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Dong H, Qin B, Zhang H, Lei L, Wu S. Current Treatment Methods for Charcot-Marie-Tooth Diseases. Biomolecules 2024; 14:1138. [PMID: 39334903 PMCID: PMC11430469 DOI: 10.3390/biom14091138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2024] [Revised: 08/21/2024] [Accepted: 08/29/2024] [Indexed: 09/30/2024] Open
Abstract
Charcot-Marie-Tooth (CMT) disease, the most common inherited neuromuscular disorder, exhibits a wide phenotypic range, genetic heterogeneity, and a variable disease course. The diverse molecular genetic mechanisms of CMT were discovered over the past three decades with the development of molecular biology and gene sequencing technologies. These methods have brought new options for CMT reclassification and led to an exciting era of treatment target discovery for this incurable disease. Currently, there are no approved disease management methods that can fully cure patients with CMT, and rehabilitation, orthotics, and surgery are the only available treatments to ameliorate symptoms. Considerable research attention has been given to disease-modifying therapies, including gene silencing, gene addition, and gene editing, but most treatments that reach clinical trials are drug treatments, while currently, only gene therapies for CMT2S have reached the clinical trial stage. In this review, we highlight the pathogenic mechanisms and therapeutic investigations of different subtypes of CMT, and promising therapeutic approaches are also discussed.
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Affiliation(s)
- Hongxian Dong
- Department of Orthopedic Surgery and Orthopedic Research Institute, West China Hospital, Sichuan University, Chengdu 610041, China; (H.D.); (B.Q.); (H.Z.)
| | - Boquan Qin
- Department of Orthopedic Surgery and Orthopedic Research Institute, West China Hospital, Sichuan University, Chengdu 610041, China; (H.D.); (B.Q.); (H.Z.)
| | - Hui Zhang
- Department of Orthopedic Surgery and Orthopedic Research Institute, West China Hospital, Sichuan University, Chengdu 610041, China; (H.D.); (B.Q.); (H.Z.)
| | - Lei Lei
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Shizhou Wu
- Department of Orthopedic Surgery and Orthopedic Research Institute, West China Hospital, Sichuan University, Chengdu 610041, China; (H.D.); (B.Q.); (H.Z.)
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2
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Ghanbari A, Ghasemi S, Zarbakhsh S. Exercise induced myelin protein zero improvement in neuropathic pain rats. Somatosens Mot Res 2023; 40:141-146. [PMID: 36630644 DOI: 10.1080/08990220.2022.2158800] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Accepted: 12/08/2022] [Indexed: 01/12/2023]
Abstract
PURPOSE Aerobic exercise including swimming plays a suitable role in improving somatosensory injuries. Neuropathic pain is a debilitating condition that occurs following injury or diseases of somatosensory system. In the present study, we tried to investigate the effect of exercise on myelin protein zero of sciatic nerve injured rats. MATERIALS AND METHODS Forty male rats (180-220 g) were divided into five groups (intact, sham, sham + exercise, neuropathy, and neuropathy + exercise). Right Sciatic nerve of anesthetized rats was exposed and loosely ligated (four ligations with 1 mm apart) using catgut chromic sutures to induce neuropathy. After 3 days of recovery, swimming exercise began (20 min/day/5 days a week/4 weeks). Mechanical allodynia and thermal hyperalgesia were detected using Von Frey filaments and plantar test, respectively. Sciatic nerve at the place of injury was dissected out to measure the myelin protein zero by western blot analysis. In the intact and sham groups, sciatic nerve removed at the place similar to injured group. RESULTS We found that neuropathy significantly (p < 0.05) reduced paw withdrawal mechanical and thermal thresholds and swimming exercise significantly (p < 0.05) increased paw withdrawal mechanical and thermal thresholds compared to the neuropathy group. Moreover, we found that MPZ level significantly (p < 0.01) decreased in neuropathy group against that in sham group, and exercise prominently (p < 0.05) reversed MPZ level towards control level. CONCLUSIONS Swimming exercise improves myelin protein zero level in neuropathic rats along with attenuating neuropathic pain. This is a promising approach in improving neuropathological disorders including Charcot-Marie-Tooth and Dejerine-Sottas disease.
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Affiliation(s)
- Ali Ghanbari
- Research Center of Physiology, Semnan University of Medical Sciences, Semnan, Iran
| | - Sahar Ghasemi
- Student Research Committee, Semnan University of Medical Sciences, Semnan, Iran
| | - Sam Zarbakhsh
- Nervous System Stem Cell Research Center, Semnan University of Medical Sciences, Semnan, Iran
- Department of anatomical sciences, Faculty of Medicine, Semnan University of Medical Sciences, Semnan, Iran
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3
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Prada V, Hamedani M, Genovese F, Zuppa A, Benedetti L, Bellone E, Grandis M, Mandich P, Schenone A. People with Charcot-Marie-Tooth disease and COVID-19: Impaired physical conditions due to the lockdown. An International cross-sectional survey. Ann Phys Rehabil Med 2020; 63:557-559. [PMID: 33065298 PMCID: PMC7553142 DOI: 10.1016/j.rehab.2020.10.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Revised: 09/29/2020] [Accepted: 10/05/2020] [Indexed: 12/13/2022]
Affiliation(s)
- Valeria Prada
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics and Maternal and Infantile Sciences (DINOGMI), University of Genova, L.go P. Daneo 3, Genova, Italy.
| | - Merhnaz Hamedani
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics and Maternal and Infantile Sciences (DINOGMI), University of Genova, L.go P. Daneo 3, Genova, Italy
| | - Filippo Genovese
- ACMT-Rete per la malattia di Charcot-Marie-Tooth OdV, Bologna, Italy
| | - Angela Zuppa
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics and Maternal and Infantile Sciences (DINOGMI), University of Genova, L.go P. Daneo 3, Genova, Italy
| | - Luana Benedetti
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics and Maternal and Infantile Sciences (DINOGMI), University of Genova, L.go P. Daneo 3, Genova, Italy
| | - Emilia Bellone
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics and Maternal and Infantile Sciences (DINOGMI), University of Genova, L.go P. Daneo 3, Genova, Italy; IRCCS Ospedale Policlinico San Martino, Genova, Italy
| | - Marina Grandis
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics and Maternal and Infantile Sciences (DINOGMI), University of Genova, L.go P. Daneo 3, Genova, Italy; IRCCS Ospedale Policlinico San Martino, Genova, Italy
| | - Paola Mandich
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics and Maternal and Infantile Sciences (DINOGMI), University of Genova, L.go P. Daneo 3, Genova, Italy; IRCCS Ospedale Policlinico San Martino, Genova, Italy
| | - Angelo Schenone
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics and Maternal and Infantile Sciences (DINOGMI), University of Genova, L.go P. Daneo 3, Genova, Italy; IRCCS Ospedale Policlinico San Martino, Genova, Italy
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4
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Visigalli D, Capodivento G, Basit A, Fernández R, Hamid Z, Pencová B, Gemelli C, Marubbi D, Pastorino C, Luoma AM, Riekel C, Kirschner DA, Schenone A, Fernández JA, Armirotti A, Nobbio L. Exploiting Sphingo- and Glycerophospholipid Impairment to Select Effective Drugs and Biomarkers for CMT1A. Front Neurol 2020; 11:903. [PMID: 32982928 PMCID: PMC7477391 DOI: 10.3389/fneur.2020.00903] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2020] [Accepted: 07/14/2020] [Indexed: 01/12/2023] Open
Abstract
In Charcot-Marie-Tooth type 1A (CMT1A), Schwann cells exhibit a preponderant transcriptional deficiency of genes involved in lipid biosynthesis. This perturbed lipid metabolism affects the peripheral nerve physiology and the structure of peripheral myelin. Nevertheless, the identification and functional characterization of the lipid species mainly responsible for CMT1A myelin impairment currently lack. This is critical in the pathogenesis of the neuropathy since lipids are many and complex molecules which play essential roles in the cell, including the structural components of cellular membranes, cell signaling, and membrane trafficking. Moreover, lipids themselves are able to modify gene transcription, thereby affecting the genotype-phenotype correlation of well-defined inherited diseases, including CMT1A. Here we report for the first time a comprehensive lipid profiling in experimental and human CMT1A, demonstrating a previously unknown specific alteration of sphingolipid (SP) and glycerophospholipid (GP) metabolism. Notably, SP, and GP changes even emerge in biological fluids of CMT1A rat and human patients, implying a systemic metabolic dysfunction for these specific lipid classes. Actually, SP and GP are not merely reduced; their expression is instead aberrant, contributing to the ultrastructural abnormalities that we detailed by X-ray diffraction in rat and human internode myelin. The modulation of SP and GP pathways in myelinating dorsal root ganglia cultures clearly sustains this issue. In fact, just selected molecules interacting with these pathways are able to modify the altered geometric parameters of CMT1A myelinated fibers. Overall, we propose to exploit the present SP and GP metabolism impairment to select effective drugs and validate a set of reliable biomarkers, which remain a challenge in CMT1A neuropathy.
