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Yang T, Zhu J, Kang Y, Tang C, Zhang L, Guo L. Two PNPLA2 heterozygous mutations result in neutral lipid storage disease with myopathy: a case report. BMC Musculoskelet Disord 2024; 25:661. [PMID: 39174932 PMCID: PMC11342685 DOI: 10.1186/s12891-024-07772-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2024] [Accepted: 08/12/2024] [Indexed: 08/24/2024] Open
Abstract
BACKGROUND Neutral Lipid Storage Disease with Myopathy (NLSDM) is a rare lipid metabolism disorder caused by PNPLA2 gene mutations. Clinical manifestations are heterogeneous, and diagnosis is often delayed, usually gaining patients' attention due to the increased risk of cardiomyopathy. CASE PRESENTATION We herein report a 36-year-old Asian male presenting with progressive limb weakness, muscle atrophy of limbs and trunk, dysarthria, and heart failure. Electromyography indicated myogenic changes, and muscle biopsy results revealed characteristics of lipid storage myopathy. Genetic analysis of PNPLA2 revealed two heterozygous mutations: c.757 + 1G > T (chr11-823588, splice-5) on intron 6 and c.919delG (chr11-823854, p.A307Pfs*13) on exon 7. The patient improved limb strength, and dysarthria disappeared after the Medium Chain Fatty Acids diet. CONCLUSIONS In conclusion, we report for the first time that the two heterozygous mutations PNPLA2 c.919delG and c.757 + 1G > T together induced NLSDM, which was confirmed by muscle biopsy.
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Affiliation(s)
- Tong Yang
- Air Force Medical Center, Air Force Medical University, Beijing, China
| | - Jie Zhu
- Department of Neurology and Centre for Clinical Neuroscience, Daping Hospital, Army Medical Centre of PLA, Army Medical University, 10 Changjiang Branch Road, Yuzhong District, Chongqing, 400042, China
| | - Yulai Kang
- Department of Neurology and Centre for Clinical Neuroscience, Daping Hospital, Army Medical Centre of PLA, Army Medical University, 10 Changjiang Branch Road, Yuzhong District, Chongqing, 400042, China
| | - Chunhua Tang
- Department of Neurology and Centre for Clinical Neuroscience, Daping Hospital, Army Medical Centre of PLA, Army Medical University, 10 Changjiang Branch Road, Yuzhong District, Chongqing, 400042, China
| | - Lili Zhang
- Department of Neurology and Centre for Clinical Neuroscience, Daping Hospital, Army Medical Centre of PLA, Army Medical University, 10 Changjiang Branch Road, Yuzhong District, Chongqing, 400042, China.
| | - Lu Guo
- Department of Neurology and Centre for Clinical Neuroscience, Daping Hospital, Army Medical Centre of PLA, Army Medical University, 10 Changjiang Branch Road, Yuzhong District, Chongqing, 400042, China.
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Fu X, Yang X, Wang X, Jia B, Ma W, Xiong H, Fang F, Ren X, Lv J. HyperCKemia: An early sign of childhood-onset neutral lipid storage disease with myopathy. Neuromuscul Disord 2023; 33:81-89. [PMID: 37620213 DOI: 10.1016/j.nmd.2023.07.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Revised: 07/12/2023] [Accepted: 07/24/2023] [Indexed: 08/26/2023]
Abstract
Neutral lipid-storage disease with myopathy (NLSDM) is an autosomal recessive neuromuscular disorder caused by mutations in PNPLA2, and the average age at onset is 30 years. To date, only eight patients with childhood-onset NLSDM have been reported in detail. We investigated 3 unreported patients with NLSDM detected in childhood and reviewed 8 childhood-onset and 82 adult-onset patients with NLSDM documented in the literature. In the childhood-onset cohort, NLSDM presented initially as asymptomatic or paucisymptomatic hyperCKemia in 6/11 patients, and follow-up data showed onset of muscle weakness in 6/11 childhood-onset patients. In the adult-onset cohort, 95.1% (78/82) of patients showed muscle weakness. Cardiac involvement developed in 6/11 childhood-onset patients. Hepatomegaly was observed in 3/11 childhood-onset patients. Serum creatine kinase levels were elevated greater than five-fold of the upper limit of normal (ULN) in most childhood-onset patients and were elevated to less than ten-fold of the ULN in most adult-onset patients. Peripheral blood smears and muscle biopsies showed cytoplasmic lipid droplets in leukocytes and myocytes. NLSDM can present in children with asymptomatic or paucisymptomatic hyperCKemia before the onset of muscle weakness. The presence of lipid droplets in leucocytes (Jordans' anomaly) aids in diagnosing and confirming the pathogenicity of PNPLA2 variants of uncertain significance. There were no clear genotype-phenotype correlations in patients with NLSDM.
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Affiliation(s)
- Xiaona Fu
- Department of Neurology, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing 100045, China
| | - Xinying Yang
- Department of Neurology, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing 100045, China
| | - Xiaofei Wang
- Department of Neurology, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing 100045, China
| | - Bingbing Jia
- Department of Neurology, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing 100045, China
| | - Wenna Ma
- Department of Neurology, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing 100045, China
| | - Hui Xiong
- Department of Pediatrics, Peking University First Hospital, Beijing, China
| | - Fang Fang
- Department of Neurology, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing 100045, China
| | - Xiaotun Ren
- Department of Neurology, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing 100045, China.
| | - Junlan Lv
- Department of Neurology, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing 100045, China.
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Bernardo-Colón A, Dong L, Abu-Asab M, Brush RS, Agbaga MP, Becerra SP. Ablation of pigment epithelium-derived factor receptor (PEDF-R/Pnpla2) causes photoreceptor degeneration. J Lipid Res 2023; 64:100358. [PMID: 36934843 PMCID: PMC10233210 DOI: 10.1016/j.jlr.2023.100358] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Revised: 03/03/2023] [Accepted: 03/04/2023] [Indexed: 03/19/2023] Open
Abstract
Photoreceptor cells express the patatin-like phospholipase domain-containing 2 (PNPLA2) gene that codes for pigment epithelium-derived factor receptor (PEDF-R) (also known as ATGL). PEDF-R exhibits phospholipase activity that mediates the neurotrophic action of its ligand PEDF. Because phospholipids are the most abundant lipid class in the retina, we investigated the role of PEDF-R in photoreceptors by generating CRISPR Pnpla2 knock-out mouse lines in a retinal degeneration-free background. Pnpla2-/- mice had undetectable retinal Pnpla2 gene expression and PEDF-R protein levels as assayed by RT-PCR and immunofluorescence, respectively. The photoreceptors of mice deficient in PEDF-R had deformities as examined by histology and transmission electron microscopy. Pnpla2 knockdown diminished the PLA2 enzymatic activity of PEDF-R in the retina. Lipidomic analyses revealed the accumulation of lysophosphatidyl choline-DHA and lysophosphatidyl ethanolamine-DHA in PEDF-R-deficient retinas, suggesting a possible causal link to photoreceptor dysfunction. Loss of PEDF-R decreased levels of rhodopsin, opsin, PKCα, and synaptophysin relative to controls. Pnpla2-/- photoreceptors had surface-exposed phosphatidylserine, and their nuclei were TUNEL positive and condensed, revealing an apoptotic onset. Paralleling its structural defects, PEDF-R deficiency compromised photoreceptor function in vivo as indicated by the attenuation of photoreceptor a- and b-waves in Pnpla2-/- and Pnpla2+/- mice relative to controls as determined by electroretinography. In conclusion, ablation of PEDF-R in mice caused alteration in phospholipid composition associated with malformation and malperformance of photoreceptors. These findings identify PEDF-R as an important component for photoreceptor structure and function, highlighting its role in phospholipid metabolism for retinal survival and its consequences.
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Affiliation(s)
- Alexandra Bernardo-Colón
- Section of Protein Structure and Function, Laboratory of Retinal Cell and Molecular Biology, National Eye Institute, National Institutes of Health, Bethesda, MD, USA
| | - Lijin Dong
- Genetic Engineering Core, National Eye Institute, National Institutes of Health, Bethesda, MD, USA
| | - Mones Abu-Asab
- Histopathology Core Facility, National Eye Institute, National Institutes of Health, Bethesda, MD, USA
| | - Richard S Brush
- Department of Ophthalmology(,) and Dean A. McGee Eye Institute, Oklahoma City, OK, USA
| | - Martin-Paul Agbaga
- Department of Ophthalmology(,) and Dean A. McGee Eye Institute, Oklahoma City, OK, USA; Department of Cell Biology, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - S Patricia Becerra
- Section of Protein Structure and Function, Laboratory of Retinal Cell and Molecular Biology, National Eye Institute, National Institutes of Health, Bethesda, MD, USA.
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4
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Landim JID, Ribeiro IS, Oliveira EB, Freitas HC, Brito LA, Maia IHM, Távora DGF, Rodrigues CL. Neutral lipid storage disease with myopathy and myotonia associated to pathogenic variants on PNPLA2 and CLCN1 genes: case report. BMC Neurol 2023; 23:171. [PMID: 37106355 PMCID: PMC10134569 DOI: 10.1186/s12883-023-03195-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Accepted: 03/30/2023] [Indexed: 04/29/2023] Open
Abstract
BACKGROUND Neutral lipid storage disease with myopathy (NLSD-M) is an autosomal recessive disease that manifests itself around the 3rd to 4th decade with chronic myopathy predominantly proximal in the shoulder girdle. Clinical myotonia is uncommon. We will report a rare case of association of pathogenic variants on PNPLA2 and CLCN1 genes with a mixed phenotype of NLSD-M and a subclinical form of Thomsen's congenital myotonia. CASE PRESENTATION We describe a patient with chronic proximal myopathy, subtle clinical myotonia and electrical myotonia on electromyography (EMG). Serum laboratory analysis disclosure hyperCKemia (CK 1280 mg/dL). A blood smear analysis showed Jordan's anomaly, a hallmark of NLSD-M. A genetic panel was collected using next-generation sequencing (NGS) technique, which identified two pathogenic variants on genes supporting two different diagnosis: NLSD-M and Thomsen congenital myotonia, whose association has not been previously described. CONCLUSIONS Although uncommon, it is important to remember the possibility of association of pathogenic variants to explain a specific neuromuscular disease phenotype. The use of a range of complementary methods, including myopathy genetic panels, may be essential to diagnostic definition in such cases.
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Affiliation(s)
| | - Ian Silva Ribeiro
- Clinical Neurology Department From Hospital Geral de Fortaleza, Ceará, Brazil
| | - Eduardo Braga Oliveira
- Neuromuscular Unit of Neurology Department From Hospital Geral de Fortaleza, Ceará, Brazil
| | - Hermany Capistrano Freitas
- Neuromuscular Unit of Neurology Department From Hospital Geral de Fortaleza, Ceará, Brazil
- Clinical Neurophysiology of Neurology Department From Hospital Geral de Fortaleza, Ceará, Brazil
| | - Lara Albuquerque Brito
- Neuromuscular Unit of Neurology Department From Hospital Geral de Fortaleza, Ceará, Brazil
| | | | | | - Cleonisio Leite Rodrigues
- Neuromuscular Unit of Neurology Department From Hospital Geral de Fortaleza, Ceará, Brazil
- Clinical Neurophysiology of Neurology Department From Hospital Geral de Fortaleza, Ceará, Brazil
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5
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Tian Y, Wang S, Wang F, Yi L, Dong M, Huang X. Late onset of neutral lipid storage disease due to a rare PNPLA2 mutation in a patient with myopathy and cardiomyopathy. Chin Med J (Engl) 2022; 135:2389-2391. [PMID: 36535014 PMCID: PMC9771202 DOI: 10.1097/cm9.0000000000002004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Indexed: 01/26/2023] Open
Affiliation(s)
- Ye Tian
- Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital; National Center for Respiratory Medicine; Institute of Respiratory Medicine, Chinese Academy of Medical Sciences; National Clinical Research Center for Respiratory Diseases, Beijing 100029, China
| | - Shiyao Wang
- Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital; National Center for Respiratory Medicine; Institute of Respiratory Medicine, Chinese Academy of Medical Sciences; National Clinical Research Center for Respiratory Diseases, Beijing 100029, China
| | - Fang Wang
- Department of Cardiology, China-Japan Friendship Hospital, Beijing 100029, China
| | - Li Yi
- Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital; National Center for Respiratory Medicine; Institute of Respiratory Medicine, Chinese Academy of Medical Sciences; National Clinical Research Center for Respiratory Diseases, Beijing 100029, China
| | - Mingrui Dong
- Department of Neurology, China-Japan Friendship Hospital, Beijing 100029, China
| | - Xu Huang
- Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital; National Center for Respiratory Medicine; Institute of Respiratory Medicine, Chinese Academy of Medical Sciences; National Clinical Research Center for Respiratory Diseases, Beijing 100029, China
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6
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Missaglia S, Tavian D, Angelini C. Neutral lipid storage disease with myopathy: A 10-year follow-up case report. Eur J Transl Myol 2022; 32. [PMID: 35713537 PMCID: PMC9295162 DOI: 10.4081/ejtm.2022.10645] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Accepted: 06/11/2022] [Indexed: 11/25/2022] Open
Abstract
Mutations in PNPLA2 gene encoding for adipose triglyceride lipase (ATGL), involved in triglyceride degradation, lead to an inborn error of neutral lipid metabolism. The disorder that results in abnormal storage of neutral lipid is known as neutral lipid storage disease with myopathy (NLSDM). We report the follow-up of a 30-year-old woman with NLSDM, asymptomatic until age 23. At the age of 18, a high level of CPK and neutral lipid abnormal accumulation in muscle and skin cells suggested NLSDM diagnosis, afterwards confirmed by PNPLA2 analysis. After 5 years, she developed weakness in the upper and lower extremities. She was put on a low-fat diet with medium-chain triglycerides (MCT) oil supplementation but, although her CPK level decreased, myopathy continued to progress. At present, she presents severe skeletal myopathy without cardiac involvement. In this patient, no beneficial effects on progressive skeletal muscle weakness were detected after the MCT diet, probably due to complete loss of PNPLA2 expression.
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Affiliation(s)
- Sara Missaglia
- Laboratory of Cellular Biochemistry and Molecular Biology, CRIBENS, Università Cattolica del Sacro Cuore, Milan, Italy; Department of Psychology, Università Cattolica del Sacro Cuore, Milan.
| | - Daniela Tavian
- Laboratory of Cellular Biochemistry and Molecular Biology, CRIBENS, Università Cattolica del Sacro Cuore, Milan, Italy; Department of Psychology, Università Cattolica del Sacro Cuore, Milan.
| | - Corrado Angelini
- Neuromuscular Laboratory, Department of Neurosciences, University of Padova, Campus Biomedico Pietro d'Abano, Padua.
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7
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Kanti MM, Striessnig-Bina I, Wieser BI, Schauer S, Leitinger G, Eichmann TO, Schweiger M, Winkler M, Winter E, Lana A, Kufferath I, Marsh LM, Kwapiszewska G, Zechner R, Hoefler G, Vesely PW. Adipose triglyceride lipase-mediated lipid catabolism is essential for bronchiolar regeneration. JCI Insight 2022; 7:e149438. [PMID: 35349484 PMCID: PMC9090255 DOI: 10.1172/jci.insight.149438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Accepted: 03/23/2022] [Indexed: 01/18/2023] Open
Abstract
The lung airways are constantly exposed to inhaled toxic substances, resulting in cellular damage that is repaired by local expansion of resident bronchiolar epithelial club cells. Disturbed bronchiolar epithelial damage repair lies at the core of many prevalent lung diseases, including chronic obstructive pulmonary disease, asthma, pulmonary fibrosis, and lung cancer. However, it is still not known how bronchiolar club cell energy metabolism contributes to this process. Here, we show that adipose triglyceride lipase (ATGL), the rate-limiting enzyme for intracellular lipolysis, is critical for normal club cell function in mice. Deletion of the gene encoding ATGL, Pnpla2 (also known as Atgl), induced substantial triglyceride accumulation, decreased mitochondrial numbers, and decreased mitochondrial respiration in club cells. This defect manifested as bronchiolar epithelial thickening and increased airway resistance under baseline conditions. After naphthalene‑induced epithelial denudation, a regenerative defect was apparent. Mechanistically, dysfunctional PPARα lipid-signaling underlies this phenotype because (a) ATGL was needed for PPARα lipid-signaling in regenerating bronchioles and (b) administration of the specific PPARα agonist WY14643 restored normal bronchiolar club cell ultrastructure and regenerative potential. Our data emphasize the importance of the cellular energy metabolism for lung epithelial regeneration and highlight the significance of ATGL-mediated lipid catabolism for lung health.
