Department of Neurology, Seoul National University Hospital, Seoul, Korea
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3
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Ramirez-Franco J, Debreux K, Extremet J, Maulet Y, Belghazi M, Villard C, Sangiardi M, Youssouf F, El Far L, Lévêque C, Debarnot C, Marchot P, Paneva S, Debanne D, Russier M, Seagar M, Irani SR, El Far O. Patient-derived antibodies reveal the subcellular distribution and heterogeneous interactome of LGI1. Brain 2022; 145:3843-3858. [PMID: 35727946 DOI: 10.1093/brain/awac218] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Revised: 06/08/2022] [Accepted: 06/10/2022] [Indexed: 11/14/2022] Open
Abstract
Autoantibodies against leucine-rich glioma-inactivated 1 (LGI1) occur in patients with encephalitis who present with frequent focal seizures and a pattern of amnesia consistent with focal hippocampal damage. To investigate whether the cellular and subcellular distribution of LGI1 may explain the localization of these features, and hence gain broader insights into LGI1's neurobiology, we analysed the detailed localization of LGI1 and the diversity of its protein interactome, in mouse brains using patient-derived recombinant monoclonal LGI1 antibodies. Combined immunofluorescence and mass spectrometry analyses showed that LGI1 is enriched in excitatory and inhibitory synaptic contact sites, most densely within CA3 regions of the hippocampus. LGI1 is secreted in both neuronal somatodendritic and axonal compartments, and occurs in oligodendrocytic, neuro-oligodendrocytic and astro-microglial protein complexes. Proteomic data support the presence of LGI1-Kv1-MAGUK complexes, but did not reveal LGI1 complexes with postsynaptic glutamate receptors. Our results extend our understanding of regional, cellular and subcellular LGI1 expression profiles and reveal novel LGI1-associated complexes, thus providing insights into the complex biology of LGI1 and its relationship to seizures and memory loss.
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Affiliation(s)
- Jorge Ramirez-Franco
- INSERM, Aix-Marseille Université (AMU), UMR 1072, Unité de Neurobiologie des canaux Ioniques et de la Synapse, 13015 Marseille, France
| | - Kévin Debreux
- INSERM, Aix-Marseille Université (AMU), UMR 1072, Unité de Neurobiologie des canaux Ioniques et de la Synapse, 13015 Marseille, France
| | - Johanna Extremet
- INSERM, Aix-Marseille Université (AMU), UMR 1072, Unité de Neurobiologie des canaux Ioniques et de la Synapse, 13015 Marseille, France
| | - Yves Maulet
- INSERM, Aix-Marseille Université (AMU), UMR 1072, Unité de Neurobiologie des canaux Ioniques et de la Synapse, 13015 Marseille, France
| | - Maya Belghazi
- Aix-Marseille University, CNRS, Institute of Neurophysiopathology (INP), PINT, PFNT, 13385 cedex 5 Marseille, France
| | - Claude Villard
- Aix-Marseille University, CNRS, Institute of Neurophysiopathology (INP), PINT, PFNT, 13385 cedex 5 Marseille, France
| | - Marion Sangiardi
- INSERM, Aix-Marseille Université (AMU), UMR 1072, Unité de Neurobiologie des canaux Ioniques et de la Synapse, 13015 Marseille, France
| | - Fahamoe Youssouf
- INSERM, Aix-Marseille Université (AMU), UMR 1072, Unité de Neurobiologie des canaux Ioniques et de la Synapse, 13015 Marseille, France
| | - Lara El Far
- INSERM, Aix-Marseille Université (AMU), UMR 1072, Unité de Neurobiologie des canaux Ioniques et de la Synapse, 13015 Marseille, France
| | - Christian Lévêque
- INSERM, Aix-Marseille Université (AMU), UMR 1072, Unité de Neurobiologie des canaux Ioniques et de la Synapse, 13015 Marseille, France
| | - Claire Debarnot
- Laboratoire 'Architecture et Fonction des Macromolécules Biologiques (AFMB)', CNRS, Aix-Marseille Université, 13288 cedex 09 Marseille, France
| | - Pascale Marchot
- Laboratoire 'Architecture et Fonction des Macromolécules Biologiques (AFMB)', CNRS, Aix-Marseille Université, 13288 cedex 09 Marseille, France
| | - Sofija Paneva
- Oxford Autoimmune Neurology Group, Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, University of Oxford, Oxford, UK
| | - Dominique Debanne
- INSERM, Aix-Marseille Université (AMU), UMR 1072, Unité de Neurobiologie des canaux Ioniques et de la Synapse, 13015 Marseille, France
| | - Michael Russier
- INSERM, Aix-Marseille Université (AMU), UMR 1072, Unité de Neurobiologie des canaux Ioniques et de la Synapse, 13015 Marseille, France
| | - Michael Seagar
- INSERM, Aix-Marseille Université (AMU), UMR 1072, Unité de Neurobiologie des canaux Ioniques et de la Synapse, 13015 Marseille, France
| | - Sarosh R Irani
- Oxford Autoimmune Neurology Group, Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, University of Oxford, Oxford, UK
- Department of Neurology, Oxford University Hospitals, Oxford, UK
| | - Oussama El Far
- INSERM, Aix-Marseille Université (AMU), UMR 1072, Unité de Neurobiologie des canaux Ioniques et de la Synapse, 13015 Marseille, France
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4
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Teng X, Hu P, Chen Y, Zang Y, Ye X, Ou J, Chen G, Shi YS. A novel
Lgi1
mutation causes white matter abnormalities and impairs motor coordination in mice. FASEB J 2022; 36:e22212. [DOI: 10.1096/fj.202101652r] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Revised: 01/18/2022] [Accepted: 02/03/2022] [Indexed: 12/22/2022]
Affiliation(s)
- Xiao‐Yu Teng
- Minister of Education Key Laboratory of Model Animal for Disease Study Model Animal Research Center, Medical School Nanjing University Nanjing China
| | - Ping Hu
- Department of Prenatal Diagnosis State Key Laboratory of Reproductive Medicine Women's Hospital of Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital Nanjing China
| | - Yangyang Chen
