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McGoldrick P, Zhang M, van Blitterswijk M, Sato C, Moreno D, Xiao S, Zhang AB, McKeever PM, Weichert A, Schneider R, Keith J, Petrucelli L, Rademakers R, Zinman L, Robertson J, Rogaeva E. Unaffected mosaic C9orf72 case: RNA foci, dipeptide proteins, but upregulated C9orf72 expression. Neurology 2017; 90:e323-e331. [PMID: 29282338 PMCID: PMC5798652 DOI: 10.1212/wnl.0000000000004865] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2017] [Accepted: 10/16/2017] [Indexed: 12/11/2022] Open
Abstract
Objective Suggested C9orf72 disease mechanisms for amyotrophic lateral sclerosis (ALS) and frontotemporal lobar degeneration include C9orf72 haploinsufficiency, G4C2/C4G2 RNA foci, and dipeptide repeat (DPR) proteins translated from the G4C2 expansion; however, the role of small expansions (e.g., 30–90 repeats) is unknown and was investigated here. Methods We conducted a molecular and pathology study of a family in which the father (unaffected at age 90) carried a 70-repeat allele in blood DNA that expanded to ≈1,750 repeats in his children, causing ALS. Results Southern blotting revealed different degrees of mosaicism of small and large expansions in the father's tissues from the CNS. Surprisingly, in each mosaic tissue, C9orf72 mRNA levels were significantly increased compared to an ALS-affected daughter with a large expansion. Increased expression correlated with higher levels of the 70-repeat allele (the upregulation was also evident at the protein level). Remarkably, RNA foci and DPR burdens were similar or even significantly increased (in cerebellum) in the unaffected father compared to the daughter with ALS. However, the father did not display TDP-43 pathology and signs of neurodegeneration. Conclusion The presence of RNA foci and DPR pathology was insufficient for disease manifestation and TDP-43 pathology in the mosaic C9orf72 carrier with upregulated C9orf72 expression. It is important to conduct an investigation of similar cases, which could be found among unaffected parents of sporadic C9orf72 patients (e.g., 21% among Finnish patients with ALS). Caution should be taken when consulting carriers of small expansions because disease manifestation could be dependent on the extent of the somatic instability in disease-relevant tissues.
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Affiliation(s)
- Philip McGoldrick
- From the Tanz Centre for Research in Neurodegenerative Diseases (P.M., M.Z., C.S., D.M., S.X., A.B.Z., P.M.M., A.W., R.S., J.R., E.R.), Department of Medicine (L.Z., E.R.), Division of Neurology, and Department of Laboratory Medicine and Pathobiology (J.R.), University of Toronto, Ontario, Canada; Department of Neuroscience (M.v.B., L.P., R.R.), Mayo Clinic, Jacksonville, FL; and Sunnybrook Health Sciences Centre (J.K., L.Z.), Toronto, Ontario, Canada
| | - Ming Zhang
- From the Tanz Centre for Research in Neurodegenerative Diseases (P.M., M.Z., C.S., D.M., S.X., A.B.Z., P.M.M., A.W., R.S., J.R., E.R.), Department of Medicine (L.Z., E.R.), Division of Neurology, and Department of Laboratory Medicine and Pathobiology (J.R.), University of Toronto, Ontario, Canada; Department of Neuroscience (M.v.B., L.P., R.R.), Mayo Clinic, Jacksonville, FL; and Sunnybrook Health Sciences Centre (J.K., L.Z.), Toronto, Ontario, Canada
| | - Marka van Blitterswijk
- From the Tanz Centre for Research in Neurodegenerative Diseases (P.M., M.Z., C.S., D.M., S.X., A.B.Z., P.M.M., A.W., R.S., J.R., E.R.), Department of Medicine (L.Z., E.R.), Division of Neurology, and Department of Laboratory Medicine and Pathobiology (J.R.), University of Toronto, Ontario, Canada; Department of Neuroscience (M.v.B., L.P., R.R.), Mayo Clinic, Jacksonville, FL; and Sunnybrook Health Sciences Centre (J.K., L.Z.), Toronto, Ontario, Canada
| | - Christine Sato
- From the Tanz Centre for Research in Neurodegenerative Diseases (P.M., M.Z., C.S., D.M., S.X., A.B.Z., P.M.M., A.W., R.S., J.R., E.R.), Department of Medicine (L.Z., E.R.), Division of Neurology, and Department of Laboratory Medicine and Pathobiology (J.R.), University of Toronto, Ontario, Canada; Department of Neuroscience (M.v.B., L.P., R.R.), Mayo Clinic, Jacksonville, FL; and Sunnybrook Health Sciences Centre (J.K., L.Z.), Toronto, Ontario, Canada
