1
|
Wilhelm SDP, Moresco AA, Rivero AD, Siu VM, Heinemann IU. Characterization of a novel heterozygous variant in the histidyl-tRNA synthetase gene associated with Charcot-Marie-Tooth disease type 2W. IUBMB Life 2024. [PMID: 39352000 DOI: 10.1002/iub.2918] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2024] [Accepted: 09/01/2024] [Indexed: 10/03/2024]
Abstract
Heterozygous pathogenic variants in the histidyl-tRNA synthetase (HARS) gene are associated with Charcot-Marie-Tooth (CMT) type 2W disease, classified as an axonal peripheral neuropathy. To date, at least 60 variants causing CMT symptoms have been identified in seven different aminoacyl-tRNA synthetases, with eight being found in the catalytic domain of HARS. The genetic data clearly show a causative role of aminoacyl-tRNA synthetases in CMT; however, the cellular mechanisms leading to pathology can vary widely and are unknown in the case of most identified variants. Here we describe a novel HARS variant, c.412T>C; p.Y138H, identified through a CMT gene panel in a patient with peripheral neuropathy. To determine the effect of p.Y138H we employed a humanized HARS yeast model and recombinant protein biochemistry, which identified a deficiency in protein dimerization and a growth defect which shows mild but significant improvement with histidine supplementation. This raises the potential for a clinical trial of histidine.
Collapse
Affiliation(s)
- Sarah D P Wilhelm
- Department of Biochemistry, The University of Western Ontario, London, Ontario, Canada
| | - Angelica A Moresco
- Division of Medical Genetics, Department of Paediatrics, The University of Western Ontario, London, Ontario, Canada
| | - Alberto D Rivero
- Institute for Neurological Research (FLENI), Buenos Aires, Argentina
| | - Victoria Mok Siu
- Division of Medical Genetics, Department of Paediatrics, The University of Western Ontario, London, Ontario, Canada
- Children's Health Research Institute, London, Ontario, Canada
| | - Ilka U Heinemann
- Department of Biochemistry, The University of Western Ontario, London, Ontario, Canada
- Children's Health Research Institute, London, Ontario, Canada
| |
Collapse
|
2
|
van Eyll J, Prior R, Celanire S, Van Den Bosch L, Rombouts F. Therapeutic indications for HDAC6 inhibitors in the peripheral and central nervous disorders. Expert Opin Ther Targets 2024; 28:719-737. [PMID: 39305025 DOI: 10.1080/14728222.2024.2404571] [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: 04/16/2024] [Accepted: 09/06/2024] [Indexed: 09/26/2024]
Abstract
INTRODUCTION Inhibition of the enzymatic function of HDAC6 is currently being explored in clinical trials ranging from peripheral neuropathies to cancers. Advances in selective HDAC6 inhibitor discovery allowed studying highly efficacious brain penetrant and peripheral restrictive compounds for treating PNS and CNS indications. AREAS COVERED This review explores the multifactorial role of HDAC6 in cells, the common pathological hallmarks of PNS and CNS disorders, and how HDAC6 modulates these mechanisms. Pharmacological inhibition of HDAC6 and genetic knockout/knockdown studies as a therapeutic strategy in PNS and CNS indications were analyzed. Furthermore, we describe the recent developments in HDAC6 PET tracers and their utility in CNS indications. Finally, we explore the advancements and challenges with HDAC6 inhibitor compounds, such as hydroxamic acid, fluoromethyl oxadiazoles, HDAC6 degraders, and thiol-based inhibitors. EXPERT OPINION Based on extensive preclinical evidence, pharmacological inhibition of HDAC6 is a promising approach for treating both PNS and CNS disorders, given its involvement in neurodegeneration and aging-related cellular processes. Despite the progress in the development of selective HDAC6 inhibitors, safety concerns remain regarding their chronic administration in PNS and CNS indications, and the development of novel compound classes and modalities inhibiting HDAC6 function offer a way to mitigate some of these safety concerns.
Collapse
Affiliation(s)
| | | | - Sylvain Celanire
- Augustine Therapeutics, Research and Development, Leuven, Belgium
| | - Ludo Van Den Bosch
- Department of Neurosciences, Experimental Neurology and Leuven Brain Institute (LBI), KU Leuven - University of Leuven, Leuven, Belgium
- VIB, Center for Brain & Disease Research, Laboratory of Neurobiology, Leuven, Belgium
| | | |
Collapse
|
3
|
Artiukhov AV, Solovjeva ON, Balashova NV, Sidorova OP, Graf AV, Bunik VI. Pharmacological Doses of Thiamine Benefit Patients with the Charcot-Marie-Tooth Neuropathy by Changing Thiamine Diphosphate Levels and Affecting Regulation of Thiamine-Dependent Enzymes. BIOCHEMISTRY. BIOKHIMIIA 2024; 89:1161-1182. [PMID: 39218016 DOI: 10.1134/s0006297924070010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/12/2024] [Revised: 05/28/2024] [Accepted: 05/28/2024] [Indexed: 09/04/2024]
Abstract
Charcot-Marie-Tooth (CMT) neuropathy is a polygenic disorder of peripheral nerves with no effective cure. Thiamine (vitamin B1) is a neurotropic compound that improves neuropathies. Our pilot study characterizes therapeutic potential of daily oral administration of thiamine (100 mg) in CMT neuropathy and its molecular mechanisms. The patient hand grip strength was determined before and after thiamine administration along with the blood levels of the thiamine coenzyme form (thiamine diphosphate, ThDP), activities of endogenous holo-transketolase (without ThDP in the assay medium) and total transketolase (with ThDP in the assay medium), and transketolase activation by ThDP [1 - (holo-transketolase/total transketolase),%], corresponding to the fraction of ThDP-free apo-transketolase. Single cases of administration of sulbutiamine (200 mg) or benfotiamine (150 mg) reveal their effects on the assayed parameters within those of thiamine. Administration of thiamine or its pharmacological forms increased the hand grip strength in the CMT patients. Comparison of the thiamin status in patients with different forms of CMT disease to that of control subjects without diagnosed pathologies revealed no significant differences in the average levels of ThDP, holo-transketolase, or relative content of holo and apo forms of transketolase. However, the regulation of transketolase by thiamine/ThDP differed in the control and CMT groups: in the assay, ThDP activated transketolase from the control individuals, but not from CMT patients. Thiamine administration paradoxically decreased endogenous holo-transketolase in CMT patients; this effect was not observed in the control group. Correlation analysis revealed sex-specific differences in the relationship between the parameters of thiamine status in both the control subjects and patients with the CMT disease. Thus, our findings link physiological benefits of thiamine administration in CMT patients to changes in their thiamine status, in particular, the blood levels of ThDP and transketolase regulation.
Collapse
Affiliation(s)
- Artem V Artiukhov
- Belozersky Institute of Physico-Chemical Biology, Lomonosov Moscow State University, Moscow, 119234, Russia
- Department of Biochemistry, Sechenov University, Moscow, 119991, Russia
| | - Olga N Solovjeva
- Belozersky Institute of Physico-Chemical Biology, Lomonosov Moscow State University, Moscow, 119234, Russia
| | - Natalia V Balashova
- Faculty of Advanced Medicine, Vladimirsky Moscow Regional Research and Clinical Institute, Moscow, 129110, Russia
- Faculty of Continuing Medical Education, RUDN Medical Institute, Moscow, 117198, Russia
| | - Olga P Sidorova
- Department of Neurology, Vladimirsky Moscow Regional Research and Clinical Institute, Moscow, 129110, Russia
| | - Anastasia V Graf
- Belozersky Institute of Physico-Chemical Biology, Lomonosov Moscow State University, Moscow, 119234, Russia
- Faculty of Biology, Lomonosov Moscow State University, Moscow, 119234, Russia
| | - Victoria I Bunik
- Belozersky Institute of Physico-Chemical Biology, Lomonosov Moscow State University, Moscow, 119234, Russia.
- Department of Biochemistry, Sechenov University, Moscow, 119991, Russia
- Faculty of Bioengineering and Bioinformatics, Lomonosov Moscow State University, Moscow, 119234, Russia
| |
Collapse
|
4
|
Tadenev ALD, Hatton CL, Burgess RW. Lack of effect from genetic deletion of Hdac6 in a humanized mouse model of CMT2D. J Peripher Nerv Syst 2024; 29:213-220. [PMID: 38551018 PMCID: PMC11209801 DOI: 10.1111/jns.12623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2024] [Revised: 03/11/2024] [Accepted: 03/18/2024] [Indexed: 06/27/2024]
Abstract
BACKGROUND Inhibition of HDAC6 has been proposed as a broadly applicable therapeutic strategy for Charcot-Marie-Tooth disease (CMT). Inhibition of HDAC6 increases the acetylation of proteins important in axonal trafficking, such as α-tubulin and Miro, and has been shown to be efficacious in several preclinical studies using mouse models of CMT. AIMS Here, we sought to expand on previous preclinical studies by testing the effect of genetic deletion of Hdac6 on mice carrying a humanized knockin allele of Gars1, a model of CMT-type 2D. METHODS Gars1ΔETAQ mice were bred to an Hdac6 knockout strain, and the resulting offspring were evaluated for clinically relevant outcomes. RESULTS The genetic deletion of Hdac6 increased α-tubulin acetylation in the sciatic nerves of both wild-type and Gars1ΔETAQ mice. However, when tested at 5 weeks of age, the Gars1ΔETAQ mice lacking Hdac6 showed no changes in body weight, muscle atrophy, grip strength or endurance, sciatic motor nerve conduction velocity, compound muscle action potential amplitude, or peripheral nerve histopathology compared to Gars1ΔETAQ mice with intact Hdac6. INTERPRETATION Our results differ from those of two previous studies that demonstrated the benefit of the HDAC6 inhibitor tubastatin A in mouse models of CMT2D. While we cannot fully explain the different outcomes, our results offer a counterexample to the benefit of inhibiting HDAC6 in CMT2D, suggesting additional research is necessary.
Collapse
|
5
|
Van Lent J, Prior R, Pérez Siles G, Cutrupi AN, Kennerson ML, Vangansewinkel T, Wolfs E, Mukherjee-Clavin B, Nevin Z, Judge L, Conklin B, Tyynismaa H, Clark AJ, Bennett DL, Van Den Bosch L, Saporta M, Timmerman V. Advances and challenges in modeling inherited peripheral neuropathies using iPSCs. Exp Mol Med 2024; 56:1348-1364. [PMID: 38825644 PMCID: PMC11263568 DOI: 10.1038/s12276-024-01250-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Revised: 02/21/2024] [Accepted: 03/18/2024] [Indexed: 06/04/2024] Open
Abstract
Inherited peripheral neuropathies (IPNs) are a group of diseases associated with mutations in various genes with fundamental roles in the development and function of peripheral nerves. Over the past 10 years, significant advances in identifying molecular disease mechanisms underlying axonal and myelin degeneration, acquired from cellular biology studies and transgenic fly and rodent models, have facilitated the development of promising treatment strategies. However, no clinical treatment has emerged to date. This lack of treatment highlights the urgent need for more biologically and clinically relevant models recapitulating IPNs. For both neurodevelopmental and neurodegenerative diseases, patient-specific induced pluripotent stem cells (iPSCs) are a particularly powerful platform for disease modeling and preclinical studies. In this review, we provide an update on different in vitro human cellular IPN models, including traditional two-dimensional monoculture iPSC derivatives, and recent advances in more complex human iPSC-based systems using microfluidic chips, organoids, and assembloids.
Collapse
Grants
- Wellcome Trust
- R01 NS119678 NINDS NIH HHS
- U01 ES032673 NIEHS NIH HHS
- DOC-PRO4 Universiteit Antwerpen (University of Antwerp)
- This work was supported in part by the University of Antwerp (DOC-PRO4 PhD fellowship to J.V.L. and TOP-BOF research grant no. 38694 to V.T.), the Association Française contre les Myopathies (AFM research grant no. 24063 to V.T.), Association Belge contre les Maladies Neuromusculaires (ABMM research grant no. 1 to J.V.L and V.T), the interuniversity research fund (iBOF project to. L.V.D.B, E.W. and V.T.). V.T. is part of the μNEURO Research Centre of Excellence of the University of Antwerp and is an active member of the European Network for Stem Cell Core Facilities (CorEUStem, COST Action CA20140). Work in the M.L.K group was supported by the NHMRC Ideas Grant (APP1186867), CMT Australia Grant awarded to M.L.K and G.P.-S and the Australian Medical Research Future Fund (MRFF) Genomics Health Futures Mission Grant 2007681. B.M.C. is supported by the American Academy of Neurology and the Passano Foundation. L.M.J. and B.R.C. are supported by the Charcot-Marie-Tooth Association, NINDS R01 NS119678, NIEHS U01 ES032673. H.T. is supported by Academy of Finland Centre of Excellence in Stem Cell Metabolism and Sigrid Juselius Foundation. Work in the D.L.B. group is supported by a Wellcome Investigator Grant (223149/Z/21/Z), the MRC (MR/T020113/1), and with funding from the MRC and Versus Arthritis to the PAINSTORM consortium as part of the Advanced Pain Discovery Platform (MR/W002388/1).
- Australian Medical Association (Australian Medical Association Limited)
- Universiteit Hasselt (UHasselt)
- American Academy of Neurology (AAN)
- Gladstone Institutes (J. David Gladstone Institutes)
- Academy of Finland (Suomen Akatemia)
- Academy of Medical Royal Colleges (AoMRC)
- Wellcome Trust (Wellcome)
- Oxford University Hospitals NHS Trust (Oxford University Hospitals National Health Service Trust)
- KU Leuven (Katholieke Universiteit Leuven)
- Vlaams Instituut voor Biotechnologie (Flanders Institute for Biotechnology)
- Miami University | Leonard M. Miller School of Medicine (Miller School of Medicine)
Collapse
Affiliation(s)
- Jonas Van Lent
- Peripheral Neuropathy Research Group, Department of Biomedical Sciences, University of Antwerp, 2610, Antwerp, Belgium
- Laboratory of Neuromuscular Pathology, Institute Born Bunge, 2610, Antwerp, Belgium
- Institute of Oncology Research (IOR), BIOS+, 6500, Bellinzona, Switzerland
- Università della Svizzera Italiana, 6900, Lugano, Switzerland
| | - Robert Prior
- Universitätsklinikum Bonn (UKB), University of Bonn, Bonn, Germany
| | - Gonzalo Pérez Siles
- Northcott Neuroscience Laboratory, ANZAC Research Institute Sydney Local Health District and Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
| | - Anthony N Cutrupi
- Northcott Neuroscience Laboratory, ANZAC Research Institute Sydney Local Health District and Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
| | - Marina L Kennerson
- Northcott Neuroscience Laboratory, ANZAC Research Institute Sydney Local Health District and Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
- Molecular Medicine Laboratory, Concord Hospital, Sydney, NSW, Australia
| | - Tim Vangansewinkel
- UHasselt - Hasselt University, BIOMED, Laboratory for Functional Imaging and Research on Stem Cells (FIERCE Lab), Agoralaan, 3590, Diepenbeek, Belgium
- VIB-Center for Brain and Disease Research, Laboratory of Neurobiology, 3000, Leuven, Belgium
| | - Esther Wolfs
- UHasselt - Hasselt University, BIOMED, Laboratory for Functional Imaging and Research on Stem Cells (FIERCE Lab), Agoralaan, 3590, Diepenbeek, Belgium
| | | | | | - Luke Judge
- Gladstone Institutes, San Francisco, CA, USA
- Department of Pediatrics, University of California, San Francisco, San Francisco, CA, USA
| | - Bruce Conklin
- Gladstone Institutes, San Francisco, CA, USA
- Department of Ophthalmology, University of California, San Francisco, San Francisco, CA, USA
- Department of Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - Henna Tyynismaa
- Stem Cells and Metabolism Research Program, Faculty of Medicine, University of Helsinki, 00290, Helsinki, Finland
| | - Alex J Clark
- Blizard Institute, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - David L Bennett
- Nuffield Department of Clinical Neuroscience, Oxford University, Oxford, UK
| | - Ludo Van Den Bosch
- VIB-Center for Brain and Disease Research, Laboratory of Neurobiology, 3000, Leuven, Belgium
- Department of Neurosciences, Experimental Neurology, and Leuven Brain Institute, KU Leuven-University of Leuven, 3000, Leuven, Belgium
| | - Mario Saporta
- Department of Neurology, Miller School of Medicine, University of Miami, Miami, FL, USA
| | - Vincent Timmerman
- Peripheral Neuropathy Research Group, Department of Biomedical Sciences, University of Antwerp, 2610, Antwerp, Belgium.
- Laboratory of Neuromuscular Pathology, Institute Born Bunge, 2610, Antwerp, Belgium.
| |
Collapse
|
6
|
Leale I, Di Stefano V, Costanza C, Brighina F, Roccella M, Palma A, Battaglia G. Telecoaching: a potential new training model for Charcot-Marie-Tooth patients: a systematic review. Front Neurol 2024; 15:1359091. [PMID: 38784904 PMCID: PMC11112069 DOI: 10.3389/fneur.2024.1359091] [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: 12/29/2023] [Accepted: 04/24/2024] [Indexed: 05/25/2024] Open
Abstract
Introduction Charcot-Marie-Tooth disease (CMT) is an inherited neuropathy that affects the sensory and motor nerves. It can be considered the most common neuromuscular disease, with a prevalence of 1/2500. Methods Considering the absence of a specific medical treatment and the benefits shown by physical activity in this population, a systematic review was completed using several search engines (Scopus, PubMed, and Web of Science) to analyze the use, effectiveness, and safety of a training program performed in telecoaching (TC). TC is a new training mode that uses mobile devices and digital technology to ensure remote access to training. Results Of the 382 studies identified, only 7 met the inclusion criteria. The effects of a TC training program included improvements in strength, cardiovascular ability, and functional abilities, as well as gait and fatigue. However, the quality of the studies was moderate, the size of the participants in each study was small, and the outcome measured was partial. Discussion Although many studies have identified statistically significant changes following the administration of the TC training protocol, further studies are needed, with appropriate study power, better quality, and a higher sample size.
