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Huq A, Thompson B, Winship I. Clinical application of whole genome sequencing in young onset dementia: challenges and opportunities. Expert Rev Mol Diagn 2024; 24:659-675. [PMID: 39135326 DOI: 10.1080/14737159.2024.2388765] [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: 04/25/2024] [Accepted: 08/01/2024] [Indexed: 08/30/2024]
Abstract
INTRODUCTION Young onset dementia (YOD) by its nature is difficult to diagnose. Despite involvement of multidisciplinary neurogenetics services, patients with YOD and their families face significant diagnostic delays. Genetic testing for people with YOD currently involves a staggered, iterative approach. There is currently no optimal single genetic investigation that simultaneously identifies the different genetic variants resulting in YOD. AREAS COVERED This review discusses the advances in clinical genomic testing for people with YOD. Whole genome sequencing (WGS) can be employed as a 'one stop shop' genomic test for YOD. In addition to single nucleotide variants, WGS can reliably detect structural variants, short tandem repeat expansions, mitochondrial genetic variants as well as capture single nucleotide polymorphisms for the calculation of polygenic risk scores. EXPERT OPINION WGS, when used as the initial genetic test, can enhance the likelihood of a precision diagnosis and curtail the time taken to reach this. Finding a clinical diagnosis using WGS can reduce invasive and expensive investigations and could be cost effective. These advances need to be balanced against the limitations of the technology and the genetic counseling needs for these vulnerable patients and their families.
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Affiliation(s)
- Aamira Huq
- Department of Genomic Medicine, Royal Melbourne Hospital, Parkville, Victoria, Australia
- Department of Medicine, University of Melbourne, Parkville, Victoria, Australia
| | - Bryony Thompson
- Department of Medicine, Royal Melbourne Hospital, Parkville, Victoria, Australia
- Department of Pathology, University of Melbourne, Parkville, Victoria, Australia
| | - Ingrid Winship
- Department of Genomic Medicine, Royal Melbourne Hospital, Parkville, Victoria, Australia
- Department of Medicine, University of Melbourne, Parkville, Victoria, Australia
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Tilliole P, Fix S, Godin JD. hnRNPs: roles in neurodevelopment and implication for brain disorders. Front Mol Neurosci 2024; 17:1411639. [PMID: 39086926 PMCID: PMC11288931 DOI: 10.3389/fnmol.2024.1411639] [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] [Received: 04/03/2024] [Accepted: 06/17/2024] [Indexed: 08/02/2024] Open
Abstract
Heterogeneous nuclear ribonucleoproteins (hnRNPs) constitute a family of multifunctional RNA-binding proteins able to process nuclear pre-mRNAs into mature mRNAs and regulate gene expression in multiple ways. They comprise at least 20 different members in mammals, named from A (HNRNP A1) to U (HNRNP U). Many of these proteins are components of the spliceosome complex and can modulate alternative splicing in a tissue-specific manner. Notably, while genes encoding hnRNPs exhibit ubiquitous expression, increasing evidence associate these proteins to various neurodevelopmental and neurodegenerative disorders, such as intellectual disability, epilepsy, microcephaly, amyotrophic lateral sclerosis, or dementias, highlighting their crucial role in the central nervous system. This review explores the evolution of the hnRNPs family, highlighting the emergence of numerous new members within this family, and sheds light on their implications for brain development.
