1
|
Laukka JJ, Kain KM, Rathnam AS, Sohi J, Khatib D, Kamholz J, Stanley JA. Altered high-energy phosphate and membrane metabolism in Pelizaeus–Merzbacher disease using phosphorus magnetic resonance spectroscopy. Brain Commun 2022; 4:fcac202. [PMID: 36003325 PMCID: PMC9396944 DOI: 10.1093/braincomms/fcac202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Revised: 06/06/2022] [Accepted: 08/04/2022] [Indexed: 11/14/2022] Open
Abstract
Pelizaeus–Merzbacher disease is an X-linked recessive leucodystrophy of the central nervous system caused by mutations affecting the major myelin protein, proteolipid protein 1. The extent of the altered in vivo neurochemistry of protein, proteolipid protein 1 duplications, the most common form of Pelizaeus–Merzbacher disease, is, however, poorly understood. Phosphorus magnetic resonance spectroscopy is the only in vivo technique that can assess the biochemistry associated with high-energy phosphate and membrane phospholipid metabolism across different cortical, subcortical and white matter areas. In this cross-sectional study, whole-brain, multi-voxel phosphorus magnetic resonance spectroscopy was acquired at 3 T on 14 patients with Pelizaeus–Merzbacher disease with protein, proteolipid protein 1 duplications and 23 healthy controls (all males). Anabolic and catabolic levels of membrane phospholipids (phosphocholine and phosphoethanolamine, and glycerophosphoethanolamine and glycerophosphocholine, respectively), as well as phosphocreatine, inorganic orthophosphate and adenosine triphosphate levels relative to the total phosphorus magnetic resonance spectroscopy signal from 12 different cortical and subcortical areas were compared between the two groups. Independent of brain area, phosphocholine, glycerophosphoethanolamine and inorganic orthophosphate levels were significantly lower (P = 0.0025, P < 0.0001 and P = 0.0002) and phosphocreatine levels were significantly higher (P < 0.0001) in Pelizaeus–Merzbacher disease patients compared with controls. Additionally, there was a significant group-by-brain area interaction for phosphocreatine with post-hoc analyses demonstrating significantly higher phosphocreatine levels in patients with Pelizaeus–Merzbacher disease compared with controls across multiple brain areas (anterior and posterior white matter, superior parietal lobe, posterior cingulate cortex, hippocampus, occipital cortex, striatum and thalamus; all P ≤ 0.0042). Phosphoethanolamine, glycerophosphoethanolamine and adenosine triphosphate levels were not significantly different between groups. For the first-time, widespread alterations in phosphorus magnetic resonance spectroscopy metabolite levels of Pelizaeus–Merzbacher disease patients are being reported. Specifically, increased high-energy phosphate storage levels of phosphocreatine concomitant with decreased inorganic orthophosphate across multiple areas suggest a widespread reduction in the high-energy phosphate utilization in Pelizaeus–Merzbacher disease, and the membrane phospholipid metabolite deficits suggest a widespread degradation in the neuropil content/maintenance of patients with Pelizaeus–Merzbacher disease which includes axons, dendrites and astrocytes within cortex and the myelin microstructure and oligodendrocytes within white matter. These results provide greater insight into the neuropathology of Pelizaeus–Merzbacher disease both in terms of energy expenditure and membrane phospholipid metabolites. Future longitudinal studies are warranted to investigate the utility of phosphorus magnetic resonance spectroscopy as surrogate biomarkers in monitoring treatment intervention for Pelizaeus–Merzbacher disease.