- Minister of Education Key Laboratory of Model Animal for Disease Study Model Animal Research Center, Medical School Nanjing University Nanjing China
| | - Yanyu Zang
- Minister of Education Key Laboratory of Model Animal for Disease Study Model Animal Research Center, Medical School Nanjing University Nanjing China
| | - Xiaolian Ye
- Minister of Education Key Laboratory of Model Animal for Disease Study Model Animal Research Center, Medical School Nanjing University Nanjing China
| | - Jingmin Ou
- Department of General Surgery Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine Shanghai China
| | - Guiquan Chen
- Minister of Education Key Laboratory of Model Animal for Disease Study Model Animal Research Center, Medical School Nanjing University Nanjing China
| | - Yun Stone Shi
- Minister of Education Key Laboratory of Model Animal for Disease Study Model Animal Research Center, Medical School Nanjing University Nanjing China
- State Key Laboratory of Pharmaceutical Biotechnology Department of Neurology Affiliated Drum Tower Hospital of Nanjing University Medical School Nanjing University Nanjing China
- Institute for Brain Sciences Nanjing University Nanjing China
- Chemistry and Biomedicine Innovation Center Nanjing University Nanjing China
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5
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Baudin P, Cousyn L, Navarro V. The LGI1 protein: molecular structure, physiological functions and disruption-related seizures. Cell Mol Life Sci 2021; 79:16. [PMID: 34967933 PMCID: PMC11072701 DOI: 10.1007/s00018-021-04088-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 12/07/2021] [Accepted: 12/09/2021] [Indexed: 01/16/2023]
Abstract
Leucine-rich, glioma inactivated 1 (LGI1) is a secreted glycoprotein, mainly expressed in the brain, and involved in central nervous system development and physiology. Mutations of LGI1 have been linked to autosomal dominant lateral temporal lobe epilepsy (ADLTE). Recently auto-antibodies against LGI1 have been described as the basis for an autoimmune encephalitis, associated with specific motor and limbic epileptic seizures. It is the second most common cause of autoimmune encephalitis. This review presents details on the molecular structure, expression and physiological functions of LGI1, and examines how their disruption underlies human pathologies. Knock-down of LGI1 in rodents reveals that this protein is necessary for normal brain development. In mature brains, LGI1 is associated with Kv1 channels and AMPA receptors, via domain-specific interaction with membrane anchoring proteins and contributes to regulation of the expression and function of these channels. Loss of function, due to mutations or autoantibodies, of this key protein in the control of neuronal activity is a common feature in the genesis of epileptic seizures in ADLTE and anti-LGI1 autoimmune encephalitis.
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Affiliation(s)
- Paul Baudin
- Sorbonne Université, Paris Brain Institute - Institut du Cerveau, ICM, INSERM, CNRS, AP-HP, Pitié-Salpêtrière Hospital, Paris, France
| | - Louis Cousyn
- Sorbonne Université, Paris Brain Institute - Institut du Cerveau, ICM, INSERM, CNRS, AP-HP, Pitié-Salpêtrière Hospital, Paris, France
- AP-HP, Epilepsy Unit, Pitié-Salpêtrière Hospital, DMU Neurosciences, Paris, France
| | - Vincent Navarro
- Sorbonne Université, Paris Brain Institute - Institut du Cerveau, ICM, INSERM, CNRS, AP-HP, Pitié-Salpêtrière Hospital, Paris, France.
- AP-HP, Epilepsy Unit, Pitié-Salpêtrière Hospital, DMU Neurosciences, Paris, France.
- AP-HP, Center of Reference for Rare Epilepsies, Pitié-Salpêtrière Hospital, 47-83 Boulevard de l'Hôpital, 75013, Paris, France.
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6
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Hu P, Wu D, Zang YY, Wang Y, Zhou YP, Qiao F, Teng XY, Chen J, Li QQ, Sun JH, Liu T, Feng HY, Zhou QG, Shi YS, Xu Z. A novel LGI1 mutation causing autosomal dominant lateral temporal lobe epilepsy confirmed by a precise knock-in mouse model. CNS Neurosci Ther 2021; 28:237-246. [PMID: 34767694 PMCID: PMC8739050 DOI: 10.1111/cns.13761] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Revised: 10/20/2021] [Accepted: 10/25/2021] [Indexed: 12/30/2022] Open
Abstract
AIMS This study aimed to explore the pathomechanism of a mutation on the leucine-rich glioma inactivated 1 gene (LGI1) identified in a family having autosomal dominant lateral temporal lobe epilepsy (ADLTE), using a precise knock-in mouse model. METHODS AND RESULTS A novel LGI1 mutation, c.152A>G; p. Asp51Gly, was identified by whole exome sequencing in a Chinese family with ADLTE. The pathomechanism of the mutation was explored by generating Lgi1D51G knock-in mice that precisely phenocopied the epileptic symptoms of human patients. The Lgi1D51G / D51G mice showed spontaneous recurrent generalized seizures and premature death. The Lgi1D51G /+ mice had partial epilepsy, with half of them displaying epileptiform discharges on electroencephalography. They also showed enhanced sensitivity to the convulsant agent pentylenetetrazole. Mechanistically, the secretion of Lgi1 was impaired in the brain of the D51G knock-in mice and the protein level was drastically reduced. Moreover, the antiepileptic drugs, carbamazepine, oxcarbazepine, and sodium valproate, could prolong the survival time of Lgi1D51G / D51G mice, and oxcarbazepine appeared to be the most effective. CONCLUSIONS We identified a novel epilepsy-causing mutation of LGI1 in humans. The Lgi1D51G /+ mouse model, precisely phenocopying epileptic symptoms of human patients, could be a useful tool in future studies on the pathogenesis and potential therapies for epilepsy.