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Affiliation(s)
- Pierre Tilliole
- Institut de Génétique et de Biologie Moléculaire et Cellulaire, IGBMC, Illkirch, France
- Centre National de la Recherche Scientifique, CNRS, UMR7104, Illkirch, France
- Institut National de la Santé et de la Recherche Médicale, INSERM, U1258, Illkirch, France
- Université de Strasbourg, Strasbourg, France
| | - Simon Fix
- Institut de Génétique et de Biologie Moléculaire et Cellulaire, IGBMC, Illkirch, France
- Centre National de la Recherche Scientifique, CNRS, UMR7104, Illkirch, France
- Institut National de la Santé et de la Recherche Médicale, INSERM, U1258, Illkirch, France
- Université de Strasbourg, Strasbourg, France
| | - Juliette D. Godin
- Institut de Génétique et de Biologie Moléculaire et Cellulaire, IGBMC, Illkirch, France
- Centre National de la Recherche Scientifique, CNRS, UMR7104, Illkirch, France
- Institut National de la Santé et de la Recherche Médicale, INSERM, U1258, Illkirch, France
- Université de Strasbourg, Strasbourg, France
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Samudra N, Lane-Donovan C, VandeVrede L, Boxer AL. Tau pathology in neurodegenerative disease: disease mechanisms and therapeutic avenues. J Clin Invest 2023; 133:e168553. [PMID: 37317972 PMCID: PMC10266783 DOI: 10.1172/jci168553] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/16/2023] Open
Abstract
Tauopathies are disorders associated with tau protein dysfunction and insoluble tau accumulation in the brain at autopsy. Multiple lines of evidence from human disease, as well as nonclinical translational models, suggest that tau has a central pathologic role in these disorders, historically thought to be primarily related to tau gain of toxic function. However, a number of tau-targeting therapies with various mechanisms of action have shown little promise in clinical trials in different tauopathies. We review what is known about tau biology, genetics, and therapeutic mechanisms that have been tested in clinical trials to date. We discuss possible reasons for failures of these therapies, such as use of imperfect nonclinical models that do not predict human effects for drug development; heterogeneity of human tau pathologies which may lead to variable responses to therapy; and ineffective therapeutic mechanisms, such as targeting of the wrong tau species or protein epitope. Innovative approaches to human clinical trials can help address some of the difficulties that have plagued our field's development of tau-targeting therapies thus far. Despite limited clinical success to date, as we continue to refine our understanding of tau's pathogenic mechanism(s) in different neurodegenerative diseases, we remain optimistic that tau-targeting therapies will eventually play a central role in the treatment of tauopathies.
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Palmieri I, Poloni TE, Medici V, Zucca S, Davin A, Pansarasa O, Ceroni M, Tronconi L, Guaita A, Gagliardi S, Cereda C. Differential Neuropathology, Genetics, and Transcriptomics in Two Kindred Cases with Alzheimer’s Disease and Lewy Body Dementia. Biomedicines 2022; 10:biomedicines10071687. [PMID: 35884993 PMCID: PMC9313121 DOI: 10.3390/biomedicines10071687] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2022] [Revised: 07/02/2022] [Accepted: 07/04/2022] [Indexed: 11/17/2022] Open
Abstract
Alzheimer’s disease (AD) and Lewy body dementia (LBD) are two different forms of dementia, but their pathology may involve the same cortical areas with overlapping cognitive manifestations. Nonetheless, the clinical phenotype is different due to the topography of the lesions driven by the different underlying molecular processes that arise apart from genetics, causing diverse neurodegeneration. Here, we define the commonalities and differences in the pathological processes of dementia in two kindred cases, a mother and a son, who developed classical AD and an aggressive form of AD/LBD, respectively, through a neuropathological, genetic (next-generation sequencing), and transcriptomic (RNA-seq) comparison of four different brain areas. A genetic analysis did not reveal any pathogenic variants in the principal AD/LBD-causative genes. RNA sequencing highlighted high transcriptional dysregulation within the substantia nigra in the AD/LBD case, while the AD case showed lower transcriptional dysregulation, with the parietal lobe being the most involved brain area. The hippocampus (the most degenerated area) and basal ganglia (lacking specific lesions) expressed the lowest level of dysregulation. Our data suggest that there is a link between transcriptional dysregulation and the amount of tissue damage accumulated across time, assessed through neuropathology. Moreover, we highlight that the molecular bases of AD and LBD follow very different pathways, which underlie their neuropathological signatures. Indeed, the transcriptome profiling through RNA sequencing may be an important tool in flanking the neuropathological analysis for a deeper understanding of AD and LBD pathogenesis.