Collapse
Affiliation(s)
- Ignazio Leale
- Sport and Exercise Research Unit, Department of Psychology, Educational Sciences and Human Movement, University of Palermo, Palermo, Italy
- Ph.D. Program in Health Promotion and Cognitive Sciences, University of Palermo, Palermo, Italy
- Department of Psychology, Educational Science and Human Movement, University of Palermo, Palermo, Italy
| | - Vincenzo Di Stefano
- Neurology Unit, Department of Biomedicine, Neuroscience, and Advanced Diagnostics (BiND), University of Palermo, Palermo, Italy
| | - Carola Costanza
- Department of Sciences for Health Promotion and Mother and Child Care “G. D’Alessandro”, University of Palermo, Palermo, Italy
| | - Filippo Brighina
- Neurology Unit, Department of Biomedicine, Neuroscience, and Advanced Diagnostics (BiND), University of Palermo, Palermo, Italy
| | - Michele Roccella
- Department of Psychology, Educational Science and Human Movement, University of Palermo, Palermo, Italy
| | - Antonio Palma
- Sport and Exercise Research Unit, Department of Psychology, Educational Sciences and Human Movement, University of Palermo, Palermo, Italy
- Department of Psychology, Educational Science and Human Movement, University of Palermo, Palermo, Italy
| | - Giuseppe Battaglia
- Sport and Exercise Research Unit, Department of Psychology, Educational Sciences and Human Movement, University of Palermo, Palermo, Italy
- Department of Psychology, Educational Science and Human Movement, University of Palermo, Palermo, Italy
- Regional Sports School of Italian National Olympic Committee (CONI) Sicilia, Palermo, Italy
| |
Collapse
|
7
|
Murray GC, Hines TJ, Tadenev ALD, Xu I, Züchner S, Burgess RW. Testing SIPA1L2 as a modifier of CMT1A using mouse models. J Neuropathol Exp Neurol 2024; 83:318-330. [PMID: 38472136 PMCID: PMC11029467 DOI: 10.1093/jnen/nlae020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/14/2024] Open
Abstract
Charcot-Marie-Tooth disease type 1A (CMT1A) is a demyelinating peripheral neuropathy caused by the duplication of peripheral myelin protein 22 (PMP22), leading to muscle weakness and loss of sensation in the hands and feet. A recent case-only genome-wide association study of CMT1A patients conducted by the Inherited Neuropathy Consortium identified a strong association between strength of foot dorsiflexion and variants in signal induced proliferation associated 1 like 2 (SIPA1L2), indicating that it may be a genetic modifier of disease. To validate SIPA1L2 as a candidate modifier and to assess its potential as a therapeutic target, we engineered mice with deletion of exon 1 (including the start codon) of the Sipa1l2 gene and crossed them to the C3-PMP22 mouse model of CMT1A. Neuromuscular phenotyping showed that Sipa1l2 deletion in C3-PMP22 mice preserved muscular endurance assayed by inverted wire hang duration and changed femoral nerve axon morphometrics such as myelin thickness. Gene expression changes suggest involvement of Sipa1l2 in cholesterol biosynthesis, a pathway that is also implicated in C3-PMP22 mice. Although Sipa1l2 deletion did impact CMT1A-associated phenotypes, thereby validating a genetic interaction, the overall effect on neuropathy was mild.
Collapse
Affiliation(s)
- George C Murray
- The Jackson Laboratory, Bar Harbor, Maine, USA
- The Graduate School of Biomedical Science and Engineering, The University of Maine, Orono, Maine, USA
| | | | | | - Isaac Xu
- Department of Human Genetics and John P Hussman Institute for Human Genomics, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Stephan Züchner
- Department of Human Genetics and John P Hussman Institute for Human Genomics, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Robert W Burgess
- The Jackson Laboratory, Bar Harbor, Maine, USA
- The Graduate School of Biomedical Science and Engineering, The University of Maine, Orono, Maine, USA
| |
Collapse
|
8
|
Rhymes ER, Simkin RL, Qu J, Villarroel-Campos D, Surana S, Tong Y, Shapiro R, Burgess RW, Yang XL, Schiavo G, Sleigh JN. Boosting BDNF in muscle rescues impaired axonal transport in a mouse model of DI-CMTC peripheral neuropathy. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2024:2023.04.09.536152. [PMID: 38559020 PMCID: PMC10979848 DOI: 10.1101/2023.04.09.536152] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 04/04/2024]
Abstract
Charcot-Marie-Tooth disease (CMT) is a genetic peripheral neuropathy caused by mutations in many functionally diverse genes. The aminoacyl-tRNA synthetase (ARS) enzymes, which transfer amino acids to partner tRNAs for protein synthesis, represent the largest protein family genetically linked to CMT aetiology, suggesting pathomechanistic commonalities. Dominant intermediate CMT type C (DI-CMTC) is caused by YARS1 mutations driving a toxic gain-of-function in the encoded tyrosyl-tRNA synthetase (TyrRS), which is mediated by exposure of consensus neomorphic surfaces through conformational changes of the mutant protein. In this study, we first showed that human DI-CMTC-causing TyrRSE196K mis-interacts with the extracellular domain of the BDNF receptor TrkB, an aberrant association we have previously characterised for several mutant glycyl-tRNA synthetases linked to CMT type 2D (CMT2D). We then performed temporal neuromuscular assessments of YarsE196K mice modelling DI-CMT. We determined that YarsE196K homozygotes display a selective, age-dependent impairment in in vivo axonal transport of neurotrophin-containing signalling endosomes, phenocopying CMT2D mice. This impairment is replicated by injection of recombinant TyrRSE196K, but not TyrRSWT, into muscles of wild-type mice. Augmenting BDNF in DI-CMTC muscles, through injection of recombinant protein or muscle-specific gene therapy, resulted in complete axonal transport correction. Therefore, this work identifies a non-cell autonomous pathomechanism common to ARS-related neuropathies, and highlights the potential of boosting BDNF levels in muscles as a therapeutic strategy.
Collapse
Affiliation(s)
- Elena R. Rhymes
- Department of Neuromuscular Diseases and UCL Queen Square Motor Neuron Disease Centre, Queen Square Institute of Neurology, University College London, London WC1N 3BG, UK
| | - Rebecca L. Simkin
- Department of Neuromuscular Diseases and UCL Queen Square Motor Neuron Disease Centre, Queen Square Institute of Neurology, University College London, London WC1N 3BG, UK
| | - Ji Qu
- Department of Neuromuscular Diseases and UCL Queen Square Motor Neuron Disease Centre, Queen Square Institute of Neurology, University College London, London WC1N 3BG, UK
| | - David Villarroel-Campos
- Department of Neuromuscular Diseases and UCL Queen Square Motor Neuron Disease Centre, Queen Square Institute of Neurology, University College London, London WC1N 3BG, UK
- UK Dementia Research Institute at University College London, London WC1N 3BG, UK
| | - Sunaina Surana
- Department of Neuromuscular Diseases and UCL Queen Square Motor Neuron Disease Centre, Queen Square Institute of Neurology, University College London, London WC1N 3BG, UK
- UK Dementia Research Institute at University College London, London WC1N 3BG, UK
| | - Yao Tong
- Department of Molecular Medicine, The Scripps Research Institute, La Jolla, CA 92037, USA
| | - Ryan Shapiro
- Department of Molecular Medicine, The Scripps Research Institute, La Jolla, CA 92037, USA
| | | | - Xiang-Lei Yang
- Department of Molecular Medicine, The Scripps Research Institute, La Jolla, CA 92037, USA
| | - Giampietro Schiavo
- Department of Neuromuscular Diseases and UCL Queen Square Motor Neuron Disease Centre, Queen Square Institute of Neurology, University College London, London WC1N 3BG, UK
- UK Dementia Research Institute at University College London, London WC1N 3BG, UK
| | - James N. Sleigh
- Department of Neuromuscular Diseases and UCL Queen Square Motor Neuron Disease Centre, Queen Square Institute of Neurology, University College London, London WC1N 3BG, UK
- UK Dementia Research Institute at University College London, London WC1N 3BG, UK
| |
Collapse
|
9
|
Murray GC, Hines TJ, Tadenev ALD, Xu I, Züchner S, Burgess RW. Testing SIPA1L2 as a modifier of CMT1A using mouse models. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2023:2023.11.30.569428. [PMID: 38076977 PMCID: PMC10705403 DOI: 10.1101/2023.11.30.569428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/17/2023]
Abstract
Charcot-Marie-Tooth 1A is a demyelinating peripheral neuropathy caused by the duplication of peripheral myelin protein 22 (PMP22), which produces muscle weakness and loss of sensation in the hands and feet. A recent case-only genome wide association study by the Inherited Neuropathy Consortium identified a strong association between variants in signal induced proliferation associated 1 like 2 (SIPA1L2) and strength of foot dorsiflexion. To validate SIPA1L2 as a candidate modifier, and to assess its potential as a therapeutic target, we engineered mice with a deletion in SIPA1L2 and crossed them to the C3-PMP22 mouse model of CMT1A. We performed neuromuscular phenotyping and identified an interaction between Sipa1l2 deletion and muscular endurance decrements assayed by wire-hang duration in C3-PMP22 mice, as well as several interactions in femoral nerve axon morphometrics such as myelin thickness. Gene expression changes suggested an involvement of Sipa1l2 in cholesterol biosynthesis, which was also implicated in C3-PMP22 mice. Though several interactions between Sipa1l2 deletion and CMT1A-associated phenotypes were identified, validating a genetic interaction, the overall effect on neuropathy was small.
Collapse
Affiliation(s)
- George C Murray
- The Jackson Laboratory, Bar Harbor, ME 04609
- The Graduate School of Biomedical Science and Engineering, The University of Maine, Orono, ME 04469
| | | | | | - Isaac Xu
- Department of Human Genetics and John P. Hussman Institute for Human Genomics, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Stephan Züchner
- Department of Human Genetics and John P. Hussman Institute for Human Genomics, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Robert W Burgess
- The Jackson Laboratory, Bar Harbor, ME 04609
- The Graduate School of Biomedical Science and Engineering, The University of Maine, Orono, ME 04469
| |
Collapse
|
10
|
Van Lent J, Vendredy L, Adriaenssens E, Da Silva Authier T, Asselbergh B, Kaji M, Weckhuysen S, Van Den Bosch L, Baets J, Timmerman V. Downregulation of PMP22 ameliorates myelin defects in iPSC-derived human organoid cultures of CMT1A. Brain 2023; 146:2885-2896. [PMID: 36511878 PMCID: PMC10316758 DOI: 10.1093/brain/awac475] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Revised: 11/23/2022] [Accepted: 11/27/2022] [Indexed: 10/11/2023] Open
Abstract
Charcot-Marie-Tooth disease is the most common inherited disorder of the PNS. CMT1A accounts for 40-50% of all cases and is caused by a duplication of the PMP22 gene on chromosome 17, leading to dysmyelination in the PNS. Patient-derived models to study such myelination defects are lacking as the in vitro generation of human myelinating Schwann cells has proved to be particularly challenging. Here, we present an induced pluripotent stem cell-derived organoid culture, containing various cell types of the PNS, including myelinating human Schwann cells, which mimics the human PNS. Single-cell analysis confirmed the PNS-like cellular composition and provides insight into the developmental trajectory. We used this organoid model to study disease signatures of CMT1A, revealing early ultrastructural myelin alterations, including increased myelin periodic line distance and hypermyelination of small axons. Furthermore, we observed the presence of onion-bulb-like formations in a later developmental stage. These hallmarks were not present in the CMT1A-corrected isogenic line or in a CMT2A iPSC line, supporting the notion that these alterations are specific to CMT1A. Downregulation of PMP22 expression using short-hairpin RNAs or a combinatorial drug consisting of baclofen, naltrexone hydrochloride and D-sorbitol was able to ameliorate the myelin defects in CMT1A-organoids. In summary, this self-organizing organoid model can capture biologically meaningful features of the disease and capture the physiological complexity, forms an excellent model for studying demyelinating diseases and supports the therapeutic approach of reducing PMP22 expression.
Collapse
Affiliation(s)
- Jonas Van Lent
- Peripheral Neuropathy Research Group, Department of Biomedical Sciences, University of Antwerp, Antwerp 2610, Belgium
- Laboratory of Neuromuscular Pathology, Institute Born Bunge, and Translational Neurosciences, Faculty of Medicine, University of Antwerp, Antwerp 2610, Belgium
| | - Leen Vendredy
- Peripheral Neuropathy Research Group, Department of Biomedical Sciences, University of Antwerp, Antwerp 2610, Belgium
- Laboratory of Neuromuscular Pathology, Institute Born Bunge, and Translational Neurosciences, Faculty of Medicine, University of Antwerp, Antwerp 2610, Belgium
| | - Elias Adriaenssens
- Peripheral Neuropathy Research Group, Department of Biomedical Sciences, University of Antwerp, Antwerp 2610, Belgium
- Laboratory of Neuromuscular Pathology, Institute Born Bunge, and Translational Neurosciences, Faculty of Medicine, University of Antwerp, Antwerp 2610, Belgium
| | - Tatiana Da Silva Authier
- Peripheral Neuropathy Research Group, Department of Biomedical Sciences, University of Antwerp, Antwerp 2610, Belgium
- Laboratory of Neuromuscular Pathology, Institute Born Bunge, and Translational Neurosciences, Faculty of Medicine, University of Antwerp, Antwerp 2610, Belgium
| | - Bob Asselbergh
- Neuromics Support Facility, VIB Center for Molecular Neurology, VIB, Antwerp 2610, Belgium
- Neuromics Support Facility, Department of Biomedical Sciences, University of Antwerp, Antwerp 2610, Belgium
| | - Marcus Kaji
- Applied & Translational Neurogenomics Group, VIB Center for Molecular Neurology, VIB, University of Antwerp, Antwerp 2610, Belgium
| | - Sarah Weckhuysen
- Applied & Translational Neurogenomics Group, VIB Center for Molecular Neurology, VIB, University of Antwerp, Antwerp 2610, Belgium
- Department of Neurology, Antwerp University Hospital, Antwerp 2610, Belgium
- Translational Neurosciences, Faculty of Medicine and Health Science, University of Antwerp, Antwerp 2610, Belgium
| | - Ludo Van Den Bosch
- Department of Neurosciences, Experimental Neurology, Leuven Brain Institute, KU Leuven—University of Leuven, Leuven 3000, Belgium
- VIB-Center for Brain & Disease Research, Laboratory of Neurobiology, Leuven 3000, Belgium
| | - Jonathan Baets
- Laboratory of Neuromuscular Pathology, Institute Born Bunge, and Translational Neurosciences, Faculty of Medicine, University of Antwerp, Antwerp 2610, Belgium
- Neuromuscular Reference Centre, Department of Neurology, Antwerp University Hospital, Antwerp 2610, Belgium
| | - Vincent Timmerman
- Peripheral Neuropathy Research Group, Department of Biomedical Sciences, University of Antwerp, Antwerp 2610, Belgium
- Laboratory of Neuromuscular Pathology, Institute Born Bunge, and Translational Neurosciences, Faculty of Medicine, University of Antwerp, Antwerp 2610, Belgium
| |
Collapse
|
11
|
Duong P, Ramesh R, Schneider A, Won S, Cooper AJ, Svaren J. Modulation of Schwann cell homeostasis by the BAP1 deubiquitinase. Glia 2023; 71:1466-1480. [PMID: 36790040 PMCID: PMC10073320 DOI: 10.1002/glia.24351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Revised: 01/24/2023] [Accepted: 01/25/2023] [Indexed: 02/16/2023]
Abstract
Schwann cell programming during myelination involves transcriptional networks that activate gene expression but also repress genes that are active in neural crest/embryonic differentiation of Schwann cells. We previously found that a Schwann cell-specific deletion of the EED subunit of the Polycomb Repressive Complex (PRC2) led to inappropriate activation of many such genes. Moreover, some of these genes become re-activated in the pro-regenerative response of Schwann cells to nerve injury, and we found premature activation of the nerve injury program in a Schwann cell-specific knockout of Eed. Polycomb-associated histone modifications include H3K27 trimethylation formed by PRC2 and H2AK119 monoubiquitination (H2AK119ub1), deposited by Polycomb repressive complex 1 (PRC1). We recently found dynamic regulation of H2AK119ub1 in Schwann cell genes after injury. Therefore, we hypothesized that H2AK119 deubiquitination modulates the dynamic polycomb repression of genes involved in Schwann cell maturation. To determine the role of H2AK119 deubiquitination, we generated a Schwann cell-specific knockout of the H2AK119 deubiquitinase Bap1 (BRCA1-associated protein). We found that loss of Bap1 causes tomacula formation, decreased axon diameters and eventual loss of myelinated axons. The gene expression changes are accompanied by redistribution of H2AK119ub1 and H3K27me3 modifications to extragenic sites throughout the genome. BAP1 interacts with OGT in the PR-DUB complex, and our data suggest that the PR-DUB complex plays a multifunctional role in repression of the injury program. Overall, our results indicate Bap1 is required to restrict the spread of polycomb-associated histone modifications in Schwann cells and to promote myelin homeostasis in peripheral nerve.
Collapse
Affiliation(s)
- Phu Duong
- Waisman Center, University of Wisconsin-Madison, Madison, Wisconsin, USA
- Cellular and Molecular Pathology Graduate Program, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Raghu Ramesh
- Waisman Center, University of Wisconsin-Madison, Madison, Wisconsin, USA
- Comparative Biomedical Sciences Graduate Program, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Andrew Schneider
- Waisman Center, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Seongsik Won
- Waisman Center, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Aaron J Cooper
- Waisman Center, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - John Svaren
- Waisman Center, University of Wisconsin-Madison, Madison, Wisconsin, USA
- Department Of Comparative Biosciences, School of Veterinary Medicine, University of Wisconsin-Madison, Madison, Wisconsin, USA
| |
Collapse
|
12
|
Higuchi Y, Takashima H. Clinical genetics of Charcot-Marie-Tooth disease. J Hum Genet 2023; 68:199-214. [PMID: 35304567 DOI: 10.1038/s10038-022-01031-2] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Revised: 03/02/2022] [Accepted: 03/06/2022] [Indexed: 02/08/2023]
Abstract
Recent research in the field of inherited peripheral neuropathies (IPNs) such as Charcot-Marie-Tooth (CMT) disease has helped identify the causative genes provided better understanding of the pathogenesis, and unraveled potential novel therapeutic targets. Several reports have described the epidemiology, clinical characteristics, molecular pathogenesis, and novel causative genes for CMT/IPNs in Japan. Based on the functions of the causative genes identified so far, the following molecular and cellular mechanisms are believed to be involved in the causation of CMTs/IPNs: myelin assembly, cytoskeletal structure, myelin-specific transcription factor, nuclear related, endosomal sorting and cell signaling, proteasome and protein aggregation, mitochondria-related, motor proteins and axonal transport, tRNA synthetases and RNA metabolism, and ion channel-related mechanisms. In this article, we review the epidemiology, genetic diagnosis, and clinicogenetic characteristics of CMT in Japan. In addition, we discuss the newly identified novel causative genes for CMT/IPNs in Japan, namely MME and COA7. Identification of the new causes of CMT will facilitate in-depth characterization of the underlying molecular mechanisms of CMT, leading to the establishment of therapeutic approaches such as drug development and gene therapy.