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Affiliation(s)
- Ping Hu
- Department of Prenatal Diagnosis, Women's Hospital of Nanjing Medical University, Nanjing Maternity and Child Health care Hospital, Nanjing, China
| | - Dan Wu
- Minister of Education Key Laboratory of Model Animal for Disease Study, Model Animal Research Center, Department of Neurology, Drum Tower Hospital, Medical School, Nanjing University, Nanjing, China.,State Key Laboratory of Pharmaceutical Biotechnology, National Resource for Mutant Mice, Jiangsu Key Laboratory of Molecular Medicine, Medical School, Nanjing University, Nanjing, China
| | - Yan-Yu Zang
- Minister of Education Key Laboratory of Model Animal for Disease Study, Model Animal Research Center, Department of Neurology, Drum Tower Hospital, Medical School, Nanjing University, Nanjing, China.,State Key Laboratory of Pharmaceutical Biotechnology, National Resource for Mutant Mice, Jiangsu Key Laboratory of Molecular Medicine, Medical School, Nanjing University, Nanjing, China
| | - Yan Wang
- Department of Prenatal Diagnosis, Women's Hospital of Nanjing Medical University, Nanjing Maternity and Child Health care Hospital, Nanjing, China
| | - Ya-Ping Zhou
- School of Pharmacy, Nanjing Medical University, Nanjing, China
| | - Fengchang Qiao
- Department of Prenatal Diagnosis, Women's Hospital of Nanjing Medical University, Nanjing Maternity and Child Health care Hospital, Nanjing, China
| | - Xiao-Yu Teng
- Minister of Education Key Laboratory of Model Animal for Disease Study, Model Animal Research Center, Department of Neurology, Drum Tower Hospital, Medical School, Nanjing University, Nanjing, China.,State Key Laboratory of Pharmaceutical Biotechnology, National Resource for Mutant Mice, Jiangsu Key Laboratory of Molecular Medicine, Medical School, Nanjing University, Nanjing, China
| | - Jiang Chen
- Minister of Education Key Laboratory of Model Animal for Disease Study, Model Animal Research Center, Department of Neurology, Drum Tower Hospital, Medical School, Nanjing University, Nanjing, China.,State Key Laboratory of Pharmaceutical Biotechnology, National Resource for Mutant Mice, Jiangsu Key Laboratory of Molecular Medicine, Medical School, Nanjing University, Nanjing, China
| | - Qing-Qing Li
- Minister of Education Key Laboratory of Model Animal for Disease Study, Model Animal Research Center, Department of Neurology, Drum Tower Hospital, Medical School, Nanjing University, Nanjing, China.,State Key Laboratory of Pharmaceutical Biotechnology, National Resource for Mutant Mice, Jiangsu Key Laboratory of Molecular Medicine, Medical School, Nanjing University, Nanjing, China
| | - Jia-Hui Sun
- Minister of Education Key Laboratory of Model Animal for Disease Study, Model Animal Research Center, Department of Neurology, Drum Tower Hospital, Medical School, Nanjing University, Nanjing, China.,State Key Laboratory of Pharmaceutical Biotechnology, National Resource for Mutant Mice, Jiangsu Key Laboratory of Molecular Medicine, Medical School, Nanjing University, Nanjing, China
| | - TingTing Liu
- Minister of Education Key Laboratory of Model Animal for Disease Study, Model Animal Research Center, Department of Neurology, Drum Tower Hospital, Medical School, Nanjing University, Nanjing, China.,State Key Laboratory of Pharmaceutical Biotechnology, National Resource for Mutant Mice, Jiangsu Key Laboratory of Molecular Medicine, Medical School, Nanjing University, Nanjing, China
| | - Hao-Yang Feng
- Department of Prenatal Diagnosis, Women's Hospital of Nanjing Medical University, Nanjing Maternity and Child Health care Hospital, Nanjing, China
| | - Qi-Gang Zhou
- School of Pharmacy, Nanjing Medical University, Nanjing, China
| | - Yun Stone Shi
- Minister of Education Key Laboratory of Model Animal for Disease Study, Model Animal Research Center, Department of Neurology, Drum Tower Hospital, Medical School, Nanjing University, Nanjing, China.,State Key Laboratory of Pharmaceutical Biotechnology, National Resource for Mutant Mice, Jiangsu Key Laboratory of Molecular Medicine, Medical School, Nanjing University, Nanjing, China.,Chemistry and Biomedicine Innovation Center, Nanjing University, Nanjing, China.,Institute for Brain Sciences, Nanjing University, Nanjing, China
| | - Zhengfeng Xu
- Department of Prenatal Diagnosis, Women's Hospital of Nanjing Medical University, Nanjing Maternity and Child Health care Hospital, Nanjing, China
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7
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Zhang SJ, Xue YY, Yu H, Tao QQ. Morvan syndrome associated with LGI1 antibody: a case report. BMC Neurol 2021; 21:185. [PMID: 33941099 PMCID: PMC8091679 DOI: 10.1186/s12883-021-02205-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Accepted: 04/16/2021] [Indexed: 12/02/2022] Open
Abstract
Background Morvan syndrome (MoS) is a rare autoimmune syndrome associated with antibodies against two kinds of potassium channel proteins, contactin associated protein-like 2 (CASPR2) and leucine-rich glioma inactivated protein 1 (LGI1). MoS patients with only LGI1-antibody seropositivity have rarely been reported. Here, we describe a 64-year-old male MoS patient with only LGI1-antibody seropositivity. Case presentation A 64-year-old male patient was referred to our hospital due to limb pain, widespread myokymia, insomnia, constipation, and hyperhidrosis for 1 month. The patient was diagnosed with MoS based on the clinical symptoms and positive LGI1-antibody in serum. He was treated with intravenous immunoglobulin (IVIG), intravenous methylprednisolone followed by oral prednisone, and other drugs for symptomatic relief. Several days later, myokymia and insomnia symptoms improved. After 60 days of follow-up, all the drugs had been stopped for 2 weeks, and the patient achieved complete remission without any medical side effects. Conclusion We report the clinical characteristics of a Chinese MoS patient with only LGI1-antibody seropositivity, and further support the view that non-neoplasm MoS patients respond well to immunotherapy. Supplementary Information The online version contains supplementary material available at 10.1186/s12883-021-02205-9.