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Affiliation(s)
- Manu Manjunath Kanti
- Diagnostic and Research Institute of Pathology, Medical University of Graz, Graz, Austria
- BioTechMed-Graz, Graz, Austria
| | - Isabelle Striessnig-Bina
- Diagnostic and Research Institute of Pathology, Medical University of Graz, Graz, Austria
- BioTechMed-Graz, Graz, Austria
| | - Beatrix Irene Wieser
- Diagnostic and Research Institute of Pathology, Medical University of Graz, Graz, Austria
- BioTechMed-Graz, Graz, Austria
| | - Silvia Schauer
- Diagnostic and Research Institute of Pathology, Medical University of Graz, Graz, Austria
| | - Gerd Leitinger
- BioTechMed-Graz, Graz, Austria
- Division of Cell Biology, Histology, and Embryology, Gottfried Schatz Research Center, Medical University of Graz, Graz, Austria
| | - Thomas O. Eichmann
- BioTechMed-Graz, Graz, Austria
- Institute of Molecular Biosciences, University of Graz, Graz, Austria
- Core Facility Mass Spectrometry, Medical University of Graz, Graz, Austria
| | - Martina Schweiger
- BioTechMed-Graz, Graz, Austria
- Institute of Molecular Biosciences, University of Graz, Graz, Austria
| | - Margit Winkler
- BioTechMed-Graz, Graz, Austria
- Institute of Molecular Biotechnology, NAWI Graz, Graz University of Technology, Graz, Austria
| | - Elke Winter
- Diagnostic and Research Institute of Pathology, Medical University of Graz, Graz, Austria
| | - Andrea Lana
- Diagnostic and Research Institute of Pathology, Medical University of Graz, Graz, Austria
| | - Iris Kufferath
- Diagnostic and Research Institute of Pathology, Medical University of Graz, Graz, Austria
| | - Leigh Matthew Marsh
- BioTechMed-Graz, Graz, Austria
- Ludwig Boltzmann Institute for Lung Vascular Research, Graz, Austria
- Otto Loewi Research Center, Medical University of Graz, Graz, Austria
| | - Grazyna Kwapiszewska
- BioTechMed-Graz, Graz, Austria
- Ludwig Boltzmann Institute for Lung Vascular Research, Graz, Austria
- Otto Loewi Research Center, Medical University of Graz, Graz, Austria
- Institute for Lung Health, Giessen, Germany
| | - Rudolf Zechner
- BioTechMed-Graz, Graz, Austria
- Institute of Molecular Biosciences, University of Graz, Graz, Austria
| | - Gerald Hoefler
- Diagnostic and Research Institute of Pathology, Medical University of Graz, Graz, Austria
- BioTechMed-Graz, Graz, Austria
| | - Paul Willibald Vesely
- Diagnostic and Research Institute of Pathology, Medical University of Graz, Graz, Austria
- BioTechMed-Graz, Graz, Austria
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8
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Hall KD, Farooqi IS, Friedman JM, Klein S, Loos RJF, Mangelsdorf DJ, O'Rahilly S, Ravussin E, Redman LM, Ryan DH, Speakman JR, Tobias DK. The energy balance model of obesity: beyond calories in, calories out. Am J Clin Nutr 2022; 115:1243-1254. [PMID: 35134825 PMCID: PMC9071483 DOI: 10.1093/ajcn/nqac031] [Citation(s) in RCA: 126] [Impact Index Per Article: 63.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Accepted: 02/02/2022] [Indexed: 02/06/2023] Open
Abstract
A recent Perspective article described the "carbohydrate-insulin model (CIM)" of obesity, asserting that it "better reflects knowledge on the biology of weight control" as compared with what was described as the "dominant energy balance model (EBM)," which fails to consider "biological mechanisms that promote weight gain." Unfortunately, the Perspective conflated and confused the principle of energy balance, a law of physics that is agnostic as to obesity mechanisms, with the EBM as a theoretical model of obesity that is firmly based on biology. In doing so, the authors presented a false choice between the CIM and a caricature of the EBM that does not reflect modern obesity science. Here, we present a more accurate description of the EBM where the brain is the primary organ responsible for body weight regulation operating mainly below our conscious awareness via complex endocrine, metabolic, and nervous system signals to control food intake in response to the body's dynamic energy needs as well as environmental influences. We also describe the recent history of the CIM and show how the latest "most comprehensive formulation" abandons a formerly central feature that required fat accumulation in adipose tissue to be the primary driver of positive energy balance. As such, the new CIM can be considered a special case of the more comprehensive EBM but with a narrower focus on diets high in glycemic load as the primary factor responsible for common obesity. We review data from a wide variety of studies that address the validity of each model and demonstrate that the EBM is a more robust theory of obesity than the CIM.
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Affiliation(s)
- Kevin D Hall
- National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health
| | - I Sadaf Farooqi
- Wellcome-MRC Institute of Metabolic Science, University of Cambridge
| | | | - Samuel Klein
- Washington University School of Medicine in St Louis
| | - Ruth J F Loos
- Washington University School of Medicine in St Louis.,Novo Nordisk Foundation Center for Basic Metabolic Research, University of Copenhagen
| | | | - Stephen O'Rahilly
- Wellcome-MRC Institute of Metabolic Science, University of Cambridge
| | | | | | | | - John R Speakman
- Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzen, China, and the University of Aberdeen, Aberdeen, United Kingdom
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9
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Suzuki M, Tomita M. Genetic Variations of Vitamin A-Absorption and Storage-Related Genes, and Their Potential Contribution to Vitamin A Deficiency Risks Among Different Ethnic Groups. Front Nutr 2022; 9:861619. [PMID: 35571879 PMCID: PMC9096837 DOI: 10.3389/fnut.2022.861619] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Accepted: 03/23/2022] [Indexed: 12/01/2022] Open
Abstract
Vitamin A, an essential fat-soluble micronutrient, plays a critical role in the body, by regulating vision, immune responses, and normal development, for instance. Vitamin A deficiency (VAD) is a major cause of xerophthalmia and increases the risk of death from infectious diseases. It is also emerging that prenatal exposure to VAD is associated with disease risks later in life. The overall prevalence of VAD has significantly declined over recent decades; however, the rate of VAD is still high in many low- and mid-income countries and even in high-income countries among specific ethnic/race groups. While VAD occurs when dietary intake is insufficient to meet demands, establishing a strong association between food insecurity and VAD, and vitamin A supplementation is the primary solution to treat VAD, genetic contributions have also been reported to effect serum vitamin A levels. In this review, we discuss genetic variations associated with vitamin A status and vitamin A bioactivity-associated genes, specifically those linked to uptake of the vitamin in the small intestine and its storage in the liver, as well as their potential contribution to vitamin A deficiency risks among different ethnic groups.
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Affiliation(s)
- Masako Suzuki
- Department of Genetics, Albert Einstein College of Medicine, Bronx, NY, United States
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10
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Yamada M, Suzuki J, Sato S, Zenimaru Y, Saito R, Konoshita T, Kraemer FB, Ishizuka T. Hormone-sensitive lipase protects adipose triglyceride lipase-deficient mice from lethal lipotoxic cardiomyopathy. J Lipid Res 2022; 63:100194. [PMID: 35283217 PMCID: PMC9062333 DOI: 10.1016/j.jlr.2022.100194] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Revised: 03/03/2022] [Accepted: 03/04/2022] [Indexed: 12/31/2022] Open
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11
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Vogel P, Read RW, Hansen GM, Powell DR. Histopathology is required to identify and characterize myopathies in high-throughput phenotype screening of genetically engineered mice. Vet Pathol 2021; 58:1158-1171. [PMID: 34269122 DOI: 10.1177/03009858211030541] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
The development of mouse models that replicate the genetic and pathological features of human disease is important in preclinical research because these types of models enable the completion of meaningful pharmacokinetic, safety, and efficacy studies. Numerous relevant mouse models of human disease have been discovered in high-throughput screening programs, but there are important specific phenotypes revealed by histopathology that are not reliably detected by any other physiological or behavioral screening tests. As part of comprehensive phenotypic analyses of over 4000 knockout (KO) mice, histopathology identified 12 lines of KO mice with lesions indicative of an autosomal recessive myopathy. This report includes a brief summary of histological and other findings in these 12 lines. Notably, the inverted screen test detected muscle weakness in only 4 of these 12 lines (Scyl1, Plpp7, Chkb, and Asnsd1), all 4 of which have been previously recognized and published. In contrast, 6 of 8 KO lines showing negative or inconclusive findings on the inverted screen test (Plppr2, Pnpla7, Tenm1, Srpk3, Sidt2, Yif1b, Mrs2, and Pnpla2) had not been previously identified as having myopathies. These findings support the need to include histopathology in phenotype screening protocols in order to identify novel genetic myopathies that are not clinically evident or not detected by the inverted screen test.
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Affiliation(s)
- Peter Vogel
- 5417St Jude Children's Research Hospital, Memphis, TN, USA
| | - Robert W Read
- 57636Lexicon Pharmaceuticals Inc, The Woodlands, TX, USA
| | | | - David R Powell
- 57636Lexicon Pharmaceuticals Inc, The Woodlands, TX, USA
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12
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Phospholipids: Identification and Implication in Muscle Pathophysiology. Int J Mol Sci 2021; 22:ijms22158176. [PMID: 34360941 PMCID: PMC8347011 DOI: 10.3390/ijms22158176] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Revised: 07/24/2021] [Accepted: 07/26/2021] [Indexed: 12/29/2022] Open
Abstract
Phospholipids (PLs) are amphiphilic molecules that were essential for life to become cellular. PLs have not only a key role in compartmentation as they are the main components of membrane, but they are also involved in cell signaling, cell metabolism, and even cell pathophysiology. Considered for a long time to simply be structural elements of membranes, phospholipids are increasingly being viewed as sensors of their environment and regulators of many metabolic processes. After presenting their main characteristics, we expose the increasing methods of PL detection and identification that help to understand their key role in life processes. Interest and importance of PL homeostasis is growing as pathogenic variants in genes involved in PL biosynthesis and/or remodeling are linked to human diseases. We here review diseases that involve deregulation of PL homeostasis and present a predominantly muscular phenotype.
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13
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Masih S, Moirangthem A, Phadke SR. Homozygous Missense Variation in PNPLA8 Causes Prenatal-Onset Severe Neurodegeneration. Mol Syndromol 2021; 12:174-178. [PMID: 34177434 DOI: 10.1159/000513524] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Accepted: 12/02/2020] [Indexed: 12/13/2022] Open
Abstract
The patatin-like protein family plays an important role in various biological functions including lipid homeostasis, cellular growth, and signaling. Conserved across species, the patatin domain is shared by all 9 members of the PNPLA family without redundancy in the coding sequences. The defective function of PNPLA2, PNPLA6, and PNPLA9 are known to cause mitochondrial-related neurodegeneration. Recently, PNPLA8 has been associated with mitochondrial myopathy and poor weight gain with lactic acidosis in 3 unrelated families. Using whole-exome sequencing, we identified a homozygous novel missense variation c.1874A>G in the patatin domain of PNPLA8. The patient had prenatal-onset severe and progressive neurodegeneration with mortality in infancy.
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Affiliation(s)
- Suzena Masih
- Department of Medical Genetics, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, India
| | - Amita Moirangthem
- Department of Medical Genetics, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, India
| | - Shubha R Phadke
- Department of Medical Genetics, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, India
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14
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Tavian D, Maggi L, Mora M, Morandi L, Bragato C, Missaglia S. A novel PNPLA2 mutation causing total loss of RNA and protein expression in two NLSDM siblings with early onset but slowly progressive severe myopathy. Genes Dis 2021; 8:73-78. [PMID: 33569515 PMCID: PMC7859421 DOI: 10.1016/j.gendis.2019.07.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2019] [Revised: 07/12/2019] [Accepted: 07/22/2019] [Indexed: 12/21/2022] Open
Abstract
Neutral lipid storage disease with myopathy (NLSDM) is a rare autosomal recessive disorder, due to an enzymatic error of lipid metabolism. Patients present always with skeletal muscle myopathy and variable cardiac and hepatic involvement. NLSDM is caused by mutations in the PNPLA2 gene, which encodes the adipose triglyceride lipase (ATGL). Here we report the molecular characterization and clinical findings of two NLSDM siblings carrying the novel c.187+1G > C homozygous PNPLA2 mutation, localized in the splice site of intron 2. Molecular analyses revealed that neither aberrant PNPLA2 mRNA isoforms, nor ATGL mutated protein were detectable in patient's cells. Clinically, both patients presented early onset muscle weakness, in particular of proximal upper limb muscles. In almost 15 years, muscle damage affected also distal upper limbs. This is a NLSDM family, displaying a severe PNPLA2 mutation in two siblings with clinical presentation characterized by an early onset, but a slowly evolution of severe myopathy.
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Affiliation(s)
- Daniela Tavian
- Laboratory of Cellular Biochemistry and Molecular Biology, CRIBENS, Università Cattolica del Sacro Cuore, pz Buonarroti 30, Milan, 20145, Italy
- Department of Psychology, Università Cattolica del Sacro Cuore, Largo Gemelli 1, Milan, 20123, Italy
| | - Lorenzo Maggi
- Neuromuscular Diseases and Neuroimmunology Unit, Fondazione IRCCS Istituto Neurologico “Carlo Besta”, Milan, Italy
| | - Marina Mora
- Neuromuscular Diseases and Neuroimmunology Unit, Fondazione IRCCS Istituto Neurologico “Carlo Besta”, Milan, Italy
| | - Lucia Morandi
- Neuromuscular Diseases and Neuroimmunology Unit, Fondazione IRCCS Istituto Neurologico “Carlo Besta”, Milan, Italy
| | - Cinzia Bragato
- Neuromuscular Diseases and Neuroimmunology Unit, Fondazione IRCCS Istituto Neurologico “Carlo Besta”, Milan, Italy
- PhD program in Neuroscience, University of Milano-Bicocca, Via Cadore 48, Monza, 20900, Italy
| | - Sara Missaglia
- Laboratory of Cellular Biochemistry and Molecular Biology, CRIBENS, Università Cattolica del Sacro Cuore, pz Buonarroti 30, Milan, 20145, Italy
- Department of Psychology, Università Cattolica del Sacro Cuore, Largo Gemelli 1, Milan, 20123, Italy
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15
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Early onset neutral lipid storage disease with myopathy presenting as congenital hypotonia and hepatomegaly. Neuromuscul Disord 2020; 31:52-55. [PMID: 33303358 DOI: 10.1016/j.nmd.2020.11.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Revised: 11/09/2020] [Accepted: 11/12/2020] [Indexed: 12/23/2022]
Abstract
Neutral lipid storage disease with myopathy is an ultra-rare, inherited autosomal recessive neuromuscular metabolic disorder caused by pathogenic variants in PNPLA2. It typically presents in adults as a progressive myopathy and is associated with myocardiopathy, hepatic involvement, and high creatine kinase levels. Only three children and adolescents with neutral lipid storage disease with myopathy have been reported. We report a female infant with congenital hypotonia born to consanguineous parents, whose mother presented with polyhydramnios during pregnancy. She demonstrated delayed acquisition of motor milestones, hepatomegaly, and elevated creatine kinase levels. Homozygous pathogenic variants in PNPLA2 were identified. Lipid accumulation was observed within the muscle fibers and Jordans' anomaly was observed in a blood smear. This is the first report to describe an infant with mildly symptomatic neutral lipid storage disease with myopathy and demonstrate hepatic involvement in a pediatric patient. Despite her mild symptoms, her ancillary test results were markedly abnormal.
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16
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Wu Y, Han J, Wang Y, Zhang J, Song X, Ji G. A family with riboflavin-reactive lipid deposition myopathy caused by a novel compound heterozygous mutation in the electron transfer flavoprotein dehydrogenase gene. J Int Med Res 2020; 48:300060520966499. [PMID: 33131365 PMCID: PMC7653293 DOI: 10.1177/0300060520966499] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
We report a family with riboflavin-reactive multiple acyl-CoA dehydrogenase
deficiency (RR-MADD) partially caused by a novel mutation in the electron
transfer flavoprotein dehydrogenase gene (ETFDH). The RR-MADD
family was identified by physical examination, electromyography, and muscle
biopsy of the proband. Laboratory examination and electromyography suggested a
muscle disease of the lipid storage myopathies. This was confirmed by a muscle
biopsy that revealed lipid deposition in the muscle fibers. The proband’s sister
previously had a similar disease, so the family underwent genetic testing. This
revealed complex heterozygous ETFDH mutations c.389A > T (p.
D130V) and c.1123C > A (p. P375T) in the proband and her sister, of which
c.1123C > A (p. P375T) is a novel pathogenic mutation. The proband was
treated with riboflavin and changes in physical symptoms and laboratory tests
were evaluated before and after treatment. The discovery of a novel locus
further expands the ETFDH mutation spectrum and suggests that
genotyping is vital for early detection of RR-MADD as it can greatly improve the
prognosis.