Collapse
Affiliation(s)
- Yujiro Higuchi
- Department of Neurology and Geriatrics, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Hiroshi Takashima
- Department of Neurology and Geriatrics, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan.
| |
Collapse
|
13
|
Kozina AA, Baryshnikova NV, Ilinskaya AY, Kim AA, Plotnikov NA, Pogodina NA, Surkova EI, Shatalov PA, Ilinsky VV. Novel mutation in the MPZ gene causes early-onset but slow-progressive Charcot-Marie-Tooth disease in a Russian family: a case report. J Int Med Res 2022; 50:3000605221139718. [PMID: 36567457 PMCID: PMC9806381 DOI: 10.1177/03000605221139718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
Charcot-Marie-Tooth disease (CMT) is a genetically heterogeneous group of peripheral neuropathies most of which are associated with mutations in four genes including peripheral myelin protein-22 (PMP22), myelin protein zero (MPZ), gap junction protein beta1 (GJB1) and mitofusin2 (MFN2). This current case report describes the clinical and genetic characteristics of a 6-year-old male proband. A physical examination revealed muscular hypotonia. He started walking on his own at 18 months. A nerve conduction study with needle electromyography revealed conduction block. A novel MPZ mutation (c.398C > T, p.Pro133Leu) was revealed in the proband. This mutation was also found in the 32-year-old father of the proband. The father had had deformity of the feet and distal muscle weakness since childhood. The novel p.Pro133Leu pathogenic mutation was responsible for early onset but slowly progressive CMT1B. We assume that this site is an intolerant to change region in the MPZ gene. This variant in the MPZ gene is an important contributor to hereditary neuropathy with reduced nerve conduction velocity in the Russian population. This case highlights the importance of whole exome sequencing for a proper clinical diagnosis of CMT associated with a mutation in the MPZ gene.
Collapse
Affiliation(s)
- Anastasiya Aleksandrovna Kozina
- Department of Medical Genomics Group, Institute of Biomedical
Chemistry, Moscow, Russia,Department of Clinical Laboratory Diagnostics, Pirogov Russian
National Research Medical University, Moscow, Russia
| | - Natalia Vladimirovna Baryshnikova
- Department of Clinical Laboratory Diagnostics, Pirogov Russian
National Research Medical University, Moscow, Russia,Department of Science, Genotek Limited, Moscow, Russia
| | | | | | | | | | - Ekaterina Ivanovna Surkova
- Department of Science, Genotek Limited, Moscow, Russia,Ekaterina Ivanovna Surkova, Department of
Science, Genotek Limited, Nastavnicheskiipereulok 17/1, Moscow, 105120, Russia.
| | - Peter Alekseevich Shatalov
- Department of Science, Genotek Limited, Moscow, Russia,Department of Molecular Genetic Service, National Medical
Research Centre of Radiology of the Ministry of Health of the Russian
Federation, Obninsk, Russia
| | | |
Collapse
|
14
|
Hines TJ, Tadenev ALD, Lone MA, Hatton CL, Bagasrawala I, Stum MG, Miers KE, Hornemann T, Burgess RW. Precision mouse models of Yars/dominant intermediate Charcot-Marie-Tooth disease type C and Sptlc1/hereditary sensory and autonomic neuropathy type 1. J Anat 2022; 241:1169-1185. [PMID: 34875719 PMCID: PMC9170831 DOI: 10.1111/joa.13605] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Revised: 11/23/2021] [Accepted: 11/26/2021] [Indexed: 01/25/2023] Open
Abstract
Animal models of neurodegenerative diseases such as inherited peripheral neuropathies sometimes accurately recreate the pathophysiology of the human disease, and sometimes accurately recreate the genetic perturbations found in patients. Ideally, models achieve both, but this is not always possible; nonetheless, such models are informative. Here we describe two animal models of inherited peripheral neuropathy: mice with a mutation in tyrosyl tRNA-synthetase, YarsE196K , modeling dominant intermediate Charcot-Marie-Tooth disease type C (diCMTC), and mice with a mutation in serine palmitoyltransferase long chain 1, Sptlc1C133W , modeling hereditary sensory and autonomic neuropathy type 1 (HSAN1). YarsE196K mice develop disease-relevant phenotypes including reduced motor performance and reduced nerve conduction velocities by 4 months of age. Peripheral motor axons are reduced in size, but there is no reduction in axon number and plasma neurofilament light chain levels are not increased. Unlike the dominant human mutations, the YarsE196K mice only show these phenotypes as homozygotes, or as compound heterozygotes with a null allele, and no phenotype is observed in E196K or null heterozygotes. The Sptlc1C133W mice carry a knockin allele and show the anticipated increase in 1-deoxysphingolipids in circulation and in a variety of tissues. They also have mild behavioral defects consistent with HSAN1, but do not show neurophysiological defects or axon loss in peripheral nerves or in the epidermis of the hind paw or tail. Thus, despite the biochemical phenotype, the Sptlc1C133W mice do not show a strong neuropathy phenotype. Surprisingly, these mice were lethal as homozygotes, but the heterozygous genotype studied corresponds to the dominant genetics seen in humans. Thus, YarsE196K homozygous mice have a relevant phenotype, but imprecisely reproduce the human genetics, whereas the Sptlc1C133W mice precisely reproduce the human genetics, but do not recreate the disease phenotype. Despite these shortcomings, both models are informative and will be useful for future research.
Collapse
Affiliation(s)
| | | | - Museer A Lone
- Institute for Clinical Chemistry, University of Zurich, Zurich, Switzerland
| | | | | | | | | | - Thorsten Hornemann
- Institute for Clinical Chemistry, University of Zurich, Zurich, Switzerland
| | | |
Collapse
|
15
|
Ostertag C, Klein D, Martini R. Presymptomatic macrophage targeting has a long-lasting therapeutic effect on treatment termination. Exp Neurol 2022; 357:114195. [PMID: 35931123 DOI: 10.1016/j.expneurol.2022.114195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Revised: 07/11/2022] [Accepted: 07/31/2022] [Indexed: 11/24/2022]
Abstract
Macrophage-mediated inflammation is a potent driver of disease progression in mouse models of Charcot-Marie-Tooth (CMT) 1 diseases. This leads to the possibility to consider these cells as therapeutic targets to dampen disease outcome in the so far non-treatable neuropathies. As a pharmacological proof-of-principle study, long-term targeting of nerve macrophages with the orally applied CSF-1 receptor specific kinase (c-FMS) inhibitor PLX5622 showed a substantial alleviation of the neuropathy in distinct CMT1 mouse models. However, regarding translational options, clinically relevant questions emerged regarding treatment onset, duration and termination. Corroborating previous data, we here show that in a model for CMT1B, peripheral neuropathy was substantially alleviated after early continuous PLX5622 treatment in CMT1B mice, leading to preserved motor function. However, late-onset treatment failed to mitigate histopathological and clinical features, despite a similar reduction in the number of macrophages. Surprisingly, in CMT1B mice, terminating early PLX5622 treatment at six months was still sufficient to preserve motor function at 12 months of age, suggesting a long-lasting, therapeutic effect of early macrophage depletion. This novel and unexpected finding may have important translational implications, since we here show that continuous macrophage targeting appears not to be necessary for disease alleviation, provided that the treatment starts within an early, critical time window.
Collapse
Affiliation(s)
- Charlotte Ostertag
- Department of Neurology, Developmental Neurobiology, University Hospital Würzburg, Würzburg, Germany
| | - Dennis Klein
- Department of Neurology, Developmental Neurobiology, University Hospital Würzburg, Würzburg, Germany.
| | - Rudolf Martini
- Department of Neurology, Developmental Neurobiology, University Hospital Würzburg, Würzburg, Germany.
| |
Collapse
|
16
|
Thomas FP, Brannagan TH, Butterfield RJ, Desai U, Habib AA, Herrmann DN, Eichinger KJ, Johnson NE, Karam C, Pestronk A, Quinn C, Shy ME, Statland JM, Subramony SH, Walk D, Stevens-Favorite K, Miller B, Leneus A, Fowler M, van de Rijn M, Attie KM. Randomized Phase 2 Study of ACE-083 in Patients With Charcot-Marie-Tooth Disease. Neurology 2022; 98:e2356-e2367. [PMID: 35545446 PMCID: PMC9202530 DOI: 10.1212/wnl.0000000000200325] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Accepted: 02/17/2022] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND AND OBJECTIVES The goal of this work was to determine whether locally acting ACE-083 is safe and well tolerated and increases muscle volume, motor function, and quality of life (QoL) in adults with Charcot-Marie-Tooth disease (CMT) type 1. METHODS This phase 2 study enrolled adults with CMT1 or CMTX (N = 63). Part 1 was open label and evaluated the safety and tolerability of different dose levels of ACE-083 for use in part 2. Part 2 was a randomized, placebo-controlled, 6-month study of 240 mg/muscle ACE-083 injected bilaterally into the tibialis anterior muscle, followed by a 6-month, open-label extension in which all patients received ACE-083. Pharmacodynamic endpoints included total muscle volume (TMV; primary endpoint), contractile muscle volume (CMV), and fat fraction. Additional secondary endpoints included 6-minute walk test, 10-m walk/run, muscle strength, and QoL. Safety was assessed with treatment-emergent adverse events (TEAEs) and clinical laboratory tests. RESULTS In part 1 (n = 18), ACE-083 was generally safe and well tolerated at all dose levels, with no serious adverse events, TEAEs of grade 3 or greater, or death reported. In part 2 (n = 45 enrolled, n = 44 treated), there was significantly greater change in TMV with ACE-083 compared with placebo (least-squares mean difference 13.5%; p = 0.0096). There was significant difference between ACE-083 and placebo for CMV and change in ankle dorsiflexion strength. Fat fraction and all other functional outcomes were not significantly improved by ACE-083. Moderate to mild injection-site reactions were the most common TEAEs. DISCUSSION Despite significantly increased TMV and CMV, patients with CMT receiving ACE-083 in tibialis anterior muscles did not demonstrate greater functional improvement compared with those receiving placebo. TRIAL REGISTRATION INFORMATION Clinical Trials Registration: NCT03124459. CLASSIFICATION OF EVIDENCE This study provides Class II evidence that intramuscular ACE-083 is safe and well tolerated and increases total muscle volume after 6 months of treatment in adults with CMT1 or CMTX.
Collapse
Affiliation(s)
- Florian P Thomas
- From Hackensack University Medical Center (F.P.T.), Hackensack Meridian School of Medicine, Nutley, NJ; Columbia University Medical Center (T.H.B.), New York, NY; University of Utah (R.J.B.), Salt Lake City; Carolinas Healthcare System Neurosciences Institute (U.D.), Charlotte, NC; University of California Irvine (A.A.H.); University of Rochester Medical Center (D.N.H., K.J.E.), NY; Virginia Commonwealth University (N.E.J.), Richmond; Oregon Health & Science University (C.K.), Portland; Washington University School of Medicine (A.P.), St. Louis, MO; University of Pennsylvania (C.Q.), Philadelphia; University of Iowa (M.E.S.), Iowa City; University of Kansas Medical Center (J.M.S.), Kansas City; University of Florida (S.H.S.), Gainesville; University of Minnesota (D.W.), Minneapolis; Cadent Medical Communications, LLC, a Syneos Health group company (K.S.-F.), New York, NY; Acceleron Pharma (B.M., A.L., M.F., M.v.d.R., K.M.A.), Cambridge, MA.
| | - Thomas H Brannagan
- From Hackensack University Medical Center (F.P.T.), Hackensack Meridian School of Medicine, Nutley, NJ; Columbia University Medical Center (T.H.B.), New York, NY; University of Utah (R.J.B.), Salt Lake City; Carolinas Healthcare System Neurosciences Institute (U.D.), Charlotte, NC; University of California Irvine (A.A.H.); University of Rochester Medical Center (D.N.H., K.J.E.), NY; Virginia Commonwealth University (N.E.J.), Richmond; Oregon Health & Science University (C.K.), Portland; Washington University School of Medicine (A.P.), St. Louis, MO; University of Pennsylvania (C.Q.), Philadelphia; University of Iowa (M.E.S.), Iowa City; University of Kansas Medical Center (J.M.S.), Kansas City; University of Florida (S.H.S.), Gainesville; University of Minnesota (D.W.), Minneapolis; Cadent Medical Communications, LLC, a Syneos Health group company (K.S.-F.), New York, NY; Acceleron Pharma (B.M., A.L., M.F., M.v.d.R., K.M.A.), Cambridge, MA
| | - Russell J Butterfield
- From Hackensack University Medical Center (F.P.T.), Hackensack Meridian School of Medicine, Nutley, NJ; Columbia University Medical Center (T.H.B.), New York, NY; University of Utah (R.J.B.), Salt Lake City; Carolinas Healthcare System Neurosciences Institute (U.D.), Charlotte, NC; University of California Irvine (A.A.H.); University of Rochester Medical Center (D.N.H., K.J.E.), NY; Virginia Commonwealth University (N.E.J.), Richmond; Oregon Health & Science University (C.K.), Portland; Washington University School of Medicine (A.P.), St. Louis, MO; University of Pennsylvania (C.Q.), Philadelphia; University of Iowa (M.E.S.), Iowa City; University of Kansas Medical Center (J.M.S.), Kansas City; University of Florida (S.H.S.), Gainesville; University of Minnesota (D.W.), Minneapolis; Cadent Medical Communications, LLC, a Syneos Health group company (K.S.-F.), New York, NY; Acceleron Pharma (B.M., A.L., M.F., M.v.d.R., K.M.A.), Cambridge, MA
| | - Urvi Desai
- From Hackensack University Medical Center (F.P.T.), Hackensack Meridian School of Medicine, Nutley, NJ; Columbia University Medical Center (T.H.B.), New York, NY; University of Utah (R.J.B.), Salt Lake City; Carolinas Healthcare System Neurosciences Institute (U.D.), Charlotte, NC; University of California Irvine (A.A.H.); University of Rochester Medical Center (D.N.H., K.J.E.), NY; Virginia Commonwealth University (N.E.J.), Richmond; Oregon Health & Science University (C.K.), Portland; Washington University School of Medicine (A.P.), St. Louis, MO; University of Pennsylvania (C.Q.), Philadelphia; University of Iowa (M.E.S.), Iowa City; University of Kansas Medical Center (J.M.S.), Kansas City; University of Florida (S.H.S.), Gainesville; University of Minnesota (D.W.), Minneapolis; Cadent Medical Communications, LLC, a Syneos Health group company (K.S.-F.), New York, NY; Acceleron Pharma (B.M., A.L., M.F., M.v.d.R., K.M.A.), Cambridge, MA
| | - Ali A Habib
- From Hackensack University Medical Center (F.P.T.), Hackensack Meridian School of Medicine, Nutley, NJ; Columbia University Medical Center (T.H.B.), New York, NY; University of Utah (R.J.B.), Salt Lake City; Carolinas Healthcare System Neurosciences Institute (U.D.), Charlotte, NC; University of California Irvine (A.A.H.); University of Rochester Medical Center (D.N.H., K.J.E.), NY; Virginia Commonwealth University (N.E.J.), Richmond; Oregon Health & Science University (C.K.), Portland; Washington University School of Medicine (A.P.), St. Louis, MO; University of Pennsylvania (C.Q.), Philadelphia; University of Iowa (M.E.S.), Iowa City; University of Kansas Medical Center (J.M.S.), Kansas City; University of Florida (S.H.S.), Gainesville; University of Minnesota (D.W.), Minneapolis; Cadent Medical Communications, LLC, a Syneos Health group company (K.S.-F.), New York, NY; Acceleron Pharma (B.M., A.L., M.F., M.v.d.R., K.M.A.), Cambridge, MA
| | - David N Herrmann
- From Hackensack University Medical Center (F.P.T.), Hackensack Meridian School of Medicine, Nutley, NJ; Columbia University Medical Center (T.H.B.), New York, NY; University of Utah (R.J.B.), Salt Lake City; Carolinas Healthcare System Neurosciences Institute (U.D.), Charlotte, NC; University of California Irvine (A.A.H.); University of Rochester Medical Center (D.N.H., K.J.E.), NY; Virginia Commonwealth University (N.E.J.), Richmond; Oregon Health & Science University (C.K.), Portland; Washington University School of Medicine (A.P.), St. Louis, MO; University of Pennsylvania (C.Q.), Philadelphia; University of Iowa (M.E.S.), Iowa City; University of Kansas Medical Center (J.M.S.), Kansas City; University of Florida (S.H.S.), Gainesville; University of Minnesota (D.W.), Minneapolis; Cadent Medical Communications, LLC, a Syneos Health group company (K.S.-F.), New York, NY; Acceleron Pharma (B.M., A.L., M.F., M.v.d.R., K.M.A.), Cambridge, MA
| | - Katy J Eichinger
- From Hackensack University Medical Center (F.P.T.), Hackensack Meridian School of Medicine, Nutley, NJ; Columbia University Medical Center (T.H.B.), New York, NY; University of Utah (R.J.B.), Salt Lake City; Carolinas Healthcare System Neurosciences Institute (U.D.), Charlotte, NC; University of California Irvine (A.A.H.); University of Rochester Medical Center (D.N.H., K.J.E.), NY; Virginia Commonwealth University (N.E.J.), Richmond; Oregon Health & Science University (C.K.), Portland; Washington University School of Medicine (A.P.), St. Louis, MO; University of Pennsylvania (C.Q.), Philadelphia; University of Iowa (M.E.S.), Iowa City; University of Kansas Medical Center (J.M.S.), Kansas City; University of Florida (S.H.S.), Gainesville; University of Minnesota (D.W.), Minneapolis; Cadent Medical Communications, LLC, a Syneos Health group company (K.S.-F.), New York, NY; Acceleron Pharma (B.M., A.L., M.F., M.v.d.R., K.M.A.), Cambridge, MA
| | - Nicholas E Johnson
- From Hackensack University Medical Center (F.P.T.), Hackensack Meridian School of Medicine, Nutley, NJ; Columbia University Medical Center (T.H.B.), New York, NY; University of Utah (R.J.B.), Salt Lake City; Carolinas Healthcare System Neurosciences Institute (U.D.), Charlotte, NC; University of California Irvine (A.A.H.); University of Rochester Medical Center (D.N.H., K.J.E.), NY; Virginia Commonwealth University (N.E.J.), Richmond; Oregon Health & Science University (C.K.), Portland; Washington University School of Medicine (A.P.), St. Louis, MO; University of Pennsylvania (C.Q.), Philadelphia; University of Iowa (M.E.S.), Iowa City; University of Kansas Medical Center (J.M.S.), Kansas City; University of Florida (S.H.S.), Gainesville; University of Minnesota (D.W.), Minneapolis; Cadent Medical Communications, LLC, a Syneos Health group company (K.S.-F.), New York, NY; Acceleron Pharma (B.M., A.L., M.F., M.v.d.R., K.M.A.), Cambridge, MA