Collapse
Affiliation(s)
- Jeremy J Laukka
- Department of Medical Education, University of Toledo College of Medicine and Life Sciences , Toledo, OH , USA
- Department of Neurology, University of Toledo College of Medicine and Life Sciences , Toledo, OH , USA
| | - Kevin M Kain
- College of Osteopathic Medicine, Kansas City University , Kansas City, MO , USA
| | | | - Jasloveleen Sohi
- Department of Neurology, Center for Molecular Medicine and Genetics, Wayne State University School of Medicine , MI , USA
| | - Dalal Khatib
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine , Detroit, MI , USA
| | - John Kamholz
- Department of Neurology, Center for Molecular Medicine and Genetics, Wayne State University School of Medicine , MI , USA
- Department of Neurology, University of Iowa Carver College of Medicine , Iowa City, IA , USA
| | - Jeffrey A Stanley
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine , Detroit, MI , USA
| |
Collapse
|
2
|
Samara A, Rahn R, Neyman O, Park KY, Samara A, Marshall B, Dougherty J, Hershey T. Developmental hypomyelination in Wolfram syndrome: new insights from neuroimaging and gene expression analyses. Orphanet J Rare Dis 2019; 14:279. [PMID: 31796109 PMCID: PMC6889680 DOI: 10.1186/s13023-019-1260-9] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2019] [Accepted: 11/22/2019] [Indexed: 12/21/2022] Open
Abstract
Wolfram syndrome is a rare multisystem disorder caused by mutations in WFS1 or CISD2 genes leading to brain structural abnormalities and neurological symptoms. These abnormalities appear in early stages of the disease. The pathogenesis of Wolfram syndrome involves abnormalities in the endoplasmic reticulum (ER) and mitochondrial dynamics, which are common features in several other neurodegenerative disorders. Mutations in WFS1 are responsible for the majority of Wolfram syndrome cases. WFS1 encodes for an endoplasmic reticulum (ER) protein, wolframin. It is proposed that wolframin deficiency triggers the unfolded protein response (UPR) pathway resulting in an increased ER stress-mediated neuronal loss. Recent neuroimaging studies showed marked alteration in early brain development, primarily characterized by abnormal white matter myelination. Interestingly, ER stress and the UPR pathway are implicated in the pathogenesis of some inherited myelin disorders like Pelizaeus-Merzbacher disease, and Vanishing White Matter disease. In addition, exploratory gene-expression network-based analyses suggest that WFS1 expression occurs preferentially in oligodendrocytes during early brain development. Therefore, we propose that Wolfram syndrome could belong to a category of neurodevelopmental disorders characterized by ER stress-mediated myelination impairment. Further studies of myelination and oligodendrocyte function in Wolfram syndrome could provide new insights into the underlying mechanisms of the Wolfram syndrome-associated brain changes and identify potential connections between neurodevelopmental disorders and neurodegeneration.
Collapse
Affiliation(s)
- Amjad Samara
- Department of Psychiatry, Washington University School of Medicine, 4525 Scott Avenue, St. Louis, MO, 63110, USA
| | - Rachel Rahn
- Department of Psychiatry, Washington University School of Medicine, 4525 Scott Avenue, St. Louis, MO, 63110, USA.,Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO, 63110, USA.,Department of Genetics, Washington University Medical School, St. Louis, MO, 63110, USA
| | - Olga Neyman
- Department of Psychiatry, Washington University School of Medicine, 4525 Scott Avenue, St. Louis, MO, 63110, USA
| | - Ki Yun Park
- Department of Psychiatry, Washington University School of Medicine, 4525 Scott Avenue, St. Louis, MO, 63110, USA
| | - Ahmad Samara
- Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine
| | - Bess Marshall
- Department of Pediatrics, Washington University Medical School, St. Louis, MO, 63110, USA
| | - Joseph Dougherty
- Department of Psychiatry, Washington University School of Medicine, 4525 Scott Avenue, St. Louis, MO, 63110, USA.,Department of Genetics, Washington University Medical School, St. Louis, MO, 63110, USA
| | - Tamara Hershey
- Department of Psychiatry, Washington University School of Medicine, 4525 Scott Avenue, St. Louis, MO, 63110, USA. .,Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO, 63110, USA. .,Department of Neurology, Washington University School of Medicine, St. Louis, MO, 63110, USA.
| |
Collapse
|
3
|
Osório MJ, Goldman SA. Neurogenetics of Pelizaeus-Merzbacher disease. HANDBOOK OF CLINICAL NEUROLOGY 2018; 148:701-722. [PMID: 29478609 DOI: 10.1016/b978-0-444-64076-5.00045-4] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Pelizaeus-Merzbacher disease (PMD) is an X-linked disorder caused by mutations in the PLP1 gene, which encodes the proteolipid protein of myelinating oligodendroglia. PMD exhibits phenotypic variability that reflects its considerable genotypic heterogeneity, but all forms of the disease result in central hypomyelination associated with early neurologic dysfunction, progressive deterioration, and ultimately death. PMD has been classified into three major subtypes, according to the age of presentation: connatal PMD, classic PMD, and transitional PMD, combining features of both connatal and classic forms. Two other less severe phenotypes were subsequently described, including the spastic paraplegia syndrome and PLP1-null disease. These disorders may be associated with duplications, as well as with point, missense, and null mutations within the PLP1 gene. A number of clinically similar Pelizaeus-Merzbacher-like disorders (PMLD) are considered in the differential diagnosis of PMD, the most prominent of which is PMLD-1, caused by misexpression of the GJC2 gene encoding connexin-47. No effective therapy for PMD exists. Yet, as a relatively pure central nervous system hypomyelinating disorder, with limited involvement of the peripheral nervous system and little attendant neuronal pathology, PMD is an attractive therapeutic target for neural stem cell and glial progenitor cell transplantation, efforts at which are now underway in a number of centers internationally.