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Affiliation(s)
- Yue Wu
- Department of Neurology, The Second Hospital of Hebei Medical University, Hebei, Shijiazhuang, P. R. China.,Neurological Laboratory of Hebei Province, Shijiazhuang, Hebei, P. R. China
| | - Jingzhe Han
- Department of Neurology, Harrison International Peace Hospital, Hebei, Hengshui, P. R. China
| | - Yaye Wang
- Department of Neurology, The Second Hospital of Hebei Medical University, Hebei, Shijiazhuang, P. R. China.,Neurological Laboratory of Hebei Province, Shijiazhuang, Hebei, P. R. China
| | - Jinru Zhang
- Department of Neurology, The Second Hospital of Hebei Medical University, Hebei, Shijiazhuang, P. R. China.,Neurological Laboratory of Hebei Province, Shijiazhuang, Hebei, P. R. China
| | - Xueqin Song
- Department of Neurology, The Second Hospital of Hebei Medical University, Hebei, Shijiazhuang, P. R. China.,Neurological Laboratory of Hebei Province, Shijiazhuang, Hebei, P. R. China
| | - Guang Ji
- Department of Neurology, The Second Hospital of Hebei Medical University, Hebei, Shijiazhuang, P. R. China.,Neurological Laboratory of Hebei Province, Shijiazhuang, Hebei, P. R. China
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17
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Friend or Foe: Lipid Droplets as Organelles for Protein and Lipid Storage in Cellular Stress Response, Aging and Disease. Molecules 2020; 25:molecules25215053. [PMID: 33143278 PMCID: PMC7663626 DOI: 10.3390/molecules25215053] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Revised: 10/20/2020] [Accepted: 10/22/2020] [Indexed: 02/06/2023] Open
Abstract
Lipid droplets (LDs) were considered as a mere lipid storage organelle for a long time. Recent evidence suggests that LDs are in fact distinct and dynamic organelles with a specialized proteome and functions in many cellular roles. As such, LDs contribute to cellular signaling, protein and lipid homeostasis, metabolic diseases and inflammation. In line with the multitude of functions, LDs interact with many cellular organelles including mitochondria, peroxisomes, lysosomes, the endoplasmic reticulum and the nucleus. LDs are highly mobile and dynamic organelles and impaired motility disrupts the interaction with other organelles. The reduction of interorganelle contacts results in a multitude of pathophysiologies and frequently in neurodegenerative diseases. Contacts not only supply lipids for β-oxidation in mitochondria and peroxisomes, but also may include the transfer of toxic lipids as well as misfolded and harmful proteins to LDs. Furthermore, LDs assist in the removal of protein aggregates when severe proteotoxic stress overwhelms the proteasomal system. During imbalance of cellular lipid homeostasis, LDs also support cellular detoxification. Fine-tuning of LD function is of crucial importance and many diseases are associated with dysfunctional LDs. We summarize the current understanding of LDs and their interactions with organelles, providing a storage site for harmful proteins and lipids during cellular stress, aging inflammation and various disease states.
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18
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Tripathi J, Segeritz CP, Griffiths G, Bushell W, Vallier L, Skarnes WC, Mota MM, Billker O. A Novel Chemically Differentiated Mouse Embryonic Stem Cell-Based Model to Study Liver Stages of Plasmodium berghei. Stem Cell Reports 2020; 14:1123-1134. [PMID: 32442532 PMCID: PMC7355138 DOI: 10.1016/j.stemcr.2020.04.010] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2019] [Revised: 04/26/2020] [Accepted: 04/27/2020] [Indexed: 01/07/2023] Open
Abstract
Asymptomatic and obligatory liver stage (LS) infection of Plasmodium parasites presents an attractive target for antimalarial vaccine and drug development. Lack of robust cellular models to study LS infection has hindered the discovery and validation of host genes essential for intrahepatic parasite development. Here, we present a chemically differentiated mouse embryonic stem cell (ESC)-based LS model, which supports complete development of Plasmodium berghei exoerythrocytic forms (EEFs) and can be used to define new host-parasite interactions. Using our model, we established that host Pnpla2, coding for adipose triglyceride lipase, is dispensable for P. berghei EEF development. In addition, we also evaluated in-vitro-differentiated human hepatocyte-like cells (iHLCs) to study LS of P. berghei and found it to be a sub-optimal infection model. Overall, our results present a new mouse ESC-based P. berghei LS infection model that can be utilized to study the impact of host genetic variation on parasite development.
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Affiliation(s)
- Jaishree Tripathi
- Wellcome Trust Sanger Institute, Wellcome Genome Campus, Hinxton, Cambridge, UK
| | - Charis-Patricia Segeritz
- Wellcome Trust and Medical Research Council Stem Cell Institute, Department of Surgery, University of Cambridge, Cambridge, UK
| | - Gareth Griffiths
- Wellcome Trust Sanger Institute, Wellcome Genome Campus, Hinxton, Cambridge, UK
| | - Wendy Bushell
- Wellcome Trust Sanger Institute, Wellcome Genome Campus, Hinxton, Cambridge, UK
| | - Ludovic Vallier
- Wellcome Trust Sanger Institute, Wellcome Genome Campus, Hinxton, Cambridge, UK; Wellcome Trust and Medical Research Council Stem Cell Institute, Department of Surgery, University of Cambridge, Cambridge, UK
| | - William C Skarnes
- The Jackson Laboratory for Genomic Medicine, Ten Discovery Drive, Farmington, CT 06032, USA
| | - Maria M Mota
- Unidade de Malária, Instituto de Medicina Molecular, Universidade de Lisboa, Lisboa, Portugal
| | - Oliver Billker
- Wellcome Trust Sanger Institute, Wellcome Genome Campus, Hinxton, Cambridge, UK; Molecular Infection Medicine Sweden and Molecular Biology Department, Umeå University, 90187 Umeå, Sweden.
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19
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Han J, Song X, Lu S, Ji G, Xie Y, Wu H. Adolescent Hyperuricemia with Lipid Storage Myopathy: A Clinical Study. Med Sci Monit 2019; 25:9103-9111. [PMID: 31785094 PMCID: PMC6900922 DOI: 10.12659/msm.918841] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2019] [Accepted: 09/04/2019] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND In this study, we investigated the clinical and pathological features of patients with lipid storage myopathy (LSM) complicated with hyperuricemia, to improve clinicians' understanding of metabolic multi-muscular disorder with metabolic disorders, and to reduce the risk of missed diagnosis of LSM. MATERIAL AND METHODS From January 2005 to December 2017, 8 patients underwent muscle biopsy and diagnosed by muscle pathology and genetic testing in our hospital. All 8 patients were in compliance with LSM diagnosis. We collected data on the patient's clinical performance, adjuvant examination, treatment, and outcomes to provide a comprehensive report and description of LSM patients with hyperuricemia. RESULTS All patients were diagnosed as having ETFDH gene mutations. The main clinical manifestations of patients were chronic limb and trunk weakness, limb numbness, and muscle pain. The serum creatine kinase (CK) values in all patients were higher than normal values. Electromyography showed 3 cases of simple myogenic damage and 3 cases of neurogenic injury. Hematuria metabolic screening showed that 2 patients had elevated glutaric aciduria, and 1 patient had elevated fatty acyl carnitine in the blood. All patients were given riboflavin treatment, and the clinical symptoms were significantly improved, and 3 patients returned to normal uric acid levels after treatment. Pathological staining showed an abnormal deposition of lipid droplets in muscle fibers. CONCLUSIONS If an adolescent hyperuricemia patient has abnormal limb weakness, exercise intolerance, and elevated serum CK values, clinicians need to be highly alert to the possibility of LSM. Early diagnosis and treatment of LSM should improve the clinical symptoms and quality of life and reduce complications.
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Affiliation(s)
- Jingzhe Han
- Department of Neurology, Harrison International Peace Hospital, Hengshui, Hebei, P.R. China
| | - Xueqin Song
- Department of Neurology, The Second Hospital of Hebei Medical University, Shijiazhuang, Hebei, P.R. China
- Institute of Cardiocerebrovascular Disease, Shijiazhuang, Hebei, P.R. China
- Neurological Laboratory of Hebei Province, Shijiazhuang, Hebei, P.R. China
| | - Shan Lu
- Department of Neurology, The Second Hospital of Hebei Medical University, Shijiazhuang, Hebei, P.R. China
| | - Guang Ji
- Department of Neurology, The Second Hospital of Hebei Medical University, Shijiazhuang, Hebei, P.R. China
| | - Yanan Xie
- Department of Cardiology, The Second Hospital of Hebei Medical University, Shijiazhuang, Hebei, P.R. China
| | - Hongran Wu
- Department of Neurology, The Second Hospital of Hebei Medical University, Shijiazhuang, Hebei, P.R. China
- Institute of Cardiocerebrovascular Disease, Shijiazhuang, Hebei, P.R. China
- Neurological Laboratory of Hebei Province, Shijiazhuang, Hebei, P.R. China
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20
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Zhang W, Wen B, Lu J, Zhao Y, Hong D, Zhao Z, Zhang C, Luo Y, Qi X, Zhang Y, Song X, Zhao Y, Zhao C, Hu J, Yang H, Wang Z, Yan C, Yuan Y. Neutral lipid storage disease with myopathy in China: a large multicentric cohort study. Orphanet J Rare Dis 2019; 14:234. [PMID: 31655616 PMCID: PMC6815004 DOI: 10.1186/s13023-019-1209-z] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2019] [Accepted: 09/24/2019] [Indexed: 06/18/2023] Open
Abstract
Background Neutral lipid storage disease with myopathy (NLSDM) is a rare clinical heterogeneous disorder caused by mutations in the patatin-like phospholipase domain-containing 2 (PNPLA2) gene. NLSDM usually presents skeletal myopathy, cardiomyopathy and the multiple organs dysfunction. Around 50 cases of NLSDM have been described worldwide, whereas the comprehensive understanding of this disease are still limited. We therefore recruit NLSDM patients from 10 centers across China, summarize the clinical, muscle imaging, pathological and genetic features, and analyze the genotype-phenotype relationship. Results A total of 45 NLSDM patients (18 men and 27 women) were recruited from 40 unrelated families. Thirteen patients were born from consanguineous parents. The phenotypes were classified as asymptomatic hyperCKemia (2/45), pure skeletal myopathy (18/45), pure cardiomyopathy (4/45), and the combination of skeletal myopathy and cardiomyopathy (21/45). Right upper limb weakness was the early and prominent feature in 61.5% of patients. On muscle MRI, the long head of the biceps femoris, semimembranosus and adductor magnus on thighs, the soleus and medial head of the gastrocnemius on lower legs showed the most severe fatty infiltration. Thirty-three families were carrying homozygous mutations, while seven families were carrying compound heterozygous mutations. A total of 23 mutations were identified including 11 (47.8%) point mutations, eight (34.8%) deletions and four (17.4%) insertions. c.757 + 1G > T, c.245G > A and c.187 + 1G > A were the three most frequent mutations. Among four groups of phenotypes, significant differences were shown in disease onset (< 20 years versus ≥20 years old, p = 0.003) and muscle pathology (with rimmed vacuoles versus without rimmed vacuoles, p = 0.001). PNPLA2 mutational type or functional defects did not show great impact on phenotypes. Conclusion We outline the clinical and genetic spectrum in a large cohort of NLSDM patients. Selective muscle fatty infiltration on posterior compartment of legs are characteristic of NLSDM. Chinese patients present with distinctive and relative hotspot PNPLA2 mutations. The disease onset age and pathological appearance of rimmed vacuoles are proved to be related with the clinical manifestations. The phenotypes are not strongly influenced by genetic defects, suggesting the multiple environmental risk factors in the development of NLSDM.
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Affiliation(s)
- Wei Zhang
- Department of Neurology, Peking University First Hospital, No.8 Xishiku Street, West District, Beijing, 100034, China
| | - Bing Wen
- Department of Neurology, Qilu Hospital of Shandong University, No. 107, West Wenhua Road, Jinan, 250012, Shandong, China
| | - Jun Lu
- Department of Neurology, Huashan Hospital of Fudan University, Shanghai, People's Republic of China
| | - Yawen Zhao
- Department of Neurology, Peking University First Hospital, No.8 Xishiku Street, West District, Beijing, 100034, China
| | - Daojun Hong
- Department of Neurology, Peking University People's Hospital, Beijing, People's Republic of China
| | - Zhe Zhao
- Department of Neurology, the Third Hospital of Hebei Medical University, Shijiazhuang, Hebei province, People's Republic of China
| | - Cheng Zhang
- Department of Neurology, the First Affiliated Hospital of Sun yat-sen University, Guangzhou, Guangdong province, People's Republic of China
| | - Yuebei Luo
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, Hunan province, People's Republic of China
| | - Xueliang Qi
- Department of Neurology, the Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi province, People's Republic of China
| | - Yingshuang Zhang
- Department of Neurology, Third Hospital, Peking University, Beijing, People's Republic of China
| | - Xueqin Song
- Department of Neurology, the Second Hospital of Hebei Medical University, Shijiazhuang, Hebei province, People's Republic of China
| | - Yuying Zhao
- Department of Neurology, Qilu Hospital of Shandong University, No. 107, West Wenhua Road, Jinan, 250012, Shandong, China
| | - Chongbo Zhao
- Department of Neurology, Huashan Hospital of Fudan University, Shanghai, People's Republic of China
| | - Jing Hu
- Department of Neurology, the Third Hospital of Hebei Medical University, Shijiazhuang, Hebei province, People's Republic of China
| | - Huan Yang
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, Hunan province, People's Republic of China
| | - Zhaoxia Wang
- Department of Neurology, Peking University First Hospital, No.8 Xishiku Street, West District, Beijing, 100034, China
| | - Chuanzhu Yan
- Department of Neurology, Qilu Hospital of Shandong University, No. 107, West Wenhua Road, Jinan, 250012, Shandong, China.
| | - Yun Yuan
- Department of Neurology, Peking University First Hospital, No.8 Xishiku Street, West District, Beijing, 100034, China.
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21
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Goldberg IJ, Reue K, Abumrad NA, Bickel PE, Cohen S, Fisher EA, Galis ZS, Granneman JG, Lewandowski ED, Murphy R, Olive M, Schaffer JE, Schwartz-Longacre L, Shulman GI, Walther TC, Chen J. Deciphering the Role of Lipid Droplets in Cardiovascular Disease: A Report From the 2017 National Heart, Lung, and Blood Institute Workshop. Circulation 2019; 138:305-315. [PMID: 30012703 DOI: 10.1161/circulationaha.118.033704] [Citation(s) in RCA: 76] [Impact Index Per Article: 15.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Lipid droplets (LDs) are distinct and dynamic organelles that affect the health of cells and organs. Much progress has been made in understanding how these structures are formed, how they interact with other cellular organelles, how they are used for storage of triacylglycerol in adipose tissue, and how they regulate lipolysis. Our understanding of the biology of LDs in the heart and vascular tissue is relatively primitive in comparison with LDs in adipose tissue and liver. The National Heart, Lung, and Blood Institute convened a working group to discuss how LDs affect cardiovascular diseases. The goal of the working group was to examine the current state of knowledge on the cell biology of LDs, including current methods to study them in cells and organs and reflect on how LDs influence the development and progression of cardiovascular diseases. This review summarizes the working group discussion and recommendations on research areas ripe for future investigation that will likely improve our understanding of atherosclerosis and heart function.
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Affiliation(s)
| | - Karen Reue
- University of California, Los Angeles (K.R.)
| | | | - Perry E Bickel
- University of Texas Southwestern Medical Center, Dallas (P.E.B.)
| | - Sarah Cohen
- University of North Carolina at Chapel Hill (S.C.)
| | | | - Zorina S Galis
- National Institutes of Health/National, Heart, Lung, and Blood Institute, Bethesda, MD (Z.S.G., M.O., L.S.-L., J.C.)
| | | | | | | | - Michelle Olive
- National Institutes of Health/National, Heart, Lung, and Blood Institute, Bethesda, MD (Z.S.G., M.O., L.S.-L., J.C.)
| | | | - Lisa Schwartz-Longacre
- National Institutes of Health/National, Heart, Lung, and Blood Institute, Bethesda, MD (Z.S.G., M.O., L.S.-L., J.C.)
| | - Gerald I Shulman
- Yale University, Howard Hughes Medical Institute, New Haven, CT (G.I.S.)
| | - Tobias C Walther
- Harvard University, Howard Hughes Medical Institute, Boston, MA (T.C.W.)
| | - Jue Chen
- National Institutes of Health/National, Heart, Lung, and Blood Institute, Bethesda, MD (Z.S.G., M.O., L.S.-L., J.C.).
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22
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Li M, Hirano KI, Ikeda Y, Higashi M, Hashimoto C, Zhang B, Kozawa J, Sugimura K, Miyauchi H, Suzuki A, Hara Y, Takagi A, Ikeda Y, Kobayashi K, Futsukaichi Y, Zaima N, Yamaguchi S, Shrestha R, Nakamura H, Kawaguchi K, Sai E, Hui SP, Nakano Y, Sawamura A, Inaba T, Sakata Y, Yasui Y, Nagasawa Y, Kinugawa S, Shimada K, Yamada S, Hao H, Nakatani D, Ide T, Amano T, Naito H, Nagasaka H, Kobayashi K. Triglyceride deposit cardiomyovasculopathy: a rare cardiovascular disorder. Orphanet J Rare Dis 2019; 14:134. [PMID: 31186072 PMCID: PMC6560904 DOI: 10.1186/s13023-019-1087-4] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2019] [Accepted: 05/01/2019] [Indexed: 12/25/2022] Open
Abstract
Triglyceride deposit cardiomyovasculopathy (TGCV) is a phenotype primarily reported in patients carrying genetic mutations in PNPLA2 encoding adipose triglyceride lipase (ATGL) which releases long chain fatty acid (LCFA) as a major energy source by the intracellular TG hydrolysis. These patients suffered from intractable heart failure requiring cardiac transplantation. Moreover, we identified TGCV patients without PNPLA2 mutations based on pathological and clinical studies. We provided the diagnostic criteria, in which TGCV with and without PNPLA2 mutations were designated as primary TGCV (P-TGCV) and idiopathic TGCV (I-TGCV), respectively. We hereby report clinical profiles of TGCV patients. Between 2014 and 2018, 7 P-TGCV and 18 I-TGCV Japanese patients have been registered in the International Registry. Patients with I-TGCV, of which etiologies and causes are not known yet, suffered from adult-onset severe heart disease, including heart failure and coronary artery disease, associated with a marked reduction in ATGL activity and myocardial washout rate of LCFA tracer, as similar to those with P-TGCV. The present first registry-based study showed that TGCV is an intractable, at least at the moment, and heterogeneous cardiovascular disorder.