| | - Chafic Karam
- From Hackensack University Medical Center (F.P.T.), Hackensack Meridian School of Medicine, Nutley, NJ; Columbia University Medical Center (T.H.B.), New York, NY; University of Utah (R.J.B.), Salt Lake City; Carolinas Healthcare System Neurosciences Institute (U.D.), Charlotte, NC; University of California Irvine (A.A.H.); University of Rochester Medical Center (D.N.H., K.J.E.), NY; Virginia Commonwealth University (N.E.J.), Richmond; Oregon Health & Science University (C.K.), Portland; Washington University School of Medicine (A.P.), St. Louis, MO; University of Pennsylvania (C.Q.), Philadelphia; University of Iowa (M.E.S.), Iowa City; University of Kansas Medical Center (J.M.S.), Kansas City; University of Florida (S.H.S.), Gainesville; University of Minnesota (D.W.), Minneapolis; Cadent Medical Communications, LLC, a Syneos Health group company (K.S.-F.), New York, NY; Acceleron Pharma (B.M., A.L., M.F., M.v.d.R., K.M.A.), Cambridge, MA
| | - Alan Pestronk
- From Hackensack University Medical Center (F.P.T.), Hackensack Meridian School of Medicine, Nutley, NJ; Columbia University Medical Center (T.H.B.), New York, NY; University of Utah (R.J.B.), Salt Lake City; Carolinas Healthcare System Neurosciences Institute (U.D.), Charlotte, NC; University of California Irvine (A.A.H.); University of Rochester Medical Center (D.N.H., K.J.E.), NY; Virginia Commonwealth University (N.E.J.), Richmond; Oregon Health & Science University (C.K.), Portland; Washington University School of Medicine (A.P.), St. Louis, MO; University of Pennsylvania (C.Q.), Philadelphia; University of Iowa (M.E.S.), Iowa City; University of Kansas Medical Center (J.M.S.), Kansas City; University of Florida (S.H.S.), Gainesville; University of Minnesota (D.W.), Minneapolis; Cadent Medical Communications, LLC, a Syneos Health group company (K.S.-F.), New York, NY; Acceleron Pharma (B.M., A.L., M.F., M.v.d.R., K.M.A.), Cambridge, MA
| | - Colin Quinn
- From Hackensack University Medical Center (F.P.T.), Hackensack Meridian School of Medicine, Nutley, NJ; Columbia University Medical Center (T.H.B.), New York, NY; University of Utah (R.J.B.), Salt Lake City; Carolinas Healthcare System Neurosciences Institute (U.D.), Charlotte, NC; University of California Irvine (A.A.H.); University of Rochester Medical Center (D.N.H., K.J.E.), NY; Virginia Commonwealth University (N.E.J.), Richmond; Oregon Health & Science University (C.K.), Portland; Washington University School of Medicine (A.P.), St. Louis, MO; University of Pennsylvania (C.Q.), Philadelphia; University of Iowa (M.E.S.), Iowa City; University of Kansas Medical Center (J.M.S.), Kansas City; University of Florida (S.H.S.), Gainesville; University of Minnesota (D.W.), Minneapolis; Cadent Medical Communications, LLC, a Syneos Health group company (K.S.-F.), New York, NY; Acceleron Pharma (B.M., A.L., M.F., M.v.d.R., K.M.A.), Cambridge, MA
| | - Michael E Shy
- From Hackensack University Medical Center (F.P.T.), Hackensack Meridian School of Medicine, Nutley, NJ; Columbia University Medical Center (T.H.B.), New York, NY; University of Utah (R.J.B.), Salt Lake City; Carolinas Healthcare System Neurosciences Institute (U.D.), Charlotte, NC; University of California Irvine (A.A.H.); University of Rochester Medical Center (D.N.H., K.J.E.), NY; Virginia Commonwealth University (N.E.J.), Richmond; Oregon Health & Science University (C.K.), Portland; Washington University School of Medicine (A.P.), St. Louis, MO; University of Pennsylvania (C.Q.), Philadelphia; University of Iowa (M.E.S.), Iowa City; University of Kansas Medical Center (J.M.S.), Kansas City; University of Florida (S.H.S.), Gainesville; University of Minnesota (D.W.), Minneapolis; Cadent Medical Communications, LLC, a Syneos Health group company (K.S.-F.), New York, NY; Acceleron Pharma (B.M., A.L., M.F., M.v.d.R., K.M.A.), Cambridge, MA
| | - Jeffrey M Statland
- From Hackensack University Medical Center (F.P.T.), Hackensack Meridian School of Medicine, Nutley, NJ; Columbia University Medical Center (T.H.B.), New York, NY; University of Utah (R.J.B.), Salt Lake City; Carolinas Healthcare System Neurosciences Institute (U.D.), Charlotte, NC; University of California Irvine (A.A.H.); University of Rochester Medical Center (D.N.H., K.J.E.), NY; Virginia Commonwealth University (N.E.J.), Richmond; Oregon Health & Science University (C.K.), Portland; Washington University School of Medicine (A.P.), St. Louis, MO; University of Pennsylvania (C.Q.), Philadelphia; University of Iowa (M.E.S.), Iowa City; University of Kansas Medical Center (J.M.S.), Kansas City; University of Florida (S.H.S.), Gainesville; University of Minnesota (D.W.), Minneapolis; Cadent Medical Communications, LLC, a Syneos Health group company (K.S.-F.), New York, NY; Acceleron Pharma (B.M., A.L., M.F., M.v.d.R., K.M.A.), Cambridge, MA
| | - Sub H Subramony
- From Hackensack University Medical Center (F.P.T.), Hackensack Meridian School of Medicine, Nutley, NJ; Columbia University Medical Center (T.H.B.), New York, NY; University of Utah (R.J.B.), Salt Lake City; Carolinas Healthcare System Neurosciences Institute (U.D.), Charlotte, NC; University of California Irvine (A.A.H.); University of Rochester Medical Center (D.N.H., K.J.E.), NY; Virginia Commonwealth University (N.E.J.), Richmond; Oregon Health & Science University (C.K.), Portland; Washington University School of Medicine (A.P.), St. Louis, MO; University of Pennsylvania (C.Q.), Philadelphia; University of Iowa (M.E.S.), Iowa City; University of Kansas Medical Center (J.M.S.), Kansas City; University of Florida (S.H.S.), Gainesville; University of Minnesota (D.W.), Minneapolis; Cadent Medical Communications, LLC, a Syneos Health group company (K.S.-F.), New York, NY; Acceleron Pharma (B.M., A.L., M.F., M.v.d.R., K.M.A.), Cambridge, MA
| | - David Walk
- From Hackensack University Medical Center (F.P.T.), Hackensack Meridian School of Medicine, Nutley, NJ; Columbia University Medical Center (T.H.B.), New York, NY; University of Utah (R.J.B.), Salt Lake City; Carolinas Healthcare System Neurosciences Institute (U.D.), Charlotte, NC; University of California Irvine (A.A.H.); University of Rochester Medical Center (D.N.H., K.J.E.), NY; Virginia Commonwealth University (N.E.J.), Richmond; Oregon Health & Science University (C.K.), Portland; Washington University School of Medicine (A.P.), St. Louis, MO; University of Pennsylvania (C.Q.), Philadelphia; University of Iowa (M.E.S.), Iowa City; University of Kansas Medical Center (J.M.S.), Kansas City; University of Florida (S.H.S.), Gainesville; University of Minnesota (D.W.), Minneapolis; Cadent Medical Communications, LLC, a Syneos Health group company (K.S.-F.), New York, NY; Acceleron Pharma (B.M., A.L., M.F., M.v.d.R., K.M.A.), Cambridge, MA
| | - Katherine Stevens-Favorite
- From Hackensack University Medical Center (F.P.T.), Hackensack Meridian School of Medicine, Nutley, NJ; Columbia University Medical Center (T.H.B.), New York, NY; University of Utah (R.J.B.), Salt Lake City; Carolinas Healthcare System Neurosciences Institute (U.D.), Charlotte, NC; University of California Irvine (A.A.H.); University of Rochester Medical Center (D.N.H., K.J.E.), NY; Virginia Commonwealth University (N.E.J.), Richmond; Oregon Health & Science University (C.K.), Portland; Washington University School of Medicine (A.P.), St. Louis, MO; University of Pennsylvania (C.Q.), Philadelphia; University of Iowa (M.E.S.), Iowa City; University of Kansas Medical Center (J.M.S.), Kansas City; University of Florida (S.H.S.), Gainesville; University of Minnesota (D.W.), Minneapolis; Cadent Medical Communications, LLC, a Syneos Health group company (K.S.-F.), New York, NY; Acceleron Pharma (B.M., A.L., M.F., M.v.d.R., K.M.A.), Cambridge, MA
| | - Barry Miller
- From Hackensack University Medical Center (F.P.T.), Hackensack Meridian School of Medicine, Nutley, NJ; Columbia University Medical Center (T.H.B.), New York, NY; University of Utah (R.J.B.), Salt Lake City; Carolinas Healthcare System Neurosciences Institute (U.D.), Charlotte, NC; University of California Irvine (A.A.H.); University of Rochester Medical Center (D.N.H., K.J.E.), NY; Virginia Commonwealth University (N.E.J.), Richmond; Oregon Health & Science University (C.K.), Portland; Washington University School of Medicine (A.P.), St. Louis, MO; University of Pennsylvania (C.Q.), Philadelphia; University of Iowa (M.E.S.), Iowa City; University of Kansas Medical Center (J.M.S.), Kansas City; University of Florida (S.H.S.), Gainesville; University of Minnesota (D.W.), Minneapolis; Cadent Medical Communications, LLC, a Syneos Health group company (K.S.-F.), New York, NY; Acceleron Pharma (B.M., A.L., M.F., M.v.d.R., K.M.A.), Cambridge, MA
| | - Ashley Leneus
- From Hackensack University Medical Center (F.P.T.), Hackensack Meridian School of Medicine, Nutley, NJ; Columbia University Medical Center (T.H.B.), New York, NY; University of Utah (R.J.B.), Salt Lake City; Carolinas Healthcare System Neurosciences Institute (U.D.), Charlotte, NC; University of California Irvine (A.A.H.); University of Rochester Medical Center (D.N.H., K.J.E.), NY; Virginia Commonwealth University (N.E.J.), Richmond; Oregon Health & Science University (C.K.), Portland; Washington University School of Medicine (A.P.), St. Louis, MO; University of Pennsylvania (C.Q.), Philadelphia; University of Iowa (M.E.S.), Iowa City; University of Kansas Medical Center (J.M.S.), Kansas City; University of Florida (S.H.S.), Gainesville; University of Minnesota (D.W.), Minneapolis; Cadent Medical Communications, LLC, a Syneos Health group company (K.S.-F.), New York, NY; Acceleron Pharma (B.M., A.L., M.F., M.v.d.R., K.M.A.), Cambridge, MA
| | - Marcie Fowler
- From Hackensack University Medical Center (F.P.T.), Hackensack Meridian School of Medicine, Nutley, NJ; Columbia University Medical Center (T.H.B.), New York, NY; University of Utah (R.J.B.), Salt Lake City; Carolinas Healthcare System Neurosciences Institute (U.D.), Charlotte, NC; University of California Irvine (A.A.H.); University of Rochester Medical Center (D.N.H., K.J.E.), NY; Virginia Commonwealth University (N.E.J.), Richmond; Oregon Health & Science University (C.K.), Portland; Washington University School of Medicine (A.P.), St. Louis, MO; University of Pennsylvania (C.Q.), Philadelphia; University of Iowa (M.E.S.), Iowa City; University of Kansas Medical Center (J.M.S.), Kansas City; University of Florida (S.H.S.), Gainesville; University of Minnesota (D.W.), Minneapolis; Cadent Medical Communications, LLC, a Syneos Health group company (K.S.-F.), New York, NY; Acceleron Pharma (B.M., A.L., M.F., M.v.d.R., K.M.A.), Cambridge, MA
| | - Marc van de Rijn
- From Hackensack University Medical Center (F.P.T.), Hackensack Meridian School of Medicine, Nutley, NJ; Columbia University Medical Center (T.H.B.), New York, NY; University of Utah (R.J.B.), Salt Lake City; Carolinas Healthcare System Neurosciences Institute (U.D.), Charlotte, NC; University of California Irvine (A.A.H.); University of Rochester Medical Center (D.N.H., K.J.E.), NY; Virginia Commonwealth University (N.E.J.), Richmond; Oregon Health & Science University (C.K.), Portland; Washington University School of Medicine (A.P.), St. Louis, MO; University of Pennsylvania (C.Q.), Philadelphia; University of Iowa (M.E.S.), Iowa City; University of Kansas Medical Center (J.M.S.), Kansas City; University of Florida (S.H.S.), Gainesville; University of Minnesota (D.W.), Minneapolis; Cadent Medical Communications, LLC, a Syneos Health group company (K.S.-F.), New York, NY; Acceleron Pharma (B.M., A.L., M.F., M.v.d.R., K.M.A.), Cambridge, MA
| | - Kenneth M Attie
- From Hackensack University Medical Center (F.P.T.), Hackensack Meridian School of Medicine, Nutley, NJ; Columbia University Medical Center (T.H.B.), New York, NY; University of Utah (R.J.B.), Salt Lake City; Carolinas Healthcare System Neurosciences Institute (U.D.), Charlotte, NC; University of California Irvine (A.A.H.); University of Rochester Medical Center (D.N.H., K.J.E.), NY; Virginia Commonwealth University (N.E.J.), Richmond; Oregon Health & Science University (C.K.), Portland; Washington University School of Medicine (A.P.), St. Louis, MO; University of Pennsylvania (C.Q.), Philadelphia; University of Iowa (M.E.S.), Iowa City; University of Kansas Medical Center (J.M.S.), Kansas City; University of Florida (S.H.S.), Gainesville; University of Minnesota (D.W.), Minneapolis; Cadent Medical Communications, LLC, a Syneos Health group company (K.S.-F.), New York, NY; Acceleron Pharma (B.M., A.L., M.F., M.v.d.R., K.M.A.), Cambridge, MA
| |
Collapse
|
17
|
Ozes B, Myers M, Moss K, Mckinney J, Ridgley A, Chen L, Bai S, Abrams CK, Freidin MM, Mendell JR, Sahenk Z. AAV1.NT-3 gene therapy for X-linked Charcot-Marie-Tooth neuropathy type 1. Gene Ther 2022; 29:127-137. [PMID: 33542455 PMCID: PMC9013664 DOI: 10.1038/s41434-021-00231-3] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Revised: 12/30/2020] [Accepted: 01/19/2021] [Indexed: 12/13/2022]
Abstract
X-linked Charcot-Marie-Tooth neuropathy (CMTX) is caused by mutations in the gene encoding Gap Junction Protein Beta-1 (GJB1)/Connexin32 (Cx32) in Schwann cells. Neurotrophin-3 (NT-3) is an important autocrine factor supporting Schwann cell survival and differentiation and stimulating axon regeneration and myelination. Improvements in these parameters have been shown previously in a CMT1 model, TremblerJ mouse, with NT-3 gene transfer therapy. For this study, scAAV1.tMCK.NT-3 was delivered to the gastrocnemius muscle of 3-month-old Cx32 knockout (KO) mice. Measurable levels of NT-3 were found in the serum at 6-month post gene delivery. The outcome measures included functional, electrophysiological and histological assessments. At 9-months of age, NT-3 treated mice showed no functional decline with normalized compound muscle action potential amplitudes. Myelin thickness and nerve conduction velocity significantly improved compared with untreated cohort. A normalization toward age-matched wildtype histopathological parameters included increased number of Schmidt-Lanterman incisures, and muscle fiber diameter. Collectively, these findings suggest a translational application to CMTX1.
Collapse
Affiliation(s)
- Burcak Ozes
- Center for Gene Therapy, The Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, OH, USA
| | - Morgan Myers
- Center for Gene Therapy, The Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, OH, USA
| | - Kyle Moss
- Center for Gene Therapy, The Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, OH, USA
| | - Jennifer Mckinney
- Department of Pediatrics and Neurology, Nationwide Children's Hospital and The Ohio State University, Columbus, OH, USA
| | - Alicia Ridgley
- Center for Gene Therapy, The Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, OH, USA
| | - Lei Chen
- Center for Gene Therapy, The Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, OH, USA
| | - Shasha Bai
- Department of Biomedical Informatics, The Ohio State University College of Medicine, Columbus, OH, USA
- Biostatistics Resource at Nationwide Children's Hospital, Columbus, OH, USA
| | - Charles K Abrams
- Department of Neurology and Rehabilitation, University of Illinois at Chicago, Chicago, IL, USA
| | - Mona M Freidin
- Department of Neurology and Rehabilitation, University of Illinois at Chicago, Chicago, IL, USA
| | - Jerry R Mendell
- Center for Gene Therapy, The Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, OH, USA
- Department of Pediatrics and Neurology, Nationwide Children's Hospital and The Ohio State University, Columbus, OH, USA
| | - Zarife Sahenk
- Center for Gene Therapy, The Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, OH, USA.
- Department of Pediatrics and Neurology, Nationwide Children's Hospital and The Ohio State University, Columbus, OH, USA.
- Department of Pathology and Laboratory Medicine, Nationwide Children's Hospital, Columbus, OH, USA.
| |
Collapse
|
18
|
Burgess RW, Saporta MA. Brain research special issue on CMT, editorial. Brain Res 2022; 1785:147891. [PMID: 35339430 DOI: 10.1016/j.brainres.2022.147891] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Affiliation(s)
| | - Mario A Saporta
- Departments of Neurology and Human Genetics, Miller School of Medicine, University of Miami, Miami, FL 33124, USA
| |
Collapse
|
19
|
Honeycutt SE, N'Guetta PEY, O'Brien LL. Innervation in organogenesis. Curr Top Dev Biol 2022; 148:195-235. [PMID: 35461566 PMCID: PMC10636594 DOI: 10.1016/bs.ctdb.2022.02.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Proper innervation of peripheral organs helps to maintain physiological homeostasis and elicit responses to external stimuli. Disruptions to normal function can result in pathophysiological consequences. The establishment of connections and communication between the central nervous system and the peripheral organs is accomplished through the peripheral nervous system. Neuronal connections with target tissues arise from ganglia partitioned throughout the body. Organ innervation is initiated during development with stimuli being conducted through several types of neurons including sympathetic, parasympathetic, and sensory. While the physiological modulation of mature organs by these nerves is largely understood, their role in mammalian development is only beginning to be uncovered. Interactions with cells in target tissues can affect the development and eventual function of several organs, highlighting their significance. This chapter will cover the origin of peripheral neurons, factors mediating organ innervation, and the composition and function of organ-specific nerves during development. This emerging field aims to identify the functional contribution of innervation to development which will inform future investigations of normal and abnormal mammalian organogenesis, as well as contribute to regenerative and organ replacement efforts where nerve-derived signals may have significant implications for the advancement of such studies.