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Affiliation(s)
- Shui-Jing Zhang
- Department of Neurology,The Third Affiliated Hospital of Zhejiang Chinese Medical University and Zhejiang Rehabilitation Medical Center, Hangzhou, China.,Department of Neurology and Research Center of Neurology in Second Affiliated Hospital, Key Laboratory of Medical Neurobiology of Zhejiang Province, Zhejiang University School of Medicine, Hangzhou, China
| | - Yan-Yan Xue
- Department of Neurology and Research Center of Neurology in Second Affiliated Hospital, Key Laboratory of Medical Neurobiology of Zhejiang Province, Zhejiang University School of Medicine, Hangzhou, China
| | - Hao Yu
- Department of Neurology and Research Center of Neurology in Second Affiliated Hospital, Key Laboratory of Medical Neurobiology of Zhejiang Province, Zhejiang University School of Medicine, Hangzhou, China
| | - Qing-Qing Tao
- Department of Neurology and Research Center of Neurology in Second Affiliated Hospital, Key Laboratory of Medical Neurobiology of Zhejiang Province, Zhejiang University School of Medicine, Hangzhou, China.
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8
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Tochigi Y, Takamatsu Y, Nakane J, Nakai R, Katayama K, Suzuki H. Loss of Wwox Causes Defective Development of Cerebral Cortex with Hypomyelination in a Rat Model of Lethal Dwarfism with Epilepsy. Int J Mol Sci 2019; 20:ijms20143596. [PMID: 31340538 PMCID: PMC6678113 DOI: 10.3390/ijms20143596] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2019] [Revised: 07/20/2019] [Accepted: 07/22/2019] [Indexed: 12/20/2022] Open
Abstract
WW domain-containing oxidoreductase (Wwox) is a putative tumor suppressor. Several germline mutations of Wwox have been associated with infant neurological disorders characterized by epilepsy, growth retardation, and early death. Less is known, however, about the pathological link between Wwox mutations and these disorders or the physiological role of Wwox in brain development. In this study, we examined age-related expression and histological localization of Wwox in forebrains as well as the effects of loss of function mutations in the Wwox gene in the immature cortex of a rat model of lethal dwarfism with epilepsy (lde/lde). Immunostaining revealed that Wwox is expressed in neurons, astrocytes, and oligodendrocytes. lde/lde cortices were characterized by a reduction in neurite growth without a reduced number of neurons, severe reduction in myelination with a reduced number of mature oligodendrocytes, and a reduction in cell populations of astrocytes and microglia. These results indicate that Wwox is essential for normal development of neurons and glial cells in the cerebral cortex.
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Affiliation(s)
- Yuki Tochigi
- Laboratory of Veterinary Physiology, School of Veterinary Medicine, Faculty of Veterinary Science, Nippon Veterinary and Life Science University, Musashino-shi, Tokyo 180-8602, Japan
| | - Yutaka Takamatsu
- Laboratory of Veterinary Physiology, School of Veterinary Medicine, Faculty of Veterinary Science, Nippon Veterinary and Life Science University, Musashino-shi, Tokyo 180-8602, Japan
| | - Jun Nakane
- Laboratory of Veterinary Physiology, School of Veterinary Medicine, Faculty of Veterinary Science, Nippon Veterinary and Life Science University, Musashino-shi, Tokyo 180-8602, Japan
| | - Rika Nakai
- Laboratory of Veterinary Physiology, School of Veterinary Medicine, Faculty of Veterinary Science, Nippon Veterinary and Life Science University, Musashino-shi, Tokyo 180-8602, Japan
| | - Kentaro Katayama
- Laboratory of Veterinary Physiology, School of Veterinary Medicine, Faculty of Veterinary Science, Nippon Veterinary and Life Science University, Musashino-shi, Tokyo 180-8602, Japan
| | - Hiroetsu Suzuki
- Laboratory of Veterinary Physiology, School of Veterinary Medicine, Faculty of Veterinary Science, Nippon Veterinary and Life Science University, Musashino-shi, Tokyo 180-8602, Japan.
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9
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Xie YJ, Zhou L, Wang Y, Jiang NW, Cao S, Shao CY, Wang XT, Li XY, Shen Y, Zhou L. Leucine-Rich Glioma Inactivated 1 Promotes Oligodendrocyte Differentiation and Myelination via TSC-mTOR Signaling. Front Mol Neurosci 2018; 11:231. [PMID: 30034322 PMCID: PMC6043672 DOI: 10.3389/fnmol.2018.00231] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2018] [Accepted: 06/12/2018] [Indexed: 12/26/2022] Open
Abstract
Leucine-rich glioma inactivated 1 (Lgi1), a putative tumor suppressor, is tightly associated with autosomal dominant lateral temporal lobe epilepsy (ADLTE). It has been shown that Lgi1 regulates the myelination of Schwann cells in the peripheral nervous system (PNS). However, the function and underlying mechanisms for Lgi1 regulation of oligodendrocyte differentiation and myelination in the central nervous system (CNS) remain elusive. In addition, whether Lgi1 is required for myelin maintenance is unknown. Here, we show that Lgi1 is necessary and sufficient for the differentiation of oligodendrocyte precursor cells and is also required for the maintenance of myelinated fibers. The hypomyelination in Lgi1-/- mice attributes to the inhibition of the biosynthesis of lipids and proteins in oligodendrocytes (OLs). Moreover, we found that Lgi1 deficiency leads to a decrease in expression of tuberous sclerosis complex 1 (TSC1) and activates mammalian target of rapamycin signaling. Together, the present work establishes that Lgi1 is a regulator of oligodendrocyte development and myelination in CNS.