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Affiliation(s)
- Davide Visigalli
- DINOGMI, University of Genoa, Genoa, Italy.,IRCCS Ospedale Policlinico S. Martino, UO Clinica Neurologica, Genoa, Italy
| | - Giovanna Capodivento
- DINOGMI, University of Genoa, Genoa, Italy.,IRCCS Ospedale Policlinico S. Martino, UO Clinica Neurologica, Genoa, Italy
| | - Abdul Basit
- Analytical Chemistry Lab, Fondazione Istituto Italiano di Tecnologia, Genoa, Italy
| | - Roberto Fernández
- Department of Physical Chemistry, Faculty of Science and Technology, University of the Basque Country, Leioa, Spain
| | - Zeeshan Hamid
- Analytical Chemistry Lab, Fondazione Istituto Italiano di Tecnologia, Genoa, Italy
| | - Barbora Pencová
- Department of Physical Chemistry, Faculty of Science and Technology, University of the Basque Country, Leioa, Spain
| | - Chiara Gemelli
- DINOGMI, University of Genoa, Genoa, Italy.,IRCCS Ospedale Policlinico S. Martino, UO Clinica Neurologica, Genoa, Italy
| | - Daniela Marubbi
- DIMES, University of Genoa, Genoa, Italy.,IRCCS Ospedale Policlinico S. Martino, UO Oncologia Cellulare Genoa, Genoa, Italy
| | - Cecilia Pastorino
- DINOGMI, University of Genoa, Genoa, Italy.,IRCCS Ospedale Policlinico S. Martino, UO Clinica Neurologica, Genoa, Italy
| | - Adrienne M Luoma
- Department of Biology, Boston College, Boston, MA, United States
| | | | | | - Angelo Schenone
- DINOGMI, University of Genoa, Genoa, Italy.,IRCCS Ospedale Policlinico S. Martino, UO Clinica Neurologica, Genoa, Italy
| | - José A Fernández
- Department of Physical Chemistry, Faculty of Science and Technology, University of the Basque Country, Leioa, Spain
| | - Andrea Armirotti
- Analytical Chemistry Lab, Fondazione Istituto Italiano di Tecnologia, Genoa, Italy
| | - Lucilla Nobbio
- DINOGMI, University of Genoa, Genoa, Italy.,IRCCS Ospedale Policlinico S. Martino, UO Clinica Neurologica, Genoa, Italy
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5
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Anandh U, Nikalji R, Parick A. Membranous Nephropathy in a Patient with Charcot-Marie-Tooth Disease: Association of Myelin Mutations. Indian J Nephrol 2018; 28:397-400. [PMID: 30271005 PMCID: PMC6146723 DOI: 10.4103/ijn.ijn_113_17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
A 40-year-old female presented to the neurologist with gradually progressive weakness of distal and proximal muscles of both lower limbs and cramps for 2 years. She gave a history of similar illness in her paternal grandmother and her father. Her examination revealed bilateral foot drop and mild proximal muscle weakness. She was diagnosed to have peripheral neuropathy and subsequently treated conservatively. Over the next year, she noticed progressive swelling of both lower limb and frothy urine. A nephrology consultation was obtained, and a renal biopsy was done, which showed membranous nephropathy. She was started on steroids and subsequently on tacrolimus as the proteinuria progressively worsened. Her anti-phospholipase A2 receptor antibody was negative both in blood and in the kidney biopsy tissue. A search for a genetic basis of this rare clinical condition was made, and heterozygous mutation was detected in the myelin gene. This mutation was confirmed with genetic sequencing. The mutation is associated with MPZ gene and is associated with multiple hereditary sensorimotor neuropathy. MPZ knockout mice have been shown to have increased glomerular permeability and proteinuria.
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Affiliation(s)
- U Anandh
- Department of Nephrology, Yashoda Hospitals, Secunderabad, Telangana, India
| | - R Nikalji
- Department of Nephrology, Apollo Hospitals, Navi Mumbai, Maharashtra, India
| | - A Parick
- Department of Pathology, Yashoda Hospitals, Secunderabad, Telangana, India
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6
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Abstract
PURPOSE OF REVIEW Genetic polyneuropathies are rare and clinically heterogeneous. This article provides an overview of the clinical features, neurologic and electrodiagnostic findings, and management strategies for Charcot-Marie-Tooth disease and other genetic polyneuropathies as well as an algorithm for genetic testing. RECENT FINDINGS In the past 10 years, many of the mutations causing genetic polyneuropathies have been identified. International collaborations have led to the development of consortiums that are undertaking careful genotype-phenotype correlations to facilitate the development of targeted therapies and validation of outcome measures for future clinical trials. Clinical trials are currently under way for some genetic polyneuropathies. SUMMARY Readers are provided a framework to recognize common presentations of various genetic polyneuropathies and a rationale for current diagnostic testing and management strategies in genetic polyneuropathies.
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7
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Prada V, Schizzi S, Poggi I, Mori L, Gemelli C, Hamedani M, Accogli S, Maggi G, Grandis M, Mancardi GL, Schenone A. Hand Rehabilitation Treatment for Charcot-Marie-Tooth Disease: An Open Label Pilot Study. JOURNAL OF NEUROLOGY & NEUROPHYSIOLOGY 2018; 9:465. [PMID: 30305981 PMCID: PMC6175056 DOI: 10.4172/2155-9562.1000465] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
OBJECTIVE Charcot-Marie-Tooth neuropathy affects mainly and early the lower limbs, but hands deformities are a relevant problem, which involves the quality of life of the patients. Unfortunately, there are few studies about the evaluation of the upper limbs and very rare works about the rehabilitation. A treatment study at the moment is missing and it is important to search rehabilitation exercises to improve the dexterity and the quality of life of the patients. METHODS We recruited 9 patients with clinical and genetic diagnosis of CMT and we proposed a rehabilitation protocol which includes muscle recruitment, stretching and proprioceptive exercises for the hand with the duration of 4 weeks (two sessions for week). We evaluated the patients before and one week after the treatment with Thumb Opposition Test, Sollerman Hand Function Scale, dynamometry (tripod pinch and hand grip). RESULTS The rehabilitation protocol has been well tolerated and there were not dropouts. We did not observe any worsening in every scale we used. Every parameter tested showed an improvement especially in the right/dominant hand. CONCLUSION This study demonstrates that this three phases treatment is well tolerated by patients, it is not detrimental for the hands status and perfectly reproducible by professionals. Moreover, this could be the basis for future randomized single blind projects.
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Affiliation(s)
- Valeria Prada
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics and Maternal/Child Sciences, University of Genova, Italy
| | - S Schizzi
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics and Maternal/Child Sciences, University of Genova, Italy
| | - I Poggi
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics and Maternal/Child Sciences, University of Genova, Italy
| | - L Mori
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics and Maternal/Child Sciences, University of Genova, Italy
- Ospedale Policlinico San Martino IRCCS, Dipartimento di Neurologia, Genova, Italy
| | - C Gemelli
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics and Maternal/Child Sciences, University of Genova, Italy
| | - M Hamedani
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics and Maternal/Child Sciences, University of Genova, Italy
| | - S Accogli
- Ospedale Policlinico San Martino IRCCS, Dipartimento di Neurologia, Genova, Italy
| | - G Maggi
- Ospedale Policlinico San Martino IRCCS, Dipartimento di Neurologia, Genova, Italy
| | - M Grandis
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics and Maternal/Child Sciences, University of Genova, Italy
- Ospedale Policlinico San Martino IRCCS, Dipartimento di Neurologia, Genova, Italy
| | - GL Mancardi
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics and Maternal/Child Sciences, University of Genova, Italy
- Ospedale Policlinico San Martino IRCCS, Dipartimento di Neurologia, Genova, Italy
| | - A Schenone
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics and Maternal/Child Sciences, University of Genova, Italy
- Ospedale Policlinico San Martino IRCCS, Dipartimento di Neurologia, Genova, Italy
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8
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Mori L, Prada V, Signori A, Pareyson D, Piscosquito G, Padua L, Pazzaglia C, Fabrizi GM, Smania N, Picelli A, Schenone A. Outcome measures in the clinical evaluation of ambulatory Charcot-Marie-Tooth 1A subjects. Eur J Phys Rehabil Med 2018; 55:47-55. [PMID: 29898585 DOI: 10.23736/s1973-9087.18.05111-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND The outcome measures (OMs) in clinical trials for Charcot-Marie-Tooth disease (CMT) still represent an issue. A recent study highlighted that three additional clinical OMs, the 10-Meter Walk Test (10MWT), the 9-Hole Peg Test, and foot dorsal flexion dynamometry, further improve discrimination between severely and mildly affected patients. Another study has recently assessed the validity and reliability of the 6-Minute Walk Test (6MWT). AIM The aim of this study was to identify the most useful scales in the clinical evaluation of CMT1A patients. DESIGN Observational study of the baseline data collected in a multicenter, prospective, randomized, single blind, controlled study to evaluate the efficacy and safety of an innovative rehabilitation protocol based on treadmill training, stretching, respiratory, and proprioceptive exercises (TreSPE study) in CMT1A patients. SETTING The outpatient service of the four Italian centers involved, which are specialized in hereditary neuropathies. POPULATION Fifty-three subjects with a clinical and genetically confirmed diagnosis of CMT1A. METHODS At baseline, in addition to the CMT Neuropathy Score, all subjects underwent walking evaluation (6MWT, 10MWT), balance assessment (Berg Balance Scale [BBS], Short Physical Performance Battery [SPPB]) and a subjective evaluation of quality of life (SF36) and walking ability (Walk12). RESULTS Analyzing the baseline data, as expected, we found a strong correlation between walk and balance evaluation, proving the validity of these tests in investigating the functional impairment of CMT1A subjects. Particularly, we found that subjects with better balance control walk at higher speed and perceive less limitations in their physical activities or motor skills. This can be reconducted to the fact that ankle stability depends upon different factors such as anatomy integrity, muscle strength and proprioception. CONCLUSIONS We identify the 6MWT, 10MWT, and SPPB as the most useful scales, in addition to the CMTNS, to evaluate the functional impairment of CMT1A patients who retain their walking capability and we suggest the use of SPPB because of its rapidity to assess balance and gait disorders in clinical settings. CLINICAL REHABILITATION IMPACT In the clinical practice it is important to evaluate patients comprehensively but rapidly. These outcome measures can help us to correctly assess balance and walking ability in CMT1A patients.