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Affiliation(s)
- Ming Li
- Laboratory of Cardiovascular Disease, Novel, Non-invasive, and Nutritional Therapeutics and Triglyceride Research Center (TGRC), Graduate School of Medicine, Osaka University, 6-2-4, Furuedai, Suita, Osaka, 565-0874, Japan
| | - Ken-Ichi Hirano
- Laboratory of Cardiovascular Disease, Novel, Non-invasive, and Nutritional Therapeutics and Triglyceride Research Center (TGRC), Graduate School of Medicine, Osaka University, 6-2-4, Furuedai, Suita, Osaka, 565-0874, Japan.
| | - Yoshihiko Ikeda
- Department of Pathology, National Cerebral and Cardiovascular Center, 5-7-1, Fujishirodai, Suita, Osaka, 565-8565, Japan
| | - Masahiro Higashi
- Department of Radiology, National Hospital Organization Osaka National Hospital, 2-1-14, Hoenzaka, Chuo-ku, Osaka, 540-0006, Japan
| | - Chikako Hashimoto
- Laboratory of Cardiovascular Disease, Novel, Non-invasive, and Nutritional Therapeutics and Triglyceride Research Center (TGRC), Graduate School of Medicine, Osaka University, 6-2-4, Furuedai, Suita, Osaka, 565-0874, Japan
| | - Bo Zhang
- Department of Biochemistry, Fukuoka University Medical School, 7-45-1, Nanakuma, Jonan-ku, Fukuoka, 814-0180, Japan
| | - Junji Kozawa
- Department of Metabolic Medicine, Graduate School of Medicine, Osaka University, 2-2, Yamadaoka, Suita, Osaka, 565-0871, Japan
| | - Koichiro Sugimura
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, 1-1, Seiryomachi, Aoba-ku, Sendai, Miyagi, 980-8574, Japan
| | - Hideyuki Miyauchi
- Department of Cardiovascular Medicine, Chiba University Graduate School of Medicine, 1-8-1, Inohara, Chuo-ku, Chiba, 260-8670, Japan
| | - Akira Suzuki
- Laboratory of Cardiovascular Disease, Novel, Non-invasive, and Nutritional Therapeutics and Triglyceride Research Center (TGRC), Graduate School of Medicine, Osaka University, 6-2-4, Furuedai, Suita, Osaka, 565-0874, Japan
| | - Yasuhiro Hara
- Laboratory of Cardiovascular Disease, Novel, Non-invasive, and Nutritional Therapeutics and Triglyceride Research Center (TGRC), Graduate School of Medicine, Osaka University, 6-2-4, Furuedai, Suita, Osaka, 565-0874, Japan
| | - Atsuko Takagi
- Laboratory of Cardiovascular Disease, Novel, Non-invasive, and Nutritional Therapeutics and Triglyceride Research Center (TGRC), Graduate School of Medicine, Osaka University, 6-2-4, Furuedai, Suita, Osaka, 565-0874, Japan
| | - Yasuyuki Ikeda
- Laboratory of Cardiovascular Disease, Novel, Non-invasive, and Nutritional Therapeutics and Triglyceride Research Center (TGRC), Graduate School of Medicine, Osaka University, 6-2-4, Furuedai, Suita, Osaka, 565-0874, Japan
| | - Kazuhiro Kobayashi
- Division of Molecular Brain Science, Kobe University Graduate School of Medicine, 7-5-1, Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan
| | - Yoshiaki Futsukaichi
- Laboratory of Cardiovascular Disease, Novel, Non-invasive, and Nutritional Therapeutics and Triglyceride Research Center (TGRC), Graduate School of Medicine, Osaka University, 6-2-4, Furuedai, Suita, Osaka, 565-0874, Japan
| | - Nobuhiro Zaima
- Department of Applied Biological Chemistry, Graduate School of Agriculture, Kindai University, 3327-204, Nakamachi, Nara, 631-8505, Japan
| | - Satoshi Yamaguchi
- Laboratory of Cardiovascular Disease, Novel, Non-invasive, and Nutritional Therapeutics and Triglyceride Research Center (TGRC), Graduate School of Medicine, Osaka University, 6-2-4, Furuedai, Suita, Osaka, 565-0874, Japan
| | - Rojeet Shrestha
- Faculty of Health Sciences, Hokkaido University, Kita-12, Nishi-5, Sapporo, 060-0812, Japan
| | - Hiroshi Nakamura
- Kure Medical Center and Chugoku Cancer Center, National Hospital Organization, 3-1, Aoyama-cho, Kure, Hiroshima, 737-0023, Japan
| | - Katsuhiro Kawaguchi
- Department of Cardiovascular Medicine, Komaki City Hospital, 1-20, Jobushi, Komaki, Aichi, 485-8520, Japan
| | - Eiryu Sai
- Department of Cardiovascular Medicine, Juntendo University Graduate School of Medicine, 2-1-1, Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan
| | - Shu-Ping Hui
- Faculty of Health Sciences, Hokkaido University, Kita-12, Nishi-5, Sapporo, 060-0812, Japan
| | - Yusuke Nakano
- Department of Cardiology, Aichi Medical University, 1-1 Yazakokarimata, Nagakute, Aichi, 480-1195, Japan
| | - Akinori Sawamura
- Department of Cardiovascular Medicine, Graduate School of Medicine, Nagoya University, 65 Tsurumai, Showa-ku, Nagoya, Aichi, 466-8560, Japan
| | - Tohru Inaba
- Department of Infection Control and Laboratory Medicine, Kyoto Prefectural University of Medicine, 465, Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto, 602-8566, Japan
| | - Yasuhiko Sakata
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, 1-1, Seiryomachi, Aoba-ku, Sendai, Miyagi, 980-8574, Japan
| | - Yoko Yasui
- Faculty of Human Life Science, Osaka City University, 3-3-138, Sugimoto, Sumiyoshi-ku, Osaka, 558-8585, Japan
| | - Yasuyuki Nagasawa
- Department of Internal Medicine, Division of Kidney and Dialysis, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, Hyogo, 663-8501, Japan
| | - Shintaro Kinugawa
- Department of Cardiovascular Medicine, Hokkaido University Graduate School of Medicine, Kita-15, Nishi-7, Kita-ku, Sapporo, 060-8638, Japan
| | - Kazunori Shimada
- Department of Cardiovascular Medicine, Juntendo University Graduate School of Medicine, 2-1-1, Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan
| | - Sohsuke Yamada
- Department of Pathology and Laboratory Medicine, Kanazawa Medical University, 1-1 Daigaku, Uchinada, Ishikawa, 920-0293, Japan
| | - Hiroyuki Hao
- Department of Pathology, Nihon University School of Medicine, 30-1 Ohyaguchikami-cho, Itabashi-ku, Tokyo, 173-8610, Japan
| | - Daisaku Nakatani
- Center for Global Health, Department of Medical Innovation, Osaka University Hospital.4F Center of Medical Innovation and Translational Research, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan.,Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine, 2-2 (A8) Yamadaoka Suita, Osaka, 565-0871, Japan
| | - Tomomi Ide
- Department of Cardiovascular Medicine, Graduate School of Medicine, Kyushu University, 3-1-1, Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan
| | - Tetsuya Amano
- Department of Cardiology, Aichi Medical University, 1-1 Yazakokarimata, Nagakute, Aichi, 480-1195, Japan
| | - Hiroaki Naito
- Department of Radiology, Nippon Life Hospital, 2-1-54, Enokojima, Nishi-ku, Osaka, 550-0006, Japan
| | - Hironori Nagasaka
- Department of Pediatrics, Takarazuka City Hospital, 4-5-1, Obama, Takarazuka, Hyogo, 665-0827, Japan
| | - Kunihisa Kobayashi
- Department of Endocrinology and Diabetes Mellitus, Fukuoka University Chikushi Hospital, 1-1-1, Zokumyoin, Chikushino, Fukuoka, 818-8502, Japan
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Shukla A, Saneto RP, Hebbar M, Mirzaa G, Girisha KM. A neurodegenerative mitochondrial disease phenotype due to biallelic loss-of-function variants in PNPLA8 encoding calcium-independent phospholipase A2γ. Am J Med Genet A 2019; 176:1232-1237. [PMID: 29681094 DOI: 10.1002/ajmg.a.38687] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2017] [Revised: 03/05/2018] [Accepted: 03/05/2018] [Indexed: 12/19/2022]
Abstract
Animal studies have demonstrated the critical roles of the patatin-like protein family plays in cellular growth, lipid homeostasis, and second messenger signaling the nervous system. Of the nine known calcium-independent phospholipase A2γ, only PNPLA2, PNLPA6, PNPLA9 and most recently a single patient with PNPLA8 are associated with mitochondrial-related neurodegeneration. Using whole exome sequencing, we report two unrelated individuals with variable but similar clinical features of microcephaly, severe global developmental delay, spasticity, lactic acidosis, and progressive cerebellar atrophy with biallelic loss-of-function variants in PNPLA8.
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Affiliation(s)
- Anju Shukla
- Department of Medical Genetics, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, India
| | - Russell P Saneto
- Center for Integrative Brain Research, Neuroscience Institute, Seattle Children's Research Institute, Seattle, Washington, USA.,Division of Pediatric Neurology, Department of Neurology, Neuroscience Institute, Seattle Children's Hospital, Seattle, Washington, USA
| | - Malavika Hebbar
- Department of Medical Genetics, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, India
| | - Ghayda Mirzaa
- Center for Integrative Brain Research, Seattle Children's Research Institute, Seattle, Washington, USA.,Department of Pediatrics, University of Washington, Seattle, Washington, USA
| | - Katta M Girisha
- Department of Medical Genetics, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, India
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24
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Angelini C, Pennisi E, Missaglia S, Tavian D. Metabolic lipid muscle disorders: biomarkers and treatment. Ther Adv Neurol Disord 2019; 12:1756286419843359. [PMID: 31040882 PMCID: PMC6477769 DOI: 10.1177/1756286419843359] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2018] [Accepted: 03/08/2019] [Indexed: 12/21/2022] Open
Abstract
Lipid storage myopathies (LSMs) are metabolic disorders of the utilization of fat in muscles due to several different defects. In this review, a molecular update of LSMs is presented and recent attempts of finding treatment options are discussed. The main topics discussed are: primary carnitine deficiency, riboflavin-responsive multiple acyl-CoA dehydrogenase deficiency, neutral lipid storage disorders and carnitine palmitoyl transferase deficiency. The most frequent presentations and genetic abnormalities are summarized. We present their diagnosis utilizing biomedical and morphological biomarkers and possible therapeutic interventions. The treatment of these metabolic disorders is a subject of active translational research but appears, in some cases, still elusive.
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Affiliation(s)
- Corrado Angelini
- Fondazione Ospedale San Camillo IRCCS, Via Alberoni 70, Venezia 30126, Italia
| | - Elena Pennisi
- Division of Neurology, S Filippo Neri Hospital, Rome, Italy
| | - Sara Missaglia
- Laboratory of Cellular Biochemistry and Molecular Biology, CRIBENS, Catholic University of the Sacred Heart, Milan, Italy Psychology Department, Catholic University of the Sacred Heart, Milan, Italy
| | - Daniela Tavian
- Laboratory of Cellular Biochemistry and Molecular Biology, CRIBENS, Catholic University of the Sacred Heart, Milan, Italy Psychology Department, Catholic University of the Sacred Heart, Milan, Italy
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25
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Neutral Lipid Storage Diseases as Cellular Model to Study Lipid Droplet Function. Cells 2019; 8:cells8020187. [PMID: 30795549 PMCID: PMC6406896 DOI: 10.3390/cells8020187] [Citation(s) in RCA: 61] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2019] [Revised: 02/14/2019] [Accepted: 02/19/2019] [Indexed: 01/10/2023] Open
Abstract
Neutral lipid storage disease with myopathy (NLSDM) and with ichthyosis (NLSDI) are rare autosomal recessive disorders caused by mutations in the PNPLA2 and in the ABHD5/CGI58 genes, respectively. These genes encode the adipose triglyceride lipase (ATGL) and α-β hydrolase domain 5 (ABHD5) proteins, which play key roles in the function of lipid droplets (LDs). LDs, the main cellular storage sites of triacylglycerols and sterol esters, are highly dynamic organelles. Indeed, LDs are critical for both lipid metabolism and energy homeostasis. Partial or total PNPLA2 or ABHD5/CGI58 knockdown is characteristic of the cells of NLSD patients; thus, these cells are natural models with which one can unravel LD function. In this review we firstly summarize genetic and clinical data collected from NLSD patients, focusing particularly on muscle, skin, heart, and liver damage due to impaired LD function. Then, we discuss how NLSD cells were used to investigate and expand the current structural and functional knowledge of LDs.
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26
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Zhang S, Wang L, Zan L. Investigation into the underlying molecular mechanisms of white adipose tissue through comparative transcriptome analysis of multiple tissues. Mol Med Rep 2019; 19:959-966. [PMID: 30569103 PMCID: PMC6323223 DOI: 10.3892/mmr.2018.9740] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2018] [Accepted: 11/14/2018] [Indexed: 01/17/2023] Open
Abstract
Adipose tissue has a primary role in lipid and glucose metabolism as a storage site for fatty acids, and also functions as an endocrine organ, producing large numbers of hormones and cytokines. Adipose dysfunction triggers a number of obesity‑associated health problems. The aim of the present study was, therefore, to investigate the molecular mechanisms of white adipose tissue (WAT). The GSE9954 microarray data were downloaded from the Gene Expression Omnibus. Adipose‑specific genes were identified through limma package analysis, based on samples of WAT and 17 other types of non‑adipose tissue obtained from mice. Process and pathway enrichment analyses were performed for these genes. Finally, protein‑protein interaction (PPI) and co‑expression networks were constructed and analyzed. In total, 202 adipose‑specific genes were identified, which were involved in key biological processes (including fat cell differentiation and lipid metabolic process) and one key pathway [namely, the adenine monophosphate‑activated protein kinase (AMPK) signaling pathway]. Construction of the PPI network and further molecular complex detection revealed the presence of 17 key genes, including acetyl‑CoA carboxylase α, peroxisome proliferator‑activated receptor (PPAR) γ and leptin, that were involved in the AMPK, PPAR and insulin signaling pathways. In addition, amine oxidase copper containing 3 and adrenoceptor beta 3 were communication hubs in the co‑expression network of adipose‑specific genes. In conclusion, the present study promotes our understanding of the underlying molecular mechanisms of WAT, and may offer an insight into the prevention and treatment of obesity‑associated diseases caused by adipose dysfunction.
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Affiliation(s)
- Song Zhang
- Key Laboratory of Animal Biotechnology, College of Animal Science and Technology, Northwest A&F University, Xianyang, Shaanxi 712100, P.R. China
| | - Li Wang
- Key Laboratory of Animal Biotechnology, College of Animal Science and Technology, Northwest A&F University, Xianyang, Shaanxi 712100, P.R. China
| | - Linsen Zan
- Key Laboratory of Animal Biotechnology, College of Animal Science and Technology, Northwest A&F University, Xianyang, Shaanxi 712100, P.R. China
- Department of Agriculture Cattle Laboratory, National Beef Cattle Improvement Center, Northwest A&F University, Xianyang, Shaanxi 712100, P.R. China
- Molecular Breeding Laboratory, Shaanxi Beef Cattle Engineering Research Center, Northwest A&F University, Xianyang, Shaanxi 712100, P.R. China
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27
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Garcia MA, Rojas JA, Millán SP, Flórez AA. Neutral lipid storage disease with myopathy and dropped head syndrome. Report of a new variant susceptible of treatment with late diagnosis. J Clin Neurosci 2018; 58:207-209. [DOI: 10.1016/j.jocn.2018.10.046] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2018] [Accepted: 10/07/2018] [Indexed: 10/28/2022]
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28
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Milone M, Liewluck T. The unfolding spectrum of inherited distal myopathies. Muscle Nerve 2018; 59:283-294. [PMID: 30171629 DOI: 10.1002/mus.26332] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2018] [Revised: 08/26/2018] [Accepted: 08/28/2018] [Indexed: 12/30/2022]
Abstract
Distal myopathies are a group of rare muscle diseases characterized by distal weakness at onset. Although acquired myopathies can occasionally present with distal weakness, the majority of distal myopathies have a genetic etiology. Their age of onset varies from early-childhood to late-adulthood while the predominant muscle weakness can affect calf, ankle dorsiflexor, or distal upper limb muscles. A spectrum of muscle pathological changes, varying from nonspecific myopathic changes to rimmed vacuoles to myofibrillar pathology to nuclei centralization, have been noted. Likewise, the underlying molecular defect is heterogeneous. In addition, there is emerging evidence that distal myopathies can result from defective proteins encoded by genes causative of neurogenic disorders, be manifestation of multisystem proteinopathies or the result of the altered interplay between different genes. In this review, we provide an overview on the clinical, electrophysiological, pathological, and molecular aspects of distal myopathies, focusing on the most recent developments in the field. Muscle Nerve 59:283-294, 2019.