| | - Danielle Moreno
- From the Tanz Centre for Research in Neurodegenerative Diseases (P.M., M.Z., C.S., D.M., S.X., A.B.Z., P.M.M., A.W., R.S., J.R., E.R.), Department of Medicine (L.Z., E.R.), Division of Neurology, and Department of Laboratory Medicine and Pathobiology (J.R.), University of Toronto, Ontario, Canada; Department of Neuroscience (M.v.B., L.P., R.R.), Mayo Clinic, Jacksonville, FL; and Sunnybrook Health Sciences Centre (J.K., L.Z.), Toronto, Ontario, Canada
| | - Shangxi Xiao
- From the Tanz Centre for Research in Neurodegenerative Diseases (P.M., M.Z., C.S., D.M., S.X., A.B.Z., P.M.M., A.W., R.S., J.R., E.R.), Department of Medicine (L.Z., E.R.), Division of Neurology, and Department of Laboratory Medicine and Pathobiology (J.R.), University of Toronto, Ontario, Canada; Department of Neuroscience (M.v.B., L.P., R.R.), Mayo Clinic, Jacksonville, FL; and Sunnybrook Health Sciences Centre (J.K., L.Z.), Toronto, Ontario, Canada
| | - Ashley B Zhang
- From the Tanz Centre for Research in Neurodegenerative Diseases (P.M., M.Z., C.S., D.M., S.X., A.B.Z., P.M.M., A.W., R.S., J.R., E.R.), Department of Medicine (L.Z., E.R.), Division of Neurology, and Department of Laboratory Medicine and Pathobiology (J.R.), University of Toronto, Ontario, Canada; Department of Neuroscience (M.v.B., L.P., R.R.), Mayo Clinic, Jacksonville, FL; and Sunnybrook Health Sciences Centre (J.K., L.Z.), Toronto, Ontario, Canada
| | - Paul M McKeever
- From the Tanz Centre for Research in Neurodegenerative Diseases (P.M., M.Z., C.S., D.M., S.X., A.B.Z., P.M.M., A.W., R.S., J.R., E.R.), Department of Medicine (L.Z., E.R.), Division of Neurology, and Department of Laboratory Medicine and Pathobiology (J.R.), University of Toronto, Ontario, Canada; Department of Neuroscience (M.v.B., L.P., R.R.), Mayo Clinic, Jacksonville, FL; and Sunnybrook Health Sciences Centre (J.K., L.Z.), Toronto, Ontario, Canada
| | - Anna Weichert
- From the Tanz Centre for Research in Neurodegenerative Diseases (P.M., M.Z., C.S., D.M., S.X., A.B.Z., P.M.M., A.W., R.S., J.R., E.R.), Department of Medicine (L.Z., E.R.), Division of Neurology, and Department of Laboratory Medicine and Pathobiology (J.R.), University of Toronto, Ontario, Canada; Department of Neuroscience (M.v.B., L.P., R.R.), Mayo Clinic, Jacksonville, FL; and Sunnybrook Health Sciences Centre (J.K., L.Z.), Toronto, Ontario, Canada
| | - Raphael Schneider
- From the Tanz Centre for Research in Neurodegenerative Diseases (P.M., M.Z., C.S., D.M., S.X., A.B.Z., P.M.M., A.W., R.S., J.R., E.R.), Department of Medicine (L.Z., E.R.), Division of Neurology, and Department of Laboratory Medicine and Pathobiology (J.R.), University of Toronto, Ontario, Canada; Department of Neuroscience (M.v.B., L.P., R.R.), Mayo Clinic, Jacksonville, FL; and Sunnybrook Health Sciences Centre (J.K., L.Z.), Toronto, Ontario, Canada
| | - Julia Keith
- From the Tanz Centre for Research in Neurodegenerative Diseases (P.M., M.Z., C.S., D.M., S.X., A.B.Z., P.M.M., A.W., R.S., J.R., E.R.), Department of Medicine (L.Z., E.R.), Division of Neurology, and Department of Laboratory Medicine and Pathobiology (J.R.), University of Toronto, Ontario, Canada; Department of Neuroscience (M.v.B., L.P., R.R.), Mayo Clinic, Jacksonville, FL; and Sunnybrook Health Sciences Centre (J.K., L.Z.), Toronto, Ontario, Canada
| | - Leonard Petrucelli
- From the Tanz Centre for Research in Neurodegenerative Diseases (P.M., M.Z., C.S., D.M., S.X., A.B.Z., P.M.M., A.W., R.S., J.R., E.R.), Department of Medicine (L.Z., E.R.), Division of Neurology, and Department of Laboratory Medicine and Pathobiology (J.R.), University of Toronto, Ontario, Canada; Department of Neuroscience (M.v.B., L.P., R.R.), Mayo Clinic, Jacksonville, FL; and Sunnybrook Health Sciences Centre (J.K., L.Z.), Toronto, Ontario, Canada
| | - Rosa Rademakers
- From the Tanz Centre for Research in Neurodegenerative Diseases (P.M., M.Z., C.S., D.M., S.X., A.B.Z., P.M.M., A.W., R.S., J.R., E.R.), Department of Medicine (L.Z., E.R.), Division of Neurology, and Department of Laboratory Medicine and Pathobiology (J.R.), University of Toronto, Ontario, Canada; Department of Neuroscience (M.v.B., L.P., R.R.), Mayo Clinic, Jacksonville, FL; and Sunnybrook Health Sciences Centre (J.K., L.Z.), Toronto, Ontario, Canada