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Affiliation(s)
- Laura Mori
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, Genoa, Italy - .,San Martino University Hospital and Institute for Cancer Research and Care, Genoa, Italy -
| | - Valeria Prada
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, Genoa, Italy.,San Martino University Hospital and Institute for Cancer Research and Care, Genoa, Italy
| | - Alessio Signori
- Division of Biostatistics, Department of Health Science (DISSAL), University of Genoa, Genoa, Italy
| | - Davide Pareyson
- Carlo Besta Neurological Institute for Research and Care, Milan, Italy
| | - Giuseppe Piscosquito
- Carlo Besta Neurological Institute for Research and Care, Milan, Italy.,Functional Neuromotor Rehabilitation Unit, Maugeri Scientific Institutes, Telese Terme, Benevento, Italy
| | - Luca Padua
- Department of Geriatrics, Neurosciences, and Orthopedics, Sacred Heart Catholic University, Rome, Italy.,Don Carlo Gnocchi Nonprofit Organization, Milan, Italy
| | | | - Gian Maria Fabrizi
- Section of Neurology, Department of Neurosciences, Biomedicine, and Movement Sciences, University of Verona, Verona, Italy
| | - Nicola Smania
- Neuromotor and Cognitive Rehabilitation Research Center, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Alessandro Picelli
- Neuromotor and Cognitive Rehabilitation Research Center, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Angelo Schenone
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, Genoa, Italy.,San Martino University Hospital and Institute for Cancer Research and Care, Genoa, Italy
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9
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Fornasari BE, Ronchi G, Pascal D, Visigalli D, Capodivento G, Nobbio L, Perroteau I, Schenone A, Geuna S, Gambarotta G. Soluble Neuregulin1 is strongly up-regulated in the rat model of Charcot-Marie-Tooth 1A disease. Exp Biol Med (Maywood) 2018; 243:370-374. [PMID: 29350067 DOI: 10.1177/1535370218754492] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Neuregulin1 (NRG1) is a growth factor playing a pivotal role in peripheral nerve development through the activation of the transmembrane co-receptors ErbB2-ErbB3. Soluble NRG1 isoforms, mainly secreted by Schwann cells, are strongly and transiently up-regulated after acute peripheral nerve injury, thus suggesting that they play a crucial role also in the response to nerve damage. Here we show that in the rat experimental model of the peripheral demyelinating neuropathy Charcot-Marie-Tooth 1A (CMT1A) the expression of the different NRG1 isoforms (soluble, type α and β, type a and b) is strongly up-regulated, as well as the expression of NRG1 co-receptors ErbB2-ErbB3, thus showing that CMT1A nerves have a gene expression pattern highly reminiscent of injured nerves. Because it has been shown that high concentrations of soluble NRG1 negatively affect myelination, we suggest that soluble NRG1 over-expression might play a negative role in the pathogenesis of CMT1A disease, and that a therapeutic approach, aimed to interfere with NRG1 activity, might be beneficial for CMT1A patients. Further studies will be necessary to test this hypothesis in animal models and to evaluate NRG1 expression in human patients. Impact statement Charcot-Marie-Tooth1A (CMT1A) is one of the most frequent inherited neurological diseases, characterized by chronic demyelination of peripheral nerves, for which effective therapies are not yet available. It has been recently proposed that the treatment with soluble Neuregulin1 (NRG1), a growth factor released by Schwann cells immediately after acute nerve injury, might be effective in CMT1A treatment. However, the expression of the different isoforms of endogenous NRG1 in CMT1A nerves has not been yet investigated. In this preliminary study, we demonstrate that different isoforms of soluble NRG1 are strongly over-expressed in CMT1A nerves, thus suggesting that a therapeutic approach based on NRG1 treatment should be carefully reconsidered. If soluble NRG1 is over-expressed also in human CMT1A nerves, a therapeutic approach aimed to inhibit (instead of stimulate) the signal transduction pathways driven by NRG1 might be fruitfully developed. Further studies will be necessary to test these hypotheses.
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Affiliation(s)
- Benedetta Elena Fornasari
- 1 Department of Clinical and Biological Sciences, University of Torino, Torino 10043, Italy.,2 Neuroscience Institute Cavalieri Ottolenghi (NICO), University of Torino, Torino 10043, Italy
| | - Giulia Ronchi
- 1 Department of Clinical and Biological Sciences, University of Torino, Torino 10043, Italy.,2 Neuroscience Institute Cavalieri Ottolenghi (NICO), University of Torino, Torino 10043, Italy
| | - Davide Pascal
- 1 Department of Clinical and Biological Sciences, University of Torino, Torino 10043, Italy.,3 Candiolo Cancer Institute-FPO, IRCCS, Candiolo (TO) 10060, Italy
| | - Davide Visigalli
- 4 Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics and Maternal-Infantile Sciences (DINOGMI) and CEBR, University of Genova, Genoa 16132, Italy
| | - Giovanna Capodivento
- 4 Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics and Maternal-Infantile Sciences (DINOGMI) and CEBR, University of Genova, Genoa 16132, Italy
| | - Lucilla Nobbio
- 4 Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics and Maternal-Infantile Sciences (DINOGMI) and CEBR, University of Genova, Genoa 16132, Italy
| | - Isabelle Perroteau
- 1 Department of Clinical and Biological Sciences, University of Torino, Torino 10043, Italy
| | - Angelo Schenone
- 4 Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics and Maternal-Infantile Sciences (DINOGMI) and CEBR, University of Genova, Genoa 16132, Italy
| | - Stefano Geuna
- 1 Department of Clinical and Biological Sciences, University of Torino, Torino 10043, Italy.,2 Neuroscience Institute Cavalieri Ottolenghi (NICO), University of Torino, Torino 10043, Italy
| | - Giovanna Gambarotta
- 1 Department of Clinical and Biological Sciences, University of Torino, Torino 10043, Italy
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10
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Effects of Self-Selected Exercise on Strength in Charcot-Marie-Tooth Disease Subtypes. Can J Neurol Sci 2017; 44:572-576. [PMID: 28669366 DOI: 10.1017/cjn.2017.204] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
BACKGROUND Preliminary studies have supported the utility of exercise as a treatment for Charcot-Marie-Tooth disease (CMT) patients. Despite being the most common inherited neuropathy, there remains a paucity of guidelines for CMT management. METHODS A retrospective chart review was performed on 297 CMT patients. Self-reported exercise and strength results from standardized dynamometer testing were obtained from adult patients' first visits. Values were converted and analyzed based on previously reported age- and sex-matched normative values. RESULTS Participants with CMT2 had greater strength values than those with CMT1 in hand grip, elbow flexion, and dorsiflexion (p<0.05). Participants with CMT1 and CMT2 who exercised were statistically significantly stronger in elbow flexion and dorsiflexion than those who did not exercise. CONCLUSIONS These preliminary results suggest that self-directed exercise is associated with greater strength in CMT patients of both CMT1 and CMT2 subtypes. Self-directed exercise may be a convenient, sustainable, and effective method of improving strength and decreasing disability in this population. Future research should explore the type of exercise prescription that best addresses the needs of the CMT population.
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11
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Pearson KT, Vota S. Amyloidosis and its management: Amyloid neuropathies. Curr Probl Cancer 2016; 40:198-208. [PMID: 27979324 DOI: 10.1016/j.currproblcancer.2016.08.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2016] [Revised: 08/25/2016] [Accepted: 08/26/2016] [Indexed: 12/24/2022]
Affiliation(s)
- Kathleen Thornton Pearson
- Department of Neurology, Virginia Commonwealth University, 417 N. 11th Street Richmond, Virginia 23298.
| | - Scott Vota
- Department of Neurology, Virginia Commonwealth University, 417 N. 11th Street Richmond, Virginia 23298.
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12
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Wegener C, Wegener K, Smith R, Schott KH, Burns J. Biomechanical effects of sensorimotor orthoses in adults with Charcot-Marie-Tooth disease. Prosthet Orthot Int 2016; 40:436-46. [PMID: 25934421 DOI: 10.1177/0309364615579318] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2014] [Accepted: 02/10/2015] [Indexed: 02/03/2023]
Abstract
BACKGROUND Charcot-Marie-Tooth disease is an inherited neuropathy causing progressive weakness, foot deformity and difficulty walking. Clinical anecdotes suggest orthoses designed on the 'sensorimotor' paradigm are beneficial for improving gait in Charcot-Marie-Tooth disease. OBJECTIVES Investigate the effect of sensorimotor orthoses on in-shoe and lower limb biomechanics in adults with Charcot-Marie-Tooth disease. STUDY DESIGN Randomised, repeated-measures, exploratory study. METHODS Eight males and two females with Charcot-Marie-Tooth disease aged 31-68 years fitted with pedorthic shoes and custom-made sensorimotor orthoses were randomly tested at baseline and after 4 weeks of adaptation. In-shoe three-dimensional multi-segment foot and lower limb kinematics and kinetics were collected as were plantar pressures, electromyography and self-reported comfort, stability, cushioning and preference. RESULTS Compared to the shoe only condition, sensorimotor orthoses increased midfoot eversion and plantarflexion, increased ankle eversion and produced small but significant changes at the knee and hip indicating increased internal rotation. The orthoses increased medial ground reaction forces and increased pressure at the heel, midfoot and toes. There were minimal effects on electromyography. The sensorimotor orthoses were rated higher for comfort, cushioning, stability and preference. CONCLUSION Sensorimotor orthoses produced changes in kinematic, kinetic and pressure variables in adults with Charcot-Marie-Tooth disease and were regarded as more comfortable, cushioned and stable during walking. CLINICAL RELEVANCE In this study, the walking ability of patients with Charcot-Marie-Tooth disease improved with the use of foot orthoses designed according to the sensorimotor paradigm. However, the mechanism of action appears to be primarily mechanical in origin. Randomised controlled trials are necessary to evaluate the long-term patient-reported outcomes of sensorimotor orthoses.