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Affiliation(s)
- Ilaria Palmieri
- IRCCS Mondino Foundation, 27100 Pavia, Italy; (I.P.); (M.C.); (S.G.); (C.C.)
| | - Tino Emanuele Poloni
- Department of Neurology-Neuropathology and Abbiategrasso Brain Bank, Golgi-Cenci Foundation, Abbiategrasso, 20081 Milan, Italy; (T.E.P.); (V.M.); (A.G.)
- Department of Rehabilitation, ASP Golgi-Redaelli, Abbiategrasso, 20081 Milan, Italy
| | - Valentina Medici
- Department of Neurology-Neuropathology and Abbiategrasso Brain Bank, Golgi-Cenci Foundation, Abbiategrasso, 20081 Milan, Italy; (T.E.P.); (V.M.); (A.G.)
| | | | - Annalisa Davin
- Laboratory of Neurobiology and Neurogenetics, Golgi Cenci Foundation, Abbiategrasso, 20081 Milan, Italy;
| | - Orietta Pansarasa
- IRCCS Mondino Foundation, 27100 Pavia, Italy; (I.P.); (M.C.); (S.G.); (C.C.)
- Correspondence:
| | - Mauro Ceroni
- IRCCS Mondino Foundation, 27100 Pavia, Italy; (I.P.); (M.C.); (S.G.); (C.C.)
- Department of Neurology-Neuropathology and Abbiategrasso Brain Bank, Golgi-Cenci Foundation, Abbiategrasso, 20081 Milan, Italy; (T.E.P.); (V.M.); (A.G.)
| | - Livio Tronconi
- U.O. Medicina Legale, IRCCS Mondino Foundation, 27100 Pavia, Italy;
- Unit of Legal Medicine and Forensic Sciences “A. Fornari”, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, 27100 Pavia, Italy
| | - Antonio Guaita
- Department of Neurology-Neuropathology and Abbiategrasso Brain Bank, Golgi-Cenci Foundation, Abbiategrasso, 20081 Milan, Italy; (T.E.P.); (V.M.); (A.G.)
- Laboratory of Neurobiology and Neurogenetics, Golgi Cenci Foundation, Abbiategrasso, 20081 Milan, Italy;
| | - Stella Gagliardi
- IRCCS Mondino Foundation, 27100 Pavia, Italy; (I.P.); (M.C.); (S.G.); (C.C.)
| | - Cristina Cereda
- IRCCS Mondino Foundation, 27100 Pavia, Italy; (I.P.); (M.C.); (S.G.); (C.C.)
- Department of Women, Mothers and Neonatal Care, Children’s Hospital “V. Buzzi”, 20100 Milan, Italy
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Piccialli I, Tedeschi V, Caputo L, D’Errico S, Ciccone R, De Feo V, Secondo A, Pannaccione A. Exploring the Therapeutic Potential of Phytochemicals in Alzheimer’s Disease: Focus on Polyphenols and Monoterpenes. Front Pharmacol 2022; 13:876614. [PMID: 35600880 PMCID: PMC9114803 DOI: 10.3389/fphar.2022.876614] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Accepted: 04/11/2022] [Indexed: 12/21/2022] Open
Abstract
Alzheimer’s disease (AD) is a chronic, complex neurodegenerative disorder mainly characterized by the irreversible loss of memory and cognitive functions. Different hypotheses have been proposed thus far to explain the etiology of this devastating disorder, including those centered on the Amyloid-β (Aβ) peptide aggregation, Tau hyperphosphorylation, neuroinflammation and oxidative stress. Nonetheless, the therapeutic strategies conceived thus far to treat AD neurodegeneration have proven unsuccessful, probably due to the use of single-target drugs unable to arrest the progressive deterioration of brain functions. For this reason, the theoretical description of the AD etiology has recently switched from over-emphasizing a single deleterious process to considering AD neurodegeneration as the result of different pathogenic mechanisms and their interplay. Moreover, much relevance has recently been conferred to several comorbidities inducing insulin resistance and brain energy hypometabolism, including diabetes and obesity. As consequence, much interest is currently accorded in AD treatment to a multi-target approach interfering with different pathways at the same time, and to life-style interventions aimed at preventing the modifiable risk-factors strictly associated with aging. In this context, phytochemical compounds are emerging as an enormous source to draw on in the search for multi-target agents completing or assisting the traditional pharmacological medicine. Intriguingly, many plant-derived compounds have proven their efficacy in counteracting several