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Xiao X, Li M, Ye Z, He X, Wei J, Zha Y. FUS gene mutation in amyotrophic lateral sclerosis: a new case report and systematic review. Amyotroph Lateral Scler Frontotemporal Degener 2024; 25:1-15. [PMID: 37926865 DOI: 10.1080/21678421.2023.2272170] [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: 07/27/2023] [Accepted: 10/08/2023] [Indexed: 11/07/2023]
Abstract
OBJECTIVE Amyotrophic lateral sclerosis (ALS) is a fatal neurodegenerative disease associated with upper and lower motor neuron degeneration and necrosis, characterized by progressive muscle weakness, atrophy, and paralysis. The FUS mutation-associated ALS has been classified as ALS6. We reported a case of ALS6 with de novo mutation and investigated retrospectively the characteristics of cases with FUS mutation. METHODS We reported a male patient with a new heterozygous variant of the FUS gene and comprehensively reviewed 173 ALS cases with FUS mutation. The literature was reviewed from the PubMed MEDLINE electronic database (https://www.ncbi.nlm.nih.gov/pubmed) using "Amyotrophic Lateral Sclerosis and Fus mutation" or "Fus mutation" as key words from 1 January 2009 to 1 January 2022. RESULTS We report a case of ALS6 with a new mutation point (c.1225-1227delGGA) and comprehensively review 173 ALS cases with FUS mutation. Though ALS6 is all with FUS mutation, it is still a highly heterogenous subtype. The average onset age of ALS6 is 35.2 ± 1.3 years, which is much lower than the average onset age of ALS (60 years old). Juvenile FUS mutations have an aggressive progression of disease, with an average time from onset to death or tracheostomy of 18.2 ± 0.5 months. FUS gene has the characteristics of early onset, faster progress, and shorter survival, especially in deletion mutation p.G504Wfs *12 and missense mutation of p.P525L. CONCLUSIONS ALS6 is a highly heterogenous subtype. Our study could allow clinicians to better understand the non-ALS typical symptoms, phenotypes, and pathophysiology of ALS6.
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Affiliation(s)
- Xin Xiao
- Department of Neurology, Yichang Central Hospital, Institute of Neural Regeneration and Repair, College of Basic Medical Science, China Three Gorges University, Yichang, China and
| | - Min Li
- Department of Neurology, Yichang Central Hospital, Institute of Neural Regeneration and Repair, College of Basic Medical Science, China Three Gorges University, Yichang, China and
- Third-grade Pharmacological Laboratory on Traditional Chinese Medicine, State Administration of Traditional Chinese Medicine, China Three Gorges University, Yichang, China
| | - Zhi Ye
- Department of Neurology, Yichang Central Hospital, Institute of Neural Regeneration and Repair, College of Basic Medical Science, China Three Gorges University, Yichang, China and
| | - Xiaoyan He
- Department of Neurology, Yichang Central Hospital, Institute of Neural Regeneration and Repair, College of Basic Medical Science, China Three Gorges University, Yichang, China and
| | - Jun Wei
- Department of Neurology, Yichang Central Hospital, Institute of Neural Regeneration and Repair, College of Basic Medical Science, China Three Gorges University, Yichang, China and
| | - Yunhong Zha
- Department of Neurology, Yichang Central Hospital, Institute of Neural Regeneration and Repair, College of Basic Medical Science, China Three Gorges University, Yichang, China and
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Shimizu T, Nakayama Y, Hayashi K, Mochizuki Y, Matsuda C, Haraguchi M, Bokuda K, Komori T, Takahashi K. Somatosensory pathway dysfunction in patients with amyotrophic lateral sclerosis in a completely locked-in state. Clin Neurophysiol 2023; 156:253-261. [PMID: 37827876 DOI: 10.1016/j.clinph.2023.09.004] [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: 06/25/2023] [Revised: 08/11/2023] [Accepted: 09/01/2023] [Indexed: 10/14/2023]
Abstract
OBJECTIVE To investigate somatosensory pathway function in patients with amyotrophic lateral sclerosis (ALS) dependent on invasive ventilation and in a completely locked-in state (CLIS). METHODS We examined median nerve somatosensory evoked potentials (SEPs) in 17 ALS patients in a CLIS, including 11 patients with sporadic ALS, one with familial ALS with genes not examined, four with a Cu/Zn superoxide-dismutase-1 (SOD1) gene variant (Val118Leu, Gly93Ser, Cys146Arg), and one with a fused-in-sarcoma gene variant (P525L). We evaluated N9, N13, N20 and P25, and central conduction time (CCT); the data were compared with those of 73 healthy controls. RESULTS N20 and N13 were abolished in 12 and 10 patients, and their latencies was prolonged in four and three patients, respectively. The CCT was prolonged in five patients with measurable N13 and N20. Two patients with SOD1 gene mutations had absent or slightly visible N9. Compared to the CCT and latencies and amplitudes of N13 and N20 in the controls, those in the patient cohort were significantly abnormal. CONCLUSIONS The central somatosensory pathway is severely involved in patients with ALS in a CLIS. SIGNIFICANCE Our findings suggest that median nerve SEP cannot be utilized for communication in patients with ALS in a CLIS.
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Affiliation(s)
- Toshio Shimizu
- Department of Neurology, Tokyo Metropolitan Neurological Hospital, Tokyo, Japan.
| | - Yuki Nakayama
- Unit for Intractable Disease Nursing Care, Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan
| | - Kentaro Hayashi
- Department of Neurology, Tokyo Metropolitan Neurological Hospital, Tokyo, Japan; Department of Neurology, Tokyo Metropolitan Matsuzawa Hospital, Tokyo, Japan
| | - Yoko Mochizuki
- Department of Neurology, Tokyo Metropolitan Kita Medical and Rehabilitation Center for the Disabled, Tokyo, Japan
| | - Chiharu Matsuda
- Unit for Intractable Disease Nursing Care, Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan
| | - Michiko Haraguchi
- Unit for Intractable Disease Nursing Care, Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan
| | - Kota Bokuda
- Department of Neurology, Tokyo Metropolitan Neurological Hospital, Tokyo, Japan
| | - Takashi Komori
- Department of Neuropathology, Tokyo Metropolitan Neurological Hospital, Tokyo, Japan
| | - Kazushi Takahashi
- Department of Neurology, Tokyo Metropolitan Neurological Hospital, Tokyo, Japan
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3
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Ali Z, Godoy-Corchuelo JM, Martins-Bach AB, Garcia-Toledo I, Fernández-Beltrán LC, Nair RR, Spring S, Nieman BJ, Jimenez-Coca I, Bains RS, Forrest H, Lerch JP, Miller KL, Fisher EMC, Cunningham TJ, Corrochano S. Mutation in the FUS nuclear localisation signal domain causes neurodevelopmental and systemic metabolic alterations. Dis Model Mech 2023; 16:dmm050200. [PMID: 37772684 PMCID: PMC10642611 DOI: 10.1242/dmm.050200] [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: 03/21/2023] [Accepted: 08/29/2023] [Indexed: 09/30/2023] Open
Abstract
Variants in the ubiquitously expressed DNA/RNA-binding protein FUS cause aggressive juvenile forms of amyotrophic lateral sclerosis (ALS). Most FUS mutation studies have focused on motor neuron degeneration; little is known about wider systemic or developmental effects. We studied pleiotropic phenotypes in a physiological knock-in mouse model carrying the pathogenic FUSDelta14 mutation in homozygosity. RNA sequencing of multiple organs aimed to identify pathways altered by the mutant protein in the systemic transcriptome, including metabolic tissues, given the link between ALS-frontotemporal dementia and altered metabolism. Few genes were commonly altered across all tissues, and most genes and pathways affected were generally tissue specific. Phenotypic assessment of mice revealed systemic metabolic alterations related to the pathway changes identified. Magnetic resonance imaging brain scans and histological characterisation revealed that homozygous FUSDelta14 brains were smaller than heterozygous and wild-type brains and displayed significant morphological alterations, including a thinner cortex, reduced neuronal number and increased gliosis, which correlated with early cognitive impairment and fatal seizures. These findings show that the disease aetiology of FUS variants can include both neurodevelopmental and systemic alterations.