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Affiliation(s)
| | | | | | | | - Joshua Burns
- The University of Sydney, Sydney, NSW, Australia The Children's Hospital at Westmead, Sydney, NSW, Australia
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13
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Sociali G, Visigalli D, Prukop T, Cervellini I, Mannino E, Venturi C, Bruzzone S, Sereda MW, Schenone A. Tolerability and efficacy study of P2X7 inhibition in experimental Charcot-Marie-Tooth type 1A (CMT1A) neuropathy. Neurobiol Dis 2016; 95:145-57. [PMID: 27431093 DOI: 10.1016/j.nbd.2016.07.017] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2016] [Revised: 06/24/2016] [Accepted: 07/13/2016] [Indexed: 12/24/2022] Open
Abstract
Charcot-Marie-Tooth 1A (CMT1A) is a demyelinating hereditary neuropathy for which pharmacological treatments are not yet available. An abnormally high intracellular Ca(2+) concentration was observed in Schwann cells (SC) from CMT1A rats, caused by the PMP22-mediated overexpression of the P2X7 purinoceptor. The purpose of this study was to investigate the tolerability and therapeutic potential of a pharmacological antagonist of the P2X7 receptor (A438079) in CMT1A. A438079 ameliorated in vitro myelination of organotypic DRG cultures from CMT1A rats. Furthermore, we performed an experimental therapeutic trial in PMP22 transgenic and in wild-type rats. A preliminary dose-escalation trial showed that 3mg/kg A438079 administered via intraperitoneal injection every 24h for four weeks was well tolerated by wild type and CMT1A rats. Affected rats treated with 3mg/kg A438079 revealed a significant improvement of the muscle strength, when compared to placebo controls. Importantly, histologic analysis revealed a significant increase of the total number of myelinated axons in tibial nerves. Moreover, a significant decrease of the hypermyelination of small caliber axons and a significant increase of the frequency and diameter of large caliber myelinated axons was highlighted. An improved distal motor latencies was recorded, whereas compound muscle action potentials (CMAP) remained unaltered. A438079 reduced the SC differentiation defect in CMT1A rats. These results show that pharmacological inhibition of the P2X7 receptor is well tolerated in CMT1A rats and represents a proof-of-principle that antagonizing this pathway may correct the molecular derangements and improve the clinical phenotype in the CMT1A neuropathy.
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Affiliation(s)
- Giovanna Sociali
- DIMES, Section of Biochemistry, and CEBR, University of Genova, Viale Benedetto XV, 1, 16132, Italy
| | - Davide Visigalli
- DINOGMI and CEBR, University of Genova, Largo P. Daneo 3, 16132 Genova, Italy
| | - Thomas Prukop
- Max Planck Institute of Experimental Medicine, Research Group "Molecular and Translational Neurology", Department of Neurogenetics, Hermann-Rein-Str. 3, 37075 Göttingen, Germany; University Medical Center Göttingen, Institute of Clinical Pharmacology, Robert-Koch-Str. 40, 37075 Göttingen, Germany
| | - Ilaria Cervellini
- Max Planck Institute of Experimental Medicine, Research Group "Molecular and Translational Neurology", Department of Neurogenetics, Hermann-Rein-Str. 3, 37075 Göttingen, Germany
| | - Elena Mannino
- DIMES, Section of Biochemistry, and CEBR, University of Genova, Viale Benedetto XV, 1, 16132, Italy
| | - Consuelo Venturi
- DINOGMI and CEBR, University of Genova, Largo P. Daneo 3, 16132 Genova, Italy
| | - Santina Bruzzone
- DIMES, Section of Biochemistry, and CEBR, University of Genova, Viale Benedetto XV, 1, 16132, Italy.
| | - Michael W Sereda
- Max Planck Institute of Experimental Medicine, Research Group "Molecular and Translational Neurology", Department of Neurogenetics, Hermann-Rein-Str. 3, 37075 Göttingen, Germany; University Medical Center Göttingen, Department of Clinical Neurophysiology, Robert-Koch-Str. 40, 37075 Göttingen, Germany
| | - Angelo Schenone
- DINOGMI and CEBR, University of Genova, Largo P. Daneo 3, 16132 Genova, Italy
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14
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Alberti MA, Mori L, Francini L, Poggi I, Monti Bragadin M, Bellone E, Grandis M, Maggi G, Reni L, Sormani MP, Tacchino A, Padua L, Prada V, Bove M, Schenone A. Innovative quantitative testing of hand function in Charcot-Marie-Tooth neuropathy. J Peripher Nerv Syst 2015; 20:410-4. [DOI: 10.1111/jns.12150] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2015] [Revised: 10/05/2015] [Accepted: 10/06/2015] [Indexed: 12/01/2022]
Affiliation(s)
- Maria A. Alberti
- Neuromuscular Unit, Department of Neurology; Hospital Universitari de Bellvitge-IDIBELL; Barcelona Spain
| | - Laura Mori
- Department of Neuroscience, Rehabilitation, Ophtalmology, Genetics, Maternal, and Child Health; University of Genoa; Genoa Italy
| | - Luca Francini
- Department of Neuroscience, Rehabilitation, Ophtalmology, Genetics, Maternal, and Child Health; University of Genoa; Genoa Italy
| | - Ilaria Poggi
- Department of Neuroscience, Rehabilitation, Ophtalmology, Genetics, Maternal, and Child Health; University of Genoa; Genoa Italy
| | - Margherita Monti Bragadin
- Department of Neuroscience, Rehabilitation, Ophtalmology, Genetics, Maternal, and Child Health; University of Genoa; Genoa Italy
| | - Emilia Bellone
- Department of Neuroscience, Rehabilitation, Ophtalmology, Genetics, Maternal, and Child Health; University of Genoa; Genoa Italy
| | - Marina Grandis
- Department of Neuroscience, Rehabilitation, Ophtalmology, Genetics, Maternal, and Child Health; University of Genoa; Genoa Italy
| | | | - Lizia Reni
- IRCCS San Martino-IST; University Hospital; Genoa Italy
| | - Maria P. Sormani
- Department of Health Science, Section of Biostatistics; University of Genoa; Genoa Italy
| | - Andrea Tacchino
- Scientific Research Area; Italian Multiple Sclerosis Foundation (FISM); Genoa Italy
| | - Luca Padua
- Department of Neurosciences; USCS University; Rome Italy
- Don Gnocchi Foundation; Milan Italy
| | - Valeria Prada
- Department of Neuroscience, Rehabilitation, Ophtalmology, Genetics, Maternal, and Child Health; University of Genoa; Genoa Italy
| | - Marco Bove
- Department of Experimental Medicine, Section of Human Physiology; University of Genoa; Genoa Italy
| | - Angelo Schenone
- Department of Neuroscience, Rehabilitation, Ophtalmology, Genetics, Maternal, and Child Health; University of Genoa; Genoa Italy
- IRCCS San Martino-IST; University Hospital; Genoa Italy
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15
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Visigalli D, Castagnola P, Capodivento G, Geroldi A, Bellone E, Mancardi G, Pareyson D, Schenone A, Nobbio L. Alternative Splicing in the HumanPMP22Gene: Implications in CMT1A Neuropathy. Hum Mutat 2015; 37:98-109. [DOI: 10.1002/humu.22921] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2015] [Accepted: 10/11/2015] [Indexed: 11/08/2022]
Affiliation(s)
- Davide Visigalli
- Department of Neurosciences; Rehabilitation Ophthalmology; Genetics and Maternal-Infantile Sciences (DINOGMI) and CEBR; University of Genoa; Genoa Italy
| | | | - Giovanna Capodivento
- Department of Neurosciences; Rehabilitation Ophthalmology; Genetics and Maternal-Infantile Sciences (DINOGMI) and CEBR; University of Genoa; Genoa Italy
| | - Alessandro Geroldi
- Department of Neurosciences; Rehabilitation Ophthalmology; Genetics and Maternal-Infantile Sciences (DINOGMI) - Section of Medical Genetics; University of Genoa IRCCS AOU San Martino-IST; UOC Medical Genetics; Genoa Italy
| | - Emilia Bellone
- Department of Neurosciences; Rehabilitation Ophthalmology; Genetics and Maternal-Infantile Sciences (DINOGMI) - Section of Medical Genetics; University of Genoa IRCCS AOU San Martino-IST; UOC Medical Genetics; Genoa Italy
| | - Gianluigi Mancardi
- Department of Neurosciences; Rehabilitation Ophthalmology; Genetics and Maternal-Infantile Sciences (DINOGMI) and CEBR; University of Genoa; Genoa Italy
| | - Davide Pareyson
- Clinic of Central and Peripheral Degenerative Neuropathies Unit; IRCCS Foundation; C. Besta Neurological Institute; Milan Italy
| | - Angelo Schenone
- Department of Neurosciences; Rehabilitation Ophthalmology; Genetics and Maternal-Infantile Sciences (DINOGMI) and CEBR; University of Genoa; Genoa Italy
| | - Lucilla Nobbio
- Department of Neurosciences; Rehabilitation Ophthalmology; Genetics and Maternal-Infantile Sciences (DINOGMI) and CEBR; University of Genoa; Genoa Italy
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16
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Klein D, Patzkó Á, Schreiber D, van Hauwermeiren A, Baier M, Groh J, West BL, Martini R. Targeting the colony stimulating factor 1 receptor alleviates two forms of Charcot-Marie-Tooth disease in mice. Brain 2015; 138:3193-205. [PMID: 26297559 DOI: 10.1093/brain/awv240] [Citation(s) in RCA: 57] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2015] [Accepted: 06/26/2015] [Indexed: 01/05/2023] Open
Abstract
See Scherer (doi:10.1093/awv279) for a scientific commentary on this article.Charcot-Marie-Tooth type 1 neuropathies are inherited disorders of the peripheral nervous system caused by mutations in Schwann cell-related genes. Typically, no causative cure is presently available. Previous preclinical data of our group highlight the low grade, secondary inflammation common to distinct Charcot-Marie-Tooth type 1 neuropathies as a disease amplifier. In the current study, we have tested one of several available clinical agents targeting macrophages through its inhibition of the colony stimulating factor 1 receptor (CSF1R). We here show that in two distinct mouse models of Charcot-Marie-Tooth type 1 neuropathies, the systemic short- and long-term inhibition of CSF1R by oral administration leads to a robust decline in nerve macrophage numbers by ∼70% and substantial reduction of the typical histopathological and functional alterations. Interestingly, in a model for the dominant X-linked form of Charcot-Marie-Tooth type 1 neuropathy, the second most common form of the inherited neuropathies, macrophage ablation favours maintenance of axonal integrity and axonal resprouting, leading to preserved muscle innervation, increased muscle action potential amplitudes and muscle strengths in the range of wild-type mice. In another model mimicking a mild, demyelination-related Charcot-Marie-Tooth type 1 neuropathy caused by reduced P0 (MPZ) gene dosage, macrophage blockade causes an improved preservation of myelin, increased muscle action potential amplitudes, improved nerve conduction velocities and ameliorated muscle strength. These observations suggest that disease-amplifying macrophages can produce multiple adverse effects in the affected nerves which likely funnel down to common clinical features. Surprisingly, treatment of mouse models mimicking Charcot-Marie-Tooth type 1A neuropathy also caused macrophage blockade, but did not result in neuropathic or clinical improvements, most likely due to the late start of treatment of this early onset disease model. In summary, our study shows that targeting peripheral nerve macrophages by an orally administered inhibitor of CSF1R may offer a highly efficacious and safe treatment option for at least two distinct forms of the presently non-treatable Charcot-Marie-Tooth type 1 neuropathies.