pathogenic processes such as the Aβ aggregation, neuroinflammation, oxidative stress and insulin resistance. Many strategies have also been conceived to overcome the limitations of some promising phytochemicals related to their poor pharmacokinetic profiles, including nanotechnology and synthetic routes. Considering the emerging therapeutic potential of natural medicine, the aim of the present review is therefore to highlight the most promising phytochemical compounds belonging to two major classes, polyphenols and monoterpenes, and to report the main findings about their mechanisms of action relating to the AD pathogenesis.
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Affiliation(s)
- Ilaria Piccialli
- Division of Pharmacology, Department of Neuroscience, Reproductive and Dentistry Sciences, School of Medicine, University of Naples “Federico II”, Naples, Italy
| | - Valentina Tedeschi
- Division of Pharmacology, Department of Neuroscience, Reproductive and Dentistry Sciences, School of Medicine, University of Naples “Federico II”, Naples, Italy
| | - Lucia Caputo
- Department of Pharmacy, University of Salerno, Salerno, Italy
| | - Stefano D’Errico
- Department of Pharmacy, University of Naples “Federico II”, Naples, Italy
| | - Roselia Ciccone
- Division of Pharmacology, Department of Neuroscience, Reproductive and Dentistry Sciences, School of Medicine, University of Naples “Federico II”, Naples, Italy
| | - Vincenzo De Feo
- Department of Pharmacy, University of Salerno, Salerno, Italy
| | - Agnese Secondo
- Division of Pharmacology, Department of Neuroscience, Reproductive and Dentistry Sciences, School of Medicine, University of Naples “Federico II”, Naples, Italy
| | - Anna Pannaccione
- Division of Pharmacology, Department of Neuroscience, Reproductive and Dentistry Sciences, School of Medicine, University of Naples “Federico II”, Naples, Italy
- *Correspondence: Anna Pannaccione,
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Huq AJ, Sexton A, Lacaze P, Masters CL, Storey E, Velakoulis D, James PA, Winship IM. Genetic testing in dementia-A medical genetics perspective. Int J Geriatr Psychiatry 2021; 36:1158-1170. [PMID: 33779003 DOI: 10.1002/gps.5535] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Revised: 02/15/2021] [Accepted: 02/26/2021] [Indexed: 01/11/2023]
Abstract
OBJECTIVE When a genetic cause is suspected in a person with dementia, it creates unique diagnostic and management challenges to the treating clinician. Many clinicians may be unaware of the practicalities surrounding genetic testing for their patients, such as when to test and what tests to use and how to counsel patients and their families. This review was conducted to provide guidance to clinicians caring for patients with dementia regarding clinically relevant genetics. METHODS We searched PubMed for studies that involved genetics of dementia up to March 2020. Patient file reviews were also conducted to create composite cases. RESULTS In addition to families where a strong Mendelian pattern of family history is seen, people with younger age of onset, especially before the age of 65 years were found to be at an increased risk of harbouring a genetic cause for their dementia. This review discusses some of the most common genetic syndromes, including Alzheimer disease, frontotemporal dementia, vascular dementia, Parkinson disease dementia/dementia with Lewy bodies and some rarer types of genetic dementias, along with illustrative clinical case studies. This is followed by a brief review of the current genetic technologies and a discussion on the unique genetic counselling issues in dementia. CONCLUSIONS Inclusion of genetic testing in the diagnostic pathway in some patients with dementia could potentially reduce the time taken to diagnose the cause of their dementia. Although a definite advantage as an addition to the diagnostic repository, genetic testing has many pros and cons which need to be carefully considered first.