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Affiliation(s)
- Zeinab Ali
- Neurological Disorders Group, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria Hospital Clínico San Carlos (IdiSSC), Madrid 28040, Spain
- Department of Physiology, Anatomy and Genetics, University of Oxford, Oxford OX1 3PT, UK
- Mammalian Genetics Unit, MRC Harwell Institute, Didcot, Oxfordshire OX11 ORD, UK
| | - Juan M. Godoy-Corchuelo
- Neurological Disorders Group, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria Hospital Clínico San Carlos (IdiSSC), Madrid 28040, Spain
| | - Aurea B. Martins-Bach
- Wellcome Centre for Integrative Neuroimaging, University of Oxford, Oxford OX3 9D, UK
| | - Irene Garcia-Toledo
- Neurological Disorders Group, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria Hospital Clínico San Carlos (IdiSSC), Madrid 28040, Spain
| | - Luis C. Fernández-Beltrán
- Neurological Disorders Group, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria Hospital Clínico San Carlos (IdiSSC), Madrid 28040, Spain
- Department of Medicine, Universidad Complutense de Madrid, Madrid 28040, Spain
| | - Remya R. Nair
- Department of Physiology, Anatomy and Genetics, University of Oxford, Oxford OX1 3PT, UK
- Mammalian Genetics Unit, MRC Harwell Institute, Didcot, Oxfordshire OX11 ORD, UK
| | - Shoshana Spring
- Mouse Imaging Centre, The Hospital for Sick Children, Toronto, ON M57 3H7, Canada
| | - Brian J. Nieman
- Mouse Imaging Centre, The Hospital for Sick Children, Toronto, ON M57 3H7, Canada
| | - Irene Jimenez-Coca
- Neurological Disorders Group, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria Hospital Clínico San Carlos (IdiSSC), Madrid 28040, Spain
| | - Rasneer S. Bains
- Mary Lyon Centre at MRC Harwell, Didcot, Oxfordshire OX11 ORD, UK
| | - Hamish Forrest
- Mary Lyon Centre at MRC Harwell, Didcot, Oxfordshire OX11 ORD, UK
| | - Jason P. Lerch
- Wellcome Centre for Integrative Neuroimaging, University of Oxford, Oxford OX3 9D, UK
| | - Karla L. Miller
- Wellcome Centre for Integrative Neuroimaging, University of Oxford, Oxford OX3 9D, UK
| | - Elizabeth M. C. Fisher
- Department of Neuromuscular Diseases, UCL Queen Square Institute of Neurology, London WC1N 3BG, UK
| | - Thomas J. Cunningham
- Mammalian Genetics Unit, MRC Harwell Institute, Didcot, Oxfordshire OX11 ORD, UK
- MRC Prion Unit at UCL, UCL Institute of Prion Diseases, University College London, London W1W 7FF, UK
| | - Silvia Corrochano
- Neurological Disorders Group, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria Hospital Clínico San Carlos (IdiSSC), Madrid 28040, Spain
- Mammalian Genetics Unit, MRC Harwell Institute, Didcot, Oxfordshire OX11 ORD, UK
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Goldstein O, Inbar T, Kedmi M, Gana-Weisz M, Abramovich B, Orr-Urtreger A, Drory VE. FUS-P525L Juvenile Amyotrophic Lateral Sclerosis and Intellectual Disability. Neurol Genet 2022; 8:e200009. [PMID: 35812163 PMCID: PMC9258982 DOI: 10.1212/nxg.0000000000200009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Accepted: 05/10/2022] [Indexed: 11/25/2022]
Abstract
Background and Objectives Amyotrophic lateral sclerosis (ALS) is characterized by upper and lower motor neuron degeneration, with juvenile ALS (jALS) defined as disease with age at onset (AAO) before 25 years. We aimed to identify the genetic basis of 2 unrelated patients with jALS with very rapid deterioration and early age intellectual disability (ID) and to assess association of genetic findings with both phenotypes in a large cohort of patients with ALS and controls, and in the literature. Methods Exome sequencing was performed in 2 unrelated probands and their parents. Trio analyses included de novo, rare homozygosity, and compound heterozygosity analyses. A TaqMan genotyping assay was used to genotype ALS cohorts. A systematic literature review was conducted and additional information from authors obtained to assess prevalence of fused in sarcoma (FUS)-ALS associated with ID. Results A de novo mutation FUS-P525L was identified in both patients. Additional variations were identified in other genes related to intellectual disabilities. Among 8 additional unrelated juvenile patients, one carried the same FUS mutation and had a similar medical history of mild ID and fulminant ALS, whereas the others did not carry any FUS coding mutations and had no reported learning or intellectual disabilities (p = 0.0083). In addition, 486 patients with ALS with AAO ≥25 years were negative for this mutation. An extensive literature review showed that among all patients with FUS-related ALS with full phenotype reports, 10.3% exhibited additional learning/intellectual disabilities. Discussion FUS-P525L mutation was identified in 3 among 10 patients with jALS (30%) in our clinical cohort, all with a very aggressive disease course and ID. Together with literature reports, these results support a novel association between mutations in FUS and early life ID. Additional variations identified in genes related to ID and brain development in our patients (GPT2, DNAH10, and SCUBE2) may suggest a complex oligogenic inheritance for this phenotype. We propose that this mutation should be screened in patients with ALS with very early AAO, aggressive disease course, and sporadic occurrence, especially when ALS is accompanied by ID.
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Basu S, Rajendra KC, Alagar S, Bahadur RP. Impaired nuclear transport induced by juvenile ALS causing P525L mutation in NLS domain of FUS: A molecular mechanistic study. BIOCHIMICA ET BIOPHYSICA ACTA. PROTEINS AND PROTEOMICS 2022; 1870:140766. [PMID: 35134572 DOI: 10.1016/j.bbapap.2022.140766] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Revised: 01/15/2022] [Accepted: 01/28/2022] [Indexed: 12/30/2022]
Abstract
Amyotrophic lateral sclerosis (ALS) and fronto-temporal lobar degeneration (FTLD) are progressive neurological disorders affecting motor neurons. Cellular aggregates of fused in sarcoma (FUS) protein are found in cytoplasm of ALS and FTLD patients. Nuclear localisation signal (NLS) domain of FUS binds to Karyopherin β2 (Kapβ2), which drives nuclear transport of FUS from cytoplasm. Several pathogenic mutations are reported in FUS NLS, which are associated with its impaired nuclear transport and cytoplasmic mis-localisation. P525L mutation in NLS is most commonly found in cases of juvenile ALS (jALS), which affects individuals below 25 years of age. jALS progresses aggressively causing death within a year of its onset. This study elucidates the molecular mechanism behind jALS-causing P525L mutation hindering nuclear transport of FUS. We perform multiple molecular dynamics simulations in aqueous and hydrophobic solvent to understand the effect of the mutation at molecular level. Dynamics of Kapβ2-FUS complex is better captured in hydrophobic solvent compared to aqueous solvent. P525 and Y526 (PY-motif) of NLS exhibit fine-tuned stereochemical arrangement, which is essential for optimum Kapβ2 binding. P525L causes loss of several native contacts at interface leading to weaker binding, which promotes self-aggregation of FUS in cytoplasm. Native complex samples closed conformation, while mutant complex exhibits open conformation exposing hydrophilic residues of Kapβ2 to hydrophobic solvent. Mutant complex also fails to exhibit spring-like motion essential for its transport through nuclear pore complex. This study provides a mechanistic insight of binding affinity between NLS and Kapβ2 that inhibits self-aggregation of FUS preventing the disease condition.
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Affiliation(s)
- Sushmita Basu
- Computational Structural Biology Lab, Department of Biotechnology, Indian Institute of Technology Kharagpur, Kharagpur 721302, India
| | - K C Rajendra
- Computational Structural Biology Lab, Department of Biotechnology, Indian Institute of Technology Kharagpur, Kharagpur 721302, India
| | - Suresh Alagar
- Computational Structural Biology Lab, Department of Biotechnology, Indian Institute of Technology Kharagpur, Kharagpur 721302, India
| | - Ranjit Prasad Bahadur
- Computational Structural Biology Lab, Department of Biotechnology, Indian Institute of Technology Kharagpur, Kharagpur 721302, India.
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6
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Lu T, Yang J, Luo L, Wei D. FUS mutations in Asian amyotrophic lateral sclerosis patients: a case report and literature review of genotype-phenotype correlations. Amyotroph Lateral Scler Frontotemporal Degener 2022; 23:580-584. [PMID: 35232295 DOI: 10.1080/21678421.2021.2023189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
Amyotrophic lateral sclerosis (ALS) is a fatal neurodegenerative disease characterized by progressive weakness and muscular atrophy in the upper or lower limbs, ultimately leading to paralysis and death. Genetic studies have demonstrated that mutation in the gene encoding fused in sarcoma (FUS) is an uncommon cause of ALS. Here, we report a case of a 31-year-old Asian man with ALS with rare onset of dropped-head syndrome. Symptoms, including asymmetric proximal weakness of the upper limbs, hoarseness, dysphagia, and nocturnal dyspnea, emerged over a period of 5 months. After genetic testing, the patient was confirmed to harbor a novel pathogenic heterozygous mutation, c.1558C > T (p.R520C). We summarize the genotype-clinical phenotype relationships in 42 Asian patients with ALS-FUS.