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Affiliation(s)
| | - Teerin Liewluck
- Department of Neurology, Mayo Clinic, Rochester, Minnesota, USA
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29
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Zhang S, Wang L, Li S, Zhang W, Ma X, Cheng G, Yang W, Zan L. Identification of Potential Key Genes Associated with Adipogenesis through Integrated Analysis of Five Mouse Transcriptome Datasets. Int J Mol Sci 2018; 19:ijms19113557. [PMID: 30424473 PMCID: PMC6274731 DOI: 10.3390/ijms19113557] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2018] [Revised: 11/01/2018] [Accepted: 11/06/2018] [Indexed: 01/12/2023] Open
Abstract
Adipose tissue is the most important energy metabolism and secretion organ, and these functions are conferred during the adipogenesis process. However, the cause and the molecular events underlying adipogenesis are still unclear. In this study, we performed integrated bioinformatics analyses to identify vital genes involved in adipogenesis and reveal potential molecular mechanisms. Five mouse high-throughput expression profile datasets were downloaded from the Gene Expression Omnibus (GEO) database; these datasets contained 24 samples of 3T3-L1 cells during adipogenesis, including 12 undifferentiated samples and 12 differentiated samples. The five datasets were reanalyzed and integrated to select differentially expressed genes (DEGs) during adipogenesis via the robust rank aggregation (RRA) method. Functional annotation of these DEGs and mining of key genes were then performed. We also verified the expression levels of some potential key genes during adipogenesis. A total of 386 consistent DEGs were identified, with 230 upregulated genes and 156 downregulated genes. Gene Ontology (GO) analysis showed that the biological functions of the DEGs primarily included fat cell differentiation, lipid metabolic processes, and cell adhesion. Kyoto Encyclopedia of Genes and Genomes (KEGG) analysis showed that these DEGs were mainly associated with metabolic pathways, the peroxisome proliferator-activated receptor (PPAR) signaling pathway, regulation of lipolysis in adipocytes, the tumor necrosis factor (TNF) signaling pathway, and the FoxO signaling pathway. The 30 most closely related genes among the DEGs were identified from the protein⁻protein interaction (PPI) network and verified by real-time quantification during 3T3-L1 preadipocyte differentiation. In conclusion, we obtained a list of consistent DEGs during adipogenesis through integrated analysis, which may offer potential targets for the regulation of adipogenesis and treatment of adipose dysfunction.
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Affiliation(s)
- Song Zhang
- College of Animal Science and Technology, Northwest A&F University, Yangling 712100, China.
| | - Li Wang
- College of Animal Science and Technology, Northwest A&F University, Yangling 712100, China.
| | - Shijun Li
- College of Animal Science and Technology, Northwest A&F University, Yangling 712100, China.
| | - Wenzhen Zhang
- College of Animal Science and Technology, Northwest A&F University, Yangling 712100, China.
| | - Xueyao Ma
- College of Animal Science and Technology, Northwest A&F University, Yangling 712100, China.
| | - Gong Cheng
- College of Animal Science and Technology, Northwest A&F University, Yangling 712100, China.
| | - Wucai Yang
- College of Animal Science and Technology, Northwest A&F University, Yangling 712100, China.
| | - Linsen Zan
- College of Animal Science and Technology, Northwest A&F University, Yangling 712100, China.
- National Beef Cattle Improvement Center, Northwest A&F University, Yangling 712100, China.
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30
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Of mice and men: The physiological role of adipose triglyceride lipase (ATGL). Biochim Biophys Acta Mol Cell Biol Lipids 2018; 1864:880-899. [PMID: 30367950 PMCID: PMC6439276 DOI: 10.1016/j.bbalip.2018.10.008] [Citation(s) in RCA: 80] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2018] [Revised: 10/18/2018] [Accepted: 10/19/2018] [Indexed: 12/12/2022]
Abstract
Adipose triglyceride lipase (ATGL) has been discovered 14 years ago and revised our view on intracellular triglyceride (TG) mobilization – a process termed lipolysis. ATGL initiates the hydrolysis of TGs to release fatty acids (FAs) that are crucial energy substrates, precursors for the synthesis of membrane lipids, and ligands of nuclear receptors. Thus, ATGL is a key enzyme in whole-body energy homeostasis. In this review, we give an update on how ATGL is regulated on the transcriptional and post-transcriptional level and how this affects the enzymes' activity in the context of neutral lipid catabolism. In depth, we highlight and discuss the numerous physiological functions of ATGL in lipid and energy metabolism. Over more than a decade, different genetic mouse models lacking or overexpressing ATGL in a cell- or tissue-specific manner have been generated and characterized. Moreover, pharmacological studies became available due to the development of a specific murine ATGL inhibitor (Atglistatin®). The identification of patients with mutations in the human gene encoding ATGL and their disease spectrum has underpinned the importance of ATGL in humans. Together, mouse models and human data have advanced our understanding of the physiological role of ATGL in lipid and energy metabolism in adipose and non-adipose tissues, and of the pathophysiological consequences of ATGL dysfunction in mice and men. Summary of mouse models with genetic or pharmacological manipulation of ATGL. Summary of patients with mutations in the human gene encoding ATGL. In depth discussion of the role of ATGL in numerous physiological processes in mice and men.
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31
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Zheng S, Liao W. Novel PNPLA2 gene mutation in a child causing neutral lipid storage disease with myopathy. BMC MEDICAL GENETICS 2018; 19:172. [PMID: 30223778 PMCID: PMC6142338 DOI: 10.1186/s12881-018-0683-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/04/2018] [Accepted: 09/09/2018] [Indexed: 12/15/2022]
Abstract
BACKGROUND PNPLA2 gene mutations cause neutral lipid storage disease with myopathy (NLSD-M) or cardiomyopathies. The clinical phenotype, blood test results, imaging examination and gene analysis can be used to improve the understanding of NLSD-M, reduce the misdiagnosis rate and prevent physical disability and even premature death. CASE PRESENTATION We report a Chinese child with NLSD-M presenting with marked asymmetric skeletal myopathy and hypertrophic cardiomyopathy. Blood biochemical tests revealed increased creatine kinase levels, and echocardiography revealed a diffuse and thick left ventricular wall. Gene analysis revealed a homozygous mutation c.155C > G (p.Thr52Arg) in PNPLA2. CONCLUSIONS An understanding of the characteristic features is essential for the early diagnosis of NLSD-M. Our data expand the allelic spectrum of PNPLA2 mutations, providing further evidence for genetic and clinical NLSD-M heterogeneity in younger individuals.
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Affiliation(s)
- Shouyan Zheng
- Department of Pediatrics, First Affiliated Hospital to Army Medical University, No. 30, Gaotanyan Street, Chongqing, 400038, China
| | - Wei Liao
- Department of Pediatrics, First Affiliated Hospital to Army Medical University, No. 30, Gaotanyan Street, Chongqing, 400038, China.
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32
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Vasiljevski ER, Summers MA, Little DG, Schindeler A. Lipid storage myopathies: Current treatments and future directions. Prog Lipid Res 2018; 72:1-17. [PMID: 30099045 DOI: 10.1016/j.plipres.2018.08.001] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2018] [Revised: 06/20/2018] [Accepted: 08/06/2018] [Indexed: 10/28/2022]
Abstract
Lipid storage myopathies (LSMs) are a heterogeneous group of genetic disorders that present with abnormal lipid storage in multiple body organs, typically muscle. Patients can clinically present with cardiomyopathy, skeletal muscle weakness, myalgia, and extreme fatigue. An early diagnosis is crucial, as some LSMs can be managed by simple nutraceutical supplementation. For example, high dosage l-carnitine is an effective intervention for patients with Primary Carnitine Deficiency (PCD). This review discusses the clinical features and management practices of PCD as well as Neutral Lipid Storage Disease (NLSD) and Multiple Acyl-CoA Dehydrogenase Deficiency (MADD). We provide a detailed summary of current clinical management strategies, highlighting issues of high-risk contraindicated treatments with case study examples not previously reviewed. Additionally, we outline current preclinical studies providing disease mechanistic insight. Lastly, we propose that a number of other conditions involving lipid metabolic dysfunction that are not classified as LSMs may share common features. These include Neurofibromatosis Type 1 (NF1) and autoimmune myopathies, including Polymyositis (PM), Dermatomyositis (DM), and Inclusion Body Myositis (IBM).
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Affiliation(s)
- Emily R Vasiljevski
- Orthopaedic Research & Biotechnology, The Children's Hospital at Westmead, Westmead, NSW, Australia.; Discipline of Paediatrics & Child Heath, Faculty of Medicine, University of Sydney, Camperdown, NSW, Australia
| | - Matthew A Summers
- Bone Biology Division, The Garvan Institute of Medical Research, Darlinghurst, NSW, Australia; St Vincent's Clinical School, University of New South Wales, Faculty of Medicine, Sydney, NSW, Australia
| | - David G Little
- Orthopaedic Research & Biotechnology, The Children's Hospital at Westmead, Westmead, NSW, Australia.; Discipline of Paediatrics & Child Heath, Faculty of Medicine, University of Sydney, Camperdown, NSW, Australia
| | - Aaron Schindeler
- Orthopaedic Research & Biotechnology, The Children's Hospital at Westmead, Westmead, NSW, Australia.; Discipline of Paediatrics & Child Heath, Faculty of Medicine, University of Sydney, Camperdown, NSW, Australia.
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33
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Debashree B, Kumar M, Keshava Prasad TS, Natarajan A, Christopher R, Nalini A, Bindu PS, Gayathri N, Srinivas Bharath MM. Mitochondrial dysfunction in human skeletal muscle biopsies of lipid storage disorder. J Neurochem 2018; 145:323-341. [PMID: 29424033 DOI: 10.1111/jnc.14318] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2017] [Revised: 01/28/2018] [Accepted: 01/30/2018] [Indexed: 02/06/2023]
Abstract
Mitochondria regulate the balance between lipid metabolism and storage in the skeletal muscle. Altered lipid transport, metabolism and storage influence the bioenergetics, redox status and insulin signalling, contributing to cardiac and neurological diseases. Lipid storage disorders (LSDs) are neurological disorders which entail intramuscular lipid accumulation and impaired mitochondrial bioenergetics in the skeletal muscle causing progressive myopathy with muscle weakness. However, the mitochondrial changes including molecular events associated with impaired lipid storage have not been completely understood in the human skeletal muscle. We carried out morphological and biochemical analysis of mitochondrial function in muscle biopsies of human subjects with LSDs (n = 7), compared to controls (n = 10). Routine histology, enzyme histochemistry and ultrastructural analysis indicated altered muscle cell morphology and mitochondrial structure. Protein profiling of the muscle mitochondria from LSD samples (n = 5) (vs. control, n = 5) by high-throughput mass spectrometric analysis revealed that impaired metabolic processes could contribute to mitochondrial dysfunction and ensuing myopathy in LSDs. We propose that impaired fatty acid and respiratory metabolism along with increased membrane permeability, elevated lipolysis and altered cristae entail mitochondrial dysfunction in LSDs. Some of these mechanisms were unique to LSD apart from others that were common to dystrophic and inflammatory muscle pathologies. Many differentially regulated mitochondrial proteins in LSD are linked with other human diseases, indicating that mitochondrial protection via targeted drugs could be a treatment modality in LSD and related metabolic diseases. Cover Image for this Issue: doi: 10.1111/jnc.14177.
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Affiliation(s)
- Bandopadhyay Debashree
- Department of Neurochemistry, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, India
| | - Manish Kumar
- Institute of Bioinformatics, Bangalore, Karnataka, India.,Manipal University, Manipal, Karnataka, India
| | - Thottethodi Subrahmanya Keshava Prasad
- Institute of Bioinformatics, Bangalore, Karnataka, India.,Center for Systems Biology and Molecular Medicine, Yenepoya University, Mangalore, Karnataka, India
| | - Archana Natarajan
- Department of Neurochemistry, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, India
| | - Rita Christopher
- Department of Neurochemistry, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, India
| | - Atchayaram Nalini
- Department of Neurology, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, India
| | - Parayil Sankaran Bindu
- Department of Neurology, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, India
| | - Narayanappa Gayathri
- Department of Neuropathology, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, India
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34
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Latimer CS, Schleit J, Reynolds A, Marshall DA, Podemski B, Wang LH, Gonzalez-Cuyar LF. Neutral lipid storage disease with myopathy: Further phenotypic characterization of a rare PNPLA2 variant. Neuromuscul Disord 2018; 28:606-609. [PMID: 29779757 DOI: 10.1016/j.nmd.2018.04.010] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2017] [Revised: 03/31/2018] [Accepted: 04/15/2018] [Indexed: 11/19/2022]
Abstract
Neutral lipid storage disease with myopathy is a rare disorder of lipid metabolism caused by variants in the Patatin-Like Phospholipase Domain Containing 2 (PNPLA2) gene. Diagnosis is often delayed due to variable presentations, which is of concern due to increased risk of cardiomyopathy. Better phenotype-genotype characterization is necessary to improve speed and accuracy of diagnosis. Here, we describe a 32-year-old woman of Hmong descent with progressive muscle pain and weakness who had a muscle biopsy with characteristic features of a lipid storage myopathy. Genetic testing revealed a homozygous splice site variant in PNPLA2, c.757 + 1G > T. This case, in combination with the one previously reported case of this PNPLA2 variant, also in a family of Hmong descent, suggests this particular variant may be unique to the Hmong population, a Southeast Asian minority group living in the United States, who immigrated to the United States as refugees after the Vietnam War.
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Affiliation(s)
- Caitlin S Latimer
- Department of Pathology, Neuropathology Division, University of Washington Medical Center, Seattle, WA
| | - Jennifer Schleit
- Department of Pathology, Center for Precision Diagnostics, University of Washington Medical Center, Seattle, WA
| | - Adam Reynolds
- Department of Neurology, University of Washington Medical Center, Seattle, WA
| | - Desiree A Marshall
- Department of Pathology, Neuropathology Division, University of Washington Medical Center, Seattle, WA
| | | | - Leo H Wang
- Department of Neurology, University of Washington Medical Center, Seattle, WA
| | - Luis F Gonzalez-Cuyar
- Department of Pathology, Neuropathology Division, University of Washington Medical Center, Seattle, WA.
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Tan J, Yang H, Fan J, Fan Y, Xiao F. Patients with neutral lipid storage disease with myopathy (NLSDM) in Southwestern China. Clin Neurol Neurosurg 2018. [PMID: 29539587 DOI: 10.1016/j.clineuro.2018.03.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
OBJECTIVES Neutral lipid storage disease with myopathy (NLSDM) is a rare metabolic myopathy occurring owing to mutations in the patatin like phospholipase domain containing 2 (PNPLA2) gene. Till date, less than 50 patients with PNPLA2 mutations have been reported. In this study, we describe the clinical, pathological, and genetic findings, and muscle magnetic resonance imaging (MRI) changes in four Chinese patients with NLSDM. PATIENTS AND METHODS Peripheral blood smears were stained using Wright's stain. Muscle biopsies, muscle MRI, and sequence analysis of PNPLA2 gene were performed. RESULTS All patients exhibited slowly progressive myopathy during adulthood. Cardiomyopathy, sensorineural hearing loss, hepatic adipose infiltration, and hypertriglyceridemia were observed in some patients. Jordan's anomaly was detected in the blood smears of all patients. Muscle biopsies revealed the presence of massive lipid droplets and rimmed vacuoles in two patients. MR images of the lower lumbar, pelvis, and lower extremities showed the involvement of posterior compartment muscles. The anterior compartment muscles were found to be less affected. Gene analysis for PNPLA2 revealed an identical homozygous mutation c.757 + 1G > T in all patients. CONCLUSION Patients with NLSDM display clinical heterogeneities despite sharing the same mutation (c.757 + 1G > T) of the PNPLA2 gene, may suggest a founder effect in the region.
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Affiliation(s)
- Jiaze Tan
- Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, Chongqing Key Laboratory of Neurology, Chongqing 400016, China
| | - Haitao Yang
- Department of Radiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China
| | - Jingchuan Fan
- Department of Medical Laboratory Technology, Institute of Life Sciences of Chongqing Medical University, Chongqing 400016, China
| | - Yulan Fan
- Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, Chongqing Key Laboratory of Neurology, Chongqing 400016, China
| | - Fei Xiao
- Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, Chongqing Key Laboratory of Neurology, Chongqing 400016, China.
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Critical roles for α/β hydrolase domain 5 (ABHD5)/comparative gene identification-58 (CGI-58) at the lipid droplet interface and beyond. Biochim Biophys Acta Mol Cell Biol Lipids 2017; 1862:1233-1241. [PMID: 28827091 DOI: 10.1016/j.bbalip.2017.07.016] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2017] [Revised: 07/24/2017] [Accepted: 07/31/2017] [Indexed: 01/04/2023]
Abstract
Mutations in the gene encoding comparative gene identification 58 (CGI-58), also known as α β hydrolase domain-containing 5 (ABHD5), cause neutral lipid storage disorder with ichthyosis (NLSDI). This inborn error in metabolism is characterized by ectopic accumulation of triacylglycerols (TAG) within cytoplasmic lipid droplets in multiple cell types. Studies over the past decade have clearly demonstrated that CGI-58 is a potent regulator of TAG hydrolysis in the disease-relevant cell types. However, despite the reproducible genetic link between CGI-58 mutations and TAG storage, the molecular mechanisms by which CGI-58 regulates TAG hydrolysis are still incompletely understood. It is clear that CGI-58 can regulate TAG hydrolysis by activating the major TAG hydrolase adipose triglyceride lipase (ATGL), yet CGI-58 can also regulate lipid metabolism via mechanisms that do not involve ATGL. This review highlights recent progress made in defining the physiologic and biochemical function of CGI-58, and its broader role in energy homeostasis. This article is part of a Special Issue entitled: Recent Advances in Lipid Droplet Biology edited by Rosalind Coleman and Matthijs Hesselink.