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Affiliation(s)
- Aamira J Huq
- Department of Genomic Medicine, The Royal Melbourne Hospital, Parkville, Victoria, Australia.,Department of Medicine, Faculty of Medicine Dentistry and Health Sciences, University of Melbourne, Parkville, Victoria, Australia
| | - Adrienne Sexton
- Department of Genomic Medicine, The Royal Melbourne Hospital, Parkville, Victoria, Australia
| | - Paul Lacaze
- Department of Genomic Medicine, The Royal Melbourne Hospital, Parkville, Victoria, Australia.,Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, The Alfred Centre, Melbourne, Victoria, Australia
| | - Colin L Masters
- Neurosciences, The Florey Institute, The University of Melbourne, Parkville, Victoria, Australia
| | - Elsdon Storey
- Department of Genomic Medicine, The Royal Melbourne Hospital, Parkville, Victoria, Australia
| | - Dennis Velakoulis
- Department of Neuropsychiatry, The Royal Melbourne Hospital, Parkville, Victoria, Australia
| | - Paul A James
- Department of Genomic Medicine, The Royal Melbourne Hospital, Parkville, Victoria, Australia
| | - Ingrid M Winship
- Department of Genomic Medicine, The Royal Melbourne Hospital, Parkville, Victoria, Australia.,Department of Medicine, Faculty of Medicine Dentistry and Health Sciences, University of Melbourne, Parkville, Victoria, Australia
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Petretto DR, Carrogu GP, Gaviano L, Pili L, Pili R. Dementia and Major Neurocognitive Disorders: Some Lessons Learned One Century after the first Alois Alzheimer's Clinical Notes. Geriatrics (Basel) 2021; 6:5. [PMID: 33440669 PMCID: PMC7838901 DOI: 10.3390/geriatrics6010005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Accepted: 01/06/2021] [Indexed: 11/30/2022] Open
Abstract
Over 100 years ago, Alois Alzheimer presented the clinical signs and symptoms of what has been later called "Alzheimer Dementia" in a young woman whose name was Augustine Deter [...].
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Affiliation(s)
- Donatella Rita Petretto
- Department of Education, Psychology and Philosophy, University of Cagliari, Via Is Mirrionis 1, 09127 Cagliari, Italy; (G.P.C.); (L.G.); (L.P.)
| | - Gian Pietro Carrogu
- Department of Education, Psychology and Philosophy, University of Cagliari, Via Is Mirrionis 1, 09127 Cagliari, Italy; (G.P.C.); (L.G.); (L.P.)
- Global Community on Longevity, Comunità Mondiale della Longevità, Selargius 09047, Italy; IERFOP Onlus, Cagliari, 09134
| | - Luca Gaviano
- Department of Education, Psychology and Philosophy, University of Cagliari, Via Is Mirrionis 1, 09127 Cagliari, Italy; (G.P.C.); (L.G.); (L.P.)
- Global Community on Longevity, Comunità Mondiale della Longevità, Selargius 09047, Italy; IERFOP Onlus, Cagliari, 09134
| | - Lorenzo Pili
- Department of Education, Psychology and Philosophy, University of Cagliari, Via Is Mirrionis 1, 09127 Cagliari, Italy; (G.P.C.); (L.G.); (L.P.)
- Global Community on Longevity, Comunità Mondiale della Longevità, Selargius 09047, Italy; IERFOP Onlus, Cagliari, 09134
| | - Roberto Pili
- Global Community on Longevity, Comunità Mondiale della Longevità, Selargius 09047, Italy; IERFOP Onlus, Cagliari, 09134
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