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Affiliation(s)
- Dennis Klein
- 1 Department of Neurology, Developmental Neurobiology, University Hospital Würzburg Josef-Schneider Str. 11, D-97080 Würzburg, Germany
| | - Ágnes Patzkó
- 1 Department of Neurology, Developmental Neurobiology, University Hospital Würzburg Josef-Schneider Str. 11, D-97080 Würzburg, Germany
| | - David Schreiber
- 1 Department of Neurology, Developmental Neurobiology, University Hospital Würzburg Josef-Schneider Str. 11, D-97080 Würzburg, Germany
| | - Anemoon van Hauwermeiren
- 1 Department of Neurology, Developmental Neurobiology, University Hospital Würzburg Josef-Schneider Str. 11, D-97080 Würzburg, Germany
| | - Michaela Baier
- 1 Department of Neurology, Developmental Neurobiology, University Hospital Würzburg Josef-Schneider Str. 11, D-97080 Würzburg, Germany
| | - Janos Groh
- 1 Department of Neurology, Developmental Neurobiology, University Hospital Würzburg Josef-Schneider Str. 11, D-97080 Würzburg, Germany
| | | | - Rudolf Martini
- 1 Department of Neurology, Developmental Neurobiology, University Hospital Würzburg Josef-Schneider Str. 11, D-97080 Würzburg, Germany
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Ravera S, Bartolucci M, Adriano E, Garbati P, Ferrando S, Ramoino P, Calzia D, Morelli A, Balestrino M, Panfoli I. Support of Nerve Conduction by Respiring Myelin Sheath: Role of Connexons. Mol Neurobiol 2015; 53:2468-79. [PMID: 26033217 DOI: 10.1007/s12035-015-9216-0] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2014] [Accepted: 05/12/2015] [Indexed: 12/15/2022]
Abstract
Recently, we have demonstrated that myelin conducts an extramitochondrial oxidative phosphorylation, hypothesizing a novel supportive role for myelin in favor of the axon. We have also hypothesized that the ATP produced in myelin could be transferred thought gap junctions. In this work, by biochemical, immunohistochemical, and electrophysiological techniques, the existence of a connection among myelin to the axon was evaluated, to understand how ATP could be transferred from sheath to the axoplasm. Data confirm a functional expression of oxidative phosphorylation in isolated myelin. Moreover, WB and immunohistochemistry on optic nerve slices show that connexins 32 and 43 are present in myelin and colocalize with myelin basic protein. Interestingly, addition of carbenoxolone or oleamide, two gap junction blockers, causes a decrease in oxidative metabolism in purified myelin, but not in mitochondria. Similar effects were observed on conduction speed in hippocampal Schaffer collateral, in the presence of oleamide. Confocal analysis of optic nerve slices showed that lucifer yellow (that only passes through aqueous pores) signal was found in both the sheath layers and the axoplasma. In the presence of oleamide, but not with oleic acid, signal significantly decreased in the sheath and was lost inside the axon. This suggests the existence of a link among myelin and axons. These results, while supporting the idea that ATP aerobically synthesized in myelin sheath could be transferred to the axoplasm through gap junctions, shed new light on the function of the sheath.
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Affiliation(s)
- Silvia Ravera
- Biochemistry Lab, Department of Pharmacy, University of Genova, Viale Benedetto XV 3, 16132, Genova, Italy.
| | - Martina Bartolucci
- Biochemistry Lab, Department of Pharmacy, University of Genova, Viale Benedetto XV 3, 16132, Genova, Italy
| | - Enrico Adriano
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genova, Via de Toni 5, 16132, Genova, Italy
| | - Patrizia Garbati
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genova, Via de Toni 5, 16132, Genova, Italy
| | - Sara Ferrando
- DISTAV, University of Genova, C.so Europa 26, 16132, Genova, Italy
| | - Paola Ramoino
- DISTAV, University of Genova, C.so Europa 26, 16132, Genova, Italy
| | - Daniela Calzia
- Biochemistry Lab, Department of Pharmacy, University of Genova, Viale Benedetto XV 3, 16132, Genova, Italy
| | - Alessandro Morelli
- Biochemistry Lab, Department of Pharmacy, University of Genova, Viale Benedetto XV 3, 16132, Genova, Italy
| | - Maurizio Balestrino
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genova, Via de Toni 5, 16132, Genova, Italy
| | - Isabella Panfoli
- Biochemistry Lab, Department of Pharmacy, University of Genova, Viale Benedetto XV 3, 16132, Genova, Italy
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18
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Klein D, Groh J, Weishaupt A, Martini R. Endogenous antibodies contribute to macrophage-mediated demyelination in a mouse model for CMT1B. J Neuroinflammation 2015; 12:49. [PMID: 25879857 PMCID: PMC4364634 DOI: 10.1186/s12974-015-0267-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2014] [Accepted: 02/17/2015] [Indexed: 01/02/2023] Open
Abstract
Background We could previously identify components of both the innate and the adaptive immune system as disease modifiers in the pathogenesis of models for Charcot-Marie-Tooth (CMT) neuropathies type 1B and 1X. As part of the adaptive immune system, here we investigated the role of antibodies in a model for CMT1B. Methods Antibodies were localized and characterized in peripheral nerves of the CMT1B model by immunohistochemistry and Western blot analysis. Experimental ablation of antibodies was performed by cross breeding the CMT1B models with mutants deficient in B-lymphocytes (JHD−/− mutants). Ameliorated demyelination by antibody deficiency was reverted by intravenous injection of mouse IgG fractions. Histopathological analysis was performed by immunocytochemistry and light and quantitative electron microscopy. Results We demonstrate that in peripheral nerves of a mouse model for CMT1B, endogenous antibodies strongly decorate endoneurial tubes of peripheral nerves. These antibodies comprise IgG and IgM subtypes and are preferentially, but not exclusively, associated with nerve fiber aspects nearby the nodes of Ranvier. In the absence of antibodies, the early demyelinating phenotype is substantially ameliorated. Reverting the neuropathy by reconstitution with murine IgG fractions identified accumulating antibodies as potentially pathogenic at this early stage of disease. Conclusions Our study demonstrates that in a mouse model for CMT1B, endogenous antibodies contribute to early macrophage-mediated demyelination and disease progression. Thus, both the innate and adaptive immune system are mutually interconnected in a genetic model for demyelination. Since in Wallerian degeneration antibodies have also been shown to be involved in myelin phagocytosis, our study supports our view that inherited demyelination and Wallerian degeneration share common mechanisms, which are detrimental when activated under nonlesion conditions.
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Affiliation(s)
- Dennis Klein
- Department of Neurology, Developmental Neurobiology, University Hospital Würzburg, Josef-Schneider-Str 11, D-97080, Würzburg, Germany.
| | - Janos Groh
- Department of Neurology, Developmental Neurobiology, University Hospital Würzburg, Josef-Schneider-Str 11, D-97080, Würzburg, Germany.
| | - Andreas Weishaupt
- Department of Neurology, Developmental Neurobiology, University Hospital Würzburg, Josef-Schneider-Str 11, D-97080, Würzburg, Germany.
| | - Rudolf Martini
- Department of Neurology, Developmental Neurobiology, University Hospital Würzburg, Josef-Schneider-Str 11, D-97080, Würzburg, Germany.