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Garibaldi M, Tasca G, Diaz-Manera J, Ottaviani P, Laschena F, Pantoli D, Gerevini S, Fiorillo C, Maggi L, Tasca E, D'Amico A, Musumeci O, Toscano A, Bruno C, Massa R, Angelini C, Bertini E, Antonini G, Pennisi EM. Muscle MRI in neutral lipid storage disease (NLSD). J Neurol 2017; 264:1334-1342. [PMID: 28503705 PMCID: PMC5502068 DOI: 10.1007/s00415-017-8498-8] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2016] [Revised: 04/23/2017] [Accepted: 04/25/2017] [Indexed: 01/28/2023]
Abstract
Neutral lipid storage disease (NLSD) is a rare inherited disorder of lipid metabolism resulting in lipid droplets accumulation in different tissues. Skeletal muscle could be affected in both two different form of disease: NLSD with myopathy (NLSD-M) and NLSD with ichthyosis (NLSD-I). We present the muscle imaging data of 12 patients from the Italian Network for NLSD: ten patients presenting NLSD-M and two patients with NLSD-I. In NLSD-M gluteus minimus, semimembranosus, soleus and gastrocnemius medialis in the lower limbs and infraspinatus in the upper limbs were the most affected muscles. Gracilis, sartorius, subscapularis, pectoralis, triceps brachii and sternocleidomastoid were spared. Muscle involvement was not homogenous and characteristic “patchy” replacement was observed in at least one muscle in all the patients. Half of the patients showed one or more STIR positive muscles. In both NLSD-I cases muscle involvement was not observed by T1-TSE sequences, but one of them showed positive STIR images in more than one muscle in the leg. Our data provides evidence that muscle imaging can identify characteristic alterations in NLSD-M, characterized by a specific pattern of muscle involvement with “patchy” areas of fatty replacement. Larger cohorts are needed to assess if a distinct pattern of muscle involvement exists also for NLSD-I.
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Affiliation(s)
- Matteo Garibaldi
- Unit of Neuromuscular Diseases, Department of Neurology Mental Health and Sensory Organs (NESMOS), Faculty of Medicine and Psychology, 'Sapienza' University of Rome, Sant'Andrea Hospital, Rome, Italy.
| | - Giorgio Tasca
- Institute of Neurology, Policlinico "A.Gemelli" Foundation University Hospital, Rome, Italy
| | - Jordi Diaz-Manera
- Neuromuscular Diseases Unit, Department of Neurology, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona (UAB), Barcelona, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), Barcelona, Spain
| | | | - Francesco Laschena
- Department of Radiology, Istituto Dermopatico dell'Immacolata, IRCCS, Rome, Italy
| | - Donatella Pantoli
- Neuroradiology Unit, Department of Radiology, San Filippo Neri Hospital, Rome, Italy
| | | | - Chiara Fiorillo
- Pediatric Neurology and Muscular Disorders, Istituto Giannina Gaslini, Genoa, Italy
| | - Lorenzo Maggi
- Neuroimmunology and Neuromuscular Diseases Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | | | - Adele D'Amico
- Unit of Neuromuscular and Neurodegenerative Disorders, Laboratory of Molecular Medicine, 'Bambino Gesù' Children's Hospital, IRCCS, Rome, Italy
| | - Olimpia Musumeci
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Antonio Toscano
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Claudio Bruno
- Pediatric Neurology and Muscular Disorders, Istituto Giannina Gaslini, Genoa, Italy
| | - Roberto Massa
- Department of Systems Medicine (Neurology), University of Rome Tor Vergata, Rome, Italy
| | | | - Enrico Bertini
- Unit of Neuromuscular and Neurodegenerative Disorders, Laboratory of Molecular Medicine, 'Bambino Gesù' Children's Hospital, IRCCS, Rome, Italy
| | - Giovanni Antonini
- Unit of Neuromuscular Diseases, Department of Neurology Mental Health and Sensory Organs (NESMOS), Faculty of Medicine and Psychology, 'Sapienza' University of Rome, Sant'Andrea Hospital, Rome, Italy
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Pennisi EM, Arca M, Bertini E, Bruno C, Cassandrini D, D'amico A, Garibaldi M, Gragnani F, Maggi L, Massa R, Missaglia S, Morandi L, Musumeci O, Pegoraro E, Rastelli E, Santorelli FM, Tasca E, Tavian D, Toscano A, Angelini C. Neutral Lipid Storage Diseases: clinical/genetic features and natural history in a large cohort of Italian patients. Orphanet J Rare Dis 2017; 12:90. [PMID: 28499397 PMCID: PMC5427600 DOI: 10.1186/s13023-017-0646-9] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2016] [Accepted: 05/03/2017] [Indexed: 12/20/2022] Open
Abstract
Background A small number of patients affected by Neutral Lipid Storage Diseases (NLSDs: NLSD type M with Myopathy and NLSD type I with Ichthyosis) have been described in various ethnic groups worldwide. However, relatively little is known about the progression and phenotypic variability of the disease in large specific populations. The aim of our study was to assess the natural history, disability and genotype-phenotype correlations in Italian patients with NLSDs. Twenty-one patients who satisfied the criteria for NLSDs were enrolled in a retrospective cross-sectional study to evaluate the genetic aspects, clinical signs at onset, disability progression and comorbidities associated with this group of diseases. Results During the clinical follow-up (range: 2–44 years, median: 17.8 years), two patients (9.5%, both with NLSD-I) died of hepatic failure, and a further five (24%) lost their ability to walk or needed help when walking after a mean period of 30.6 years of disease. None of the patients required mechanical ventilation. No patient required a heart transplant, one patient with NLSD-M was implanted with a cardioverter defibrillator for severe arrhythmias. Conclusion The genotype/phenotype correlation analysis in our population showed that the same gene mutations were associated with a varying clinical onset and course. This study highlights peculiar aspects of Italian NLSD patients that differ from those observed in Japanese patients, who were found to be affected by a marked hypertrophic cardiopathy. Owing to the varying phenotypic expression of the same mutations, it is conceivable that some additional genetic or epigenetic factors affect the symptoms and progression in this group of diseases.
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Affiliation(s)
- Elena Maria Pennisi
- UOC of Neurology, San Filippo Neri Hospital, via Martinotti 20, 00135, Rome, Italy.
| | - Marcello Arca
- Department of Internal Medicine and Allied Sciences, Atherosclerosis Unit, Sapienza University of Rome, Rome, Italy
| | | | | | | | | | | | | | - Lorenzo Maggi
- Neuroimmunology and Neuromuscular Diseases Unit, Foundation IRCCS Neurological Institute "Carlo Besta", Milan, Italy
| | - Roberto Massa
- Department of Systems Medicine, Centre of Neuromuscular Disorders, Tor Vergata University, Rome, Italy
| | - Sara Missaglia
- CRIBENS, Catholic University of the Sacred Heart, Milan, Italy
| | - Lucia Morandi
- Neuroimmunology and Neuromuscular Diseases Unit, Foundation IRCCS Neurological Institute "Carlo Besta", Milan, Italy
| | - Olimpia Musumeci
- Department of Neurosciences, University of Messina, Messina, Italy
| | - Elena Pegoraro
- Department of Neurology, University of Padova, Padova, Italy
| | - Emanuele Rastelli
- Department of Systems Medicine, Centre of Neuromuscular Disorders, Tor Vergata University, Rome, Italy
| | | | | | - Daniela Tavian
- CRIBENS, Catholic University of the Sacred Heart, Milan, Italy
| | - Antonio Toscano
- Department of Neurosciences, University of Messina, Messina, Italy
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Tavian D, Missaglia S, Castagnetta M, Degiorgio D, Pennisi EM, Coleman RA, Dell'Era P, Mora C, Angelini C, Coviello DA. Generation of induced Pluripotent Stem Cells as disease modelling of NLSDM. Mol Genet Metab 2017; 121:28-34. [PMID: 28391974 PMCID: PMC5434246 DOI: 10.1016/j.ymgme.2017.03.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2017] [Revised: 03/31/2017] [Accepted: 03/31/2017] [Indexed: 01/10/2023]
Abstract
Neutral Lipid Storage Disease with Myopathy (NLSDM) is a rare defect of triacylglycerol metabolism, characterized by the abnormal storage of neutral lipid in organelles known as lipid droplets (LDs). The main clinical features are progressive myopathy and cardiomyopathy. The onset of NLSDM is caused by autosomal recessive mutations in the PNPLA2 gene, which encodes adipose triglyceride lipase (ATGL). Despite its name, this enzyme is present in a wide variety of cell types and catalyzes the first step in triacylglycerol lipolysis and the release of fatty acids. Here, we report the derivation of NLSDM-induced pluripotent stem cells (NLSDM-iPSCs) from fibroblasts of two patients carrying different PNPLA2 mutations. The first patient was homozygous for the c.541delAC, while the second was homozygous for the c.662G>C mutation in the PNPLA2 gene. We verified that the two types of NLSDM-iPSCs possessed properties of embryonic-like stem cells and could differentiate into the three germ layers in vitro. Immunofluorescence analysis revealed that iPSCs had an abnormal accumulation of triglycerides in LDs, the hallmark of NLSDM. Furthermore, NLSDM-iPSCs were deficient in long chain fatty acid lipolysis, when subjected to a pulse chase experiment with oleic acid. Collectively, these results demonstrate that NLSDM-iPSCs are a promising in vitro model to investigate disease mechanisms and screen drug compounds for NLSDM, a rare disease with few therapeutic options.
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Affiliation(s)
- D Tavian
- Laboratory of Cellular Biochemistry and Molecular Biology, CRIBENS, Catholic University of the Sacred Heart, pz Buonarroti 30, Milan 20145, Italy; Psychology Department, Catholic University of the Sacred Heart, Largo Gemelli 1, Milan 20123, Italy.
| | - S Missaglia
- Laboratory of Cellular Biochemistry and Molecular Biology, CRIBENS, Catholic University of the Sacred Heart, pz Buonarroti 30, Milan 20145, Italy; Psychology Department, Catholic University of the Sacred Heart, Largo Gemelli 1, Milan 20123, Italy
| | - M Castagnetta
- Laboratory of Human Genetics, E.O. Ospedali Galliera, Via Volta 6, Genoa 16128, Italy
| | - D Degiorgio
- Laboratory of Human Genetics, E.O. Ospedali Galliera, Via Volta 6, Genoa 16128, Italy; Stem Cell Laboratory, Department of Experimental Medicine, University of Genoa, c/o Advanced Biotechnology Center, L.go R. Benzi, 10, Genoa 16132, Italy
| | - E M Pennisi
- UOC Neurologia, San Filippo Neri Hospital, via Martinotti 20, Rome 00135, Italy
| | - R A Coleman
- Department of Nutrition, University of North Carolina, Chapel Hill, NC 27599, USA
| | - P Dell'Era
- Cellular Fate Reprogramming Unit, Department of Molecular and Translational Medicine, University of Brescia, Brescia 25123, Italy
| | - C Mora
- Cellular Fate Reprogramming Unit, Department of Molecular and Translational Medicine, University of Brescia, Brescia 25123, Italy
| | - C Angelini
- IRCCS Fondazione Ospedale S. Camillo, Venice, Italy
| | - D A Coviello
- Laboratory of Human Genetics, E.O. Ospedali Galliera, Via Volta 6, Genoa 16128, Italy
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Missaglia S, Maggi L, Mora M, Gibertini S, Blasevich F, Agostoni P, Moro L, Cassandrini D, Santorelli FM, Gerevini S, Tavian D. Late onset of neutral lipid storage disease due to novel PNPLA2 mutations causing total loss of lipase activity in a patient with myopathy and slight cardiac involvement. Neuromuscul Disord 2017; 27:481-486. [PMID: 28258942 PMCID: PMC5424884 DOI: 10.1016/j.nmd.2017.01.011] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2016] [Revised: 11/19/2016] [Accepted: 01/15/2017] [Indexed: 01/16/2023]
Abstract
Two novel mutations in PNPLA2 gene have been identified in a neutral lipid storage disease with myopathy (NLSDM) female patient. The mutations are located in exon 5 of PNPLA2 and abrogate lipase function. The patient showed late onset skeletal muscle myopathy and mild cardiac impairment. Clinical cardiac phenotype is milder in NLSDM female patients, beyond genetics.
Neutral lipid storage disease with myopathy (NLSDM) presents with skeletal muscle myopathy and severe dilated cardiomyopathy in nearly 40% of cases. NLSDM is caused by mutations in the PNPLA2 gene, which encodes the adipose triglyceride lipase (ATGL). Here we report clinical and genetic findings of a patient carrying two novel PNPLA2 mutations (c.696+4A>G and c.553_565delGTCCCCCTTCTCG). She presented at age 39 with right upper limb abduction weakness slowly progressing over the years with asymmetric involvement of proximal upper and lower limb muscles. Cardiological evaluation through ECG and heart echo scan was normal until the age 53, when mild left ventricular diastolic dysfunction was detected. Molecular analysis revealed that only one type of PNPLA2 transcript, with exon 5 skipping, was expressed in patient cells. Such aberrant mRNA causes the production of a shorter ATGL protein, lacking part of the catalytic domain. This is an intriguing case, displaying severe PNPLA2 mutations with clinical presentation characterized by slight cardiac impairment and full expression of severe asymmetric myopathy.
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Affiliation(s)
- Sara Missaglia
- Laboratory of Cellular Biochemistry and Molecular Biology, CRIBENS, Catholic University of the Sacred Heart, pz Buonarroti 30, Milan 20145, Italy; Department of Psychology, Catholic University of the Sacred Heart, Largo Gemelli, 1, Milan 20123, Italy
| | - Lorenzo Maggi
- Neuromuscular Diseases and Neuroimmunology Unit, Fondazione IRCCS Istituto Neurologico "Carlo Besta", Milan, Italy
| | - Marina Mora
- Neuromuscular Diseases and Neuroimmunology Unit, Fondazione IRCCS Istituto Neurologico "Carlo Besta", Milan, Italy
| | - Sara Gibertini
- Neuromuscular Diseases and Neuroimmunology Unit, Fondazione IRCCS Istituto Neurologico "Carlo Besta", Milan, Italy
| | - Flavia Blasevich
- Neuromuscular Diseases and Neuroimmunology Unit, Fondazione IRCCS Istituto Neurologico "Carlo Besta", Milan, Italy
| | - Piergiuseppe Agostoni
- Centro Cardiologico Monzino, IRCCS, Milan, Italy; Department of Clinical and Community Sciences, University of Milan, Milan, Italy
| | - Laura Moro
- Department of Pharmaceutical Sciences, University of Piemonte Orientale "Amedeo-Avogadro", Novara, Italy
| | | | | | | | - Daniela Tavian
- Laboratory of Cellular Biochemistry and Molecular Biology, CRIBENS, Catholic University of the Sacred Heart, pz Buonarroti 30, Milan 20145, Italy; Department of Psychology, Catholic University of the Sacred Heart, Largo Gemelli, 1, Milan 20123, Italy.
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Jousserand G, Streichenberger N, Petiot P. [Unusual phenotype of myopathy associated with a new PNPLA2 mutation]. Med Sci (Paris) 2016; 32 Hors série n°2:10-11. [PMID: 27869069 DOI: 10.1051/medsci/201632s203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
La myopathie due à des mutations du gène PNPLA2 est une entité rare entraînant une accumulation de gouttelettes lipidiques dans différents tissus dont le muscle et les leucocytes. Ce gène code l’ATGL (adipose triacylglycerol lipase), une enzyme qui catalyse l’hydrolyse des triglycérides. Nous rapportons ici le cas d’un patient de 54 ans présentant une myopathie distale et une cardiomyopathie. La biopsie musculaire met en évidence une accumulation de gouttelettes lipidiques dans les myocytes. Malgré l’absence de corps de Jordan dans les leucocytes, le diagnostic de myopathie par mutation du gène PNPLA2 est quand même envisagé, diagnostic que la biologie moléculaire confirmera avec l’identification d’une nouvelle mutation (c.798_799insC ; p.Ala267Argfsx40) dans l’exon 7 du gène PNPLA2.