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Affiliation(s)
- Ting Lu
- Department of Neurology, The First Hospital of Wuhan, Wuhan, PR China.,The First Clinical Medical Institute, Hubei University of Traditional Chinese Medicine, Wuhan, PR China
| | - Jie Yang
- Department of Neurology, The First Hospital of Wuhan, Wuhan, PR China
| | - Lijun Luo
- Department of Neurology, The First Hospital of Wuhan, Wuhan, PR China
| | - Dongsheng Wei
- Department of Neurology, The First Hospital of Wuhan, Wuhan, PR China
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7
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Genetic architecture of motor neuron diseases. J Neurol Sci 2021; 434:120099. [PMID: 34965490 DOI: 10.1016/j.jns.2021.120099] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Revised: 11/26/2021] [Accepted: 12/14/2021] [Indexed: 12/18/2022]
Abstract
Motor neuron diseases (MNDs) are rare and frequently fatal neurological disorders in which motor neurons within the brainstem and spinal cord regions slowly die. MNDs are primarily caused by genetic mutations, and > 100 different mutant genes in humans have been discovered thus far. Given the fact that many more MND-related genes have yet to be discovered, the growing body of genetic evidence has offered new insights into the diverse cellular and molecular mechanisms involved in the aetiology and pathogenesis of MNDs. This search may aid in the selection of potential candidate genes for future investigation and, eventually, may open the door to novel interventions to slow down disease progression. In this review paper, we have summarized detailed existing research findings of different MNDs, such as amyotrophic lateral sclerosis (ALS), spinal muscular atrophy (SMA), spinal bulbar muscle atrophy (SBMA) and hereditary spastic paraplegia (HSP) in relation to their complex genetic architecture.
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8
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Jin M, Akgün K, Ziemssen T, Kipp M, Günther R, Hermann A. Interleukin-17 and Th17 Lymphocytes Directly Impair Motoneuron Survival of Wildtype and FUS-ALS Mutant Human iPSCs. Int J Mol Sci 2021; 22:ijms22158042. [PMID: 34360808 PMCID: PMC8348495 DOI: 10.3390/ijms22158042] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Revised: 07/22/2021] [Accepted: 07/23/2021] [Indexed: 11/16/2022] Open
Abstract
Amyotrophic lateral sclerosis (ALS) is a progressive disease leading to the degeneration of motor neurons (MNs). Neuroinflammation is involved in the pathogenesis of ALS; however, interactions of specific immune cell types and MNs are not well studied. We recently found a shift toward T helper (Th)1/Th17 cell-mediated, pro-inflammatory immune responses in the peripheral immune system of ALS patients, which positively correlated with disease severity and progression. Whether Th17 cells or their central mediator, Interleukin-17 (IL-17), directly affects human motor neuron survival is currently unknown. Here, we evaluated the contribution of Th17 cells and IL-17 on MN degeneration using the co-culture of iPSC-derived MNs of fused in sarcoma (FUS)-ALS patients and isogenic controls with Th17 lymphocytes derived from ALS patients, healthy controls, and multiple sclerosis (MS) patients (positive control). Only Th17 cells from MS patients induced severe MN degeneration in FUS-ALS as well as in wildtype MNs. Their main effector, IL-17A, yielded in a dose-dependent decline of the viability and neurite length of MNs. Surprisingly, IL-17F did not influence MNs. Importantly, neutralizing IL-17A and anti-IL-17 receptor A treatment reverted all effects of IL-17A. Our results offer compelling evidence that Th17 cells and IL-17A do directly contribute to MN degeneration.
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Affiliation(s)
- Mengmeng Jin
- Department of Neurology, Technische Universität Dresden, 01307 Dresden, Germany; (M.J.); (K.A.); (T.Z.); (R.G.)
- Center for Clinical Neuroscience, University Hospital Carl Gustav Carus, 01307 Dresden, Germany
| | - Katja Akgün
- Department of Neurology, Technische Universität Dresden, 01307 Dresden, Germany; (M.J.); (K.A.); (T.Z.); (R.G.)
- Center for Clinical Neuroscience, University Hospital Carl Gustav Carus, 01307 Dresden, Germany
| | - Tjalf Ziemssen
- Department of Neurology, Technische Universität Dresden, 01307 Dresden, Germany; (M.J.); (K.A.); (T.Z.); (R.G.)
- Center for Clinical Neuroscience, University Hospital Carl Gustav Carus, 01307 Dresden, Germany
| | - Markus Kipp
- Institute of Anatomy, University Medical Center Rostock, Gertrudenstrasse 9, 18057 Rostock, Germany;
- Center for Transdisciplinary Neurosciences, University Medical Center Rostock, 18057 Rostock, Germany
| | - Rene Günther
- Department of Neurology, Technische Universität Dresden, 01307 Dresden, Germany; (M.J.); (K.A.); (T.Z.); (R.G.)
- German Center for Neurodegenerative Diseases (DZNE), 01307 Dresden, Germany
| | - Andreas Hermann
- Department of Neurology, Technische Universität Dresden, 01307 Dresden, Germany; (M.J.); (K.A.); (T.Z.); (R.G.)
- Center for Transdisciplinary Neurosciences, University Medical Center Rostock, 18057 Rostock, Germany
- Translational Neurodegeneration Section, “Albrecht-Kossel”, Department of Neurology, University Medical Center Rostock, 18057 Rostock, Germany
- German Center for Neurodegenerative Diseases (DZNE) Rostock/Greifswald, 18147 Rostock, Germany
- Correspondence: ; Tel.: +49-(0)381-494-9541
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Tanemoto M, Hisahara S, Ikeda K, Yokokawa K, Manabe T, Tsuda R, Yamamoto D, Matsushita T, Matsumura A, Suzuki S, Shimohama S. Sporadic Amyotrophic Lateral Sclerosis Due to a FUS P525L Mutation with Asymmetric Muscle Weakness and Anti-ganglioside Antibodies. Intern Med 2021; 60:1949-1953. [PMID: 33518565 PMCID: PMC8263198 DOI: 10.2169/internalmedicine.6168-20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Amyotrophic lateral sclerosis (ALS) due to a fused in sarcoma (FUS) P525L mutation is characterized by a rapidly progressive course. Multifocal motor neuropathy (MMN) may resemble ALS in early stage and is associated with anti-ganglioside antibodies. A 38-year-old woman was admitted to our hospital because of progressive muscle weakness in the right limbs. She had mild mental retardation and minor deformities. Initially, we suspected MMN given the asymmetric muscle weakness and detection of anti-ganglioside antibodies. However, physical and electrophysiological tests did not support MMN, instead suggesting ALS. We confirmed a heterozygous P525L mutation and finally diagnosed this case as ALS due to an FUS mutation.
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Affiliation(s)
- Masanobu Tanemoto
- Department of Neurology, Sapporo Medical University, School of Medicine, Japan
| | - Shin Hisahara
- Department of Neurology, Sapporo Medical University, School of Medicine, Japan
| | - Kazuna Ikeda
- Department of Neurology, Sapporo Medical University, School of Medicine, Japan
| | - Kazuki Yokokawa
- Department of Neurology, Sapporo Medical University, School of Medicine, Japan
| | - Tatsuo Manabe
- Department of Neurology, Sapporo Medical University, School of Medicine, Japan
| | - Reiko Tsuda
- Department of Neurology, Sapporo Medical University, School of Medicine, Japan
| | - Daisuke Yamamoto
- Department of Neurology, Sapporo Medical University, School of Medicine, Japan
| | - Takashi Matsushita
- Department of Neurology, Sapporo Medical University, School of Medicine, Japan
| | - Akihiro Matsumura
- Department of Neurology, Sapporo Medical University, School of Medicine, Japan
| | - Syuuichirou Suzuki
- Department of Neurology, Sapporo Medical University, School of Medicine, Japan
| | - Shun Shimohama
- Department of Neurology, Sapporo Medical University, School of Medicine, Japan
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Selective neuronal degeneration in MATR3 S85C knock-in mouse model of early-stage ALS. Nat Commun 2020; 11:5304. [PMID: 33082323 PMCID: PMC7576598 DOI: 10.1038/s41467-020-18949-w] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2020] [Accepted: 09/17/2020] [Indexed: 12/12/2022] Open
Abstract
A missense mutation, S85C, in the MATR3 gene is a genetic cause for amyotrophic lateral sclerosis (ALS). It is unclear how the S85C mutation affects MATR3 function and contributes to disease. Here, we develop a mouse model that harbors the S85C mutation in the endogenous Matr3 locus using the CRISPR/Cas9 system. MATR3 S85C knock-in mice recapitulate behavioral and neuropathological features of early-stage ALS including motor impairment, muscle atrophy, neuromuscular junction defects, Purkinje cell degeneration and neuroinflammation in the cerebellum and spinal cord. Our neuropathology data reveals a loss of MATR3 S85C protein in the cell bodies of Purkinje cells and motor neurons, suggesting that a decrease in functional MATR3 levels or loss of MATR3 function contributes to neuronal defects. Our findings demonstrate that the MATR3 S85C mouse model mimics aspects of early-stage ALS and would be a promising tool for future basic and preclinical research.