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Attarian S, Vallat JM, Magy L, Funalot B, Gonnaud PM, Lacour A, Péréon Y, Dubourg O, Pouget J, Micallef J, Franques J, Lefebvre MN, Ghorab K, Al-Moussawi M, Tiffreau V, Preudhomme M, Magot A, Leclair-Visonneau L, Stojkovic T, Bossi L, Lehert P, Gilbert W, Bertrand V, Mandel J, Milet A, Hajj R, Boudiaf L, Scart-Grès C, Nabirotchkin S, Guedj M, Chumakov I, Cohen D. An exploratory randomised double-blind and placebo-controlled phase 2 study of a combination of baclofen, naltrexone and sorbitol (PXT3003) in patients with Charcot-Marie-Tooth disease type 1A. Orphanet J Rare Dis 2014; 9:199. [PMID: 25519680 PMCID: PMC4311411 DOI: 10.1186/s13023-014-0199-0] [Citation(s) in RCA: 79] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2014] [Accepted: 11/20/2014] [Indexed: 11/29/2022] Open
Abstract
Background Charcot-Marie-Tooth type 1A disease (CMT1A) is a rare orphan inherited neuropathy caused by an autosomal dominant duplication of a gene encoding for the structural myelin protein PMP22, which induces abnormal Schwann cell differentiation and dysmyelination, eventually leading to axonal suffering then loss and muscle wasting. We favour the idea that diseases can be more efficiently treated when targeting multiple disease-relevant pathways. In CMT1A patients, we therefore tested the potential of PXT3003, a low-dose combination of three already approved compounds (baclofen, naltrexone and sorbitol). Our study conceptually builds on preclinical experiments highlighting a pleiotropic mechanism of action that includes downregulation of PMP22. The primary objective was to assess safety and tolerability of PXT3003. The secondary objective aimed at an exploratory analysis of efficacy of PXT3003 in CMT1A, to be used for designing next clinical development stages (Phase 2b/3). Methods 80 adult patients with mild-to-moderate CMT1A received in double-blind for 1 year Placebo or one of the three increasing doses of PXT3003 tested, in four equal groups. Safety and tolerability were assessed with the incidence of related adverse events. Efficacy was assessed using the Charcot-Marie-Tooth Neuropathy Score (CMTNS) and the Overall Neuropathy Limitations Scale (ONLS) as main endpoints, as well as various clinical and electrophysiological outcomes. Results This trial confirmed the safety and tolerability of PXT3003. The highest dose (HD) showed consistent evidence of improvement beyond stabilization. CMTNS and ONLS, with a significant improvement of respectively of 8% (0.4% - 16.2%) and 12.1% (2% - 23.2%) in the HD group versus the pool of all other groups, appear to be the most sensitive clinical endpoints to treatment despite their quasi-stability over one year under Placebo. Patients who did not deteriorate over one year were significantly more frequent in the HD group. Conclusions These results confirm that PXT3003 deserves further investigation in adults and could greatly benefit CMT1A-diagnosed children, usually less affected than adults. Trial registration EudraCT Number: 2010-023097-40. ClinicalTrials.gov Identifier: NCT01401257. The Committee for Orphan Medicinal Products issued in February 2014 a positive opinion on the application for orphan designation for PXT3003 (EMA/OD/193/13). Electronic supplementary material The online version of this article (doi:10.1186/s13023-014-0199-0) contains supplementary material, which is available to authorized users.
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20
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Mannil M, Solari A, Leha A, Pelayo-Negro AL, Berciano J, Schlotter-Weigel B, Walter MC, Rautenstrauss B, Schnizer TJ, Schenone A, Seeman P, Kadian C, Schreiber O, Angarita NG, Fabrizi GM, Gemignani F, Padua L, Santoro L, Quattrone A, Vita G, Calabrese D, Young P, Laurà M, Haberlová J, Mazanec R, Paulus W, Beissbarth T, Shy ME, Reilly MM, Pareyson D, Sereda MW. Selected items from the Charcot-Marie-Tooth (CMT) Neuropathy Score and secondary clinical outcome measures serve as sensitive clinical markers of disease severity in CMT1A patients. Neuromuscul Disord 2014; 24:1003-17. [DOI: 10.1016/j.nmd.2014.06.431] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2014] [Revised: 05/14/2014] [Accepted: 06/03/2014] [Indexed: 12/31/2022]
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21
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Nobbio L, Visigalli D, Mannino E, Fiorese F, Kassack MU, Sturla L, Prada V, De Flora A, Zocchi E, Bruzzone S, Schenone A. The diadenosine homodinucleotide P18 improves in vitro myelination in experimental Charcot-Marie-Tooth type 1A. J Cell Biochem 2014; 115:161-7. [PMID: 23959806 DOI: 10.1002/jcb.24644] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2013] [Accepted: 08/02/2013] [Indexed: 11/05/2022]
Abstract
Charcot-Marie-Tooth 1A (CMT1A) is a demyelinating hereditary neuropathy whose pathogenetic mechanisms are still poorly defined and an etiologic treatment is not yet available. An abnormally high intracellular Ca(2+) concentration ([Ca(2+)]i) occurs in Schwann cells from CMT1A rats (CMT1A SC) and is caused by overexpression of the purinoceptor P2X7. Normalization of the Ca(2+) levels through down-regulation of P2X7 appears to restore the normal phenotype of CMT1A SC in vitro. We recently demonstrated that the diadenosine 5',5'''-P1, P2-diphosphate (Ap2A) isomer P18 behaves as an antagonist of the P2X7 purinergic receptor, effectively blocking channel opening induced by ATP. In addition, P18 behaves as a P2Y11 agonist, inducing cAMP overproduction in P2Y11-overexpressing cells. Here we investigated the in vitro effects of P18 on CMT1A SC. We observed that basal levels of intracellular cAMP ([cAMP]i), a known regulator of SC differentiation and myelination, are significantly lower in CMT1A SC than in wild-type (wt) cells. P18 increased [cAMP]i in both CMT1A and wt SC, and this effects was blunted by NF157, a specific P2Y11 antagonist. Prolonged treatment of organotypic dorsal root ganglia (DRG) cultures with P18 significantly increased expression of myelin protein zero, a marker of myelin production, in both CMT1A and wt cultures. Interestingly, P18 decreased the content of non-phosphorylated neurofilaments, a marker of axonal damage, only in CMT1A DRG cultures. These results suggest that P2X7 antagonists, in combination with [cAMP]i-increasing agents, could represent a therapeutic strategy aimed at correcting the molecular derangements causing the CMT1A phenotype.
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Affiliation(s)
- Lucilla Nobbio
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics and Mother and Child Sciences and CEBR, University of Genova, Genova, Italy
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Lencioni T, Rabuffetti M, Piscosquito G, Pareyson D, Aiello A, Di Sipio E, Padua L, Stra F, Ferrarin M. Postural stabilization and balance assessment in Charcot-Marie-Tooth 1A subjects. Gait Posture 2014; 40:481-6. [PMID: 25082324 PMCID: PMC4180012 DOI: 10.1016/j.gaitpost.2014.07.006] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
The aim of the present study was to assess postural stabilization skill in adult subjects affected by Charcot-Marie-Tooth disease (CMT) type 1A. For this purpose ground reaction force (GRF) was measured by means of a piezoelectric force platform during the sit-to-stand (STS) movement, until a steady state erect posture was achieved. Specific indexes to quantify Centre of Mass acceleration, both during postural stabilization and during quiet standing, were computed using a mathematical model. Forty-seven CMT1A subjects were recruited for the study, and the control group was formed by forty-one age- and sex-matched healthy subjects. The results show that CMT1A subjects are less stable than controls during the quiet stance. Greater difficulty (high values of Yinf, the final instability rate) to maintain erect posture appears to be mainly associated with plantar-flexor muscle weakness, rather than to damage of the proprioceptive system. The worst performances shown by CMT1A subjects in the stabilization phase (high values of I, the global index of postural stabilization performance) seem to be associated with reduced muscle strength and the loss of large sensory nerve fibres. Distal muscle weakness appears to affect both postural stabilization and quiet erect posture. The presented protocol and the analysis of postural stabilization parameters provide useful information on CMT1A balance disorders.
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Affiliation(s)
- T. Lencioni
- Biomedical Technology Department, IRCCS Foundation Don Carlo Gnocchi Onlus, Milano, Italy,Corresponding author at: Fondazione Don Carlo Gnocchi, Via Capecelatro, 66, 20148 Milano, Italy. Tel.: +39 0240308305 8545.
| | - M. Rabuffetti
- Biomedical Technology Department, IRCCS Foundation Don Carlo Gnocchi Onlus, Milano, Italy
| | - G. Piscosquito
- Unit of Clinic of Central and Peripheral Degenerative Neuropathies, IRCCS Foundation, C. Besta Neurological Institute, Milano, Italy
| | - D. Pareyson
- Unit of Clinic of Central and Peripheral Degenerative Neuropathies, IRCCS Foundation, C. Besta Neurological Institute, Milano, Italy
| | - A. Aiello
- Department of Neuroscience, Ophthalmology and Genetics, University of Genoa, Genova, Italy
| | - E. Di Sipio
- Centro S. Maria della Pace, Foundation Don Gnocchi Onlus, Roma, Italy
| | - L. Padua
- Centro S. Maria della Pace, Foundation Don Gnocchi Onlus, Roma, Italy
| | - F. Stra
- Polo Riabilitativo del Levante Ligure, Foundation Don Gnocchi Onlus, Sarzana, Italy
| | - M. Ferrarin
- Biomedical Technology Department, IRCCS Foundation Don Carlo Gnocchi Onlus, Milano, Italy
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Nobbio L, Visigalli D, Radice D, Fiorina E, Solari A, Lauria G, Reilly MM, Santoro L, Schenone A, Pareyson D. PMP22 messenger RNA levels in skin biopsies: testing the effectiveness of a Charcot-Marie-Tooth 1A biomarker. Brain 2014; 137:1614-20. [PMID: 24812204 DOI: 10.1093/brain/awu071] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Charcot-Marie-Tooth disease type 1A (CMT1A) is associated with increased gene dosage for PMP22. Therapeutic approaches are currently aiming at correcting PMP22 over-expression. It is unknown whether PMP22 can be used as a biological marker of disease progression and therapy efficacy. We performed quantitative real-time polymerase chain reaction on skin biopsies of 45 patients with CMT1A, obtained at study entry and after 24-months of treatment either with ascorbic acid or placebo. Data of a subgroup of patients were also compared with matched healthy subjects. Finally, we analysed PMP22 messenger RNA levels in sural nerve biopsies. We did not find significant differences in the levels of any known PMP22 transcripts in treated or untreated patients with CMT1A, thus confirming that ascorbic acid does not impact on the molecular features of CMT1A. Most importantly, we did not observe any correlation between PMP22 messenger RNA levels and the different clinical and electrophysiological outcome measures, underscoring the weakness of PMP22 to mirror the phenotypic variability of patients with CMT1A. We did not find increased PMP22 messenger RNA levels in skin and sural nerve biopsies of patients with CMT1A compared with relative controls. In conclusion, this study shows that ascorbic acid does not impact on PMP22 transcriptional regulation and PMP22 is not a suitable biomarker for CMT1A.