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Affiliation(s)
- Ya-Jun Xie
- Key Laboratory of Medical Neurobiology of Ministry of Health, Department of Neurobiology, Zhejiang University School of MedicineHangzhou, China
| | - Lin Zhou
- Key Laboratory of Medical Neurobiology of Ministry of Health, Department of Neurobiology, Zhejiang University School of MedicineHangzhou, China
| | - Yin Wang
- Laboratory of Craniocerebral Diseases of Ningxia Hui Autonomous Region, Ningxia Medical UniversityYinchuan, China
| | - Nan-Wei Jiang
- Ningbo Key Laboratory of Behavioral Neuroscience, Department of Physiology and Pharmacology, Ningbo University School of MedicineNingbo, China
| | - Shenglong Cao
- Department of Neurosurgery, Second Affiliated Hospital of Zhejiang University School of MedicineHangzhou, China
| | - Chong-Yu Shao
- Key Laboratory of Medical Neurobiology of Ministry of Health, Department of Neurobiology, Zhejiang University School of MedicineHangzhou, China
| | - Xin-Tai Wang
- Key Laboratory of Medical Neurobiology of Ministry of Health, Department of Neurobiology, Zhejiang University School of MedicineHangzhou, China
| | - Xiang-Yao Li
- Key Laboratory of Medical Neurobiology of Ministry of Health, Department of Neurobiology, Zhejiang University School of MedicineHangzhou, China
| | - Ying Shen
- Key Laboratory of Medical Neurobiology of Ministry of Health, Department of Neurobiology, Zhejiang University School of MedicineHangzhou, China
| | - Liang Zhou
- Key Laboratory of Medical Neurobiology of Ministry of Health, Department of Neurobiology, Zhejiang University School of MedicineHangzhou, China
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Gadoth A, Pittock SJ, Dubey D, McKeon A, Britton JW, Schmeling JE, Smith A, Kotsenas AL, Watson RE, Lachance DH, Flanagan EP, Lennon VA, Klein CJ. Expanded phenotypes and outcomes among 256 LGI1/CASPR2-IgG-positive patients. Ann Neurol 2017. [PMID: 28628235 DOI: 10.1002/ana.24979] [Citation(s) in RCA: 208] [Impact Index Per Article: 29.7] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
OBJECTIVE To describe an expanded phenotypic spectrum and longitudinal outcome in 256 LGI1-IgG-seropositive and/or CASPR2-IgG-seropositive patients. METHODS Patients were identified through service neural autoantibody evaluation. Ninety-five had longitudinal follow-up (7-456 months; median = 35). RESULTS Among 3,910 patients tested, 196 were LGI1-IgG positive, 51 were CASPR2-IgG positive, and 9 were dual positive. Cerebrospinal fluid testing was less sensitive than serum testing, detecting only 24 of 38 (63%) LGI1-IgG-positive and 5 of 6 (83%) CASPR2-IgG-positive patients. LGI1-IgG-positive specimens had higher voltage-gated potassium channel-IgG immunoprecipitation values (0.33nmol/l, range = 0.02-5.14) than CASPR2-IgG-positive specimens (0.10nmol/l, range = 0.00-0.45, p < 0.001). Of patients presenting with pain or peripheral nervous system (PNS) manifestations, 39% were LGI1-IgG seropositive (7% had solely neuropathy or pain). Multivariate analysis identified age as the only significant predictor of central nervous system (CNS) versus PNS involvement (>50 years; odds ratio = 15, p < 0.001). Paroxysmal dizziness spells (PDS), a unique LGI1-IgG accompaniment (14% of patients), frequently delayed the diagnosis. T2-mesiotemporal hyperintensity was more common in LGI1-IgG-positive (41%) than in CASPR2-IgG-positive patients (p = 0.033). T1-bright basal ganglia were confined to LGI1-IgG-positive patients with faciobrachial-dystonic seizures (9 of 39, 31%). Cancer was found in 44% of LGI1-IgG/CASPR2-IgG dual seropositive patients (one-third thymoma). Response to initial immunotherapy was favorable in 97%; mean modified Rankin score was 3 (range = 1-5) at onset and 1.74 (range = 0-6) at last follow-up, with 9% having severe refractory disability, 20% being asymptomatic, 28% receiving immunotherapy, and 58% receiving antiepileptic medication. INTERPRETATION Older age is a strong predictor of CNS involvement in patients seropositive for CASPR2-IgG or LGI1-IgG. Pain, peripheral manifestations, and stereotypic paroxysmal dizziness spells are common with LGI1-IgG. Response to initial immunotherapy is often favorable, but some patients remain severely disabled, requiring long-term immunotherapy and/or antiepileptic medications. Ann Neurol 2017;82:79-92.