Collapse
Affiliation(s)
- Samuel E Honeycutt
- Department of Cell Biology and Physiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Pierre-Emmanuel Y N'Guetta
- Department of Cell Biology and Physiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Lori L O'Brien
- Department of Cell Biology and Physiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States.
| |
Collapse
|
20
|
Hines TJ, Lutz C, Murray SA, Burgess RW. An Integrated Approach to Studying Rare Neuromuscular Diseases Using Animal and Human Cell-Based Models. Front Cell Dev Biol 2022; 9:801819. [PMID: 35047510 PMCID: PMC8762301 DOI: 10.3389/fcell.2021.801819] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Accepted: 11/30/2021] [Indexed: 11/13/2022] Open
Abstract
As sequencing technology improves, the identification of new disease-associated genes and new alleles of known genes is rapidly increasing our understanding of the genetic underpinnings of rare diseases, including neuromuscular diseases. However, precisely because these disorders are rare and often heterogeneous, they are difficult to study in patient populations. In parallel, our ability to engineer the genomes of model organisms, such as mice or rats, has gotten increasingly efficient through techniques such as CRISPR/Cas9 genome editing, allowing the creation of precision human disease models. Such in vivo model systems provide an efficient means for exploring disease mechanisms and identifying therapeutic strategies. Furthermore, animal models provide a platform for preclinical studies to test the efficacy of those strategies. Determining whether the same mechanisms are involved in the human disease and confirming relevant parameters for treatment ideally involves a human experimental system. One system currently being used is induced pluripotent stem cells (iPSCs), which can then be differentiated into the relevant cell type(s) for in vitro confirmation of disease mechanisms and variables such as target engagement. Here we provide a demonstration of these approaches using the example of tRNA-synthetase-associated inherited peripheral neuropathies, rare forms of Charcot-Marie-Tooth disease (CMT). Mouse models have led to a better understanding of both the genetic and cellular mechanisms underlying the disease. To determine if the mechanisms are similar in human cells, we will use genetically engineered iPSC-based models. This will allow comparisons of different CMT-associated GARS alleles in the same genetic background, reducing the variability found between patient samples and simplifying the availability of cell-based models for a rare disease. The necessity of integrating mouse and human models, strategies for accomplishing this integration, and the challenges of doing it at scale are discussed using recently published work detailing the cellular mechanisms underlying GARS-associated CMT as a framework.
Collapse
|
21
|
Nagappa M, Sharma S, Govindaraj P, Chickabasaviah Y, Siram R, Shroti A, Seshagiri D, Debnath M, Bindu P, Taly A. Genetic spectrum of inherited neuropathies in India. Ann Indian Acad Neurol 2022; 25:407-416. [PMID: 35936615 PMCID: PMC9350795 DOI: 10.4103/aian.aian_269_22] [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: 03/21/2022] [Revised: 04/29/2022] [Accepted: 04/30/2022] [Indexed: 11/17/2022] Open
Abstract
Background and Objectives: Charcot-Marie-Tooth (CMT) disease is the commonest inherited neuromuscular disorder and has heterogeneous manifestations. Data regarding genetic basis of CMT from India is limited. This study aims to report the variations by using high throughput sequencing in Indian CMT cohort. Methods: Fifty-five probands (M:F 29:26) with suspected inherited neuropathy underwent genetic testing (whole exome: 31, clinical exome: 17 and targeted panel: 7). Their clinical and genetic data were analysed. Results: Age at onset ranged from infancy to 54 years. Clinical features included early-onset neuropathy (n=23), skeletal deformities (n=45), impaired vision (n=8), impaired hearing (n=6), facial palsy (n=8), thickened nerves (n=4), impaired cognition (n=5), seizures (n=5), pyramidal signs (n=7), ataxia (n=8) and vocal cord palsy, slow tongue movements and psychosis in one patient each. Twenty-eight patients had demyelinating electrophysiology. Abnormal visual and auditory evoked potentials were noted in 60.60% and 37.5% respectively. Sixty two variants were identified in 37 genes including variants of uncertain significance (n=34) and novel variants (n=45). Eleven patients had additional variations in genes implicated in CMTs/ other neurological disorders. Ten patients did not have variations in neuropathy associated genes, but had variations in genes implicated in other neurological disorders. In seven patients, no variations were detected. Conclusion: In this single centre cohort study from India, genetic diagnosis could be established in 87% of patients with inherited neuropathy. The identified spectrum of genetic variations adds to the pool of existing data and provides a platform for validation studies in cell culture or animal model systems.
Collapse
|
22
|
Kanwal S, Choi YJI, Lim SO, Choi HJ, Park JH, Nuzhat R, Khan A, Perveen S, Choi BO, Chung KW. Novel homozygous mutations in Pakistani families with Charcot-Marie-Tooth disease. BMC Med Genomics 2021; 14:174. [PMID: 34193129 PMCID: PMC8247155 DOI: 10.1186/s12920-021-01019-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Accepted: 06/18/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Charcot-Marie-Tooth disease (CMT) is a group of genetically and clinically heterogeneous peripheral nervous system disorders. Few studies have identified genetic causes of CMT in the Pakistani patients. METHODS This study was performed to identify pathogenic mutations in five consanguineous Pakistani CMT families negative for PMP22 duplication. Genomic screening was performed by application of whole exome sequencing. RESULTS We identified five pathogenic or likely pathogenic homozygous mutations in four genes: c.2599C > T (p.Gln867*) and c.3650G > A (p.Gly1217Asp) in SH3TC2, c.19C > T (p.Arg7*) in HK1, c.247delG (p.Gly83Alafs*44) in REEP1, and c.334G > A (p.Val112Met) in MFN2. These mutations have not been reported in CMT patients. Mutations in SH3TC2, HK1, REEP1, and MFN2 have been reported to be associated with CMT4C, CMT4G, dHMN5B (DSMA5B), and CMT2A, respectively. The genotype-phenotype correlations were confirmed in all the examined families. We also confirmed that both alleles from the homozygous variants originated from a single ancestor using homozygosity mapping. CONCLUSIONS This study found five novel mutations as the underlying causes of CMT. Pathogenic mutations in SH3TC2, HK1, and REEP1 have been reported rarely in other populations, suggesting ethnic-specific distribution. This study would be useful for the exact molecular diagnosis and treatment of CMT in Pakistani patients.
Collapse
Affiliation(s)
- Sumaira Kanwal
- Department of Biosciences, COMSATS University Islamabad, Sahiwal, Pakistan
| | - Yu JIn Choi
- Department of Biological Sciences, Kongju National University, 56 Gongjudaehakro, Gongju, 32588, Korea
| | - Si On Lim
- Department of Biological Sciences, Kongju National University, 56 Gongjudaehakro, Gongju, 32588, Korea
| | - Hee Ji Choi
- Department of Biological Sciences, Kongju National University, 56 Gongjudaehakro, Gongju, 32588, Korea
| | - Jin Hee Park
- Department of Biological Sciences, Kongju National University, 56 Gongjudaehakro, Gongju, 32588, Korea
| | - Rana Nuzhat
- Department of Pediatric Neurology, The Children Hospital and Institute of Child Health, Multan, Pakistan
| | - Aneela Khan
- Department of Pediatric Neurology, The Children Hospital and Institute of Child Health, Multan, Pakistan
| | - Shazia Perveen
- Department of Zoology, The Women University, Multan, Pakistan
| | - Byung-Ok Choi
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, Korea.
| | - Ki Wha Chung
- Department of Biological Sciences, Kongju National University, 56 Gongjudaehakro, Gongju, 32588, Korea.
| |
Collapse
|
23
|
Stone EJ, Kolb SJ, Brown A. A review and analysis of the clinical literature on Charcot-Marie-Tooth disease caused by mutations in neurofilament protein L. Cytoskeleton (Hoboken) 2021; 78:97-110. [PMID: 33993654 PMCID: PMC10174713 DOI: 10.1002/cm.21676] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Revised: 05/05/2021] [Accepted: 05/06/2021] [Indexed: 01/22/2023]
Abstract
Charcot-Marie-Tooth disease (CMT) is one of the most common inherited neurological disorders and can be caused by mutations in over 100 different genes. One of the causative genes is NEFL on chromosome 8 which encodes neurofilament light protein (NEFL), one of five proteins that co-assemble to form neurofilaments. At least 34 different CMT-causing mutations in NEFL have been reported which span the head, rod, and tail domains of the protein. The majority of these mutations are inherited dominantly, but some are inherited recessively. The resulting disease is classified variably in clinical reports based on electrodiagnostic studies as either axonal (type 2; CMT2E), demyelinating (type 1; CMT1F), or a form intermediate between the two (dominant intermediate; DI-CMTG). In this article, we first present a brief introduction to CMT and neurofilaments. We then collate and analyze the data from the clinical literature on the disease classification, age of onset and electrodiagnostic test results for the various mutations. We find that mutations in the head, rod, and tail domains can all cause disease with early onset and profound neurological impairment, with a trend toward greater severity for head domain mutations. We also find that the disease classification does not correlate with specific mutation or domain. In fact, different individuals with the same mutation can be classified as having axonal, demyelinating, or dominant intermediate forms of the disease. This suggests that the classification of the disease as CMT2E, CMT1F or DI-CMTG has more to do with variable disease presentation than to differences in the underlying disease mechanism, which is most likely primarily axonal in all cases.
Collapse
Affiliation(s)
- Elizabeth J Stone
- Department of Neuroscience, Ohio State University, Columbus, Ohio, USA.,Neuroscience Graduate Program, Ohio State University, Columbus, Ohio, USA
| | - Stephen J Kolb
- Department of Neurology, Ohio State University, Columbus, Ohio, USA.,Department of Biological Chemistry and Pharmacology, Ohio State University, Columbus, Ohio, USA
| | - Anthony Brown
- Department of Neuroscience, Ohio State University, Columbus, Ohio, USA
| |
Collapse
|
24
|
Presa M, Bailey RM, Davis C, Murphy T, Cook J, Walls R, Wilpan H, Bogdanik L, Lenk GM, Burgess RW, Gray SJ, Lutz C. AAV9-mediated FIG4 delivery prolongs life span in Charcot-Marie-Tooth disease type 4J mouse model. J Clin Invest 2021; 131:137159. [PMID: 33878035 PMCID: PMC8159684 DOI: 10.1172/jci137159] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Accepted: 04/15/2021] [Indexed: 12/23/2022] Open
Abstract
Charcot-Marie-Tooth disease type 4J (CMT4J) is caused by recessive, loss-of-function mutations in FIG4, encoding a phosphoinositol(3,5)P2-phosphatase. CMT4J patients have both neuron loss and demyelination in the peripheral nervous system, with vacuolization indicative of endosome/lysosome trafficking defects. Although the disease is highly variable, the onset is often in childhood and FIG4 mutations can dramatically shorten life span. There is currently no treatment for CMT4J. Here, we present the results of preclinical studies testing a gene-therapy approach to restoring FIG4 expression. A mouse model of CMT4J, the Fig4-pale tremor (plt) allele, was dosed with a single-stranded adeno-associated virus serotype 9 (AAV9) to deliver a codon-optimized human FIG4 sequence. Untreated, Fig4plt/plt mice have a median survival of approximately 5 weeks. When treated with the AAV9-FIG4 vector at P1 or P4, mice survived at least 1 year, with largely normal gross motor performance and little sign of neuropathy by neurophysiological or histopathological evaluation. When mice were treated at P7 or P11, life span was still significantly prolonged and peripheral nerve function was improved, but rescue was less complete. No unanticipated adverse effects were observed. Therefore, AAV9-mediated delivery of FIG4 is a well-tolerated and efficacious strategy in a mouse model of CMT4J.
Collapse
Affiliation(s)
| | - Rachel M. Bailey
- Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | | | - Tara Murphy
- The Jackson Laboratory, Bar Harbor, Maine, USA
| | - Jenn Cook
- The Jackson Laboratory, Bar Harbor, Maine, USA
| | - Randy Walls
- The Jackson Laboratory, Bar Harbor, Maine, USA
| | | | | | - Guy M. Lenk
- Department of Human Genetics, University of Michigan, Ann Arbor, Michigan, USA
| | | | - Steven J. Gray
- Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | | |
Collapse
|
25
|
Schorling E, Senn KC, Thiele S, Gumbert L, Krause S, Schreiber-Katz O, Walter MC, Reilich P, Nagels KH. Health-related Quality of Life and Satisfaction with German Health Care Services in Patients with Charcot-Marie-Tooth Neuropathy. J Neuromuscul Dis 2021; 9:211-220. [PMID: 34057093 DOI: 10.3233/jnd-210667] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
BackgroundCharcot-Marie-Tooth (CMT) neuropathies entail a large group of diseases with different gene mutation patterns, which produce heterogeneous phenotypes. Although health-related quality of life (HRQOL) is significantly impaired, a comprehensive assessment of HRQOL in CMT patients in Germany considering phenotypical heterogeneity represented a research gap.ObjectiveThe aim was to assess HRQOL and the satisfaction with health care in CMT patients in Germany.MethodsCMT patients > 15 years with a genetically confirmed CMT subtype were recruited through a national CMT patient registry. HRQOL was assessed using the EQ-5D-5L questionnaire. Furthermore, subjective impairments in daily or work activities and satisfaction with health care were assessed using 4-point scales.ResultsHRQOL in CMT patients (n = 385) was impaired compared to the German population. Most patients reported problems in the dimension mobility (89.6%), pain/discomfort (89.4%) and usual activities (81.0%). Except for patients with hereditary neuropathy with liability to pressure palsy (HNPP), we found no differences in HRQOL between the CMT subtypes. 72.0%of CMT patients were satisfied with available health care services. However, patients reported to expect more CMT-specific knowledge and support as well as easier prescription and cost coverage procedures from health professionals and insurances.ConclusionsThe patient-reported outcomes in the assessed CMT cohort elucidate the need for more specific health care services that also address the heterogeneous phenotypes. Although the assessment has been limited to the German health services setting, insights may be applicable to CMT-specific care in other national settings.
Collapse
Affiliation(s)
- Elisabeth Schorling
- University of Bayreuth, Institute for Healthcare Management and Health Sciences, Bayreuth, Germany.,Max Rubner-Institute, Kulmbach, Germany
| | - Katja C Senn
- University of Bayreuth, Chair of Healthcare Management and Health Services Research, Bayreuth, Germany
| | - Simone Thiele
- Ludwig-Maximilians-University of Munich, Friedrich-Baur-Institute, Department of Neurology, Munich, Germany
| | - Laura Gumbert
- University of Bayreuth, Chair of Healthcare Management and Health Services Research, Bayreuth, Germany
| | - Sabine Krause
- Ludwig-Maximilians-University of Munich, Friedrich-Baur-Institute, Department of Neurology, Munich, Germany
| | | | - Maggie C Walter
- Ludwig-Maximilians-University of Munich, Friedrich-Baur-Institute, Department of Neurology, Munich, Germany
| | - Peter Reilich
- Ludwig-Maximilians-University of Munich, Friedrich-Baur-Institute, Department of Neurology, Munich, Germany
| | - Klaus H Nagels
- University of Bayreuth, Chair of Healthcare Management and Health Services Research, Bayreuth, Germany
| |
Collapse
|
26
|
Mustonen V, Muruganandam G, Loris R, Kursula P, Ruskamo S. Crystal and solution structure of NDRG1, a membrane-binding protein linked to myelination and tumour suppression. FEBS J 2021; 288:3507-3529. [PMID: 33305529 DOI: 10.1111/febs.15660] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Revised: 10/27/2020] [Accepted: 12/07/2020] [Indexed: 01/13/2023]
Abstract
N-myc downstream-regulated gene 1 (NDRG1) is a tumour suppressor involved in vesicular trafficking and stress response. NDRG1 participates in peripheral nerve myelination, and mutations in the NDRG1 gene lead to Charcot-Marie-Tooth neuropathy. The 43-kDa NDRG1 is considered as an inactive member of the α/β hydrolase superfamily. In addition to a central α/β hydrolase fold domain, NDRG1 consists of a short N terminus and a C-terminal region with three 10-residue repeats. We determined the crystal structure of the α/β hydrolase domain of human NDRG1 and characterised the structure and dynamics of full-length NDRG1. The structure of the α/β hydrolase domain resembles the canonical α/β hydrolase fold with a central β sheet surrounded by α helices. Small-angle X-ray scattering and CD spectroscopy indicated a variable conformation for the N- and C-terminal regions. NDRG1 binds to various types of lipid vesicles, and the conformation of the C-terminal region is modulated upon lipid interaction. Intriguingly, NDRG1 interacts with metal ions, such as nickel, but is prone to aggregation in their presence. Our results uncover the structural and dynamic features of NDRG1, as well as elucidate its interactions with metals and lipids, and encourage studies to identify a putative hydrolase activity of NDRG1. DATABASES: The coordinates and structure factors for the crystal structure of human NDRG1 were deposited to PDB (PDB ID: 6ZMM).
Collapse
Affiliation(s)
- Venla Mustonen
- Faculty of Biochemistry and Molecular Medicine & Biocenter Oulu, University of Oulu, Finland
| | - Gopinath Muruganandam
- VIB-VUB Center for Structural Biology, Vlaams Instituut voor Biotechnologie, Brussels, Belgium.,Structural Biology Brussels, Department of Bioengineering Sciences, Vrije Universiteit Brussel, Belgium
| | - Remy Loris
- VIB-VUB Center for Structural Biology, Vlaams Instituut voor Biotechnologie, Brussels, Belgium.,Structural Biology Brussels, Department of Bioengineering Sciences, Vrije Universiteit Brussel, Belgium
| | - Petri Kursula
- Faculty of Biochemistry and Molecular Medicine & Biocenter Oulu, University of Oulu, Finland.,Department of Biomedicine, University of Bergen, Norway
| | - Salla Ruskamo
- Faculty of Biochemistry and Molecular Medicine & Biocenter Oulu, University of Oulu, Finland
| |
Collapse
|
27
|
Paketci C, Karakaya M, Edem P, Bayram E, Keller N, Daimagüler HS, Cirak S, Jordanova A, Hiz S, Wirth B, Yiş U. Clinical, electrophysiological and genetic characteristics of childhood hereditary polyneuropathies. Rev Neurol (Paris) 2020; 176:846-855. [DOI: 10.1016/j.neurol.2020.04.016] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Revised: 04/04/2020] [Accepted: 04/07/2020] [Indexed: 12/26/2022]
|
28
|
Chkheidze R, Pytel P. What Every Neuropathologist Needs to Know: Peripheral Nerve Biopsy. J Neuropathol Exp Neurol 2020; 79:355-364. [PMID: 32167544 DOI: 10.1093/jnen/nlaa012] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Peripheral neuropathy is a common disorder with many possible etiologies including metabolic diseases, inflammatory conditions, infections, malignancy, inherited diseases, drugs, and toxins. In most instances, diagnosis and treatment plan can be established based on clinical presentation, family history, laboratory results, genetic testing, and electrophysiological studies. But in some situations, a peripheral nerve biopsy remains a valuable tool. This is especially true in patients with rapidly progressive disease, with atypical presentation or for whom other approaches fail to yield a definitive diagnosis. The pathologic examination starts with basic decisions about specimen triage. A few basic questions help to provide an initial framework for the assessment of a nerve biopsy-is the specimen adequate; are there inflammatory changes; are there vascular changes; is there amyloid; are there changes to axonal density and the Schwann cell-myelin-axon unit. In the appropriate context and with such an approach peripheral nerve biopsies can still represent a clinically helpful test.