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11
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Involvement of the dentate nucleus in the pathophysiology of amyotrophic lateral sclerosis: A multi-center and multi-modal neuroimaging study. NEUROIMAGE-CLINICAL 2020; 28:102385. [PMID: 32871387 PMCID: PMC7476068 DOI: 10.1016/j.nicl.2020.102385] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Revised: 08/01/2020] [Accepted: 08/12/2020] [Indexed: 12/11/2022]
Abstract
This original research article highlights cerebellar structural and functional connectivity abnormalities implicated in the pathophysiology of ALS. In this study, resting-state functional MRI (rs-FMRI), diffusion tensor imaging (DTI), and 3D T1W structural images were examined. Functional connectivity was investigated between the cerebral cortex and cerebellum targeting the dentate nucleus (DN). Microstructural white matter diffusivity was examined along the cerebellar peduncles connecting the DN with the cerebral cortex and brain stem. Grey matter volumes of the cerebellar lobules and DN were determined. Overall, we provide evidence supporting involvement of the DN and associated cerebellar white matter tracts in the pathophysiology of ALS.
Amyotrophic lateral sclerosis (ALS) is characterized primarily by motor neuron but also frontotemporal lobar degeneration. Although the cerebellum is involved in both motor and cognitive functions, little is known of its role in ALS. We targeted the dentate nucleus (DN) in the cerebellum and the associated white matter fibers tracts connecting the DN to the rest of the brain using multimodal imaging techniques to examine the cerebellar structural and functional connectivity patterns in ALS patients and hypothesized that the DN is implicated in the pathophysiology of ALS. A cohort of 127 participants (56 healthy subjects (HS); 71 ALS patients) were recruited across Canada through the Canadian ALS Neuroimaging Consortium (CALSNIC). Resting state functional MRI, diffusion tensor imaging (DTI), and 3D weighted T1 structural images were acquired on a 3-tesla scanner. The DN in the cerebellum was used as a seed to evaluate the whole brain cerebral resting-state functional connectivity (rsFC). The superior cerebellar peduncle (SCP), middle cerebellar peduncle (MCP) and inferior cerebellar peduncle (ICP) were used as a region of interest in DTI to evaluate the structural integrity of the DN with the cortex and brain stem. Cerebellar volumetric analysis was done to examine the lobular and DN grey matter (GM) changes in ALS patients. Lastly, an association between DN rsFC and structural alterations were explored. DN rsFC was reduced with cerebrum (supplementary motor area, precentral gyrus, frontal, posterior parietal, temporal), lobule IV, and brain stem, and increased with parieto-occipital region. DN rsFC and white matter (WM) diffusivity alterations at SCP, MCP, and ICP were accompanied by correlations with ALSFRS-R. There were no DN volumetric changes. Notably, DN rsFC correlated with WM abnormalities at superior cerebellar peduncle. The DN plays a pathophysiological role in ALS. Impaired rsFC is likely due to the observed cerebellar peduncular WM damage given the lack of GM atrophy of the DN. This study demonstrates altered cerebellar rsFC connectivity with motor and extra-motor regions in ALS, and impaired rsFC is likely due to the observed cerebellar peduncular WM damage given the lack of GM atrophy of the DN. The correlation between the altered DN connectivity, and the behavioral data support the hypothesis that the DN plays a pathophysiological role in ALS.
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Perrone B, Conforti FL. Common mutations of interest in the diagnosis of amyotrophic lateral sclerosis: how common are common mutations in ALS genes? Expert Rev Mol Diagn 2020; 20:703-714. [PMID: 32497448 DOI: 10.1080/14737159.2020.1779060] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
INTRODUCTION Amyotrophic lateral sclerosis (ALS) is a complex neurodegenerative disease predominantly affecting upper and lower motor neurons. Diagnosis of this devastating pathology is very difficult because the high degree of clinical heterogeneity with which it occurs and until now, no truly effective treatment exists. AREAS COVERED Molecular diagnosis may be a valuable tool for dissecting out ALS complex heterogeneity and for identifying new molecular mechanisms underlying the characteristic selective degeneration and death of motor neurons. To date, pathogenic variants in ALS genes are known to be present in up to 70% of familial and 10% of apparently sporadic ALS cases and can be associated with risks for ALS only or risks for other neurodegenerative diseases. This paper shows the procedure currently used in diagnostic laboratories to investigate most frequent mutations in ALS and evaluating the utility of involved molecular techniques as potential tools to discriminate 'common mutations' in ALS patients. EXPERT OPINION Genetic testing may allow for establishing an accurate pathological diagnosis and a more precise stratification of patient groups in future drug trials.
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Affiliation(s)
- Benedetta Perrone
- Department of Pharmacy, Health and Nutritional Sciences, University of Calabria , Arcavacata di Rende (Cosenza), Italy
| | - Francesca Luisa Conforti
- Department of Pharmacy, Health and Nutritional Sciences, University of Calabria , Arcavacata di Rende (Cosenza), Italy
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Zhou B, Wang H, Cai Y, Wen H, Wang L, Zhu M, Chen Y, Yu Y, Lu X, Zhou M, Fang P, Li X, Hong D. FUS P525L mutation causing amyotrophic lateral sclerosis and movement disorders. Brain Behav 2020; 10:e01625. [PMID: 32307925 PMCID: PMC7303404 DOI: 10.1002/brb3.1625] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Revised: 03/08/2020] [Accepted: 03/20/2020] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Mutations in the fused in sarcoma (FUS) gene have been associated with amyotrophic lateral sclerosis (ALS), frontotemporal lobar degeneration, and essential tremor. Among the FUS mutations, p.P525L as a hot spot variant has been reported in more than 20 patients with ALS. Apart from the typical ALS phenotype, patients with p.P525L mutation exhibit some atypical symptoms. However, movement disorders related to p.P525L mutation have not been emphasized currently. METHODS Two unrelated patients with ALS were evaluated through a set of clinical and laboratory tests. The genetic screening was performed through next-generation sequencing. Muscle biopsies were performed on the 2 patients. Muscle samples were stained according to standard histological and immunohistochemical procedures. RESULTS The first patient presented with juvenile-onset neurogenic weakness and wasting and simultaneously had dropped head, ophthalmoplegia, tremor, involuntary movements, and cognitive impairments. The second patient showed a typical ALS phenotype and prominent adventitious movements. Genetic screening disclosed de novo p.P525L FUS mutation in the 2 patients by family cosegregation analysis. Muscle biopsy showed neurogenic patterns and numerous lipid droplets aggregating in the fibers. CONCLUSION Apart from the typical ALS phenotype, patients with p.P525L mutation in the FUS gene can present with great clinical heterogeneity including multiple movement disorders. Numerous lipid droplets in muscle fibers indicate that skeletal muscle is likely an important therapeutic target for ALS.