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Affiliation(s)
- Avi Gadoth
- Neuroimmunology Laboratory, Department of Neurology, Mayo Clinic, Rochester, MN
| | - Sean J Pittock
- Neuroimmunology Laboratory, Department of Neurology, Mayo Clinic, Rochester, MN
| | - Divyanshu Dubey
- Neuroimmunology Laboratory, Department of Neurology, Mayo Clinic, Rochester, MN
| | - Andrew McKeon
- Neuroimmunology Laboratory, Department of Neurology, Mayo Clinic, Rochester, MN
| | - Jeff W Britton
- Neuroimmunology Laboratory, Department of Neurology, Mayo Clinic, Rochester, MN
| | - John E Schmeling
- Neuroimmunology Laboratory, Department of Neurology, Mayo Clinic, Rochester, MN
| | - Aurelia Smith
- Neuroimmunology Laboratory, Department of Neurology, Mayo Clinic, Rochester, MN
| | | | | | - Daniel H Lachance
- Neuroimmunology Laboratory, Department of Neurology, Mayo Clinic, Rochester, MN
| | - Eoin P Flanagan
- Neuroimmunology Laboratory, Department of Neurology, Mayo Clinic, Rochester, MN
| | - Vanda A Lennon
- Neuroimmunology Laboratory, Department of Neurology, Mayo Clinic, Rochester, MN
| | - Christopher J Klein
- Neuroimmunology Laboratory, Department of Neurology, Mayo Clinic, Rochester, MN
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Lahoria R, Pittock SJ, Gadoth A, Engelstad JK, Lennon VA, Klein CJ. Clinical-pathologic correlations in voltage-gated Kv1 potassium channel complex-subtyped autoimmune painful polyneuropathy. Muscle Nerve 2017; 55:520-525. [DOI: 10.1002/mus.25371] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2016] [Revised: 08/03/2016] [Accepted: 08/08/2016] [Indexed: 01/16/2023]
Affiliation(s)
- Rajat Lahoria
- Peripheral Neuropathy Research Laboratory, Mayo Clinic; Rochester Minnesota USA
| | - Sean J. Pittock
- Neuroimmunology Laboratory, Mayo Clinic; 200 First Street SW Rochester Minnesota 55905 USA
| | - Avi Gadoth
- Neuroimmunology Laboratory, Mayo Clinic; 200 First Street SW Rochester Minnesota 55905 USA
| | - Janean K. Engelstad
- Peripheral Neuropathy Research Laboratory, Mayo Clinic; Rochester Minnesota USA
| | - Vanda A. Lennon
- Neuroimmunology Laboratory, Mayo Clinic; 200 First Street SW Rochester Minnesota 55905 USA
| | - Christopher J. Klein
- Peripheral Neuropathy Research Laboratory, Mayo Clinic; Rochester Minnesota USA
- Neuroimmunology Laboratory, Mayo Clinic; 200 First Street SW Rochester Minnesota 55905 USA
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12
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Tumminelli G, Battisti C, Cioni C, Mignarri A, Annunziata P, Federico A. Demyelinating polyneuropathy in a case of anti-LGI1 encephalitis. Muscle Nerve 2017; 56:E2-E3. [PMID: 28073143 DOI: 10.1002/mus.25572] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2016] [Revised: 01/04/2017] [Accepted: 01/08/2017] [Indexed: 01/12/2023]
Affiliation(s)
- Gemma Tumminelli
- Department of Medicine, Surgery, and Neurosciences, University of Siena, Siena, Italy
| | - Carla Battisti
- Department of Medicine, Surgery, and Neurosciences, University of Siena, Siena, Italy
| | - Chiara Cioni
- Department of Medicine, Surgery, and Neurosciences, University of Siena, Siena, Italy
| | - Andrea Mignarri
- Department of Medicine, Surgery, and Neurosciences, University of Siena, Siena, Italy
| | - Pasquale Annunziata
- Department of Medicine, Surgery, and Neurosciences, University of Siena, Siena, Italy
| | - Antonio Federico
- Department of Medicine, Surgery, and Neurosciences, University of Siena, Siena, Italy
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Urbach H, Rauer S, Mader I, Paus S, Wagner J, Malter MP, Prüss H, Lewerenz J, Kassubek J, Hegen H, Auer M, Deisenhammer F, Ufer F, Bien CG, Baumgartner A. Supratentorial white matter blurring associated with voltage-gated potassium channel-complex limbic encephalitis. Neuroradiology 2015; 57:1203-9. [PMID: 26293130 DOI: 10.1007/s00234-015-1581-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2015] [Accepted: 08/11/2015] [Indexed: 01/01/2023]
Abstract
INTRODUCTION Limbic encephalitis (LE) associated with voltage-gated potassium channel-complex antibodies (VGKC-LE) is frequently non-paraneoplastic and associated with marked improvement following corticosteroid therapy. Mesial temporal lobe abnormalities are present in around 80 % of patients. If associated or preceded by faciobrachial dystonic seizures, basal ganglia signal changes may occur. In some patients, blurring of the supratentorial white matter on T2-weighted images (SWMB) may be seen. The purpose of this study was to evaluate the incidence of SWMB and whether it is specific for VGKC-LE. METHODS Two experienced neuroradiologists independently evaluated signal abnormalities on FLAIR MRI in 79 patients with LE while unaware on the antibody type. RESULTS SWMB was independently assessed as present in 10 of 36 (28 %) compared to 2 (5 %) of 43 non-VGKC patients (p = 0.009). It was not related to the presence of LGI1 or CASPR2 proteins of VGKC antibodies. MRI showed increased temporomesial FLAIR signal in 22 (61 %) VGKC compared to 14 (33 %) non-VGKC patients (p = 0.013), and extratemporomesial structures were affected in one VGKC (3 %) compared to 11 (26 %) non-VGKC patients (p = 0.005). CONCLUSION SWMB is a newly described MRI sign rather specific for VGKC-LE.