Collapse
Affiliation(s)
- Rati Chkheidze
- From the Department of Pathology, UT Southwestern Medical Center, Dallas, Texas
| | - Peter Pytel
- Department of Pathology, University of Chicago, Chicago, Illinois
| |
Collapse
|
29
|
Morelli KH, Griffin LB, Pyne NK, Wallace LM, Fowler AM, Oprescu SN, Takase R, Wei N, Meyer-Schuman R, Mellacheruvu D, Kitzman JO, Kocen SG, Hines TJ, Spaulding EL, Lupski JR, Nesvizhskii A, Mancias P, Butler IJ, Yang XL, Hou YM, Antonellis A, Harper SQ, Burgess RW. Allele-specific RNA interference prevents neuropathy in Charcot-Marie-Tooth disease type 2D mouse models. J Clin Invest 2020; 129:5568-5583. [PMID: 31557132 DOI: 10.1172/jci130600] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2019] [Accepted: 09/10/2019] [Indexed: 12/24/2022] Open
Abstract
Gene therapy approaches are being deployed to treat recessive genetic disorders by restoring the expression of mutated genes. However, the feasibility of these approaches for dominantly inherited diseases - where treatment may require reduction in the expression of a toxic mutant protein resulting from a gain-of-function allele - is unclear. Here we show the efficacy of allele-specific RNAi as a potential therapy for Charcot-Marie-Tooth disease type 2D (CMT2D), caused by dominant mutations in glycyl-tRNA synthetase (GARS). A de novo mutation in GARS was identified in a patient with a severe peripheral neuropathy, and a mouse model precisely recreating the mutation was produced. These mice developed a neuropathy by 3-4 weeks of age, validating the pathogenicity of the mutation. RNAi sequences targeting mutant GARS mRNA, but not wild-type, were optimized and then packaged into AAV9 for in vivo delivery. This almost completely prevented the neuropathy in mice treated at birth. Delaying treatment until after disease onset showed modest benefit, though this effect decreased the longer treatment was delayed. These outcomes were reproduced in a second mouse model of CMT2D using a vector specifically targeting that allele. The effects were dose dependent, and persisted for at least 1 year. Our findings demonstrate the feasibility of AAV9-mediated allele-specific knockdown and provide proof of concept for gene therapy approaches for dominant neuromuscular diseases.
Collapse
Affiliation(s)
- Kathryn H Morelli
- The Jackson Laboratory, Bar Harbor, Maine, USA.,Graduate School of Biomedical Science and Engineering, University of Maine, Orono, Maine, USA
| | - Laurie B Griffin
- Program in Cellular and Molecular Biology, and.,Medical Scientist Training Program, University of Michigan, Ann Arbor, Michigan, USA
| | - Nettie K Pyne
- Center for Gene Therapy, The Research Institute at Nationwide Children's Hospital, Columbus, Ohio, USA
| | - Lindsay M Wallace
- Center for Gene Therapy, The Research Institute at Nationwide Children's Hospital, Columbus, Ohio, USA
| | - Allison M Fowler
- Center for Gene Therapy, The Research Institute at Nationwide Children's Hospital, Columbus, Ohio, USA
| | - Stephanie N Oprescu
- Department of Human Genetics, University of Michigan, Ann Arbor, Michigan, USA
| | - Ryuichi Takase
- Department of Biochemistry and Molecular Biochemistry, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Na Wei
- Department of Molecular Medicine, The Scripps Research Institute, La Jolla, California, USA
| | | | - Dattatreya Mellacheruvu
- Department of Pathology, and.,Department of Computational Medicine and Bioinformatics, University of Michigan, Ann Arbor, Michigan, USA
| | - Jacob O Kitzman
- Department of Human Genetics, University of Michigan, Ann Arbor, Michigan, USA
| | | | | | - Emily L Spaulding
- The Jackson Laboratory, Bar Harbor, Maine, USA.,Graduate School of Biomedical Science and Engineering, University of Maine, Orono, Maine, USA
| | - James R Lupski
- Department of Molecular and Human Genetics, and.,Department of Pediatrics, Baylor College of Medicine, Houston, Texas, USA.,Texas Children's Hospital, Houston, Texas, USA
| | - Alexey Nesvizhskii
- Department of Pathology, and.,Department of Computational Medicine and Bioinformatics, University of Michigan, Ann Arbor, Michigan, USA
| | - Pedro Mancias
- Department of Pediatrics, McGovern Medical School, The University of Texas Health Science Center at Houston, and Children's Memorial Hermann Hospital, Houston, Texas, USA
| | - Ian J Butler
- Department of Pediatrics, McGovern Medical School, The University of Texas Health Science Center at Houston, and Children's Memorial Hermann Hospital, Houston, Texas, USA
| | - Xiang-Lei Yang
- Department of Molecular Medicine, The Scripps Research Institute, La Jolla, California, USA
| | - Ya-Ming Hou
- Department of Biochemistry and Molecular Biochemistry, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Anthony Antonellis
- Program in Cellular and Molecular Biology, and.,Department of Human Genetics, University of Michigan, Ann Arbor, Michigan, USA
| | - Scott Q Harper
- Center for Gene Therapy, The Research Institute at Nationwide Children's Hospital, Columbus, Ohio, USA.,Department of Pediatrics, The Ohio State University College of Medicine, Columbus, Ohio, USA
| | - Robert W Burgess
- The Jackson Laboratory, Bar Harbor, Maine, USA.,Graduate School of Biomedical Science and Engineering, University of Maine, Orono, Maine, USA
| |
Collapse
|
30
|
Pereira JA, Gerber J, Ghidinelli M, Gerber D, Tortola L, Ommer A, Bachofner S, Santarella F, Tinelli E, Lin S, Rüegg MA, Kopf M, Toyka KV, Suter U. Mice carrying an analogous heterozygous dynamin 2 K562E mutation that causes neuropathy in humans develop predominant characteristics of a primary myopathy. Hum Mol Genet 2020; 29:1253-1273. [PMID: 32129442 PMCID: PMC7254847 DOI: 10.1093/hmg/ddaa034] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2020] [Revised: 02/21/2020] [Accepted: 02/25/2020] [Indexed: 12/13/2022] Open
Abstract
Some mutations affecting dynamin 2 (DNM2) can cause dominantly inherited Charcot-Marie-Tooth (CMT) neuropathy. Here, we describe the analysis of mice carrying the DNM2 K562E mutation which has been associated with dominant-intermediate CMT type B (CMTDIB). Contrary to our expectations, heterozygous DNM2 K562E mutant mice did not develop definitive signs of an axonal or demyelinating neuropathy. Rather, we found a primary myopathy-like phenotype in these mice. A likely interpretation of these results is that the lack of a neuropathy in this mouse model has allowed the unmasking of a primary myopathy due to the DNM2 K562E mutation which might be overshadowed by the neuropathy in humans. Consequently, we hypothesize that a primary myopathy may also contribute to the disease mechanism in some CMTDIB patients. We propose that these findings should be considered in the evaluation of patients, the determination of the underlying disease processes and the development of tailored potential treatment strategies.
Collapse
Affiliation(s)
- Jorge A Pereira
- Department of Biology, Institute of Molecular Health Sciences, Swiss Federal Institute of Technology, ETH Zurich, 8093 Zurich, Switzerland
| | - Joanne Gerber
- Department of Biology, Institute of Molecular Health Sciences, Swiss Federal Institute of Technology, ETH Zurich, 8093 Zurich, Switzerland
| | - Monica Ghidinelli
- Department of Biology, Institute of Molecular Health Sciences, Swiss Federal Institute of Technology, ETH Zurich, 8093 Zurich, Switzerland
| | - Daniel Gerber
- Department of Biology, Institute of Molecular Health Sciences, Swiss Federal Institute of Technology, ETH Zurich, 8093 Zurich, Switzerland
| | - Luigi Tortola
- Department of Biology, Institute of Molecular Health Sciences, Swiss Federal Institute of Technology, ETH Zurich, 8093 Zurich, Switzerland
| | - Andrea Ommer
- Department of Biology, Institute of Molecular Health Sciences, Swiss Federal Institute of Technology, ETH Zurich, 8093 Zurich, Switzerland
| | - Sven Bachofner
- Department of Biology, Institute of Molecular Health Sciences, Swiss Federal Institute of Technology, ETH Zurich, 8093 Zurich, Switzerland
| | - Francesco Santarella
- Department of Biology, Institute of Molecular Health Sciences, Swiss Federal Institute of Technology, ETH Zurich, 8093 Zurich, Switzerland
| | - Elisa Tinelli
- Department of Biology, Institute of Molecular Health Sciences, Swiss Federal Institute of Technology, ETH Zurich, 8093 Zurich, Switzerland
| | - Shuo Lin
- Biozentrum, University of Basel, Klingelbergstrasse 50/70, CH-4056 Basel, Switzerland
| | - Markus A Rüegg
- Biozentrum, University of Basel, Klingelbergstrasse 50/70, CH-4056 Basel, Switzerland
| | - Manfred Kopf
- Department of Biology, Institute of Molecular Health Sciences, Swiss Federal Institute of Technology, ETH Zurich, 8093 Zurich, Switzerland
| | - Klaus V Toyka
- Department of Neurology, University Hospital of Würzburg, University of Würzburg, 97080 Würzburg, Germany
| | - Ueli Suter
- Department of Biology, Institute of Molecular Health Sciences, Swiss Federal Institute of Technology, ETH Zurich, 8093 Zurich, Switzerland
| |
Collapse
|
31
|
Bailey RM, Rozenberg A, Gray SJ. Comparison of high-dose intracisterna magna and lumbar puncture intrathecal delivery of AAV9 in mice to treat neuropathies. Brain Res 2020; 1739:146832. [PMID: 32289279 DOI: 10.1016/j.brainres.2020.146832] [Citation(s) in RCA: 43] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2020] [Revised: 04/08/2020] [Accepted: 04/09/2020] [Indexed: 02/06/2023]
Abstract
Gene therapy clinical trials for neurological disorders are ongoing using intrathecal injection of adeno-associated virus (AAV) vector directly into the cerebral spinal fluid. Preliminary findings from these trials and results from extensive animal studies provides compelling data supporting the safety and benefit of intrathecal delivery of AAV vectors for inherited neurological disorders. Intrathecal delivery can be achieved by a lumbar puncture (LP) or intracisterna magna (ICM) injection, although ICM is not commonly used in clinical practice due to increased procedural risk. Few studies directly compared these delivery methods and there are limited reports on transduction of the PNS. To further test the utility of ICM or LP delivery for neuropathies, we performed a head to head comparison of AAV serotype 9 (AAV9) vectors expressing GFP injected into the cisterna magna or lumbar subarachnoid space in mice. We report that an intrathecal gene delivery of AAV9 in mice leads to stable transduction of neurons and glia in the brain and spinal cord and has a widespread distribution that includes components of the PNS. Vector expression was notably higher in select brain and PNS regions following ICM injection, while higher amounts of vector was found in the lower spinal cord and peripheral organs following LP injection. These findings support that intrathecal AAV9 delivery is a translationally relevant delivery method for inherited neuropathies.
Collapse
Affiliation(s)
- Rachel M Bailey
- Gene Therapy Center, University of North Carolina at Chapel Hill, United States; Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, TX, United States; Center for Alzheimer's and Neurodegenerative Diseases, University of Texas Southwestern Medical Center, Dallas, TX, United States.
| | - Alejandra Rozenberg
- Gene Therapy Center, University of North Carolina at Chapel Hill, United States
| | - Steven J Gray
- Gene Therapy Center, University of North Carolina at Chapel Hill, United States; Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, TX, United States; Department of Ophthalmology, University of North Carolina School of Medicine, Chapel Hill, NC, United States; Department of Molecular Biology, University of Texas Southwestern Medical Center, Dallas, TX, United States; Department of Neurology and Neurotherapeutics, University of Texas Southwestern Medical Center, Dallas, TX, United States.
| |
Collapse
|
32
|
Alirezaei Z, Pourhanifeh MH, Borran S, Nejati M, Mirzaei H, Hamblin MR. Neurofilament Light Chain as a Biomarker, and Correlation with Magnetic Resonance Imaging in Diagnosis of CNS-Related Disorders. Mol Neurobiol 2020; 57:469-491. [PMID: 31385229 PMCID: PMC6980520 DOI: 10.1007/s12035-019-01698-3] [Citation(s) in RCA: 44] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2019] [Accepted: 07/09/2019] [Indexed: 12/11/2022]
Abstract
The search for diagnostic and prognostic biomarkers for neurodegenerative conditions is of high importance, since these disorders may present difficulties in differential diagnosis. Biomarkers with high sensitivity and specificity are required. Neurofilament light chain (NfL) is a unique biomarker related to axonal damage and neural cell death, which is elevated in a number of neurological disorders, and can be detected in cerebrospinal fluid (CSF), as well as blood, serum, or plasma samples. Although the NfL concentration in CSF is higher than that in blood, blood measurement may be easier in practice due to its lesser invasiveness, reproducibility, and convenience. Many studies have investigated NfL in both CSF and serum/plasma as a potential biomarker of neurodegenerative disorders. Neuroimaging biomarkers can also potentially improve detection of CNS-related disorders at an early stage. Magnetic resonance imaging (MRI) and diffusion tensor imaging (DTI) are sensitive techniques to visualize neuroaxonal loss. Therefore, investigating the combination of NfL levels with indices extracted from MRI and DTI scans could potentially improve diagnosis of CNS-related disorders. This review summarizes the evidence for NfL being a reliable biomarker in the early detection and disease management in several CNS-related disorders. Moreover, we highlight the correlation between MRI and NfL and ask whether they can be combined.
Collapse
Affiliation(s)
- Zahra Alirezaei
- Department of Medical Physics, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mohammad Hossein Pourhanifeh
- Research Center for Biochemistry and Nutrition in Metabolic Diseases, Kashan University of Medical Sciences, Kashan, Islamic Republic of Iran
| | - Sarina Borran
- School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Majid Nejati
- Anatomical Sciences Research Center, Kashan University of Medical Sciences, Kashan, Iran
| | - Hamed Mirzaei
- Research Center for Biochemistry and Nutrition in Metabolic Diseases, Kashan University of Medical Sciences, Kashan, Islamic Republic of Iran.
| | - Michael R Hamblin
- Wellman Center for Photomedicine, Massachusetts General Hospital, Harvard Medical School, 40 Blossom Street, Boston, MA, 02114, USA.
| |
Collapse
|
33
|
Maciel R, Correa R, Bosso Taniguchi J, Prufer Araujo I, Saporta MA. Human Tridimensional Neuronal Cultures for Phenotypic Drug Screening in Inherited Peripheral Neuropathies. Clin Pharmacol Ther 2019; 107:1231-1239. [PMID: 31715019 DOI: 10.1002/cpt.1718] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2019] [Accepted: 09/20/2019] [Indexed: 01/04/2023]
Abstract
Length-dependent axonal degeneration is the pathologic hallmark of several neurodegenerative disorders, including inherited peripheral neuropathies (Charcot-Marie-Tooth (CMT) disease). CMT is currently an untreatable disorder. This is partially due to lack of translational models suitable for drug discovery. In vitro models of CMT have been hindered by the 2D configuration of neuronal cultures, which limits visualization and orientation of axons. To overcome these limitations, we cultured induced pluripotent stem cell (iPSC)-derived spinal motor neurons as 3D spheroids, which grow axons in a centrifugal fashion when plated. Using these iPSC-derived spinal spheroids, we demonstrate neurofilament deposits in motor neuron axons of three patients with CMT2E, caused by mutations in the NEFL gene. This phenotype is partially reversed by two kinase inhibitors. In summary, we developed a human tridimensional in vitro system that models length-dependent axonopathies, recapitulates key pathophysiologic features of CMT2E, and should facilitate the identification of new therapeutic compounds for CMT.
Collapse
Affiliation(s)
- Renata Maciel
- Department of Neurology, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Renata Correa
- Department of Neurology, University of Miami Miller School of Medicine, Miami, Florida, USA
| | | | - Igor Prufer Araujo
- Department of Neurology, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Mario A Saporta
- Department of Neurology, University of Miami Miller School of Medicine, Miami, Florida, USA
| |
Collapse
|
34
|
Stone EJ, Uchida A, Brown A. Charcot-Marie-Tooth disease Type 2E/1F mutant neurofilament proteins assemble into neurofilaments. Cytoskeleton (Hoboken) 2019; 76:423-439. [PMID: 31574566 DOI: 10.1002/cm.21566] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2019] [Revised: 08/30/2019] [Accepted: 09/13/2019] [Indexed: 11/12/2022]
Abstract
Charcot-Marie-Tooth disease Type 2E/1F (CMT2E/1F) is a peripheral neuropathy caused by mutations in neurofilament protein L (NFL), which is one of five neurofilament subunit proteins that co-assemble to form neurofilaments in vivo. Prior studies on cultured cells have shown that CMT2E/1F mutations disrupt neurofilament assembly and lead to protein aggregation, suggesting a possible disease mechanism. However, electron microscopy of axons in peripheral nerve biopsies from patients has revealed accumulations of neurofilament polymers of normal appearance and no evidence of protein aggregates. To reconcile these observations, we reexamined the assembly of seven CMT2E/1F NFL mutants in cultured cells. None of the mutants assembled into homopolymers in SW13vim- cells, but P8R, P22S, L268/269P, and P440/441L mutant NFL assembled into heteropolymers in the presence of neurofilament protein M (NFM) alone, and N98S, Q332/333P, and E396/397K mutant NFL assembled in the presence of NFM and peripherin. P8R, P22S, N98S, L268/269P, E396/397K, and P440/441L mutant NFL co-assembled into neurofilaments with endogenous NFL, NFM, and α-internexin in cultured neurons, although the N98S and E396/397K mutants showed reduced filament incorporation, and the Q332/333P mutant showed limited incorporation. We conclude that all the mutants are capable of assembling into neurofilaments, but for some of the mutants this was dependent on the identity of the other neurofilament proteins available for co-assembly, and most likely also their relative expression level. Thus, caution should be exercised when drawing conclusions about the assembly capacity of CMT2E/1F mutants based on transient transfections in cultured cells.