Collapse
Affiliation(s)
- M Joana Osório
- Center for Translational Neuromedicine and Department of Neurology, University of Rochester Medical Center, Rochester, NY, United States; Center for Translational Neuromedicine, University of Copenhagen Faculty of Health and Medical Sciences, Copenhagen, Denmark
| | - Steven A Goldman
- Center for Translational Neuromedicine and Department of Neurology, University of Rochester Medical Center, Rochester, NY, United States; Center for Translational Neuromedicine, University of Copenhagen Faculty of Health and Medical Sciences, Copenhagen, Denmark.
| |
Collapse
|
4
|
Nevin ZS, Factor DC, Karl RT, Douvaras P, Laukka J, Windrem MS, Goldman SA, Fossati V, Hobson GM, Tesar PJ. Modeling the Mutational and Phenotypic Landscapes of Pelizaeus-Merzbacher Disease with Human iPSC-Derived Oligodendrocytes. Am J Hum Genet 2017; 100:617-634. [PMID: 28366443 DOI: 10.1016/j.ajhg.2017.03.005] [Citation(s) in RCA: 46] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2016] [Accepted: 03/09/2017] [Indexed: 02/07/2023] Open
Abstract
Pelizaeus-Merzbacher disease (PMD) is a pediatric disease of myelin in the central nervous system and manifests with a wide spectrum of clinical severities. Although PMD is a rare monogenic disease, hundreds of mutations in the X-linked myelin gene proteolipid protein 1 (PLP1) have been identified in humans. Attempts to identify a common pathogenic process underlying PMD have been complicated by an incomplete understanding of PLP1 dysfunction and limited access to primary human oligodendrocytes. To address this, we generated panels of human induced pluripotent stem cells (hiPSCs) and hiPSC-derived oligodendrocytes from 12 individuals with mutations spanning the genetic and clinical diversity of PMD-including point mutations and duplication, triplication, and deletion of PLP1-and developed an in vitro platform for molecular and cellular characterization of all 12 mutations simultaneously. We identified individual and shared defects in PLP1 mRNA expression and splicing, oligodendrocyte progenitor development, and oligodendrocyte morphology and capacity for myelination. These observations enabled classification of PMD subgroups by cell-intrinsic phenotypes and identified a subset of mutations for targeted testing of small-molecule modulators of the endoplasmic reticulum stress response, which improved both morphologic and myelination defects. Collectively, these data provide insights into the pathogeneses of a variety of PLP1 mutations and suggest that disparate etiologies of PMD could require specific treatment approaches for subsets of individuals. More broadly, this study demonstrates the versatility of a hiPSC-based panel spanning the mutational heterogeneity within a single disease and establishes a widely applicable platform for genotype-phenotype correlation and drug screening in any human myelin disorder.
Collapse
Affiliation(s)
- Zachary S Nevin
- Department of Genetics and Genome Sciences, School of Medicine, Case Western Reserve University, Cleveland, OH 44106, USA
| | - Daniel C Factor
- Department of Genetics and Genome Sciences, School of Medicine, Case Western Reserve University, Cleveland, OH 44106, USA
| | - Robert T Karl
- Department of Genetics and Genome Sciences, School of Medicine, Case Western Reserve University, Cleveland, OH 44106, USA
| | | | - Jeremy Laukka
- Departments of Neurology and Neuroscience, College of Medicine and Life Science, University of Toledo, Toledo, OH 43614, USA
| | - Martha S Windrem
- Center for Translational Neuromedicine, University of Rochester Medical Center, Rochester, NY 14642, USA
| | - Steven A Goldman
- Center for Translational Neuromedicine, University of Rochester Medical Center, Rochester, NY 14642, USA; Center for Neuroscience, Faculty of Medicine and Health Sciences, University of Copenhagen, 2200 Copenhagen, Denmark
| | - Valentina Fossati
- New York Stem Cell Foundation Research Institute, New York, NY 10032, USA
| | - Grace M Hobson
- Nemours Biomedical Research, Alfred I. duPont Hospital for Children, Wilmington, DE 19803, USA; Department of Biological Sciences, University of Delaware, Newark, DE 19716, USA; Department of Pediatrics, Jefferson Medical College, Thomas Jefferson University, Philadelphia, PA 19107, USA
| | - Paul J Tesar
- Department of Genetics and Genome Sciences, School of Medicine, Case Western Reserve University, Cleveland, OH 44106, USA.