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Affiliation(s)
- Lucilla Nobbio
- 1 Department of Neurosciences, Rehabilitation Ophthalmology, Genetics and Maternal-Infantile Sciences (DINOGMI), University of Genoa, Largo P. Daneo 3, 16132 Genoa, Italy
| | - Davide Visigalli
- 1 Department of Neurosciences, Rehabilitation Ophthalmology, Genetics and Maternal-Infantile Sciences (DINOGMI), University of Genoa, Largo P. Daneo 3, 16132 Genoa, Italy
| | - Davide Radice
- 2 Department of Epidemiology and Biostatistics, European Institute of Oncology, Via G. Ripamonti 435, 20141 Milan, Italy
| | - Elisabetta Fiorina
- 1 Department of Neurosciences, Rehabilitation Ophthalmology, Genetics and Maternal-Infantile Sciences (DINOGMI), University of Genoa, Largo P. Daneo 3, 16132 Genoa, Italy
| | - Alessandra Solari
- 3 Unit of Neuroepidemiology, IRCCS Foundation, C. Besta Neurological Institute, Via Celoria 11, 20133 Milan, Italy
| | - Giuseppe Lauria
- 4 Headache and Pain Syndromes Unit, IRCCS Foundation, C. Besta Neurological Institute, Via Celoria 11, 20133 Milan, Italy
| | - Mary M Reilly
- 5 MRC Centre for Neuromuscular Diseases, UCL Institute of Neurology and National Hospital for Neurology and Neurosurgery, Queen Square, London WC1N 3BG, UK
| | - Lucio Santoro
- 6 Department of Neurosciences, Reproductive Sciences and Odontostomatology, University "Federico II", Corso Umberto I 40, 80138 Naples, Italy
| | - Angelo Schenone
- 1 Department of Neurosciences, Rehabilitation Ophthalmology, Genetics and Maternal-Infantile Sciences (DINOGMI), University of Genoa, Largo P. Daneo 3, 16132 Genoa, Italy
| | - Davide Pareyson
- 7 Clinic of Central and Peripheral Degenerative Neuropathies Unit, IRCCS Foundation, C. Besta Neurological Institute, Via Celoria 11, 20133 Milan, Italy
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Prukop T, Epplen D, Nientiedt T, Wichert S, Fledrich R, Stassart R, Rossner M, Edgar J, Werner H, Nave KA, Sereda M. Progesterone antagonist therapy in a Pelizaeus-Merzbacher mouse model. Am J Hum Genet 2014; 94:533-46. [PMID: 24680886 DOI: 10.1016/j.ajhg.2014.03.001] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2013] [Accepted: 03/04/2014] [Indexed: 10/25/2022] Open
Abstract
Pelizaeus-Merzbacher disease (PMD) is a severe hypomyelinating disease, characterized by ataxia, intellectual disability, epilepsy, and premature death. In the majority of cases, PMD is caused by duplication of PLP1 that is expressed in myelinating oligodendrocytes. Despite detailed knowledge of PLP1, there is presently no curative therapy for PMD. We used a Plp1 transgenic PMD mouse model to test the therapeutic effect of Lonaprisan, an antagonist of the nuclear progesterone receptor, in lowering Plp1 mRNA overexpression. We applied placebo-controlled Lonaprisan therapy to PMD mice for 10 weeks and performed the grid slip analysis to assess the clinical phenotype. Additionally, mRNA expression and protein accumulation as well as histological analysis of the central nervous system were performed. Although Plp1 mRNA levels are increased 1.8-fold in PMD mice compared to wild-type controls, daily Lonaprisan treatment reduced overexpression at the RNA level to about 1.5-fold, which was sufficient to significantly improve the poor motor phenotype. Electron microscopy confirmed a 25% increase in the number of myelinated axons in the corticospinal tract when compared to untreated PMD mice. Microarray analysis revealed the upregulation of proapoptotic genes in PMD mice that could be partially rescued by Lonaprisan treatment, which also reduced microgliosis, astrogliosis, and lymphocyte infiltration.
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25
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Alvarez S, Moldovan M, Krarup C. Prolonged high frequency electrical stimulation is lethal to motor axons of mice heterozygously deficient for the myelin protein P0 gene. Exp Neurol 2013; 247:552-61. [DOI: 10.1016/j.expneurol.2013.02.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2012] [Revised: 02/09/2013] [Accepted: 02/13/2013] [Indexed: 10/27/2022]
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Biopsy in a patient with PMP22 exon 2 mutation recapitulates pathology of Trembler-J mouse. Neuromuscul Disord 2013; 23:345-8. [DOI: 10.1016/j.nmd.2012.12.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2012] [Revised: 11/07/2012] [Accepted: 12/11/2012] [Indexed: 01/13/2023]
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Wilmshurst JM. Diagnosis and management of pediatric peripheral neuropathies in resource-poor settings. FUTURE NEUROLOGY 2013. [DOI: 10.2217/fnl.12.97] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
The diagnosis of a peripheral neuropathy in a child who resides in the majority of resource-poor settings is based on the history taken and the clinical examination. The majority of children, unless they demonstrate additional clinical markers, will lack a more definitive diagnosis beyond the label ‘peripheral neuropathy’. The treatable, typically acquired conditions, which are prevalent in these settings, are the priority to identify. This would include neuroinfections, neuroinflammation, toxins and vitamin deficiencies. The management of children with peripheral neuropathies in resource-poor settings must be approached in a different manner to that of more ‘resource-equipped’ settings. Secondary or tertiary centers are scarce, often significant distances away from the patient, and this leads to long delays before access is possible. Most children present to primary healthcare settings and are seen by practitioners with little training in the features suggestive of a peripheral neuropathy. As such, basic aids to assist the healthcare worker in the early recognition and interventions of a child with a peripheral neuropathy are important. In addition, there must be recognition of the child with a rapidly progressive neuropathy where a life-threatening condition is present, and urgent referral to a tertiary setting made wherever possible.
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Affiliation(s)
- Jo M Wilmshurst
- Pediatric Neurology Department, Red Cross War Memorial Children’s Hospital, University of Cape Town, 7700, Cape Town, South Africa
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Cogli L, Progida C, Thomas CL, Spencer-Dene B, Donno C, Schiavo G, Bucci C. Charcot-Marie-Tooth type 2B disease-causing RAB7A mutant proteins show altered interaction with the neuronal intermediate filament peripherin. Acta Neuropathol 2013; 125:257-72. [PMID: 23179371 PMCID: PMC3549248 DOI: 10.1007/s00401-012-1063-8] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2012] [Revised: 10/29/2012] [Accepted: 10/29/2012] [Indexed: 12/13/2022]
Abstract
Charcot-Marie-Tooth type 2B (CMT2B) is a peripheral ulcero-mutilating neuropathy caused by four missense mutations in the rab7a gene. CMT2B is clinically characterized by prominent sensory loss, distal muscle weakness leading to muscle atrophy, high frequency of foot ulcers and infections that often results in toe amputations. RAB7A is a ubiquitous small GTPase, which controls transport to late endocytic compartments. Although the biochemical and functional properties of disease-causing RAB7A mutant proteins have been investigated, it is not yet clear how the disease originates. To understand how mutations in a ubiquitous protein specifically affect peripheral neurons, we performed a two-hybrid screen using a dorsal root ganglia cDNA library with the purpose of identifying RAB7A interactors specific for these cells. We identified peripherin, an intermediate filament protein expressed primarily in peripheral neurons, as a putative RAB7A interacting protein. The interaction was confirmed by co-immunoprecipitation and pull-down experiments, and established that the interaction is direct using recombinant proteins. Silencing or overexpression of wild type RAB7A changed the soluble/insoluble rate of peripherin indicating that RAB7A is important for peripherin organization and function. In addition, disease-causing RAB7A mutant proteins bind more strongly to peripherin and their expression causes a significant increase in the amount of soluble peripherin. Since peripherin plays a role not only in neurite outgrowth during development but also in axonal regeneration after injury, these data suggest that the altered interaction between disease-causing RAB7A mutants and peripherin could play an important role in CMT2B neuropathy.
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Affiliation(s)
- Laura Cogli
- Department of Biological and Environmental Sciences and Technologies (DiSTeBA), University of Salento, Via Provinciale Monteroni 165, 73100 Lecce, Italy
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29
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Evliyaoglu F, Karadag R, Burakgazi AZ. Ocular neuropathy in peripheral neuropathies. Muscle Nerve 2012; 46:681-6. [PMID: 23055310 DOI: 10.1002/mus.23414] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Ocular movements and coordination require complex and integrated functions of somatic and autonomic nervous systems. Neurological disorders affecting these nervous systems may cause ocular dysfunction involving extraocular muscles and pupils. In this article, the prevalence, clinical presentations, and management of ocular neuropathy related to certain peripheral neuropathies, including diabetic neuropathy, Guillain-Barré syndrome (GBS), chronic inflammatory neuropathies, human immunodeficiency virus (HIV)-associated neuropathy, and hereditary neuropathies, are examined in detail.
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Affiliation(s)
- Ferhat Evliyaoglu
- Department of Ophthalmology, Okmeydani Research and Training Hospital, Istanbul, Turkey
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Abstract
PURPOSE OF REVIEW The inherited peripheral neuropathies are a complex group of disorders caused by mutations in more than 50 genes. Scientifically, these disorders provide extensive information on molecular pathways that cause demyelination, axonal loss, and abnormal interactions between Schwann cells and the axons they ensheathe. Clinically, however, these neuropathies are confusing because it is difficult to determine what gene to test for in a given patient, inheritance patterns may differ among patients, and genetic testing is expensive. This review provides a biological context and guidelines to help neurologists better understand the basis and focus of genetic testing for these disorders. RECENT FINDINGS In the past 5 years, many of the genetic causes of inherited neuropathies have been discovered and the phenotypes of inherited neuropathies have been characterized. Clinical trials of genetic neuropathies are now underway. SUMMARY It is hoped that this review will lead to a better understanding of these fascinating neuropathies for health care professionals and that this improved understanding will facilitate treatment advances for these presently untreatable diseases.