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Affiliation(s)
- Guillemette Jousserand
- Service d'explorations fonctionnelles neurologiques, Hospices Civils de Lyon, Hôpital de la Croix-Rousse, Centre de Référence Maladies Neuromusculaires Rares Rhône Alpes, FILNEMUS
| | - Nathalie Streichenberger
- Service d'explorations fonctionnelles neurologiques, Hospices Civils de Lyon, Hôpital de la Croix-Rousse, Centre de Référence Maladies Neuromusculaires Rares Rhône Alpes, FILNEMUS
| | - Philippe Petiot
- Service d'explorations fonctionnelles neurologiques, Hospices Civils de Lyon, Hôpital de la Croix-Rousse, Centre de Référence Maladies Neuromusculaires Rares Rhône Alpes, FILNEMUS
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Foster LA, Courville EL, Manousakis G. Clinical Reasoning: A 33-year-old man with cardiomyopathy and myopathy. Neurology 2016; 87:e74-8. [PMID: 27550897 DOI: 10.1212/wnl.0000000000002999] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- Laura A Foster
- From the Departments of Neurology (L.A.F., G.M.) and Clinical Pathology (E.L.C.), University of Minnesota, Minneapolis.
| | - Elizabeth L Courville
- From the Departments of Neurology (L.A.F., G.M.) and Clinical Pathology (E.L.C.), University of Minnesota, Minneapolis
| | - Georgios Manousakis
- From the Departments of Neurology (L.A.F., G.M.) and Clinical Pathology (E.L.C.), University of Minnesota, Minneapolis
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Whole exome sequence analysis reveals a homozygous mutation in PNPLA2 as the cause of severe dilated cardiomyopathy secondary to neutral lipid storage disease. Int J Cardiol 2016; 210:41-4. [DOI: 10.1016/j.ijcard.2016.02.082] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2015] [Revised: 01/21/2016] [Accepted: 02/01/2016] [Indexed: 11/19/2022]
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Massa R, Pozzessere S, Rastelli E, Serra L, Terracciano C, Gibellini M, Bozzali M, Arca M. Neutral lipid-storage disease with myopathy and extended phenotype with novel PNPLA2 mutation. Muscle Nerve 2016; 53:644-8. [PMID: 26600210 DOI: 10.1002/mus.24983] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/19/2015] [Indexed: 11/11/2022]
Abstract
INTRODUCTION Neutral lipid-storage disease with myopathy is caused by mutations in PNPLA2, which produce skeletal and cardiac myopathy. We report a man with multiorgan neutral lipid storage and unusual multisystem clinical involvement, including cognitive impairment. METHODS Quantitative brain MRI with voxel-based morphometry and extended neuropsychological assessment were performed. In parallel, the coding sequences and intron/exon boundaries of the PNPLA2 gene were screened by direct sequencing. RESULTS Neuropsychological assessment revealed global cognitive impairment, and brain MRI showed reduced gray matter volume in the temporal lobes. Molecular characterization revealed a novel homozygous mutation in exon 5 of PNPLA2 (c.714C>A), resulting in a premature stop codon (p.Cys238*). CONCLUSIONS Some PNPLA2 mutations, such as the one described here, may present with an extended phenotype, including brain involvement. In these cases, complete neuropsychological testing, combined with quantitative brain MRI, may help to characterize and quantify cognitive impairment.
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Affiliation(s)
- Roberto Massa
- Department of Systems Medicine (Neurology), University of Rome Tor Vergata, Via Montpellier 1, 00133, Rome, Italy
| | - Simone Pozzessere
- Dipartimento di Medicina Interna e Specialità Mediche, Sapienza Università di Roma, Rome, Italy
| | - Emanuele Rastelli
- Department of Systems Medicine (Neurology), University of Rome Tor Vergata, Via Montpellier 1, 00133, Rome, Italy
| | - Laura Serra
- Neuroimaging Laboratory, IRCCS Santa Lucia Foundation, Rome, Italy
| | - Chiara Terracciano
- Department of Systems Medicine (Neurology), University of Rome Tor Vergata, Via Montpellier 1, 00133, Rome, Italy
| | - Manuela Gibellini
- Department of Systems Medicine (Neurology), University of Rome Tor Vergata, Via Montpellier 1, 00133, Rome, Italy
| | - Marco Bozzali
- Neuroimaging Laboratory, IRCCS Santa Lucia Foundation, Rome, Italy
| | - Marcello Arca
- Dipartimento di Medicina Interna e Specialità Mediche, Sapienza Università di Roma, Rome, Italy
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Pasanisi MB, Missaglia S, Cassandrini D, Salerno F, Farina S, Andreini D, Agostoni P, Morandi L, Mora M, Tavian D. Severe cardiomyopathy in a young patient with complete deficiency of adipose triglyceride lipase due to a novel mutation in PNPLA2 gene. Int J Cardiol 2016; 207:165-7. [PMID: 26803235 PMCID: PMC4766941 DOI: 10.1016/j.ijcard.2016.01.137] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2015] [Accepted: 01/05/2016] [Indexed: 01/14/2023]
Affiliation(s)
- Maria Barbara Pasanisi
- Neuromuscular Diseases and Neuroimmunology, Fondazione IRCCS Istituto Neurologico "Carlo Besta", Milan, Italy
| | - Sara Missaglia
- Laboratory of Cellular Biochemistry and Molecular Biology, CRIBENS, Catholic University of the Sacred Heart, Milan, Italy
| | | | - Franco Salerno
- Neuromuscular Diseases and Neuroimmunology, Fondazione IRCCS Istituto Neurologico "Carlo Besta", Milan, Italy
| | | | - Daniele Andreini
- Centro Cardiologico Monzino, IRCCS, Milan, Italy; Departement of Clinical and Community Sciences, Univerisity of Milan, Milan, Italy
| | - Piergiuseppe Agostoni
- Centro Cardiologico Monzino, IRCCS, Milan, Italy; Departement of Clinical and Community Sciences, Univerisity of Milan, Milan, Italy
| | - Lucia Morandi
- Neuromuscular Diseases and Neuroimmunology, Fondazione IRCCS Istituto Neurologico "Carlo Besta", Milan, Italy
| | - Marina Mora
- Neuromuscular Diseases and Neuroimmunology, Fondazione IRCCS Istituto Neurologico "Carlo Besta", Milan, Italy
| | - Daniela Tavian
- Laboratory of Cellular Biochemistry and Molecular Biology, CRIBENS, Catholic University of the Sacred Heart, Milan, Italy.
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46
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Saunders CJ, Moon SH, Liu X, Thiffault I, Coffman K, LePichon JB, Taboada E, Smith LD, Farrow EG, Miller N, Gibson M, Patterson M, Kingsmore SF, Gross RW. Loss of function variants in human PNPLA8 encoding calcium-independent phospholipase A2 γ recapitulate the mitochondriopathy of the homologous null mouse. Hum Mutat 2015; 36:301-6. [PMID: 25512002 DOI: 10.1002/humu.22743] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2014] [Accepted: 12/09/2014] [Indexed: 12/13/2022]
Abstract
Mitochondriopathies are a group of clinically heterogeneous genetic diseases caused by defects in mitochondrial metabolism, bioenergetic efficiency, and/or signaling functions. The large majority of proteins involved in mitochondrial function are encoded by nuclear genes, with many yet to be associated with human disease. We performed exome sequencing on a young girl with a suspected mitochondrial myopathy that manifested as progressive muscle weakness, hypotonia, seizures, poor weight gain, and lactic acidosis. She was compound heterozygous for two frameshift mutations, p.Asn112HisfsX29 and p.Leu659AlafsX4, in the PNPLA8 gene, which encodes mitochondrial calcium-independent phospholipase A2 γ (iPLA2 γ). Western blot analysis of affected muscle displayed the absence of PNPLA8 protein. iPLA2 s are critical mediators of a variety of cellular processes including growth, metabolism, and lipid second messenger generation, exerting their functions through catalyzing the cleavage of the acyl groups in glycerophospholipids. The clinical presentation, muscle histology and the mitochondrial ultrastructural abnormalities of this proband are highly reminiscent of Pnpla8 null mice. Although other iPLA2 -related diseases have been identified, namely, infantile neuroaxonal dystrophy and neutral lipid storage disease with myopathy, this is the first report of PNPLA8-related disease in a human. We suggest PNPLA8 join the increasing list of human genes involved in lipid metabolism associated with neuromuscular diseases due to mitochondrial dysfunction.
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Affiliation(s)
- Carol J Saunders
- Center for Pediatric Genomic Medicine, Children's Mercy Hospitals, Kansas City, Missouri
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Barnérias C, Bassez G, Schischmanoff O. [Chanarin-Dorfman syndrome in a 7-year-old child: when myophathy and skin involvement are all but one]. Med Sci (Paris) 2015; 31 Spec No 3:11-3. [PMID: 26546924 DOI: 10.1051/medsci/201531s303] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Affiliation(s)
- Christine Barnérias
- Service de neuropédiatrie et Centre de Référence des maladies neuromusculaires Garches-Necker-Mondor-Hendaye, site Necker, AP-HP
| | - Guillaume Bassez
- Laboratoire d'anatomopathologie et Centre de Référence des maladies neuromusculaires Garches-Necker-Mondor-Hendaye, site Mondor, AP-HP
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48
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Sanders MA, Madoux F, Mladenovic L, Zhang H, Ye X, Angrish M, Mottillo EP, Caruso JA, Halvorsen G, Roush WR, Chase P, Hodder P, Granneman JG. Endogenous and Synthetic ABHD5 Ligands Regulate ABHD5-Perilipin Interactions and Lipolysis in Fat and Muscle. Cell Metab 2015; 22:851-60. [PMID: 26411340 PMCID: PMC4862007 DOI: 10.1016/j.cmet.2015.08.023] [Citation(s) in RCA: 79] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2014] [Revised: 06/15/2015] [Accepted: 08/27/2015] [Indexed: 12/18/2022]
Abstract
Fat and muscle lipolysis involves functional interactions of adipose triglyceride lipase (ATGL), α-β hydrolase domain-containing protein 5 (ABHD5), and tissue-specific perilipins 1 and 5 (PLIN1 and PLIN5). ABHD5 potently activates ATGL, but this lipase-promoting activity is suppressed when ABHD5 is bound to PLIN proteins on lipid droplets. In adipocytes, protein kinase A (PKA) phosphorylation of PLIN1 rapidly releases ABHD5 to activate ATGL, but mechanisms for rapid regulation of PLIN5-ABHD5 interaction in muscle are unknown. Here, we identify synthetic ligands that release ABHD5 from PLIN1 or PLIN5 without PKA activation and rapidly activate adipocyte and muscle lipolysis. Molecular imaging and affinity probe labeling demonstrated that ABHD5 is directly targeted by these synthetic ligands and additionally revealed that ABHD5-PLIN interactions are regulated by endogenous ligands, including long-chain acyl-CoA. Our results reveal a new locus of lipolysis control and suggest ABHD5 ligands might be developed into novel therapeutics that directly promote fat catabolism.
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Affiliation(s)
- Matthew A Sanders
- Center for Integrative Metabolic and Endocrine Research, Wayne State University School of Medicine, Detroit, MI 48201, USA
| | - Franck Madoux
- Lead Identification Division, The Scripps Research Institute, Jupiter, FL 33458, USA
| | - Ljiljana Mladenovic
- Center for Integrative Metabolic and Endocrine Research, Wayne State University School of Medicine, Detroit, MI 48201, USA
| | - Huamei Zhang
- Center for Integrative Metabolic and Endocrine Research, Wayne State University School of Medicine, Detroit, MI 48201, USA
| | - Xiangqun Ye
- Center for Integrative Metabolic and Endocrine Research, Wayne State University School of Medicine, Detroit, MI 48201, USA
| | - Michelle Angrish
- Center for Integrative Metabolic and Endocrine Research, Wayne State University School of Medicine, Detroit, MI 48201, USA
| | - Emilio P Mottillo
- Center for Integrative Metabolic and Endocrine Research, Wayne State University School of Medicine, Detroit, MI 48201, USA
| | - Joseph A Caruso
- Institute of Environmental Health Sciences, Wayne State University School of Medicine, Detroit, MI 48201, USA
| | - Geoff Halvorsen
- Department of Chemistry, The Scripps Research Institute, Jupiter, FL 33458, USA
| | - William R Roush
- Department of Chemistry, The Scripps Research Institute, Jupiter, FL 33458, USA
| | - Peter Chase
- Lead Identification Division, The Scripps Research Institute, Jupiter, FL 33458, USA
| | - Peter Hodder
- Lead Identification Division, The Scripps Research Institute, Jupiter, FL 33458, USA
| | - James G Granneman
- Center for Integrative Metabolic and Endocrine Research, Wayne State University School of Medicine, Detroit, MI 48201, USA; John Dingell Veterans Administration Medical Center, Detroit, MI 48201, USA.
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49
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Schoiswohl G, Stefanovic-Racic M, Menke MN, Wills RC, Surlow BA, Basantani MK, Sitnick MT, Cai L, Yazbeck CF, Stolz DB, Pulinilkunnil T, O'Doherty RM, Kershaw EE. Impact of Reduced ATGL-Mediated Adipocyte Lipolysis on Obesity-Associated Insulin Resistance and Inflammation in Male Mice. Endocrinology 2015; 156. [PMID: 26196542 PMCID: PMC4588821 DOI: 10.1210/en.2015-1322] [Citation(s) in RCA: 135] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Emerging evidence suggests that impaired regulation of adipocyte lipolysis contributes to the proinflammatory immune cell infiltration of metabolic tissues in obesity, a process that is proposed to contribute to the development and exacerbation of insulin resistance. To test this hypothesis in vivo, we generated mice with adipocyte-specific deletion of adipose triglyceride lipase (ATGL), the rate-limiting enzyme catalyzing triacylglycerol hydrolysis. In contrast to previous models, adiponectin-driven Cre expression was used for targeted ATGL deletion. The resulting adipocyte-specific ATGL knockout (AAKO) mice were then characterized for metabolic and immune phenotypes. Lean and diet-induced obese AAKO mice had reduced adipocyte lipolysis, serum lipids, systemic lipid oxidation, and expression of peroxisome proliferator-activated receptor alpha target genes in adipose tissue (AT) and liver. These changes did not increase overall body weight or fat mass in AAKO mice by 24 weeks of age, in part due to reduced expression of genes involved in lipid uptake, synthesis, and adipogenesis. Systemic glucose and insulin tolerance were improved in AAKO mice, primarily due to enhanced hepatic insulin signaling, which was accompanied by marked reduction in diet-induced hepatic steatosis as well as hepatic immune cell infiltration and activation. In contrast, although adipocyte ATGL deletion reduced AT immune cell infiltration in response to an acute lipolytic stimulus, it was not sufficient to ameliorate, and may even exacerbate, chronic inflammatory changes that occur in AT in response to diet-induced obesity.