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Affiliation(s)
- Binbin Zhou
- Department of Neurology, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Huan Wang
- Department of Neurology, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Yu Cai
- Department of Diagnostic Center, Ascension Seton Medical Center Austin, Austin, TX, USA
| | - Han Wen
- Department of Neurology, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Lulu Wang
- Department of Neurology, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Min Zhu
- Department of Neurology, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Yunqing Chen
- Department of Neurology, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Yanyan Yu
- Department of Neurology, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Xi Lu
- Department of Neurology, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Meihong Zhou
- Department of Neurology, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Pu Fang
- Department of Neurology, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Xiaobing Li
- Department of Neurology, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Daojun Hong
- Department of Neurology, The First Affiliated Hospital of Nanchang University, Nanchang, China
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Larner AJ, Fratalia L. Focal limb weakness (monoparesis): when family history holds the key to diagnosis. Br J Hosp Med (Lond) 2019; 80:110-111. [DOI: 10.12968/hmed.2019.80.2.110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- AJ Larner
- Consultant Neurologist, Walton Centre for Neurology and Neurosurgery, Liverpool L9 7LJ
| | - L Fratalia
- Consultant Neurologist, Walton Centre for Neurology and Neurosurgery, Liverpool
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15
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Fungal Neurotoxins and Sporadic Amyotrophic Lateral Sclerosis. Neurotox Res 2018; 35:969-980. [PMID: 30515715 DOI: 10.1007/s12640-018-9980-5] [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] [Received: 09/08/2018] [Revised: 11/07/2018] [Accepted: 11/07/2018] [Indexed: 12/11/2022]
Abstract
We review several lines of evidence that point to a potential fungal origin of sporadic amyotrophic lateral sclerosis (ALS). ALS is the most common form of motor neuron disease (MND) in adults. It is a progressive and fatal disease. Approximately 90% cases of ALS are sporadic, and 5-10% are due to genetic mutations (familial). About 25 genes implicated in familial ALS have been identified so far, including SOD1 and TARDBP, the gene encoding 43 kDa transactive response (TAR) DNA-binding protein (TDP-43). Despite intensive research over many decades, the aetiology of sporadic ALS is still unknown. An environmental cause, including grass or soil-associated fungal infections, is suggested from a range of widely diverse lines of evidence. Clusters of ALS have been reported in soccer players, natives of Guam and farmers. Grass-associated fungi are known to produce a range of neurotoxins and, in symbiotic associations, high levels of fungal SOD1. Exposure of neurons to fungal neurotoxins elicits a significant increase in glutamate production. High levels of glutamate stimulate TDP-43 translocation and modification, providing a link between fungal infection and one of the molecular and histologic hallmarks of sporadic ALS. A recent study provided evidence of a variety of fungi in the cerebrospinal fluid and brain tissue of ALS patients. This review provides a rational explanation for this observation. If a fungal infection could be confirmed as a potential cause of ALS, this could provide a straightforward treatment strategy for this fatal and incurable disease.
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Kuang L, Kamelgarn M, Arenas A, Gal J, Taylor D, Gong W, Brown M, St Clair D, Kasarskis EJ, Zhu H. Clinical and experimental studies of a novel P525R FUS mutation in amyotrophic lateral sclerosis. NEUROLOGY-GENETICS 2017; 3:e172. [PMID: 28812062 PMCID: PMC5546284 DOI: 10.1212/nxg.0000000000000172] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/28/2017] [Accepted: 05/16/2017] [Indexed: 12/13/2022]
Abstract
Objective: To describe the clinical features of a novel fused in sarcoma (FUS) mutation in a young adult female amyotrophic lateral sclerosis (ALS) patient with rapid progression of weakness and to experimentally validate the consequences of the P525R mutation in cellular neuronal models. Methods: We conducted sequencing of genomic DNA from the index patient and her family members. Immunocytochemistry was performed in various cellular models to determine whether the newly identified P525R mutant FUS protein accumulated in cytoplasmic inclusions. Clinical features of the index patient were compared with 19 other patients with ALS carrying the P525L mutation in the same amino acid position. Results: A novel mutation c.1574C>G (p.525P>R) in the FUS gene was identified in the index patient. The clinical symptoms are similar to those in familial ALS patients with the P525L mutation at the same position. The P525R mutant FUS protein showed cytoplasmic localization and formed large stress granule–like cytoplasmic inclusions in multiple cellular models. Conclusions: The clinical features of the patient and the cytoplasmic inclusions of the P525R mutant FUS protein strengthen the notion that mutations at position 525 of the FUS protein result in a coherent phenotype characterized by juvenile or young adult onset, rapid progression, variable positive family history, and female preponderance.
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Affiliation(s)
- Lisha Kuang
- Molecular and Cellular Biochemistry (L.K., J.G., H.Z.), Department of Toxicology and Cancer Biology (M.K., A.A., D.S.C., H.Z.), and Department of Neurology (D.T., E.J.K.), College of Medicine, University of Kentucky, Lexington; Hefei National Laboratory for Physical Sciences at the Microscale (W.G.), University of Science and Technology of China, Anhui; Department of Neurology (M.B.), University of Louisville; and Research and Development (E.J.K., H.Z.), Lexington VA Medical Center, KY
| | - Marisa Kamelgarn
- Molecular and Cellular Biochemistry (L.K., J.G., H.Z.), Department of Toxicology and Cancer Biology (M.K., A.A., D.S.C., H.Z.), and Department of Neurology (D.T., E.J.K.), College of Medicine, University of Kentucky, Lexington; Hefei National Laboratory for Physical Sciences at the Microscale (W.G.), University of Science and Technology of China, Anhui; Department of Neurology (M.B.), University of Louisville; and Research and Development (E.J.K., H.Z.), Lexington VA Medical Center, KY
| | - Alexandra Arenas
- Molecular and Cellular Biochemistry (L.K., J.G., H.Z.), Department of Toxicology and Cancer Biology (M.K., A.A., D.S.C., H.Z.), and Department of Neurology (D.T., E.J.K.), College of Medicine, University of Kentucky, Lexington; Hefei National Laboratory for Physical Sciences at the Microscale (W.G.), University of Science and Technology of China, Anhui; Department of Neurology (M.B.), University of Louisville; and Research and Development (E.J.K., H.Z.), Lexington VA Medical Center, KY
| | - Jozsef Gal
- Molecular and Cellular Biochemistry (L.K., J.G., H.Z.), Department of Toxicology and Cancer Biology (M.K., A.A., D.S.C., H.Z.), and Department of Neurology (D.T., E.J.K.), College of Medicine, University of Kentucky, Lexington; Hefei National Laboratory for Physical Sciences at the Microscale (W.G.), University of Science and Technology of China, Anhui; Department of Neurology (M.B.), University of Louisville; and Research and Development (E.J.K., H.Z.), Lexington VA Medical Center, KY
| | - Deborah Taylor
- Molecular and Cellular Biochemistry (L.K., J.G., H.Z.), Department of Toxicology and Cancer Biology (M.K., A.A., D.S.C., H.Z.), and Department of Neurology (D.T., E.J.K.), College of Medicine, University of Kentucky, Lexington; Hefei National Laboratory for Physical Sciences at the Microscale (W.G.), University of Science and Technology of China, Anhui; Department of Neurology (M.B.), University of Louisville; and Research and Development (E.J.K., H.Z.), Lexington VA Medical Center, KY
| | - Weiming Gong
- Molecular and Cellular Biochemistry (L.K., J.G., H.Z.), Department of Toxicology and Cancer Biology (M.K., A.A., D.S.C., H.Z.), and Department of Neurology (D.T., E.J.K.), College of Medicine, University of Kentucky, Lexington; Hefei National Laboratory for Physical Sciences at the Microscale (W.G.), University of Science and Technology of China, Anhui; Department of Neurology (M.B.), University of Louisville; and Research and Development (E.J.K., H.Z.), Lexington VA Medical Center, KY
| | - Martin Brown
- Molecular and Cellular Biochemistry (L.K., J.G., H.Z.), Department of Toxicology and Cancer Biology (M.K., A.A., D.S.C., H.Z.), and Department of Neurology (D.T., E.J.K.), College of Medicine, University of Kentucky, Lexington; Hefei National Laboratory for Physical Sciences at the Microscale (W.G.), University of Science and Technology of China, Anhui; Department of Neurology (M.B.), University of Louisville; and Research and Development (E.J.K., H.Z.), Lexington VA Medical Center, KY
| | - Daret St Clair