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Affiliation(s)
- H Urbach
- Department of Neuroradiology, University Medical Center Freiburg, Breisacher Str. 64, 79106, Freiburg, Germany.
| | - S Rauer
- Department of Neurology, University Medical Center Freiburg, Freiburg, Germany
| | - I Mader
- Department of Neuroradiology, University Medical Center Freiburg, Breisacher Str. 64, 79106, Freiburg, Germany
| | - S Paus
- Department of Neurology, University Medical Center, Bonn, Germany
| | - J Wagner
- Department of Epileptology, University Medical Center, Bonn, Germany
| | - M P Malter
- Department of Neurology, University of Cologne, Cologne, Germany
| | - H Prüss
- Department of Neurology, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - J Lewerenz
- Department of Neurology, Ulm University, Ulm, Germany
| | - J Kassubek
- Department of Neurology, Ulm University, Ulm, Germany
| | - H Hegen
- Department of Neurology, University Innsbruck, Innsbruck, Austria
| | - M Auer
- Department of Neurology, University Innsbruck, Innsbruck, Austria
| | - F Deisenhammer
- Department of Neurology, University Innsbruck, Innsbruck, Austria
| | - F Ufer
- Department of Neurology, University Medical Center, Hamburg, Germany
| | - C G Bien
- Epilepsy Centre Bethel, Bielefeld-Bethel, Germany
| | - A Baumgartner
- Department of Neurology, University Medical Center Freiburg, Freiburg, Germany
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Xie YJ, Zhou L, Jiang N, Zhang N, Zou N, Zhou L, Wang Y, Cowell JK, Shen Y. Essential roles of leucine-rich glioma inactivated 1 in the development of embryonic and postnatal cerebellum. Sci Rep 2015; 5:7827. [PMID: 25591666 PMCID: PMC4296302 DOI: 10.1038/srep07827] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2014] [Accepted: 12/12/2014] [Indexed: 11/24/2022] Open
Abstract
Leucine-rich glioma inactivated 1 (LGI1) is a secreted protein that interacts with ADAM transmembrane proteins, and its mutations are linked to human epilepsy. The function of LGI1 in CNS development remains undefined. Here, we report novel functions of LGI1 in the generation of cerebellar granule precursors (CGPs) and differentiation of radial glial cells (RGCs) in the cerebellum. A reduction in external granule layer thickness and defects in foliation were seen in embryonic and new-born LGI1 knockout (KO) mice. BrdU staining showed an inhibited proliferation of CGPs in KO embryos, which might be explained by the reduced Sonic hedgehog in embryos. In addition, the differentiation of RGCs into Bergmann glias was suppressed in KO mice. Enhanced Jagged1-Notch1 signaling in KO mice via reduced β-secretase proteolysis suggests that altered phenotype of RGCs is due to abnormal Notch1 signaling. Together, our results demonstrate that LGI1 is an essential player in the cerebellar development.
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Affiliation(s)
- Ya-Jun Xie
- Department of Neurobiology, Key Laboratory of Medical Neurobiology of the Ministry of Health, Zhejiang Province Key Laboratory of Neurobiology, Zhejiang University School of Medicine, Hangzhou, China
| | - Liang Zhou
- Department of Neurobiology, Key Laboratory of Medical Neurobiology of the Ministry of Health, Zhejiang Province Key Laboratory of Neurobiology, Zhejiang University School of Medicine, Hangzhou, China
| | - Nanwei Jiang
- Zhejiang Provincial Key Laboratory of Pathophysiology, Department of Physiology and Pharmacology, Ningbo University School of Medicine, Ningbo, China
| | - Nan Zhang
- Ningxia Key Laboratory of Cerebrocranial Diseases, Ningxia Medical University, Yinchuan, China
| | - Na Zou
- Department of Neurobiology, Key Laboratory of Medical Neurobiology of the Ministry of Health, Zhejiang Province Key Laboratory of Neurobiology, Zhejiang University School of Medicine, Hangzhou, China
| | - Lin Zhou
- Department of Neurobiology, Key Laboratory of Medical Neurobiology of the Ministry of Health, Zhejiang Province Key Laboratory of Neurobiology, Zhejiang University School of Medicine, Hangzhou, China
| | - Yin Wang
- Ningxia Key Laboratory of Cerebrocranial Diseases, Ningxia Medical University, Yinchuan, China
| | - John K Cowell
- Georgia Regents University, Cancer Center, Augusta, GA, USA
| | - Ying Shen
- Department of Neurobiology, Key Laboratory of Medical Neurobiology of the Ministry of Health, Zhejiang Province Key Laboratory of Neurobiology, Zhejiang University School of Medicine, Hangzhou, China
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Axonal dysfunction with voltage gated potassium channel complex antibodies. Exp Neurol 2014; 261:337-42. [DOI: 10.1016/j.expneurol.2014.06.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2014] [Revised: 05/29/2014] [Accepted: 06/01/2014] [Indexed: 12/13/2022]
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Abstract
Mutations in the LGI1 gene predispose to autosomal dominant lateral temporal lobe epilepsy, a rare hereditary form with incomplete penetrance and associated with acoustic auras. LGI1 is not a structural component of an ion channel like most epilepsy-related genes, but is a secreted protein. Mutant null mice exhibit early-onset seizures, and electrophysiological analysis shows abnormal synaptic transmission. LGI1 binds to ADAM23 on the presynaptic membrane and ADAM22 on the postsynaptic membrane, further implicating it in regulating the strength of synaptic transmission. Patients with limbic encephalitis show autoantibodies against LGI1 and develop seizures, supporting a role for LGI1 in synapse transmission in the post developmental brain. LGI1, however, also seems to be involved in aspects of neurite development and dendritic pruning, suggesting an additional role in corticogenesis. LGI1 is also involved in cell movement and suppression of dendritic outgrowth in in vitro systems, possibly involving actin cytoskeleton dynamics. Expression patterns in embryonic development correspond to areas of neuronal migration. Loss of LGI1 expression also impacts on myelination of the central and peripheral nervous systems. In zebrafish embryos, knockdown of lgi1a leads to a seizure-like behavior and abnormal brain development, providing a system to study its role in early embryogenesis. Despite being implicated in a role in both synapse transmission and neuronal development, how LGI1 predisposes to epilepsy is still largely unknown. It appears, however, that LGI1 may function differently in a cell context-specific manner, implying a complex involvement in brain development and function that remains to be defined.