| | - Lorne Zinman
- From the Tanz Centre for Research in Neurodegenerative Diseases (P.M., M.Z., C.S., D.M., S.X., A.B.Z., P.M.M., A.W., R.S., J.R., E.R.), Department of Medicine (L.Z., E.R.), Division of Neurology, and Department of Laboratory Medicine and Pathobiology (J.R.), University of Toronto, Ontario, Canada; Department of Neuroscience (M.v.B., L.P., R.R.), Mayo Clinic, Jacksonville, FL; and Sunnybrook Health Sciences Centre (J.K., L.Z.), Toronto, Ontario, Canada
| | - Janice Robertson
- From the Tanz Centre for Research in Neurodegenerative Diseases (P.M., M.Z., C.S., D.M., S.X., A.B.Z., P.M.M., A.W., R.S., J.R., E.R.), Department of Medicine (L.Z., E.R.), Division of Neurology, and Department of Laboratory Medicine and Pathobiology (J.R.), University of Toronto, Ontario, Canada; Department of Neuroscience (M.v.B., L.P., R.R.), Mayo Clinic, Jacksonville, FL; and Sunnybrook Health Sciences Centre (J.K., L.Z.), Toronto, Ontario, Canada.
| | - Ekaterina Rogaeva
- From the Tanz Centre for Research in Neurodegenerative Diseases (P.M., M.Z., C.S., D.M., S.X., A.B.Z., P.M.M., A.W., R.S., J.R., E.R.), Department of Medicine (L.Z., E.R.), Division of Neurology, and Department of Laboratory Medicine and Pathobiology (J.R.), University of Toronto, Ontario, Canada; Department of Neuroscience (M.v.B., L.P., R.R.), Mayo Clinic, Jacksonville, FL; and Sunnybrook Health Sciences Centre (J.K., L.Z.), Toronto, Ontario, Canada.
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Figueroa KP, Gan SR, Perlman S, Wilmot G, Gomez CM, Schmahmann J, Paulson H, Shakkottai VG, Ying SH, Zesiewicz T, Bushara K, Geschwind M, Xia G, Subramony SH, Ashizawa T, Pulst SM, Kuo SH. C9orf72 repeat expansions as genetic modifiers for depression in spinocerebellar ataxias. Mov Disord 2017; 33:497-498. [PMID: 29193335 DOI: 10.1002/mds.27258] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2017] [Revised: 09/14/2017] [Accepted: 10/16/2017] [Indexed: 12/27/2022] Open
Affiliation(s)
- Karla P Figueroa
- Department of Neurology, University of Utah, Salt Lake City, Utah, USA
| | - Shi-Rui Gan
- Department of Neurology and Institute of Neurology, First Affiliated Hospital, Fujian Medical University, Fuzhou, China.,Department of Neurology, College of Physicians and Surgeons, Columbia University, New York, New York, USA
| | - Susan Perlman
- Department of Neurology, University of California Los Angeles, Los Angeles, California, USA
| | - George Wilmot
- Department of Neurology, Emory University, Atlanta, Georgia, USA
| | | | - Jeremy Schmahmann
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Henry Paulson
- Department of Neurology, University of Michigan, Ann Arbor, Michigan, USA
| | | | - Sarah H Ying
- Department of Neurology, Johns Hopkins University, Baltimore, Maryland, USA
| | - Theresa Zesiewicz
- Department of Neurology, University of South Florida, Tampa, Florida, USA
| | - Khalaf Bushara
- Department of Neurology, University of Minnesota, Minneapolis, Minnesota, USA
| | - Michael Geschwind
- Department of Neurology, University of California San Francisco, San Francisco, California, USA
| | - Guangbin Xia
- Department of Neurology, University of New Mexico, Albuquerque, USA
| | - S H Subramony
- Department of Neurology, University of New Mexico, Albuquerque, USA
| | | | - Stefan M Pulst
- Department of Neurology, University of Utah, Salt Lake City, Utah, USA
| | - Sheng-Han Kuo
- Department of Neurology, College of Physicians and Surgeons, Columbia University, New York, New York, USA
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14
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Zhang M, Tartaglia MC, Moreno D, Sato C, McKeever P, Weichert A, Keith J, Robertson J, Zinman L, Rogaeva E. DNA methylation age-acceleration is associated with disease duration and age at onset in C9orf72 patients. Acta Neuropathol 2017; 134:271-279. [PMID: 28439722 PMCID: PMC5508035 DOI: 10.1007/s00401-017-1713-y] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2017] [Revised: 04/13/2017] [Accepted: 04/14/2017] [Indexed: 12/23/2022]
Abstract