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Affiliation(s)
- Agnes Patzko
- Wayne State University, Detroit, Michigan 48201, USA
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31
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Fledrich R, Stassart RM, Sereda MW. Murine therapeutic models for Charcot-Marie-Tooth (CMT) disease. Br Med Bull 2012; 102:89-113. [PMID: 22551516 DOI: 10.1093/bmb/lds010] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
INTRODUCTION OR BACKGROUND Charcot-Marie-Tooth (CMT) disease represents a broad group of inherited motor and sensory neuropathies which can originate from various genetic aberrations, e.g. mutations, deletions and duplications. SOURCES OF DATA We performed a literature review on murine animal models of CMT disease with regard to experimental therapeutic approaches. Hereby, we focussed on the demyelinating subforms of CMT (CMT1). PubMed items were CMT, animal model, demyelination and therapy. AREAS OF AGREEMENT Patients affected by CMT suffer from slowly progressive, distally pronounced muscle atrophy caused by an axonal loss. The disease severity is highly variable and impairments may result in wheelchair boundness. No therapy is available yet. AREAS OF CONTROVERSY Numerous rodent models for the various CMT subtypes are available today. The selection of the correct animal model for the specific CMT subtype provides an important prerequisite for the successful translation of experimental findings in patients. GROWING POINTS Despite more than 20 years of remarkable progress in CMT research, the disease is still left untreatable. There is a growing number of experimental therapeutic strategies that may be translated into future clinical trials in patients with CMT. AREAS TIMELY FOR DEVELOPING RESEARCH The slow disease progression and insensitive outcome measures hamper clinical therapy trials in CMT. Biomarkers may provide powerful tools to monitor therapeutic efficacy. Recently, we have shown that transcriptional profiling can be utilized to assess and predict the disease severity in a transgenic rat model and in affected humans.
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Affiliation(s)
- Robert Fledrich
- Research Group 'Molecular and Translational Neurology', Department of Neurogenetics, Max-Planck-Institute of Experimental Medicine, Göttingen, Germany
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Bucci C, Bakke O, Progida C. Charcot-Marie-Tooth disease and intracellular traffic. Prog Neurobiol 2012; 99:191-225. [PMID: 22465036 PMCID: PMC3514635 DOI: 10.1016/j.pneurobio.2012.03.003] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2011] [Revised: 12/23/2011] [Accepted: 03/13/2012] [Indexed: 12/23/2022]
Abstract
Mutations of genes whose primary function is the regulation of membrane traffic are increasingly being identified as the underlying causes of various important human disorders. Intriguingly, mutations in ubiquitously expressed membrane traffic genes often lead to cell type- or organ-specific disorders. This is particularly true for neuronal diseases, identifying the nervous system as the most sensitive tissue to alterations of membrane traffic. Charcot-Marie-Tooth (CMT) disease is one of the most common inherited peripheral neuropathies. It is also known as hereditary motor and sensory neuropathy (HMSN), which comprises a group of disorders specifically affecting peripheral nerves. This peripheral neuropathy, highly heterogeneous both clinically and genetically, is characterized by a slowly progressive degeneration of the muscle of the foot, lower leg, hand and forearm, accompanied by sensory loss in the toes, fingers and limbs. More than 30 genes have been identified as targets of mutations that cause CMT neuropathy. A number of these genes encode proteins directly or indirectly involved in the regulation of intracellular traffic. Indeed, the list of genes linked to CMT disease includes genes important for vesicle formation, phosphoinositide metabolism, lysosomal degradation, mitochondrial fission and fusion, and also genes encoding endosomal and cytoskeletal proteins. This review focuses on the link between intracellular transport and CMT disease, highlighting the molecular mechanisms that underlie the different forms of this peripheral neuropathy and discussing the pathophysiological impact of membrane transport genetic defects as well as possible future ways to counteract these defects.
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Affiliation(s)
- Cecilia Bucci
- Department of Biological and Environmental Sciences and Technologies (DiSTeBA), University of Salento, Via Provinciale Monteroni, 73100 Lecce, Italy.
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Nakagawa M. [Therapeutic strategies for Charcot-Marie-Tooth disease]. Rinsho Shinkeigaku 2012; 51:1015-8. [PMID: 22277462 DOI: 10.5692/clinicalneurol.51.1015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Recently, causative gene discovery and genetic diagnosis system for Charcot-Marie-Tooth disease (CMT) have been rapidly developed. These genetic information and research progress, however, have not been informed to medical staff and CMT patients. CMT-Japan, which is an association of Japanese CMT patients, has been organized in 2008. Many of CMTJ members have not been diagnosed genetically. Most of medical staff and CMT patients may imagine that there is no hope for the CMT feature. Research on CMT therapy, however, has been progressing such as clinical trial of ascorbic acid, and experimental trial of curcumin and antiprogesterone. The development of robot technology and brain machine interface open a new way of therapy for CMT. Elucidation of molecular mechanisms and finding of effective treatments for CMT using cell culture, iPS cell, animal model, agents to suppress PMP22 expression, and read-through of stop codon methods are expected in the near features. In addition, development of surrogate markers, improvement of clinical trial design, establishment of nationwide diagnostic system, and assessment of natural history with international collaboration study must be done as soon as possible. CMT management manual, review of CMT research, open seminar for CMT, and genetic counseling are essential to improve the medical management for CMT. The collaboration among medical engineers, neurophysiologists, rehabilitation team, orthopedist, neurologists, genetic researchers and CMT patients and their families is of cardinal importance to achieve these studies for CMT.
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Affiliation(s)
- Masanori Nakagawa
- Department of Neurology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine
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Abstract
PURPOSE OF REVIEW The aim is to review the most relevant findings published during the last year concerning clinical, genetic, pathogenic, and therapeutic advances in motor neuron disease, neuropathies, and neuromuscular junction disorders. RECENT FINDINGS Studies on animal and cell models have improved the understanding of how mutated survival motor neuron protein in spinal muscular atrophy governs the pathogenetic processes. New phenotypes of SOD1 mutations have been described. Moreover, animal models enhanced the insight into the pathogenetic background of sporadic and familial amyotrophic lateral sclerosis. Novel treatment options for motor neuron disease have been described in humans and animal models. Considerable progress has been achieved also in elucidating the genetic background of many forms of inherited neuropathies and high clinical and genetic heterogeneity has been demonstrated. Mutations in MuSK and GFTP1 have been shown to cause new types of congenital myasthenic syndromes. A third type of autoantibodies (Lrp4) has been detected to cause myasthenia gravis. SUMMARY Advances in the clinical and genetic characterization of motor neuron diseases, neuropathies, and neuromuscular transmission defects have important implications on the fundamental understanding, diagnosis, and management of these disorders. Identification of crucial steps of the pathogenetic process may provide the basis for the development of novel therapeutic strategies.
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Groh J, Weis J, Zieger H, Stanley ER, Heuer H, Martini R. Colony-stimulating factor-1 mediates macrophage-related neural damage in a model for Charcot-Marie-Tooth disease type 1X. Brain 2012; 135:88-104. [PMID: 22094537 PMCID: PMC3267979 DOI: 10.1093/brain/awr283] [Citation(s) in RCA: 64] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2011] [Revised: 08/19/2011] [Accepted: 08/26/2011] [Indexed: 12/22/2022] Open
Abstract
Previous studies in our laboratory have shown that in models for three distinct forms of the inherited and incurable nerve disorder, Charcot-Marie-Tooth neuropathy, low-grade inflammation implicating phagocytosing macrophages mediates demyelination and perturbation of axons. In the present study, we focus on colony-stimulating factor-1, a cytokine implicated in macrophage differentiation, activation and proliferation and fostering neural damage in a model for Charcot-Marie-Tooth neuropathy 1B. By crossbreeding a model for the X-linked form of Charcot-Marie-Tooth neuropathy with osteopetrotic mice, a spontaneous null mutant for colony-stimulating factor-1, we demonstrate a robust and persistent amelioration of demyelination and axon perturbation. Furthermore, functionally important domains of the peripheral nervous system, such as juxtaparanodes and presynaptic terminals, were preserved in the absence of colony-stimulating factor-1-dependent macrophage activation. As opposed to other Schwann cell-derived cytokines, colony-stimulating factor-1 is expressed by endoneurial fibroblasts, as revealed by in situ hybridization, immunocytochemistry and detection of β-galactosidase expression driven by the colony-stimulating factor-1 promoter. By both light and electron microscopic studies, we detected extended cell-cell contacts between the colony-stimulating factor-1-expressing fibroblasts and endoneurial macrophages as a putative prerequisite for the effective and constant activation of macrophages by fibroblasts in the chronically diseased nerve. Interestingly, in human biopsies from patients with Charcot-Marie-Tooth type 1, we also found frequent cell-cell contacts between macrophages and endoneurial fibroblasts and identified the latter as main source for colony-stimulating factor-1. Therefore, our study provides strong evidence for a similarly pathogenic role of colony-stimulating factor-1 in genetically mediated demyelination in mice and Charcot-Marie-Tooth type 1 disease in humans. Thus, colony-stimulating factor-1 or its cognate receptor are promising target molecules for treating the detrimental, low-grade inflammation of several inherited neuropathies in humans.
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Affiliation(s)
- Janos Groh
- Department of Neurology, Section of Developmental Neurobiology, University of Würzburg, Josef-Schneiderstr. 11, 97080 Würzburg, Germany
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