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Affiliation(s)
- Gabriele Schoiswohl
- Division of Endocrinology and Metabolism (G.S., M.S.-R., R.C.W., B.A.S., M.K.B., M.T.S., L.C., C.F.Y., R.M.O., E.E.K.), Department of Medicine, and Department of Cell Biology (D.B.S.), University of Pittsburgh, Pittsburgh, Pennsylvania 15261; Department of Obstetrics, Gynecology, and Reproductive Sciences (M.N.M.), Magee-Womens Hospital, University of Pittsburgh, Pittsburgh, Pennsylvania 15213; and Department of Biochemistry and Molecular Biology (T.P.), Dalhousie Medicine New Brunswick, Dalhousie University, St John, Canada NB E2L 4L5
| | - Maja Stefanovic-Racic
- Division of Endocrinology and Metabolism (G.S., M.S.-R., R.C.W., B.A.S., M.K.B., M.T.S., L.C., C.F.Y., R.M.O., E.E.K.), Department of Medicine, and Department of Cell Biology (D.B.S.), University of Pittsburgh, Pittsburgh, Pennsylvania 15261; Department of Obstetrics, Gynecology, and Reproductive Sciences (M.N.M.), Magee-Womens Hospital, University of Pittsburgh, Pittsburgh, Pennsylvania 15213; and Department of Biochemistry and Molecular Biology (T.P.), Dalhousie Medicine New Brunswick, Dalhousie University, St John, Canada NB E2L 4L5
| | - Marie N Menke
- Division of Endocrinology and Metabolism (G.S., M.S.-R., R.C.W., B.A.S., M.K.B., M.T.S., L.C., C.F.Y., R.M.O., E.E.K.), Department of Medicine, and Department of Cell Biology (D.B.S.), University of Pittsburgh, Pittsburgh, Pennsylvania 15261; Department of Obstetrics, Gynecology, and Reproductive Sciences (M.N.M.), Magee-Womens Hospital, University of Pittsburgh, Pittsburgh, Pennsylvania 15213; and Department of Biochemistry and Molecular Biology (T.P.), Dalhousie Medicine New Brunswick, Dalhousie University, St John, Canada NB E2L 4L5
| | - Rachel C Wills
- Division of Endocrinology and Metabolism (G.S., M.S.-R., R.C.W., B.A.S., M.K.B., M.T.S., L.C., C.F.Y., R.M.O., E.E.K.), Department of Medicine, and Department of Cell Biology (D.B.S.), University of Pittsburgh, Pittsburgh, Pennsylvania 15261; Department of Obstetrics, Gynecology, and Reproductive Sciences (M.N.M.), Magee-Womens Hospital, University of Pittsburgh, Pittsburgh, Pennsylvania 15213; and Department of Biochemistry and Molecular Biology (T.P.), Dalhousie Medicine New Brunswick, Dalhousie University, St John, Canada NB E2L 4L5
| | - Beth A Surlow
- Division of Endocrinology and Metabolism (G.S., M.S.-R., R.C.W., B.A.S., M.K.B., M.T.S., L.C., C.F.Y., R.M.O., E.E.K.), Department of Medicine, and Department of Cell Biology (D.B.S.), University of Pittsburgh, Pittsburgh, Pennsylvania 15261; Department of Obstetrics, Gynecology, and Reproductive Sciences (M.N.M.), Magee-Womens Hospital, University of Pittsburgh, Pittsburgh, Pennsylvania 15213; and Department of Biochemistry and Molecular Biology (T.P.), Dalhousie Medicine New Brunswick, Dalhousie University, St John, Canada NB E2L 4L5
| | - Mahesh K Basantani
- Division of Endocrinology and Metabolism (G.S., M.S.-R., R.C.W., B.A.S., M.K.B., M.T.S., L.C., C.F.Y., R.M.O., E.E.K.), Department of Medicine, and Department of Cell Biology (D.B.S.), University of Pittsburgh, Pittsburgh, Pennsylvania 15261; Department of Obstetrics, Gynecology, and Reproductive Sciences (M.N.M.), Magee-Womens Hospital, University of Pittsburgh, Pittsburgh, Pennsylvania 15213; and Department of Biochemistry and Molecular Biology (T.P.), Dalhousie Medicine New Brunswick, Dalhousie University, St John, Canada NB E2L 4L5
| | - Mitch T Sitnick
- Division of Endocrinology and Metabolism (G.S., M.S.-R., R.C.W., B.A.S., M.K.B., M.T.S., L.C., C.F.Y., R.M.O., E.E.K.), Department of Medicine, and Department of Cell Biology (D.B.S.), University of Pittsburgh, Pittsburgh, Pennsylvania 15261; Department of Obstetrics, Gynecology, and Reproductive Sciences (M.N.M.), Magee-Womens Hospital, University of Pittsburgh, Pittsburgh, Pennsylvania 15213; and Department of Biochemistry and Molecular Biology (T.P.), Dalhousie Medicine New Brunswick, Dalhousie University, St John, Canada NB E2L 4L5
| | - Lingzhi Cai
- Division of Endocrinology and Metabolism (G.S., M.S.-R., R.C.W., B.A.S., M.K.B., M.T.S., L.C., C.F.Y., R.M.O., E.E.K.), Department of Medicine, and Department of Cell Biology (D.B.S.), University of Pittsburgh, Pittsburgh, Pennsylvania 15261; Department of Obstetrics, Gynecology, and Reproductive Sciences (M.N.M.), Magee-Womens Hospital, University of Pittsburgh, Pittsburgh, Pennsylvania 15213; and Department of Biochemistry and Molecular Biology (T.P.), Dalhousie Medicine New Brunswick, Dalhousie University, St John, Canada NB E2L 4L5
| | - Cynthia F Yazbeck
- Division of Endocrinology and Metabolism (G.S., M.S.-R., R.C.W., B.A.S., M.K.B., M.T.S., L.C., C.F.Y., R.M.O., E.E.K.), Department of Medicine, and Department of Cell Biology (D.B.S.), University of Pittsburgh, Pittsburgh, Pennsylvania 15261; Department of Obstetrics, Gynecology, and Reproductive Sciences (M.N.M.), Magee-Womens Hospital, University of Pittsburgh, Pittsburgh, Pennsylvania 15213; and Department of Biochemistry and Molecular Biology (T.P.), Dalhousie Medicine New Brunswick, Dalhousie University, St John, Canada NB E2L 4L5
| | - Donna B Stolz
- Division of Endocrinology and Metabolism (G.S., M.S.-R., R.C.W., B.A.S., M.K.B., M.T.S., L.C., C.F.Y., R.M.O., E.E.K.), Department of Medicine, and Department of Cell Biology (D.B.S.), University of Pittsburgh, Pittsburgh, Pennsylvania 15261; Department of Obstetrics, Gynecology, and Reproductive Sciences (M.N.M.), Magee-Womens Hospital, University of Pittsburgh, Pittsburgh, Pennsylvania 15213; and Department of Biochemistry and Molecular Biology (T.P.), Dalhousie Medicine New Brunswick, Dalhousie University, St John, Canada NB E2L 4L5
| | - Thomas Pulinilkunnil
- Division of Endocrinology and Metabolism (G.S., M.S.-R., R.C.W., B.A.S., M.K.B., M.T.S., L.C., C.F.Y., R.M.O., E.E.K.), Department of Medicine, and Department of Cell Biology (D.B.S.), University of Pittsburgh, Pittsburgh, Pennsylvania 15261; Department of Obstetrics, Gynecology, and Reproductive Sciences (M.N.M.), Magee-Womens Hospital, University of Pittsburgh, Pittsburgh, Pennsylvania 15213; and Department of Biochemistry and Molecular Biology (T.P.), Dalhousie Medicine New Brunswick, Dalhousie University, St John, Canada NB E2L 4L5
| | - Robert M O'Doherty
- Division of Endocrinology and Metabolism (G.S., M.S.-R., R.C.W., B.A.S., M.K.B., M.T.S., L.C., C.F.Y., R.M.O., E.E.K.), Department of Medicine, and Department of Cell Biology (D.B.S.), University of Pittsburgh, Pittsburgh, Pennsylvania 15261; Department of Obstetrics, Gynecology, and Reproductive Sciences (M.N.M.), Magee-Womens Hospital, University of Pittsburgh, Pittsburgh, Pennsylvania 15213; and Department of Biochemistry and Molecular Biology (T.P.), Dalhousie Medicine New Brunswick, Dalhousie University, St John, Canada NB E2L 4L5
| | - Erin E Kershaw
- Division of Endocrinology and Metabolism (G.S., M.S.-R., R.C.W., B.A.S., M.K.B., M.T.S., L.C., C.F.Y., R.M.O., E.E.K.), Department of Medicine, and Department of Cell Biology (D.B.S.), University of Pittsburgh, Pittsburgh, Pennsylvania 15261; Department of Obstetrics, Gynecology, and Reproductive Sciences (M.N.M.), Magee-Womens Hospital, University of Pittsburgh, Pittsburgh, Pennsylvania 15213; and Department of Biochemistry and Molecular Biology (T.P.), Dalhousie Medicine New Brunswick, Dalhousie University, St John, Canada NB E2L 4L5
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50
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Schlager S, Goeritzer M, Jandl K, Frei R, Vujic N, Kolb D, Strohmaier H, Dorow J, Eichmann TO, Rosenberger A, Wölfler A, Lass A, Kershaw EE, Ceglarek U, Dichlberger A, Heinemann A, Kratky D. Adipose triglyceride lipase acts on neutrophil lipid droplets to regulate substrate availability for lipid mediator synthesis. J Leukoc Biol 2015; 98:837-50. [PMID: 26109679 PMCID: PMC4594763 DOI: 10.1189/jlb.3a0515-206r] [Citation(s) in RCA: 59] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2015] [Accepted: 06/09/2015] [Indexed: 01/18/2023] Open
Abstract
Lipid mediator release depends on the hydrolysis of triglyceride-rich lipid droplets mediated by ATGL, a potent regulator of inflammatory diseases. In humans, mutations in ATGL lead to TG accumulation in LDs of most tissues and cells, including peripheral blood leukocytes. This pathologic condition is called Jordans’ anomaly, in which functional consequences have not been investigated. In the present study, we tested the hypothesis that ATGL plays a role in leukocyte LD metabolism and immune cell function. Similar to humans with loss-of-function mutations in ATGL, we found that global and myeloid-specific Atgl−/− mice exhibit Jordans’ anomaly with increased abundance of intracellular TG-rich LDs in neutrophil granulocytes. In a model of inflammatory peritonitis, lipid accumulation was also observed in monocytes and macrophages but not in eosinophils or lymphocytes. Neutrophils from Atgl−/− mice showed enhanced immune responses in vitro, which were more prominent in cells from global compared with myeloid-specific Atgl−/− mice. Mechanistically, ATGL−/− as well as pharmacological inhibition of ATGL led to an impaired release of lipid mediators from neutrophils. These findings demonstrate that the release of lipid mediators is dependent on the liberation of precursor molecules from the TG-rich pool of LDs by ATGL. Our data provide mechanistic insights into Jordans’ anomaly in neutrophils and suggest that ATGL is a potent regulator of immune cell function and inflammatory diseases.
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Affiliation(s)
- Stefanie Schlager
- Institutes of *Molecular Biology and Biochemistry and Experimental and Clinical Pharmacology, Center for Medical Research, and Division of Hematology, Medical University of Graz, Graz, Austria; Institute of Laboratory Medicine, Clinical Chemistry and Molecular Diagnostics, University Hospital Leipzig, Leipzig, Germany; LIFE-Leipzig Research Center for Civilization Diseases, University of Leipzig, Leipzig, Germany; Institute of Molecular Biosciences, University of Graz, Graz, Austria; **Division of Endocrinology and Metabolism, Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA; and Department of Anatomy, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Madeleine Goeritzer
- Institutes of *Molecular Biology and Biochemistry and Experimental and Clinical Pharmacology, Center for Medical Research, and Division of Hematology, Medical University of Graz, Graz, Austria; Institute of Laboratory Medicine, Clinical Chemistry and Molecular Diagnostics, University Hospital Leipzig, Leipzig, Germany; LIFE-Leipzig Research Center for Civilization Diseases, University of Leipzig, Leipzig, Germany; Institute of Molecular Biosciences, University of Graz, Graz, Austria; **Division of Endocrinology and Metabolism, Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA; and Department of Anatomy, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Katharina Jandl
- Institutes of *Molecular Biology and Biochemistry and Experimental and Clinical Pharmacology, Center for Medical Research, and Division of Hematology, Medical University of Graz, Graz, Austria; Institute of Laboratory Medicine, Clinical Chemistry and Molecular Diagnostics, University Hospital Leipzig, Leipzig, Germany; LIFE-Leipzig Research Center for Civilization Diseases, University of Leipzig, Leipzig, Germany; Institute of Molecular Biosciences, University of Graz, Graz, Austria; **Division of Endocrinology and Metabolism, Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA; and Department of Anatomy, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Robert Frei
- Institutes of *Molecular Biology and Biochemistry and Experimental and Clinical Pharmacology, Center for Medical Research, and Division of Hematology, Medical University of Graz, Graz, Austria; Institute of Laboratory Medicine, Clinical Chemistry and Molecular Diagnostics, University Hospital Leipzig, Leipzig, Germany; LIFE-Leipzig Research Center for Civilization Diseases, University of Leipzig, Leipzig, Germany; Institute of Molecular Biosciences, University of Graz, Graz, Austria; **Division of Endocrinology and Metabolism, Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA; and Department of Anatomy, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Nemanja Vujic
- Institutes of *Molecular Biology and Biochemistry and Experimental and Clinical Pharmacology, Center for Medical Research, and Division of Hematology, Medical University of Graz, Graz, Austria; Institute of Laboratory Medicine, Clinical Chemistry and Molecular Diagnostics, University Hospital Leipzig, Leipzig, Germany; LIFE-Leipzig Research Center for Civilization Diseases, University of Leipzig, Leipzig, Germany; Institute of Molecular Biosciences, University of Graz, Graz, Austria; **Division of Endocrinology and Metabolism, Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA; and Department of Anatomy, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Dagmar Kolb
- Institutes of *Molecular Biology and Biochemistry and Experimental and Clinical Pharmacology, Center for Medical Research, and Division of Hematology, Medical University of Graz, Graz, Austria; Institute of Laboratory Medicine, Clinical Chemistry and Molecular Diagnostics, University Hospital Leipzig, Leipzig, Germany; LIFE-Leipzig Research Center for Civilization Diseases, University of Leipzig, Leipzig, Germany; Institute of Molecular Biosciences, University of Graz, Graz, Austria; **Division of Endocrinology and Metabolism, Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA; and Department of Anatomy, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Heimo Strohmaier
- Institutes of *Molecular Biology and Biochemistry and Experimental and Clinical Pharmacology, Center for Medical Research, and Division of Hematology, Medical University of Graz, Graz, Austria; Institute of Laboratory Medicine, Clinical Chemistry and Molecular Diagnostics, University Hospital Leipzig, Leipzig, Germany; LIFE-Leipzig Research Center for Civilization Diseases, University of Leipzig, Leipzig, Germany; Institute of Molecular Biosciences, University of Graz, Graz, Austria; **Division of Endocrinology and Metabolism, Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA; and Department of Anatomy, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Juliane Dorow
- Institutes of *Molecular Biology and Biochemistry and Experimental and Clinical Pharmacology, Center for Medical Research, and Division of Hematology, Medical University of Graz, Graz, Austria; Institute of Laboratory Medicine, Clinical Chemistry and Molecular Diagnostics, University Hospital Leipzig, Leipzig, Germany; LIFE-Leipzig Research Center for Civilization Diseases, University of Leipzig, Leipzig, Germany; Institute of Molecular Biosciences, University of Graz, Graz, Austria; **Division of Endocrinology and Metabolism, Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA; and Department of Anatomy, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Thomas O Eichmann
- Institutes of *Molecular Biology and Biochemistry and Experimental and Clinical Pharmacology, Center for Medical Research, and Division of Hematology, Medical University of Graz, Graz, Austria; Institute of Laboratory Medicine, Clinical Chemistry and Molecular Diagnostics, University Hospital Leipzig, Leipzig, Germany; LIFE-Leipzig Research Center for Civilization Diseases, University of Leipzig, Leipzig, Germany; Institute of Molecular Biosciences, University of Graz, Graz, Austria; **Division of Endocrinology and Metabolism, Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA; and Department of Anatomy, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Angelika Rosenberger
- Institutes of *Molecular Biology and Biochemistry and Experimental and Clinical Pharmacology, Center for Medical Research, and Division of Hematology, Medical University of Graz, Graz, Austria; Institute of Laboratory Medicine, Clinical Chemistry and Molecular Diagnostics, University Hospital Leipzig, Leipzig, Germany; LIFE-Leipzig Research Center for Civilization Diseases, University of Leipzig, Leipzig, Germany; Institute of Molecular Biosciences, University of Graz, Graz, Austria; **Division of Endocrinology and Metabolism, Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA; and Department of Anatomy, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Albert Wölfler
- Institutes of *Molecular Biology and Biochemistry and Experimental and Clinical Pharmacology, Center for Medical Research, and Division of Hematology, Medical University of Graz, Graz, Austria; Institute of Laboratory Medicine, Clinical Chemistry and Molecular Diagnostics, University Hospital Leipzig, Leipzig, Germany; LIFE-Leipzig Research Center for Civilization Diseases, University of Leipzig, Leipzig, Germany; Institute of Molecular Biosciences, University of Graz, Graz, Austria; **Division of Endocrinology and Metabolism, Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA; and Department of Anatomy, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Achim Lass
- Institutes of *Molecular Biology and Biochemistry and Experimental and Clinical Pharmacology, Center for Medical Research, and Division of Hematology, Medical University of Graz, Graz, Austria; Institute of Laboratory Medicine, Clinical Chemistry and Molecular Diagnostics, University Hospital Leipzig, Leipzig, Germany; LIFE-Leipzig Research Center for Civilization Diseases, University of Leipzig, Leipzig, Germany; Institute of Molecular Biosciences, University of Graz, Graz, Austria; **Division of Endocrinology and Metabolism, Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA; and Department of Anatomy, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Erin E Kershaw
- Institutes of *Molecular Biology and Biochemistry and Experimental and Clinical Pharmacology, Center for Medical Research, and Division of Hematology, Medical University of Graz, Graz, Austria; Institute of Laboratory Medicine, Clinical Chemistry and Molecular Diagnostics, University Hospital Leipzig, Leipzig, Germany; LIFE-Leipzig Research Center for Civilization Diseases, University of Leipzig, Leipzig, Germany; Institute of Molecular Biosciences, University of Graz, Graz, Austria; **Division of Endocrinology and Metabolism, Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA; and Department of Anatomy, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Uta Ceglarek
- Institutes of *Molecular Biology and Biochemistry and Experimental and Clinical Pharmacology, Center for Medical Research, and Division of Hematology, Medical University of Graz, Graz, Austria; Institute of Laboratory Medicine, Clinical Chemistry and Molecular Diagnostics, University Hospital Leipzig, Leipzig, Germany; LIFE-Leipzig Research Center for Civilization Diseases, University of Leipzig, Leipzig, Germany; Institute of Molecular Biosciences, University of Graz, Graz, Austria; **Division of Endocrinology and Metabolism, Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA; and Department of Anatomy, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Andrea Dichlberger
- Institutes of *Molecular Biology and Biochemistry and Experimental and Clinical Pharmacology, Center for Medical Research, and Division of Hematology, Medical University of Graz, Graz, Austria; Institute of Laboratory Medicine, Clinical Chemistry and Molecular Diagnostics, University Hospital Leipzig, Leipzig, Germany; LIFE-Leipzig Research Center for Civilization Diseases, University of Leipzig, Leipzig, Germany; Institute of Molecular Biosciences, University of Graz, Graz, Austria; **Division of Endocrinology and Metabolism, Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA; and Department of Anatomy, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Akos Heinemann
- Institutes of *Molecular Biology and Biochemistry and Experimental and Clinical Pharmacology, Center for Medical Research, and Division of Hematology, Medical University of Graz, Graz, Austria; Institute of Laboratory Medicine, Clinical Chemistry and Molecular Diagnostics, University Hospital Leipzig, Leipzig, Germany; LIFE-Leipzig Research Center for Civilization Diseases, University of Leipzig, Leipzig, Germany; Institute of Molecular Biosciences, University of Graz, Graz, Austria; **Division of Endocrinology and Metabolism, Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA; and Department of Anatomy, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Dagmar Kratky
- Institutes of *Molecular Biology and Biochemistry and Experimental and Clinical Pharmacology, Center for Medical Research, and Division of Hematology, Medical University of Graz, Graz, Austria; Institute of Laboratory Medicine, Clinical Chemistry and Molecular Diagnostics, University Hospital Leipzig, Leipzig, Germany; LIFE-Leipzig Research Center for Civilization Diseases, University of Leipzig, Leipzig, Germany; Institute of Molecular Biosciences, University of Graz, Graz, Austria; **Division of Endocrinology and Metabolism, Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA; and Department of Anatomy, Faculty of Medicine, University of Helsinki, Helsinki, Finland
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