| |
Collapse
|
5
|
Schiffmann R, Banwell B. Brain MRI and motor function in leukodystrophies. Neurology 2016; 87:748-9. [PMID: 27440145 DOI: 10.1212/wnl.0000000000003017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- Raphael Schiffmann
- From the Institute of Metabolic Disease (R.S.), Baylor Research Institute, Dallas, TX; and Division of Child Neurology (B.B.), Children's Hospital of Philadelphia, Perelman School of Medicine, University of Pennsylvania, Philadelphia.
| | - Brenda Banwell
- From the Institute of Metabolic Disease (R.S.), Baylor Research Institute, Dallas, TX; and Division of Child Neurology (B.B.), Children's Hospital of Philadelphia, Perelman School of Medicine, University of Pennsylvania, Philadelphia
| |
Collapse
|
6
|
Laukka JJ, Kamholz J, Bessert D, Skoff RP. Novel pathologic findings in patients with Pelizaeus-Merzbacher disease. Neurosci Lett 2016; 627:222-32. [PMID: 27222925 PMCID: PMC4948744 DOI: 10.1016/j.neulet.2016.05.028] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2016] [Revised: 05/13/2016] [Accepted: 05/14/2016] [Indexed: 10/21/2022]
Abstract
Pelizaeus-Merzbacher disease (PMD) is an X-linked inherited hypomyelinating disorder caused by mutations in the gene encoding proteolipid protein (PLP), the major structural protein in central nervous system (CNS) myelin. Prior to our study, whether hypomyelination in PMD was caused by demyelination, abnormally thin sheaths or failure to form myelin was unknown. In this study, we compared the microscopic pathology of myelin from brain tissue of 3 PMD patients with PLP1 duplications to that of a patient with a complete PLP1 deletion. Autopsy tissue procured from PMD patients was embedded in paraffin for immunocytochemistry and plastic for electron microscopy to obtain highresolution fiber pathology of cerebrum and corpus callosum. Through histological stains, immunocytochemistry and electron microscopy, our study illustrates unique pathologic findings between the two different types of mutations. Characteristic of the patient with a PLP1 deletion, myelin sheaths showed splitting and decompaction of myelin, confirming for the first time that myelin in PLP1 deletion patients is similar to that of rodent models with gene deletions. Myelin thickness and g-ratios of some fibers, in relation to axon diameter was abnormally thin, suggesting that oligodendrocytes remain metabolically functional and/or are attempting to make myelin. Many fibers showed swollen, progressive degenerative changes to axons in addition to the dissolution of myelin. All three duplication cases shared remarkable fiber pathology including swellings, constriction and/or transection and involution of myelin. Characteristic of PLP1 duplication patients, many axons showed segmental demyelination along their length. Still other axons had abnormally thick myelin sheaths, suggestive of continued myelination. Thus, each type of mutation exhibited unique pathology even though commonality to both mutations included involution of myelin, myelin balls and degeneration of axons. This pathology study describes findings unique to each mutation that suggests the mechanism causing fiber pathology is likewise heterogeneous.