Collapse
Affiliation(s)
- Elizabeth J Stone
- Department of Neuroscience, Ohio State University, Columbus, Ohio.,Neuroscience Graduate Program, Ohio State University, Columbus, Ohio
| | - Atsuko Uchida
- Department of Neuroscience, Ohio State University, Columbus, Ohio
| | - Anthony Brown
- Department of Neuroscience, Ohio State University, Columbus, Ohio
| |
Collapse
|
35
|
Sahenk Z, Ozes B. Gene therapy to promote regeneration in Charcot-Marie-Tooth disease. Brain Res 2019; 1727:146533. [PMID: 31669284 DOI: 10.1016/j.brainres.2019.146533] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2019] [Revised: 10/20/2019] [Accepted: 10/22/2019] [Indexed: 12/12/2022]
Abstract
The molecular pathogenesis underlying Charcot-Marie-Tooth (CMT) neuropathy subtypes is becoming increasingly variable and identification of common approaches for treatment, independently of the disease causing gene defect, is therefore much desirable. Gene therapy approach from the clinical translational view point is particularly challenging for the most common "demyelinating" CMT1 subtypes, caused by primary Schwann cell genetic defects. Studies have shown that impaired regenerative capacity of distal axons is major contributing factor to distal axonal loss in primary Schwann cell genetic defects and neurotrophin 3 (NT-3) improves impaired regeneration in CMT1 mouse models. This review surveys the evidence supporting the rationale for AAV1.NT-3 surrogate gene therapy to improve nerve regeneration in CMT1A. The translational process, from proof of principal studies to the design of the phase I/IIa trial evaluating scAAV1.tMCK.NTF3 gene therapy for treatment of CMT1A is summarized.
Collapse
Affiliation(s)
- Zarife Sahenk
- Center for Gene Therapy, Abigail Wexner Research Institute, Nationwide Children's Hospital, Columbus, OH, United States; Department of Pediatrics and Neurology, Nationwide Children's Hospital and The Ohio State University, United States; Department of Pathology and Laboratory Medicine, Nationwide Children's Hospital, Columbus, OH, United States; Department of Neurology, The Ohio State University, United States.
| | - Burcak Ozes
- Center for Gene Therapy, Abigail Wexner Research Institute, Nationwide Children's Hospital, Columbus, OH, United States
| |
Collapse
|
36
|
Schorling E, Thiele S, Gumbert L, Krause S, Klug C, Schreiber-Katz O, Reilich P, Nagels K, Walter MC. Cost of illness in Charcot-Marie-Tooth neuropathy: Results from Germany. Neurology 2019; 92:e2027-e2037. [PMID: 30918088 DOI: 10.1212/wnl.0000000000007376] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2018] [Accepted: 01/03/2019] [Indexed: 02/06/2023] Open
Abstract
OBJECTIVE To assess cost associated with the disease-specific need of patients diagnosed with Charcot-Marie-Tooth neuropathies (CMT) in Germany. METHODS Patients with CMT were identified through the national patient registry and invited to complete a standardized questionnaire. The data collected include information about health care use, informal care, and other disease-related expenses as well as the working situation. Based on this information, we estimated the annual cost of CMT from the perspective of society. RESULTS This study included 397 patients with a genetically confirmed CMT diagnosis. We estimated total annual cost of illness (COI) of $22,362 (95% CI $19,464-$25,723) per patient, of which 67.3% were direct costs. The highest single cost factor was informal care cost. For Germany, we extrapolated total cost of CMT of $735.0 million ($639.8 million-$845.5 million). Multivariate regression analysis showed that total annual cost increased with disease severity (Charcot-Marie-Tooth Neuropathy Score). Age, CMT subtype, comorbidities, body mass index, and employment status were also predictors of a change in cost (p < 0.05). Moreover, we found differences in total cost depending on marital status, subjectively evaluated impairments, dependence on other persons, care level, educational level, and disease duration. CONCLUSIONS CMT is associated with a substantial economic burden. For the first time, the COI of CMT has been assessed and will serve as important input to decision-making in health policy, especially regarding research and development of therapies. Moreover, our results indicate the importance of the patient-reported perception of disease severity related to the consumption of resources.
Collapse
Affiliation(s)
- Elisabeth Schorling
- From the Institute for Healthcare Management and Health Sciences (E.S., C.K.) and Healthcare Management and Health Services Research (L.G., K.N.), University of Bayreuth; Department of Neurology (S.T., S.K., P.R., M.C.W.), Friedrich-Baur-Institute, Ludwig-Maximilians-University of Munich; and Department of Neurology (O.S.-K.), Hannover Medical School, Germany
| | - Simone Thiele
- From the Institute for Healthcare Management and Health Sciences (E.S., C.K.) and Healthcare Management and Health Services Research (L.G., K.N.), University of Bayreuth; Department of Neurology (S.T., S.K., P.R., M.C.W.), Friedrich-Baur-Institute, Ludwig-Maximilians-University of Munich; and Department of Neurology (O.S.-K.), Hannover Medical School, Germany
| | - Laura Gumbert
- From the Institute for Healthcare Management and Health Sciences (E.S., C.K.) and Healthcare Management and Health Services Research (L.G., K.N.), University of Bayreuth; Department of Neurology (S.T., S.K., P.R., M.C.W.), Friedrich-Baur-Institute, Ludwig-Maximilians-University of Munich; and Department of Neurology (O.S.-K.), Hannover Medical School, Germany
| | - Sabine Krause
- From the Institute for Healthcare Management and Health Sciences (E.S., C.K.) and Healthcare Management and Health Services Research (L.G., K.N.), University of Bayreuth; Department of Neurology (S.T., S.K., P.R., M.C.W.), Friedrich-Baur-Institute, Ludwig-Maximilians-University of Munich; and Department of Neurology (O.S.-K.), Hannover Medical School, Germany
| | - Constanze Klug
- From the Institute for Healthcare Management and Health Sciences (E.S., C.K.) and Healthcare Management and Health Services Research (L.G., K.N.), University of Bayreuth; Department of Neurology (S.T., S.K., P.R., M.C.W.), Friedrich-Baur-Institute, Ludwig-Maximilians-University of Munich; and Department of Neurology (O.S.-K.), Hannover Medical School, Germany
| | - Olivia Schreiber-Katz
- From the Institute for Healthcare Management and Health Sciences (E.S., C.K.) and Healthcare Management and Health Services Research (L.G., K.N.), University of Bayreuth; Department of Neurology (S.T., S.K., P.R., M.C.W.), Friedrich-Baur-Institute, Ludwig-Maximilians-University of Munich; and Department of Neurology (O.S.-K.), Hannover Medical School, Germany
| | - Peter Reilich
- From the Institute for Healthcare Management and Health Sciences (E.S., C.K.) and Healthcare Management and Health Services Research (L.G., K.N.), University of Bayreuth; Department of Neurology (S.T., S.K., P.R., M.C.W.), Friedrich-Baur-Institute, Ludwig-Maximilians-University of Munich; and Department of Neurology (O.S.-K.), Hannover Medical School, Germany
| | - Klaus Nagels
- From the Institute for Healthcare Management and Health Sciences (E.S., C.K.) and Healthcare Management and Health Services Research (L.G., K.N.), University of Bayreuth; Department of Neurology (S.T., S.K., P.R., M.C.W.), Friedrich-Baur-Institute, Ludwig-Maximilians-University of Munich; and Department of Neurology (O.S.-K.), Hannover Medical School, Germany
| | - Maggie C Walter
- From the Institute for Healthcare Management and Health Sciences (E.S., C.K.) and Healthcare Management and Health Services Research (L.G., K.N.), University of Bayreuth; Department of Neurology (S.T., S.K., P.R., M.C.W.), Friedrich-Baur-Institute, Ludwig-Maximilians-University of Munich; and Department of Neurology (O.S.-K.), Hannover Medical School, Germany.
| |
Collapse
|
37
|
A network biology approach to unraveling inherited axonopathies. Sci Rep 2019; 9:1692. [PMID: 30737464 PMCID: PMC6368620 DOI: 10.1038/s41598-018-37119-z] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2018] [Accepted: 11/23/2018] [Indexed: 12/14/2022] Open
Abstract
Inherited axonopathies represent a spectrum of disorders unified by the common pathological mechanism of length-dependent axonal degeneration. Progressive axonal degeneration can lead to both Charcot-Marie-Tooth type 2 (CMT2) and Hereditary Spastic Paraplegia (HSP) depending on the affected neurons: peripheral motor and sensory nerves or central nervous system axons of the corticospinal tract and dorsal columns, respectively. Inherited axonopathies display an extreme degree of genetic heterogeneity of Mendelian high-penetrance genes. High locus heterogeneity is potentially advantageous to deciphering disease etiology by providing avenues to explore biological pathways in an unbiased fashion. Here, we investigate ‘gene modules’ in inherited axonopathies through a network-based analysis of the Human Integrated Protein-Protein Interaction rEference (HIPPIE) database. We demonstrate that CMT2 and HSP disease proteins are significantly more connected than randomly expected. We define these connected disease proteins as ‘proto-modules’ and show the topological relationship of these proto-modules by evaluating their overlap through a shortest-path based measurement. In particular, we observe that the CMT2 and HSP proto-modules significantly overlapped, demonstrating a shared genetic etiology. Comparison of both modules with other diseases revealed an overlapping relationship between HSP and hereditary ataxia and between CMT2 + HSP and hereditary ataxia. We then use the DIseAse Module Detection (DIAMOnD) algorithm to expand the proto-modules into comprehensive disease modules. Analysis of disease modules thus obtained reveals an enrichment of ribosomal proteins and pathways likely central to inherited axonopathy pathogenesis, including protein processing in the endoplasmic reticulum, spliceosome, and mRNA processing. Furthermore, we determine pathways specific to each axonopathy by analyzing the difference of the axonopathy modules. CMT2-specific pathways include glycolysis and gluconeogenesis-related processes, while HSP-specific pathways include processes involved in viral infection response. Unbiased characterization of inherited axonopathy disease modules will provide novel candidate disease genes, improve interpretation of candidate genes identified through patient data, and guide therapy development.
Collapse
|
38
|
Yoshimura A, Yuan JH, Hashiguchi A, Ando M, Higuchi Y, Nakamura T, Okamoto Y, Nakagawa M, Takashima H. Genetic profile and onset features of 1005 patients with Charcot-Marie-Tooth disease in Japan. J Neurol Neurosurg Psychiatry 2019; 90:195-202. [PMID: 30257968 PMCID: PMC6518473 DOI: 10.1136/jnnp-2018-318839] [Citation(s) in RCA: 43] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2018] [Revised: 08/19/2018] [Accepted: 08/26/2018] [Indexed: 12/25/2022]
Abstract
OBJECTIVE : To identify the genetic characteristics in a large-scale of patients with Charcot-Marie-Tooth disease (CMT). METHODS: From May 2012 to August 2016, we collected 1005 cases with suspected CMT throughout Japan, whereas PMP22 duplication/deletion were excluded in advance for demyelinating CMT cases. We performed next-generation sequencing targeting CMT-related gene panels using Illumina MiSeq or Ion Proton, then analysed the gene-specific onset age of the identified cases and geographical differences in terms of their genetic spectrum. RESULTS : From 40 genes, we identified pathogenic or likely pathogenic variants in 301 cases (30.0%). The most common causative genes were GJB1 (n=66, 21.9%), MFN2 (n=66, 21.9%) and MPZ (n=51, 16.9%). In demyelinating CMT, variants were detected in 45.7% cases, and the most common reasons were GJB1 (40.3%), MPZ (27.1%), PMP22 point mutations (6.2%) and NEFL (4.7%). Axonal CMT yielded a relatively lower detection rate (22.9%), and the leading causes, occupying 72.4%, were MFN2 (37.2%), MPZ (9.0%), HSPB1 (8.3%), GJB1 (7.7%), GDAP1 (5.1%) and MME (5.1%). First decade of life was found as the most common disease onset period, and early-onset CMT cases were most likely to receive a molecular diagnosis. Geographical distribution analysis indicated distinctive genetic spectrums in different regions of Japan. CONCLUSIONS : Our results updated the genetic profile within a large-scale of Japanese CMT cases. Subsequent analyses regarding onset age and geographical distribution advanced our understanding of CMT, which would be beneficial for clinicians.
Collapse
Affiliation(s)
- Akiko Yoshimura
- Department of Neurology and Geriatrics, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Jun-Hui Yuan
- Department of Neurology and Geriatrics, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Akihiro Hashiguchi
- Department of Neurology and Geriatrics, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Masahiro Ando
- Department of Neurology and Geriatrics, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Yujiro Higuchi
- Department of Neurology and Geriatrics, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Tomonori Nakamura
- Department of Neurology and Geriatrics, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Yuji Okamoto
- Department of Neurology and Geriatrics, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Masanori Nakagawa
- North Medical Center, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Hiroshi Takashima
- Department of Neurology and Geriatrics, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| |
Collapse
|
39
|
Gerber D, Ghidinelli M, Tinelli E, Somandin C, Gerber J, Pereira JA, Ommer A, Figlia G, Miehe M, Nägeli LG, Suter V, Tadini V, Sidiropoulos PNM, Wessig C, Toyka KV, Suter U. Schwann cells, but not Oligodendrocytes, Depend Strictly on Dynamin 2 Function. eLife 2019; 8:e42404. [PMID: 30648534 PMCID: PMC6335055 DOI: 10.7554/elife.42404] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2018] [Accepted: 12/31/2018] [Indexed: 12/13/2022] Open
Abstract
Myelination requires extensive plasma membrane rearrangements, implying that molecules controlling membrane dynamics play prominent roles. The large GTPase dynamin 2 (DNM2) is a well-known regulator of membrane remodeling, membrane fission, and vesicular trafficking. Here, we genetically ablated Dnm2 in Schwann cells (SCs) and in oligodendrocytes of mice. Dnm2 deletion in developing SCs resulted in severely impaired axonal sorting and myelination onset. Induced Dnm2 deletion in adult SCs caused a rapidly-developing peripheral neuropathy with abundant demyelination. In both experimental settings, mutant SCs underwent prominent cell death, at least partially due to cytokinesis failure. Strikingly, when Dnm2 was deleted in adult SCs, non-recombined SCs still expressing DNM2 were able to remyelinate fast and efficiently, accompanied by neuropathy remission. These findings reveal a remarkable self-healing capability of peripheral nerves that are affected by SC loss. In the central nervous system, however, we found no major defects upon Dnm2 deletion in oligodendrocytes.
Collapse
Affiliation(s)
- Daniel Gerber
- Department of BiologyInstitute of Molecular Health Sciences, Swiss Federal Institute of Technology, ETH ZurichZurichSwitzerland
| | - Monica Ghidinelli
- Department of BiologyInstitute of Molecular Health Sciences, Swiss Federal Institute of Technology, ETH ZurichZurichSwitzerland
| | - Elisa Tinelli
- Department of BiologyInstitute of Molecular Health Sciences, Swiss Federal Institute of Technology, ETH ZurichZurichSwitzerland
| | - Christian Somandin
- Department of BiologyInstitute of Molecular Health Sciences, Swiss Federal Institute of Technology, ETH ZurichZurichSwitzerland
| | - Joanne Gerber
- Department of BiologyInstitute of Molecular Health Sciences, Swiss Federal Institute of Technology, ETH ZurichZurichSwitzerland
| | - Jorge A Pereira
- Department of BiologyInstitute of Molecular Health Sciences, Swiss Federal Institute of Technology, ETH ZurichZurichSwitzerland
| | - Andrea Ommer
- Department of BiologyInstitute of Molecular Health Sciences, Swiss Federal Institute of Technology, ETH ZurichZurichSwitzerland
| | - Gianluca Figlia
- Department of BiologyInstitute of Molecular Health Sciences, Swiss Federal Institute of Technology, ETH ZurichZurichSwitzerland
| | - Michaela Miehe
- Department of BiologyInstitute of Molecular Health Sciences, Swiss Federal Institute of Technology, ETH ZurichZurichSwitzerland
| | - Lukas G Nägeli
- Department of BiologyInstitute of Molecular Health Sciences, Swiss Federal Institute of Technology, ETH ZurichZurichSwitzerland
| | - Vanessa Suter
- Department of BiologyInstitute of Molecular Health Sciences, Swiss Federal Institute of Technology, ETH ZurichZurichSwitzerland
| | - Valentina Tadini
- Department of BiologyInstitute of Molecular Health Sciences, Swiss Federal Institute of Technology, ETH ZurichZurichSwitzerland
| | - Páris NM Sidiropoulos
- Department of BiologyInstitute of Molecular Health Sciences, Swiss Federal Institute of Technology, ETH ZurichZurichSwitzerland
| | - Carsten Wessig
- Department of NeurologyUniversity Hospital of Würzburg, University of WürzburgWürzburgGermany
| | - Klaus V Toyka
- Department of NeurologyUniversity Hospital of Würzburg, University of WürzburgWürzburgGermany
| | - Ueli Suter
- Department of BiologyInstitute of Molecular Health Sciences, Swiss Federal Institute of Technology, ETH ZurichZurichSwitzerland
| |
Collapse
|
40
|
Akaishi T, Takahashi T, Nakashima I, Aoki M. Abnormal Osmolality Gap Exists in Distal Symmetric Polyneuropathy. TOHOKU J EXP MED 2018; 246:59-64. [PMID: 30270254 DOI: 10.1620/tjem.246.59] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Distal symmetric polyneuropathy, represented by chronic inflammatory demyelinating polyneuropathy, is a popular neurological condition. Some cases are known to be associated with genetic mutations or serum auto-antibodies, but the exact mechanisms in most cases are unknown. Recently, osmotic factors have been suggested to trigger some neurological disorders, such as neuromyelitis optica. The aim of the present study was to assess the possible association of osmotic factors in the pathogenesis of distal polyneuropathy. We prospectively measured the serum levels of osmolality, electrolytes, total protein, albumin, blood urea nitrogen, glucose, and osmolality gap in the patients with acute distal polyneuropathy before treatments (n = 12) and those with other comprehensive neurological disorders such as multiple sclerosis and neurodegenerative diseases (n = 176). Then, we compared each osmotic fraction between the two groups. As a result, all of the 12 patients with acute distal polyneuropathy, including 4 patients with chronic inflammatory demyelinating polyneuropathy, showed abnormally high or low values of osmolality gap, compared to the others (p < 0.0001, F-test). In the patients with other diseases, there were 2 patients with abnormally high osmolality gap values, which were attributable to their hyperlipidemia or high titer of serum autoantibody unrelated to polyneuropathy. In conclusion, serum osmolality gap would be elevated or decreased in the acute phase of distal symmetric polyneuropathy. Osmotic imbalance between the serum and nerve cells, based on abnormal excess or deficit of some unidentified serum osmolytes, may be one of the mechanisms in symmetric polyneuropathy with unknown causes.