- Molecular and Cellular Biochemistry (L.K., J.G., H.Z.), Department of Toxicology and Cancer Biology (M.K., A.A., D.S.C., H.Z.), and Department of Neurology (D.T., E.J.K.), College of Medicine, University of Kentucky, Lexington; Hefei National Laboratory for Physical Sciences at the Microscale (W.G.), University of Science and Technology of China, Anhui; Department of Neurology (M.B.), University of Louisville; and Research and Development (E.J.K., H.Z.), Lexington VA Medical Center, KY
| | - Edward J Kasarskis
- Molecular and Cellular Biochemistry (L.K., J.G., H.Z.), Department of Toxicology and Cancer Biology (M.K., A.A., D.S.C., H.Z.), and Department of Neurology (D.T., E.J.K.), College of Medicine, University of Kentucky, Lexington; Hefei National Laboratory for Physical Sciences at the Microscale (W.G.), University of Science and Technology of China, Anhui; Department of Neurology (M.B.), University of Louisville; and Research and Development (E.J.K., H.Z.), Lexington VA Medical Center, KY
| | - Haining Zhu
- Molecular and Cellular Biochemistry (L.K., J.G., H.Z.), Department of Toxicology and Cancer Biology (M.K., A.A., D.S.C., H.Z.), and Department of Neurology (D.T., E.J.K.), College of Medicine, University of Kentucky, Lexington; Hefei National Laboratory for Physical Sciences at the Microscale (W.G.), University of Science and Technology of China, Anhui; Department of Neurology (M.B.), University of Louisville; and Research and Development (E.J.K., H.Z.), Lexington VA Medical Center, KY
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Afshar P, Ashtari N, Jiao X, Rahimi-Balaei M, Zhang X, Yaganeh B, Del Bigio MR, Kong J, Marzban H. Overexpression of Human SOD1 Leads to Discrete Defects in the Cerebellar Architecture in the Mouse. Front Neuroanat 2017; 11:22. [PMID: 28424594 PMCID: PMC5372795 DOI: 10.3389/fnana.2017.00022] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2016] [Accepted: 03/07/2017] [Indexed: 12/11/2022] Open
Abstract
The human superoxide dismutase 1 (SOD1) gene is responsible for neutralizing supercharged oxygen radicals within the cell. Mutation in SOD1 gene causes amyotrophic lateral sclerosis (ALS). Recent studies have shown involvement of the cerebellum in ALS, although the cerebellar contribution in SOD1 transgenic mice remains unclear. Using immunohistopathology, we investigated the Purkinje cell phenotype in the vermis of the SOD1 transgenic mice cerebellum. Calbindin 1 (Calb1) and three well-known zone and stripe markers, zebrin II, HSP25, and PLCβ4 have been used to explore possible alteration in zone and stripe. Here we show that Calb1 expression is significantly reduced in a subset of the Purkinje cells that is almost aligned with the cerebellar zones and stripes pattern. The Purkinje cells of SOD1 transgenic mice display a pattern of Calb1 down-regulation, which seems to proceed to Purkinje cell degeneration as the mice age. The onset of Calb1 down-regulation in Purkinje cells begins from the central zone and continues into the nodular zone, however it has not been observed in the anterior and posterior zones. In a subgroup of SOD1 transgenic mice in which gait unsteadiness was apparent, down-regulation of Calb1 is seen in a subset of PLCβ4+ Purkinje cells in the anterior zone. These observations suggest that the Calb1- subset of Purkinje cells in the anterior zone, which receives somatosensory input, causes unsteady gait. Our data suggest that human SOD1 overexpression leads to Calb1 down-regulation in the zone and strip pattern and raise the question of whether SOD1 overexpression leads to Purkinje cells degeneration.
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Affiliation(s)
- Pegah Afshar
- Department of Human Anatomy and Cell Science, The Children's Hospital Foundation University of Manitoba, Rady Faculty of Health Sciences, Max Rady College of Medicine, University of ManitobaWinnipeg, MB, Canada
| | - Niloufar Ashtari
- Department of Human Anatomy and Cell Science, The Children's Hospital Foundation University of Manitoba, Rady Faculty of Health Sciences, Max Rady College of Medicine, University of ManitobaWinnipeg, MB, Canada
| | - Xiaodan Jiao
- Department of Human Anatomy and Cell Science, The Children's Hospital Foundation University of Manitoba, Rady Faculty of Health Sciences, Max Rady College of Medicine, University of ManitobaWinnipeg, MB, Canada
| | - Maryam Rahimi-Balaei
- Department of Human Anatomy and Cell Science, The Children's Hospital Foundation University of Manitoba, Rady Faculty of Health Sciences, Max Rady College of Medicine, University of ManitobaWinnipeg, MB, Canada
| | - Xiaosha Zhang
- Department of Human Anatomy and Cell Science, The Children's Hospital Foundation University of Manitoba, Rady Faculty of Health Sciences, Max Rady College of Medicine, University of ManitobaWinnipeg, MB, Canada
| | - Behzad Yaganeh
- Program in Physiology and Experimental Medicine, Hospital for Sick Children and University of TorontoToronto, ON, Canada
| | - Marc R Del Bigio
- Department of Human Anatomy and Cell Science, The Children's Hospital Foundation University of Manitoba, Rady Faculty of Health Sciences, Max Rady College of Medicine, University of ManitobaWinnipeg, MB, Canada.,Department of Pathology, Faculty of Medicine, University of ManitobaWinnipeg, MB, Canada
| | - Jiming Kong
- Department of Human Anatomy and Cell Science, The Children's Hospital Foundation University of Manitoba, Rady Faculty of Health Sciences, Max Rady College of Medicine, University of ManitobaWinnipeg, MB, Canada
| | - Hassan Marzban
- Department of Human Anatomy and Cell Science, The Children's Hospital Foundation University of Manitoba, Rady Faculty of Health Sciences, Max Rady College of Medicine, University of ManitobaWinnipeg, MB, Canada
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18
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Hayashi K, Mochizuki Y, Takeuchi R, Shimizu T, Nagao M, Watabe K, Arai N, Oyanagi K, Onodera O, Hayashi M, Takahashi H, Kakita A, Isozaki E. Clinicopathological characteristics of patients with amyotrophic lateral sclerosis resulting in a totally locked-in state (communication Stage V). Acta Neuropathol Commun 2016; 4:107. [PMID: 27716404 PMCID: PMC5045653 DOI: 10.1186/s40478-016-0379-3] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2016] [Accepted: 09/22/2016] [Indexed: 12/12/2022] Open
Abstract
In the present study, we performed a comprehensive analysis to clarify the clinicopathological characteristics of patients with amyotrophic lateral sclerosis (ALS) that had progressed to result in a totally locked-in state (communication Stage V), in which all voluntary movements are lost and communication is impossible. In 11 patients, six had phosphorylated TAR DNA-binding protein 43 (pTDP-43)-immunoreactive (ir) neuronal cytoplasmic inclusions (NCI), two had fused in sarcoma (FUS)-ir NCI, and three had copper/zinc superoxide dismutase (SOD1)-ir NCI. The time from ALS onset to the need for tracheostomy invasive ventilation was less than 24 months in ten patients. Regardless of accumulated protein, all the patients showed common lesions in the pallido–nigro–luysian system, brainstem reticular formation, and cerebellar efferent system, in addition to motor neurons. In patients with pTDP-43-ir NCI, patients with NCI in the hippocampal dentate granule neurons (DG) showed a neuronal loss in the cerebral cortex, and patients without NCI in DG showed a preserved cerebral cortex. By contrast, in patients with FUS-ir NCI, patients with NCI in DG showed a preserved cerebral cortex and patients without NCI in DG showed marked cerebral degeneration. The cerebral cortex of patients with SOD1-ir NCI was preserved. Together, these findings suggest that lesions of the cerebrum are probably not necessary for progression to Stage V. In conclusion, patients with ALS that had progressed to result in communication Stage V showed rapidly-progressed symptoms, and their common lesions could cause the manifestations of communication Stage V.
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Nolan M, Talbot K, Ansorge O. Pathogenesis of FUS-associated ALS and FTD: insights from rodent models. Acta Neuropathol Commun 2016; 4:99. [PMID: 27600654 PMCID: PMC5011941 DOI: 10.1186/s40478-016-0358-8] [Citation(s) in RCA: 82] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2016] [Accepted: 07/31/2016] [Indexed: 12/29/2022] Open
Abstract
Disruptions to genes linked to RNA processing and homeostasis are implicated in the pathogenesis of two pathologically related but clinically heterogeneous neurodegenerative diseases, amyotrophic lateral sclerosis (ALS) and frontotemporal dementia (FTD). Mutations in the Fused-in-Sarcoma (FUS) gene encoding a 526 amino-acid RNA-binding protein are found in a small subset of ALS cases, but FUS mutations do not appear to be a direct cause of FTD. Structural and functional similarities between FUS and another ALS-related RNA-binding protein, TDP-43, highlight the potential importance of aberrant RNA processing in ALS/FTD, and this pathway is now a major focus of interest. Recently, several research groups have reported transgenic vertebrate models of FUSopathy, with varying results. Here, we discuss the evidence for FUS pathogenicity in ALS/FTD, review the experimental approaches used and phenotypic features of FUS rodent models reported to date, and outline their contribution to our understanding of pathogenic mechanisms. Further refinement of vertebrate models will likely aid our understanding of the role of FUS in both diseases.