Collapse
Affiliation(s)
- Jeremy J Laukka
- Department of Neuroscience, University of Toledo, College of Medicine and Life Science, Toledo, OH 43614, United States; Department of Neurology, University of Toledo, College of Medicine and Life Science, Toledo, OH 43614, United States.
| | - John Kamholz
- Center for Molecular Medicine and Genetics, Wayne State University, School of Medicine, Detroit, MI 48201, United States; Department of Neurology, University of Iowa, Carver College of Medicine, Iowa City, IA 52242, United States
| | - Denise Bessert
- Department of Anatomy and Cell Biology, Wayne State University, School of Medicine, Detroit, MI 48201, United States
| | - Robert P Skoff
- Center for Molecular Medicine and Genetics, Wayne State University, School of Medicine, Detroit, MI 48201, United States; Department of Anatomy and Cell Biology, Wayne State University, School of Medicine, Detroit, MI 48201, United States
| |
Collapse
|
7
|
Lugar HM, Koller JM, Rutlin J, Marshall BA, Kanekura K, Urano F, Bischoff AN, Shimony JS, Hershey T. Neuroimaging evidence of deficient axon myelination in Wolfram syndrome. Sci Rep 2016; 6:21167. [PMID: 26888576 PMCID: PMC4758056 DOI: 10.1038/srep21167] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2015] [Accepted: 01/15/2016] [Indexed: 11/09/2022] Open
Abstract
Wolfram syndrome is a rare autosomal recessive genetic disease characterized by insulin dependent diabetes and vision, hearing and brain abnormalities which generally emerge in childhood. Mutations in the WFS1 gene predispose cells to endoplasmic reticulum stress-mediated apoptosis and may induce myelin degradation in neuronal cell models. However, in vivo evidence of this phenomenon in humans is lacking. White matter microstructure and regional volumes were measured using magnetic resonance imaging in children and young adults with Wolfram syndrome (n = 21) and healthy and diabetic controls (n = 50). Wolfram patients had lower fractional anisotropy and higher radial diffusivity in major white matter tracts and lower volume in the basilar (ventral) pons, cerebellar white matter and visual cortex. Correlations were found between key brain findings and overall neurological symptoms. This pattern of findings suggests that reduction in myelin is a primary neuropathological feature of Wolfram syndrome. Endoplasmic reticulum stress-related dysfunction in Wolfram syndrome may interact with the development of myelin or promote degeneration of myelin during the progression of the disease. These measures may provide objective indices of Wolfram syndrome pathophysiology that will be useful in unraveling the underlying mechanisms and in testing the impact of treatments on the brain.
Collapse
Affiliation(s)
- Heather M Lugar
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA
| | - Jonathan M Koller
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA
| | - Jerrel Rutlin
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA
| | - Bess A Marshall
- Department of Pediatrics, Washington University School of Medicine, St. Louis, MO, USA.,Department of Cell Biology, Washington University School of Medicine, St. Louis, MO, USA
| | - Kohsuke Kanekura
- Department of Medicine, Washington University School of Medicine, St. Louis, MO, USA
| | - Fumihiko Urano
- Department of Medicine, Washington University School of Medicine, St. Louis, MO, USA
| | - Allison N Bischoff
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA
| | - Joshua S Shimony
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO, USA
| | - Tamara Hershey
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA.,Department of Neurology, Washington University School of Medicine, St. Louis, MO, USA.,Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO, USA
| | | |
Collapse
|
8
|
Saher G, Stumpf SK. Cholesterol in myelin biogenesis and hypomyelinating disorders. Biochim Biophys Acta Mol Cell Biol Lipids 2015; 1851:1083-94. [PMID: 25724171 DOI: 10.1016/j.bbalip.2015.02.010] [Citation(s) in RCA: 108] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2014] [Revised: 02/05/2015] [Accepted: 02/12/2015] [Indexed: 02/05/2023]
Abstract
The largest pool of free cholesterol in mammals resides in myelin membranes. Myelin facilitates rapid saltatory impulse propagation by electrical insulation of axons. This function is achieved by ensheathing axons with a tightly compacted stack of membranes. Cholesterol influences myelination at many steps, from the differentiation of myelinating glial cells, over the process of myelin membrane biogenesis, to the functionality of mature myelin. Cholesterol emerged as the only integral myelin component that is essential and rate-limiting for the development of myelin in the central and peripheral nervous system. Moreover, disorders that interfere with sterol synthesis or intracellular trafficking of cholesterol and other lipids cause hypomyelination and neurodegeneration. This review summarizes recent results on the roles of cholesterol in CNS myelin biogenesis in normal development and under different pathological conditions. This article is part of a Special Issue entitled Brain Lipids.
Collapse
Affiliation(s)
- Gesine Saher
- Neurogenetics, Max Planck Institute of Experimental Medicine, 37075 Göttingen, Germany.
| | - Sina Kristin Stumpf
- Neurogenetics, Max Planck Institute of Experimental Medicine, 37075 Göttingen, Germany.
| |
Collapse
|