The repeat expansion in C9orf72 is the most common cause of amyotrophic lateral sclerosis and frontotemporal dementia. C9orf72 patients present with a wide range in disease duration and age of onset. The strongest risk factor for both syndromes is aging, which was linked to DNA methylation (DNAm) age based on the cumulative assessment of the methylation levels of 353 CpGs included on the genome-wide 450k BeadChip. DNAm age may reflect biological age better than chronological age. We conducted a genome-wide blood DNA methylation study of 46 unrelated C9orf72 patients. After correction for multiple testing, none of the CpGs demonstrated association between its methylation level and disease duration or age of onset. However, we detected a significant reverse correlation of DNAm age-acceleration with disease duration and age of onset, suggesting that for every 5-year increase in DNAm age-acceleration there is a 3.2-year earlier age of onset and 1.5-year shorter disease duration. The significant correlations remain after adjusting for gender, TMEM106B genotypes, disease phenotype and C9orf72 5′CpG island methylation status. A similar trend was observed for the blood DNA of affected members of an extended C9orf72 family; and tissues from the central nervous system of C9orf72 autopsy cases. For instance, regression analysis suggested that a 5-year increase in DNAm age-acceleration is linked to an earlier age of onset by 4.7 or 5.5 years for frontal cortex or spinal cord, respectively. Blood DNAm age may be a useful biomarker for biological age, because blood DNAm age-acceleration was similar to all investigated brain tissues, except for cerebellum that ages more slowly. In conclusion, DNA methylation analysis of C9orf72 patients revealed that increased DNAm age-acceleration is associated with a more severe disease phenotype with a shorter disease duration and earlier age of onset.
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Affiliation(s)
- Ming Zhang
- Tanz Centre for Research in Neurodegenerative Diseases, University of Toronto, 60 Leonard Ave., Toronto, ON, M5T 2S8, Canada
| | - Maria Carmela Tartaglia
- Tanz Centre for Research in Neurodegenerative Diseases, University of Toronto, 60 Leonard Ave., Toronto, ON, M5T 2S8, Canada
- Division of Neurology, Department of Medicine, University of Toronto, 1 King's College Circle, Toronto, ON, M5S 1A8, Canada
- Krembil Neuroscience Center, University Health Network Memory Clinic, Toronto Western Hospital, 399 Bathurst St., Toronto, ON, M5T 2S8, Canada
| | - Danielle Moreno
- Tanz Centre for Research in Neurodegenerative Diseases, University of Toronto, 60 Leonard Ave., Toronto, ON, M5T 2S8, Canada
| | - Christine Sato
- Tanz Centre for Research in Neurodegenerative Diseases, University of Toronto, 60 Leonard Ave., Toronto, ON, M5T 2S8, Canada
| | - Paul McKeever
- Tanz Centre for Research in Neurodegenerative Diseases, University of Toronto, 60 Leonard Ave., Toronto, ON, M5T 2S8, Canada
- Department of Laboratory Medicine and Pathobiology, 27 King's College Circle, Toronto, ON, M5S 1A1, Canada
| | - Anna Weichert
- Tanz Centre for Research in Neurodegenerative Diseases, University of Toronto, 60 Leonard Ave., Toronto, ON, M5T 2S8, Canada
| | - Julia Keith
- Department of Laboratory Medicine and Pathobiology, 27 King's College Circle, Toronto, ON, M5S 1A1, Canada
- Sunnybrook Health Sciences Centre, 2075 Bayview Ave., Toronto, ON, M4N 3M5, Canada
| | - Janice Robertson
- Tanz Centre for Research in Neurodegenerative Diseases, University of Toronto, 60 Leonard Ave., Toronto, ON, M5T 2S8, Canada
- Department of Laboratory Medicine and Pathobiology, 27 King's College Circle, Toronto, ON, M5S 1A1, Canada
| | - Lorne Zinman
- Division of Neurology, Department of Medicine, University of Toronto, 1 King's College Circle, Toronto, ON, M5S 1A8, Canada.
- Sunnybrook Health Sciences Centre, 2075 Bayview Ave., Toronto, ON, M4N 3M5, Canada.
| | - Ekaterina Rogaeva
- Tanz Centre for Research in Neurodegenerative Diseases, University of Toronto, 60 Leonard Ave., Toronto, ON, M5T 2S8, Canada.
- Division of Neurology, Department of Medicine, University of Toronto, 1 King's College Circle, Toronto, ON, M5S 1A8, Canada.
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