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20
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Hayashi K, Mochizuki Y, Koide R, Kawata A, Homma T, Shimizu T, Komori T, Isozaki E. A Japanese familial ALS patient with autonomic failure and a p.Cys146Arg mutation in the gene for SOD1 (SOD1). Neuropathology 2016; 36:551-555. [PMID: 27090969 DOI: 10.1111/neup.12303] [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] [Received: 12/22/2015] [Revised: 03/04/2016] [Accepted: 03/05/2016] [Indexed: 12/13/2022]
Abstract
We describe a Japanese man with familial amyotrophic lateral sclerosis (ALS) associated with a p.Cys146Arg mutation in the copper/zinc superoxide dismutase gene (SOD1). The patient developed bulbar signs followed by rapidly progressive limb muscle weakness. The prominent clinical feature was orthostatic hypotension due to autonomic failure, which occurred after he underwent tracheostomy 1 year and 3 months after the onset. Thereafter, he required mechanical ventilation and progressed to communication stage V (totally locked-in state) 7 years after the onset. Neuropathology showed ALS with posterior column degeneration and multiple system degeneration. Severe neuronal loss in the intermediolateral nucleus was also observed. Two previously reported cases of ALS patients with autonomic failure showed severe neuronal loss in the intermediolateral nucleus in addition to degeneration of the motor neurons. Thus, autonomic failure due to neuronal loss in the intermediolateral nucleus could present in patients with ALS associated with certain mutations in SOD1.
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Affiliation(s)
- Kentaro Hayashi
- Department of Neurology, Tokyo Metropolitan Neurological Hospital
| | - Yoko Mochizuki
- Department of Pathology, Tokyo Metropolitan Neurological Hospital.,Department of Neurology, Tokyo Metropolitan Kita Medical and Rehabilitation center for the disabled
| | - Reiji Koide
- Department of Neurology, Tokyo Metropolitan Neurological Hospital.,Division of Neurology, Department of Medicine, Jichi Medical University School of Medicine
| | - Akihiro Kawata
- Department of Neurology, Tokyo Metropolitan Neurological Hospital
| | - Taku Homma
- Department of Pathology, Tokyo Metropolitan Neurological Hospital.,Department of Pathology, Nihon University School of Medicine
| | - Toshio Shimizu
- Department of Neurology, Tokyo Metropolitan Neurological Hospital
| | - Takashi Komori
- Department of Pathology, Tokyo Metropolitan Neurological Hospital
| | - Eiji Isozaki
- Department of Neurology, Tokyo Metropolitan Neurological Hospital
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Akiyama T, Warita H, Kato M, Nishiyama A, Izumi R, Ikeda C, Kamada M, Suzuki N, Aoki M. Genotype-phenotype relationships in familial amyotrophic lateral sclerosis with FUS/TLS mutations in Japan. Muscle Nerve 2016; 54:398-404. [PMID: 26823199 DOI: 10.1002/mus.25061] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/25/2016] [Indexed: 12/19/2022]
Abstract
INTRODUCTION We investigated possible genotype-phenotype correlations in Japanese patients with familial amyotrophic lateral sclerosis (FALS) carrying fused in sarcoma/translated in liposarcoma (FUS/TLS) gene mutations. METHODS A consecutive series of 111 Japanese FALS pedigrees were screened for copper/zinc superoxide dismutase 1 (SOD1) and FUS/TLS gene mutations. Clinical data, including onset age, onset site, disease duration, and extramotor symptoms, were collected. RESULTS Nine different FUS/TLS mutations were found in 12 pedigrees. Most of the patients with FUS/TLS-linked FALS demonstrated early onset in the brainstem/upper cervical region, and relatively short disease duration. A few mutations exhibited phenotypes that were distinct from typical cases. Frontotemporal dementia was present in 1 patient. CONCLUSIONS This study revealed a characteristic phenotype in FUS/TLS-linked FALS patients in Japan. FUS/TLS screening is recommended in patients with FALS with this phenotype. Muscle Nerve 54: 398-404, 2016.
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Affiliation(s)
- Tetsuya Akiyama
- Department of Neurology, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai, 980-8574, Japan
| | - Hitoshi Warita
- Department of Neurology, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai, 980-8574, Japan
| | - Masaaki Kato
- Department of Neurology, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai, 980-8574, Japan
| | - Ayumi Nishiyama
- Department of Neurology, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai, 980-8574, Japan
| | - Rumiko Izumi
- Department of Neurology, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai, 980-8574, Japan
| | - Chikako Ikeda
- Department of Neuropsychiatry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Masaki Kamada
- Department of Neurological Intractable Disease Research, Kagawa University Faculty of Medicine, Kagawa, Japan
| | - Naoki Suzuki
- Department of Neurology, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai, 980-8574, Japan
| | - Masashi Aoki
- Department of Neurology, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai, 980-8574, Japan
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22
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Tarlarini C, Lunetta C, Mosca L, Avemaria F, Riva N, Mantero V, Maestri E, Quattrini A, Corbo M, Melazzini MG, Penco S. Novel FUS mutations identified through molecular screening in a large cohort of familial and sporadic amyotrophic lateral sclerosis. Eur J Neurol 2015; 22:1474-81. [DOI: 10.1111/ene.12772] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2015] [Accepted: 04/27/2015] [Indexed: 02/02/2023]
Affiliation(s)
- C. Tarlarini
- Medical Genetics Unit; Department of Laboratory Medicine; Niguarda Ca' Granda Hospital; Milan Italy
| | - C. Lunetta
- NEuroMuscular Omnicentre (NEMO); Fondazione Serena Onlus; Niguarda Ca' Granda Hospital; Milan Italy
| | - L. Mosca
- Medical Genetics Unit; Department of Laboratory Medicine; Niguarda Ca' Granda Hospital; Milan Italy
| | - F. Avemaria
- Medical Genetics Unit; Department of Laboratory Medicine; Niguarda Ca' Granda Hospital; Milan Italy
| | - N. Riva
- Neuropathology Unit; Institute of Experimental Neurology and Division of Neuroscience; IRCCS San Raffaele Scientific Institute; Milan Italy
| | - V. Mantero
- Neurological Department; A. Manzoni Hospital; Lecco Italy
| | - E. Maestri
- NEuroMuscular Omnicentre (NEMO); Fondazione Serena Onlus; Niguarda Ca' Granda Hospital; Milan Italy
| | - A. Quattrini
- Neuropathology Unit; Institute of Experimental Neurology and Division of Neuroscience; IRCCS San Raffaele Scientific Institute; Milan Italy
| | - M. Corbo
- NEuroMuscular Omnicentre (NEMO); Fondazione Serena Onlus; Niguarda Ca' Granda Hospital; Milan Italy
- Department of Neurorehabilitation Sciences; Casa Cura Policlinico; Milan Italy
| | - M. G. Melazzini
- NEuroMuscular Omnicentre (NEMO); Fondazione Serena Onlus; Niguarda Ca' Granda Hospital; Milan Italy
| | - S. Penco
- Medical Genetics Unit; Department of Laboratory Medicine; Niguarda Ca' Granda Hospital; Milan Italy
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23
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Liu X, Chen J, liu W, Li X, Chen Q, Liu T, Gao S, Deng M. The fused in sarcoma protein forms cytoplasmic aggregates in motor neurons derived from integration-free induced pluripotent stem cells generated from a patient with familial amyotrophic lateral sclerosis carrying the FUS-P525L mutation. Neurogenetics 2015; 16:223-31. [DOI: 10.1007/s10048-015-0448-y] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2014] [Accepted: 04/14/2015] [Indexed: 12/17/2022]
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24
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Deng H, Gao K, Jankovic J. The role of FUS gene variants in neurodegenerative diseases. Nat Rev Neurol 2014; 10:337-48. [DOI: 10.1038/nrneurol.2014.78] [Citation(s) in RCA: 197] [Impact Index Per Article: 19.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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25
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Mochizuki Y, Kawata A, Maruyama H, Homma T, Watabe K, Kawakami H, Komori T, Mizutani T, Matsubara S. A Japanese patient with familial ALS and a p.K510M mutation in the gene for FUS (FUS) resulting in the totally locked-in state. Neuropathology 2014; 34:504-9. [PMID: 24841222 DOI: 10.1111/neup.12130] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2014] [Accepted: 04/17/2014] [Indexed: 12/13/2022]
Abstract
We describe a Japanese patient with familial amyotrophic lateral sclerosis (ALS) and a p.K510M mutation in the fused in sarcoma gene (FUS). The patient's condition was characterized clinically by an early onset and rapid progression. The patient eventually required mechanical ventilation and progressed to the totally locked-in state. Neuropathologically, multiple system degeneration with many FUS-immunoreactive structures was observed. The involvement of the globus pallidus, subthalamic nucleus, substantia nigra, cerebellar efferent system, and both upper and lower motor neurons in the present patient was comparable to that described for ALS patients with different mutations in FUS, all of whom progressed to the totally locked-in state. However, the patient also exhibited degeneration of the cerebellar afferent system and posterior column. Furthermore, the appearance of non-compact FUS-immunoreactive neuronal cytoplasmic inclusions and many FUS-immunoreactive glial cytoplasmic inclusions were unique to the present patient. These features suggest that the morphological characteristics of the FUS-immunoreactive structures and distribution of the lesions vary with the diversity of mutations in FUS.