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Affiliation(s)
- John K Cowell
- Georgia Regents University Cancer Center, Augusta, GA, USA.
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Klein CJ, Lennon VA, Aston PA, McKeon A, Pittock SJ. Chronic pain as a manifestation of potassium channel-complex autoimmunity. Neurology 2012; 79:1136-44. [PMID: 22895588 DOI: 10.1212/wnl.0b013e3182698cab] [Citation(s) in RCA: 137] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
OBJECTIVE Autoantibodies targeting voltage-gated potassium channel (VGKC) complexes cause a spectrum of neuronal hyperexcitability disorders. We investigated pain as a manifestation of VGKC-complex autoimmunity. METHODS We reviewed the prevalence and characteristics of pain in VGKC-complex-immunoglobulin G (IgG)-seropositive patients in 25 months of comprehensive service testing for neural autoantibodies, subtyped positive sera for LGI1-IgG and CASPR2-IgG specificities, and reviewed pain prevalence in autoimmune control patients. RESULTS VGKC-complex-IgG was identified in 1,992 patients of 54,853 tested (4%). Of 316 evaluated neurologically at Mayo Clinic, 159 (50%) had pain, in isolation (28%) or with accompanying neurologic manifestations (72%), and not attributable to alternative cause. Pain was subacute in onset, chronic in course, neuropathic, nociceptive, regional, or diffuse and sometimes attributed to fibromyalgia (6%) or psychogenic cause (13%). Most patients had normal peripheral nervous system function, measured by neuropathy impairment scores and nerve conduction. Evidence of neuronal hyperexcitability (hyperhidrosis, quantitative heat-pain hyperalgesia, or electromyographic excitability) was 25-fold more common in pain patients. Pain management required multiple medications in 70% (narcotics, 30%); 13 of 16 patients reported pain relief with immunotherapy. Pain was significantly associated with CASPR2-IgG-positivity (16% positive with pain, 7% without pain; p = 0.014) but not with LGI1-IgG. Less than 10% of 167 patients with neural autoantibodies other than VGKC-complex-IgG reported pain. CONCLUSIONS Chronic idiopathic pain is a syndromic manifestation of VGKC-complex autoimmunity. Hyperexcitability of nociceptive pathways is implicated. CASPR2-IgG significantly associates with pain, but in most patients the antigenic VGKC-complex molecule remains to be determined. VGKC-complex autoimmunity represents an important new direction for pain research and therapy.
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Velíšek L, Shang E, Velíšková J, Chachua T, Macchiarulo S, Maglakelidze G, Wolgemuth DJ, Greenberg DA. GABAergic neuron deficit as an idiopathic generalized epilepsy mechanism: the role of BRD2 haploinsufficiency in juvenile myoclonic epilepsy. PLoS One 2011; 6:e23656. [PMID: 21887291 PMCID: PMC3161054 DOI: 10.1371/journal.pone.0023656] [Citation(s) in RCA: 62] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2011] [Accepted: 07/22/2011] [Indexed: 11/23/2022] Open
Abstract
Idiopathic generalized epilepsy (IGE) syndromes represent about 30% of all epilepsies. They have strong, but elusive, genetic components and sex-specific seizure expression. Multiple linkage and population association studies have connected the bromodomain-containing gene BRD2 to forms of IGE. In mice, a null mutation at the homologous Brd2 locus results in embryonic lethality while heterozygous Brd2+/− mice are viable and overtly normal. However, using the flurothyl model, we now show, that compared to the Brd2+/+ littermates, Brd2+/− males have a decreased clonic, and females a decreased tonic-clonic, seizure threshold. Additionally, long-term EEG/video recordings captured spontaneous seizures in three out of five recorded Brd2+/− female mice. Anatomical analysis of specific regions of the brain further revealed significant differences in Brd2+/− vs +/+ mice. Specifically, there were decreases in the numbers of GABAergic (parvalbumin- or GAD67-immunopositive) neurons along the basal ganglia pathway, i.e., in the neocortex and striatum of Brd2+/− mice, compared to Brd2+/+ mice. There were also fewer GABAergic neurons in the substantia nigra reticulata (SNR), yet there was a minor, possibly compensatory increase in the GABA producing enzyme GAD67 in these SNR cells. Further, GAD67 expression in the superior colliculus and ventral medial thalamic nucleus, the main SNR outputs, was significantly decreased in Brd2+/− mice, further supporting GABA downregulation. Our data show that the non-channel-encoding, developmentally critical Brd2 gene is associated with i) sex-specific increases in seizure susceptibility, ii) the development of spontaneous seizures, and iii) seizure-related anatomical changes in the GABA system, supporting BRD2's involvement in human IGE.
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Affiliation(s)
- Libor Velíšek
- Department of Cell Biology & Anatomy, New York College of Medicine, Valhalla, New York, United States of America.
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Elucidating the Complex Interactions between Stress and Epileptogenic Pathways. Cardiovasc Psychiatry Neurol 2011; 2011:461263. [PMID: 21547249 PMCID: PMC3085328 DOI: 10.1155/2011/461263] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2010] [Accepted: 01/22/2011] [Indexed: 11/24/2022] Open
Abstract
Clinical and experimental data suggest that stress contributes to the pathology of epilepsy. We review mechanisms by which stress, primarily via stress hormones, may exacerbate epilepsy, focusing on the intersection between stress-induced pathways and the progression of pathological events that occur before, during, and after the onset of epileptogenesis. In addition to this temporal nuance, we discuss other complexities in stress-epilepsy interactions, including the role of blood-brain barrier dysfunction, neuron-glia interactions, and inflammatory/cytokine pathways that may be protective or damaging depending on context. We advocate the use of global analytical tools, such as microarray, in support of a shift away from a narrow focus on seizures and towards profiling the complex, early process of epileptogenesis, in which multiple pathways may interact to dictate the ultimate onset of chronic, recurring seizures.
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