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Affiliation(s)
- Yoko Mochizuki
- Department of Pathology, Tokyo Metropolitan Neurological Hospital, Tokyo, Japan; Department of Neurology, Tokyo Metropolitan Kita Medical and Rehabilitation Centre for the Disabled, Tokyo, Japan
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26
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Ito H. Basophilic inclusions and neuronal intermediate filament inclusions in amyotrophic lateral sclerosis and frontotemporal lobar degeneration. Neuropathology 2014; 34:589-95. [PMID: 24673472 DOI: 10.1111/neup.12119] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2014] [Accepted: 02/22/2014] [Indexed: 12/13/2022]
Abstract
Basophilic inclusions (BIs) and neuronal intermediate filament inclusions (NIFIs) are key structures of basophilic inclusion body disease and neuronal intermediate filament inclusion disease (NIFID), respectively. BIs are sharply-defined, oval or crescent neuronal intracytoplasmic inclusions that appear pale blue-gray in color with HE staining and purple in color with Nissl but are stained poorly with silver impregnation techniques. Immunohistochemically BIs are negative for tau, trans-activation response DNA 43 (TDP-43), α-synuclein, neurofilament (NF) and α-internexin, positive for p62, and variably ubiquitinated. Noticeably, BIs are consistently fused in sarcoma (FUS) positive. NIFIs are by definition immuno-positive for class IV IFs including three NF triplet subunit proteins and α-internexin but negative for tau, TDP-43, and α-synuclein. In NIFID cases several types of inclusions have been identified. Among them, hyaline conglomerate-like inclusions are the only type that meets the above immunohistochemical features of NIFIs. This type of inclusion appears upon HE staining as multilobulated, faintly eosinophilic or pale amphophilic spherical masses with a glassy appearance. These hyaline conglomerates appear strongly argyrophilic, and robustly and consistently immuno-positive for IFs. In contrast, this type of inclusion shows no or only occasional dot-like FUS immunoreactivity. Therefore, BIs and NIFIs are distinct from each other in terms of morphological, tinctorial and immunohistochemical features. However, basophilic inclusion body disease (BIBD) and NIFID are difficult to differentiate clinically. Moreover, Pick body-like inclusions, the predominant type of inclusions seen in NIFID, are considerably similar to the BIs of BIBD in that this type of inclusion is basophilic, poorly argyrophilic, negative for IFs and intensely immuno-positive for FUS. As BIBD and NIFID share FUS accumulation as the most prominent molecular pathology, whether these two diseases are discrete entities or represent a pathological continuum remains a question to be answered.
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Affiliation(s)
- Hidefumi Ito
- Department of Neurology, Wakayama Medical University, Wakayama, Japan
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27
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Mochizuki Y, Kawata A, Hashimoto T, Akiyama H, Kawakami H, Komori T, Oyanagi K, Mizutani T, Matsubara S. An autopsy case of familial amyotrophic lateral sclerosis with FUS R521G mutation. Amyotroph Lateral Scler Frontotemporal Degener 2014; 15:305-8. [PMID: 24575823 DOI: 10.3109/21678421.2014.881500] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Affiliation(s)
- Yoko Mochizuki
- Department of Pathology, Tokyo Metropolitan Neurological Hospital , Japan
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28
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Prell T, Grosskreutz J. The involvement of the cerebellum in amyotrophic lateral sclerosis. Amyotroph Lateral Scler Frontotemporal Degener 2013; 14:507-15. [DOI: 10.3109/21678421.2013.812661] [Citation(s) in RCA: 65] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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29
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Groen EJN, Fumoto K, Blokhuis AM, Engelen-Lee J, Zhou Y, van den Heuvel DMA, Koppers M, van Diggelen F, van Heest J, Demmers JAA, Kirby J, Shaw PJ, Aronica E, Spliet WGM, Veldink JH, van den Berg LH, Pasterkamp RJ. ALS-associated mutations in FUS disrupt the axonal distribution and function of SMN. Hum Mol Genet 2013; 22:3690-704. [PMID: 23681068 DOI: 10.1093/hmg/ddt222] [Citation(s) in RCA: 114] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Mutations in the RNA binding protein fused in sarcoma/translated in liposarcoma (FUS/TLS) cause amyotrophic lateral sclerosis (ALS). Although ALS-linked mutations in FUS often lead to a cytosolic mislocalization of the protein, the pathogenic mechanisms underlying these mutations remain poorly understood. To gain insight into these mechanisms, we examined the biochemical, cell biological and functional properties of mutant FUS in neurons. Expression of different FUS mutants (R521C, R521H, P525L) in neurons caused axonal defects. A protein interaction screen performed to explain these phenotypes identified numerous FUS interactors including the spinal muscular atrophy (SMA) causing protein survival motor neuron (SMN). Biochemical experiments showed that FUS and SMN interact directly and endogenously, and that this interaction can be regulated by FUS mutations. Immunostaining revealed co-localization of mutant FUS aggregates and SMN in primary neurons. This redistribution of SMN to cytosolic FUS accumulations led to a decrease in axonal SMN. Finally, cell biological experiments showed that overexpression of SMN rescued the axonal defects induced by mutant FUS, suggesting that FUS mutations cause axonal defects through SMN. This study shows that neuronal aggregates formed by mutant FUS protein may aberrantly sequester SMN and concomitantly cause a reduction of SMN levels in the axon, leading to axonal defects. These data provide a functional link between ALS-linked FUS mutations, SMN and neuronal connectivity and support the idea that different motor neuron disorders such as SMA and ALS may be caused, in part, by defects in shared molecular pathways.
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Affiliation(s)
- Ewout J N Groen
- Department of Neuroscience and Pharmacology, Rudolf Magnus Institute of Neuroscience, University Medical Centre Utrecht, Utrecht, The Netherlands
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30
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Lattante S, Rouleau GA, Kabashi E. TARDBPandFUSMutations Associated with Amyotrophic Lateral Sclerosis: Summary and Update. Hum Mutat 2013; 34:812-26. [DOI: 10.1002/humu.22319] [Citation(s) in RCA: 183] [Impact Index Per Article: 16.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2012] [Accepted: 02/28/2013] [Indexed: 12/11/2022]
Affiliation(s)
- Serena Lattante
- Institut du Cerveau et de la Moelle épinière; Centre de Recherche, CHU Pitié-Salpétrière, Inserm, UMR_S975, CRICM, F-75013; UPMC Univ Paris 06, UMR_S975, F-75013; CNRS UMR 7225; F-75013; Paris; France
| | - Guy A. Rouleau
- Montreal Neurological Institute; Department of Neurology and Neurosurgery, McGill University; Montreal; Canada
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31
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Hayashi K, Mochizuki Y, Nakayama Y, Shimizu T, Kawata A, Nagao M, Mizutani T, Matsubara S. [Communication disorder in amyotrophic lateral sclerosis after ventilation--a proposal of staging and a study of predictive factor]. Rinsho Shinkeigaku 2013; 53:98-103. [PMID: 23470888 DOI: 10.5692/clinicalneurol.53.98] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
ALS patients supported by a ventilator often suffered from difficulty in communicating with others. We herein proposed a new classification of clinical stages of advanced ALS focusing on the degree of communication disturbance. We analyzed the relationship between clinical findings and the prognosis for communication disturbance. Twenty-nine ALS patients without dementia were enrolled in the study. The proposed classification consisted of five stages. Stage I: communicate in sentences, stage II: communicate with one word answers only, stage III: communicate with nonverbal yes/no response only, stage IV: cannot communicate occasionally due to uncertain yes/no responses, stage V: cannot communicate by any means. Clinical analysis showed that patients who reached stage V had begun to use the ventilator significantly earlier than patients with the final stages of IV or less. In addition, patients in stage V frequently had a family history of ALS. Rapid disease progression before ventilator use in patients with a family history might predict a poor long-term prognosis for communication disorder after using the ventilator.
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Affiliation(s)
- Kentaro Hayashi
- Department of Neurology, Tokyo Metropolitan Neurological Hospital
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