Collapse
Affiliation(s)
- Tetsuya Akaishi
- Department of Neurology, Tohoku University Graduate School of Medicine.,Department of Education and Support for Community Medicine, Tohoku University Hospital
| | - Toshiyuki Takahashi
- Department of Neurology, Tohoku University Graduate School of Medicine.,Department of Neurology, Yonezawa National Hospital
| | - Ichiro Nakashima
- Department of Neurology, Tohoku Medical and Pharmaceutical University
| | - Masashi Aoki
- Department of Neurology, Tohoku University Graduate School of Medicine
| |
Collapse
|
41
|
Park S, Jung N, Myung S, Choi Y, Chung KW, Choi BO, Jung SC. Differentiation of Human Tonsil-Derived Mesenchymal Stem Cells into Schwann-Like Cells Improves Neuromuscular Function in a Mouse Model of Charcot-Marie-Tooth Disease Type 1A. Int J Mol Sci 2018; 19:ijms19082393. [PMID: 30110925 PMCID: PMC6121309 DOI: 10.3390/ijms19082393] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2018] [Revised: 08/06/2018] [Accepted: 08/10/2018] [Indexed: 01/18/2023] Open
Abstract
Charcot-Marie-Tooth disease type 1A (CMT1A) is the most common inherited motor and sensory neuropathy, and is caused by duplication of PMP22, alterations of which are a characteristic feature of demyelination. The clinical phenotype of CMT1A is determined by the degree of axonal loss, and patients suffer from progressive muscle weakness and impaired sensation. Therefore, we investigated the potential of Schwann-like cells differentiated from human tonsil-derived stem cells (T-MSCs) for use in neuromuscular regeneration in trembler-J (Tr-J) mice, a model of CMT1A. After differentiation, we confirmed the increased expression of Schwann cell (SC) markers, including glial fibrillary acidic protein (GFAP), nerve growth factor receptor (NGFR), S100 calcium-binding protein B (S100B), glial cell-derived neurotrophic factor (GDNF), and brain-derived neurotrophic factor (BDNF), which suggests the differentiation of T-MSCs into SCs (T-MSC-SCs). To test their functional efficiency, the T-MSC-SCs were transplanted into the caudal thigh muscle of Tr-J mice. Recipients’ improved locomotive activity on a rotarod test, and their sciatic function index, which suggests that transplanted T-MSC-SCs ameliorated demyelination and atrophy of nerve and muscle in Tr-J mice. Histological and molecular analyses showed the possibility of in situ remyelination by T-MSC-SCs transplantation. These findings demonstrate that the transplantation of heterologous T-MSC-SCs induced neuromuscular regeneration in mice and suggest they could be useful for the therapeutic treatment of patients with CMT1A disease.
Collapse
Affiliation(s)
- Saeyoung Park
- Department of Biochemistry, College of Medicine, Ewha Womans University, Seoul 07985, Korea.
| | - Namhee Jung
- Department of Biochemistry, College of Medicine, Ewha Womans University, Seoul 07985, Korea.
| | - Seoha Myung
- Department of Biochemistry, College of Medicine, Ewha Womans University, Seoul 07985, Korea.
| | - Yoonyoung Choi
- Department of Biochemistry, College of Medicine, Ewha Womans University, Seoul 07985, Korea.
| | - Ki Wha Chung
- Department of Biological Sciences, Kongju National University, Gongju 32588, Korea.
| | - Byung-Ok Choi
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, Korea.
| | - Sung-Chul Jung
- Department of Biochemistry, College of Medicine, Ewha Womans University, Seoul 07985, Korea.
| |
Collapse
|
42
|
Straub V, Murphy A, Udd B, Corrado A, Aymé S, Bönneman C, de Visser M, Hamosh A, Jacobs L, Khizanishvili N, Kroneman M, Laflorêt P, Murphy A, Nigro V, Rufibach L, Sarkozy A, Swanepoel S, Torrente I, Udd B, Urtizberea A, Vissing J, Walter M. 229th ENMC international workshop: Limb girdle muscular dystrophies – Nomenclature and reformed classification Naarden, the Netherlands, 17–19 March 2017. Neuromuscul Disord 2018; 28:702-710. [DOI: 10.1016/j.nmd.2018.05.007] [Citation(s) in RCA: 178] [Impact Index Per Article: 29.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2018] [Revised: 05/13/2018] [Accepted: 05/16/2018] [Indexed: 11/26/2022]
|
43
|
Juneja M, Azmi A, Baets J, Roos A, Jennings MJ, Saveri P, Pisciotta C, Bernard-Marissal N, Schneider BL, Verfaillie C, Chrast R, Seeman P, Hahn AF, de Jonghe P, Maudsley S, Horvath R, Pareyson D, Timmerman V. PFN2 and GAMT as common molecular determinants of axonal Charcot-Marie-Tooth disease. J Neurol Neurosurg Psychiatry 2018; 89:870-878. [PMID: 29449460 DOI: 10.1136/jnnp-2017-317562] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2017] [Revised: 01/24/2018] [Accepted: 01/30/2018] [Indexed: 11/04/2022]
Abstract
BACKGROUND Charcot-Marie-Tooth type 2 (CMT2) neuropathy is characterised by a vast clinical and genetic heterogeneity complicating its diagnosis and therapeutic intervention. Identification of molecular signatures that are common to multiple CMT2 subtypes can aid in developing therapeutic strategies and measuring disease outcomes. METHODS A proteomics-based approach was performed on lymphoblasts from CMT2 patients genetically diagnosed with different gene mutations to identify differentially regulated proteins. The candidate proteins were validated through real-time quantitative PCR and western blotting on lymphoblast samples of patients and controls, motor neurons differentiated from patient-derived induced pluripotent stem cells (iPSCs) and sciatic nerves of CMT2 mouse models. RESULTS Proteomic profiling of patient lymphoblasts resulted in the identification of profilin 2 (PFN2) and guanidinoacetate methyltransferase (GAMT) as commonly downregulated proteins in different genotypes compared with healthy controls. This decrease was also observed at the transcriptional level on screening 43 CMT2 patients and 22 controls, respectively. A progressive decrease in PFN2 expression with age was observed in patients, while in healthy controls its expression increased with age. Reduced PFN2 expression was also observed in motor neurons differentiated from CMT2 patient-derived iPSCs and sciatic nerves of CMT2 mice when compared with controls. However, no change in GAMT levels was observed in motor neurons and CMT2 mouse-derived sciatic nerves. CONCLUSIONS We unveil PFN2 and GAMT as molecular determinants of CMT2 with possible indications of the role of PFN2 in the pathogenesis and disease progression. This is the first study describing biomarkers that can boost the development of therapeutic strategies targeting a wider spectrum of CMT2 patients.
Collapse
Affiliation(s)
- Manisha Juneja
- Peripheral Neuropathy Research Group, University of Antwerp, Antwerp, Belgium.,Institute Born Bunge, Antwerp, Belgium
| | - Abdelkrim Azmi
- VIB Center for Molecular Neurology, University of Antwerp, Antwerp, Belgium
| | - Jonathan Baets
- Institute Born Bunge, Antwerp, Belgium.,VIB Center for Molecular Neurology, University of Antwerp, Antwerp, Belgium.,Neuromuscular Reference Centre, Department of Neurology, Antwerp University Hospital, Antwerpen, Belgium
| | - Andreas Roos
- Institute of Genetic Medicine, Newcastle University, Newcastle upon Tyne, UK.,Leibniz-Institut für Analytische Wissenschaften -ISAS- e.V., Dortmund, Germany
| | - Matthew J Jennings
- Institute of Genetic Medicine, Newcastle University, Newcastle upon Tyne, UK
| | - Paola Saveri
- Unit of Rare Neurodegenerative and Neurometabolic Diseases, Department of Clinical Neurosciences, C. Besta Neurological Institute IRCCS Foundation, Milan, Italy
| | - Chiara Pisciotta
- Unit of Rare Neurodegenerative and Neurometabolic Diseases, Department of Clinical Neurosciences, C. Besta Neurological Institute IRCCS Foundation, Milan, Italy
| | - Nathalie Bernard-Marissal
- Aix Marseille University, INSERM, MMG, U1251, Marseille, France.,Brain Mind Institute, Ecole Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland
| | - Bernard L Schneider
- Brain Mind Institute, Ecole Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland
| | | | - Roman Chrast
- Department of Neuroscience, Karolinska Institutet, Stockholm, Sweden.,Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Pavel Seeman
- DNA Laboratory, Department of Child Neurology, 2nd Medical School, Charles University and University Hospital Motol, Prague, Czech Republic
| | - Angelika F Hahn
- Department of Clinical Neurological Sciences Centre, University Hospital, Western University, London, Ontario, Canada
| | - Peter de Jonghe
- Institute Born Bunge, Antwerp, Belgium.,VIB Center for Molecular Neurology, University of Antwerp, Antwerp, Belgium
| | - Stuart Maudsley
- VIB Center for Molecular Neurology, University of Antwerp, Antwerp, Belgium
| | - Rita Horvath
- Institute of Genetic Medicine, Newcastle University, Newcastle upon Tyne, UK
| | - Davide Pareyson
- Unit of Rare Neurodegenerative and Neurometabolic Diseases, Department of Clinical Neurosciences, C. Besta Neurological Institute IRCCS Foundation, Milan, Italy
| | - Vincent Timmerman
- Peripheral Neuropathy Research Group, University of Antwerp, Antwerp, Belgium.,Institute Born Bunge, Antwerp, Belgium
| |
Collapse
|
44
|
Shah RM, Maize KM, West HT, Strom AM, Finzel BC, Wagner CR. Structure and Functional Characterization of Human Histidine Triad Nucleotide-Binding Protein 1 Mutations Associated with Inherited Axonal Neuropathy with Neuromyotonia. J Mol Biol 2018; 430:2709-2721. [PMID: 29787766 DOI: 10.1016/j.jmb.2018.05.028] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2018] [Revised: 05/15/2018] [Accepted: 05/15/2018] [Indexed: 11/30/2022]
Abstract
Inherited peripheral neuropathies are a group of neurodegenerative disorders that clinically affect 1 in 2500 individuals. Recently, genetic mutations in human histidine nucleotide-binding protein 1 (hHint1) have been strongly and most frequently associated with patients suffering from axonal neuropathy with neuromyotonia. However, the correlation between the impact of these mutations on the hHint1 structure, enzymatic activity and in vivo function has remained ambiguous. Here, we provide detailed biochemical characterization of a set of these hHint1 mutations. Our findings indicate that half of the mutations (R37P, G93D and W123*) resulted in a destabilization of the dimeric state and a significant decrease in catalytic activity and HINT1 inhibitor binding affinity. The H112N mutant was found to be dimeric, but devoid of catalytic activity, due to the loss of the catalytically essential histidine; nevertheless, it exhibited high affinity to AMP and a HINT1 inhibitor. In contrast to the active-site mutants, the catalytic activity and dimeric structure of the surface mutants, C84R and G89V, were found to be similar to the wild-type enzyme. Taken together, our results suggest that the pathophysiology of inherited axonal neuropathy with neuromyotonia can be induced by conversion of HINT1 from a homodimer to monomer, by modification of select surface residues or by a significant reduction of the enzyme's catalytic efficiency.
Collapse
Affiliation(s)
- Rachit M Shah
- Department of Medicinal Chemistry, University of Minnesota, Minneapolis, MN 55455, USA
| | - Kimberly M Maize
- Department of Medicinal Chemistry, University of Minnesota, Minneapolis, MN 55455, USA
| | - Harrison T West
- Department of Medicinal Chemistry, University of Minnesota, Minneapolis, MN 55455, USA
| | - Alexander M Strom
- Department of Medicinal Chemistry, University of Minnesota, Minneapolis, MN 55455, USA
| | - Barry C Finzel
- Department of Medicinal Chemistry, University of Minnesota, Minneapolis, MN 55455, USA
| | - Carston R Wagner
- Department of Medicinal Chemistry, University of Minnesota, Minneapolis, MN 55455, USA; Department of Chemistry, University of Minnesota, Minneapolis, MN 55455, USA.
| |
Collapse
|
45
|
Saghira C, Bis DM, Stanek D, Strickland A, Herrmann DN, Reilly MM, Scherer SS, Shy ME, Züchner S. Variant pathogenicity evaluation in the community-driven Inherited Neuropathy Variant Browser. Hum Mutat 2018; 39:635-642. [PMID: 29473246 DOI: 10.1002/humu.23412] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2017] [Revised: 02/09/2018] [Accepted: 02/16/2018] [Indexed: 12/13/2022]
Abstract
Charcot-Marie-Tooth disease (CMT) is an umbrella term for inherited neuropathies affecting an estimated one in 2,500 people. Over 120 CMT and related genes have been identified and clinical gene panels often contain more than 100 genes. Such a large genomic space will invariantly yield variants of uncertain clinical significance (VUS) in nearly any person tested. This rise in number of VUS creates major challenges for genetic counseling. Additionally, fewer individual variants in known genes are being published as the academic merit is decreasing, and most testing now happens in clinical laboratories, which typically do not correlate their variants with clinical phenotypes. For CMT, we aim to encourage and facilitate the global capture of variant data to gain a large collection of alleles in CMT genes, ideally in conjunction with phenotypic information. The Inherited Neuropathy Variant Browser provides user-friendly open access to currently reported variation in CMT genes. Geneticists, physicians, and genetic counselors can enter variants detected by clinical tests or in research studies in addition to genetic variation gathered from published literature, which are then submitted to ClinVar biannually. Active participation of the broader CMT community will provide an advance over existing resources for interpretation of CMT genetic variation.
Collapse
Affiliation(s)
- Cima Saghira
- Dr. John T. Macdonald Foundation Department of Human Genetics, University of Miami, Miami, Florida
- Hussman Institute for Human Genomics, University of Miami, Miami, Florida
| | - Dana M Bis
- Dr. John T. Macdonald Foundation Department of Human Genetics, University of Miami, Miami, Florida
- Hussman Institute for Human Genomics, University of Miami, Miami, Florida
| | - David Stanek
- Department of Paediatric Neurology, Charles University, Prague, Czech Republic
| | - Alleene Strickland
- Dr. John T. Macdonald Foundation Department of Human Genetics, University of Miami, Miami, Florida
- Hussman Institute for Human Genomics, University of Miami, Miami, Florida
| | - David N Herrmann
- Department of Neurology, University of Rochester, Rochester, New York
| | - Mary M Reilly
- MRC Centre for Neuromuscular Diseases, UCL Institute of Neurology, Queen Square, London, UK
| | - Steven S Scherer
- Department of Neurology, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Michael E Shy
- Department of Neurology, University of Iowa, Iowa City, Iowa
| | - Stephan Züchner
- Dr. John T. Macdonald Foundation Department of Human Genetics, University of Miami, Miami, Florida
- Hussman Institute for Human Genomics, University of Miami, Miami, Florida
| |
Collapse
|
46
|
Muhammad AKMG, Kim K, Epifantseva I, Aghamaleky-Sarvestany A, Simpkinson ME, Carmona S, Landeros J, Bell S, Svaren J, Baloh RH. Cell transplantation strategies for acquired and inherited disorders of peripheral myelin. Ann Clin Transl Neurol 2018; 5:186-200. [PMID: 29468179 PMCID: PMC5817839 DOI: 10.1002/acn3.517] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2017] [Revised: 11/27/2017] [Accepted: 12/01/2017] [Indexed: 01/26/2023] Open
Abstract
Objective To investigate transplantation of rat Schwann cells or human iPSC-derived neural crest cells and derivatives into models of acquired and inherited peripheral myelin damage. Methods Primary cultured rat Schwann cells labeled with a fluorescent protein for monitoring at various times after transplantation. Human-induced pluripotent stem cells (iPSCs) were differentiated into neural crest stem cells, and subsequently toward a Schwann cell lineage via two different protocols. Cell types were characterized using flow cytometry, immunocytochemistry, and transcriptomics. Rat Schwann cells and human iPSC derivatives were transplanted into (1) nude rats pretreated with lysolecithin to induce demyelination or (2) a transgenic rat model of dysmyelination due to PMP22 overexpression. Results Rat Schwann cells transplanted into sciatic nerves with either toxic demyelination or genetic dysmyelination engrafted successfully, and migrated longitudinally for relatively long distances, with more limited axial migration. Transplanted Schwann cells engaged existing axons and displaced dysfunctional Schwann cells to form normal-appearing myelin. Human iPSC-derived neural crest stem cells and their derivatives shared similar engraftment and migration characteristics to rat Schwann cells after transplantation, but did not further differentiate into Schwann cells or form myelin. Interpretation These results indicate that cultured Schwann cells surgically delivered to peripheral nerve can engraft and form myelin in either acquired or inherited myelin injury, as proof of concept for pursuing cell therapy for diseases of peripheral nerve. However, lack of reliable technology for generating human iPSC-derived Schwann cells for transplantation therapy remains a barrier in the field.
Collapse
Affiliation(s)
- A K M G Muhammad
- Board of Governors Regenerative Medicine Institute Cedars-Sinai Medical Center 8700 Beverly Boulevard Los Angeles California 90048
| | - Kevin Kim
- Board of Governors Regenerative Medicine Institute Cedars-Sinai Medical Center 8700 Beverly Boulevard Los Angeles California 90048
| | - Irina Epifantseva
- Board of Governors Regenerative Medicine Institute Cedars-Sinai Medical Center 8700 Beverly Boulevard Los Angeles California 90048
| | - Arwin Aghamaleky-Sarvestany
- Board of Governors Regenerative Medicine Institute Cedars-Sinai Medical Center 8700 Beverly Boulevard Los Angeles California 90048
| | - Megan E Simpkinson
- Board of Governors Regenerative Medicine Institute Cedars-Sinai Medical Center 8700 Beverly Boulevard Los Angeles California 90048
| | - Sharon Carmona
- Board of Governors Regenerative Medicine Institute Cedars-Sinai Medical Center 8700 Beverly Boulevard Los Angeles California 90048
| | - Jesse Landeros
- Board of Governors Regenerative Medicine Institute Cedars-Sinai Medical Center 8700 Beverly Boulevard Los Angeles California 90048
| | - Shaughn Bell
- Board of Governors Regenerative Medicine Institute Cedars-Sinai Medical Center 8700 Beverly Boulevard Los Angeles California 90048
| | - John Svaren
- Waisman Center and Department of Comparative Biosciences University of Wisconsin-Madison Madison Wisconsin 53706
| | - Robert H Baloh
- Board of Governors Regenerative Medicine Institute Cedars-Sinai Medical Center 8700 Beverly Boulevard Los Angeles California 90048.,Department of Neurology Cedars-Sinai Medical Center 8700 Beverly Boulevard Los Angeles California 90048
| |
Collapse
|
47
|
|
48
|
Lee S, Bazick H, Chittoor-Vinod V, Al Salihi MO, Xia G, Notterpek L. Elevated Peripheral Myelin Protein 22, Reduced Mitotic Potential, and Proteasome Impairment in Dermal Fibroblasts from Charcot-Marie-Tooth Disease Type 1A Patients. THE AMERICAN JOURNAL OF PATHOLOGY 2017; 188:728-738. [PMID: 29246495 PMCID: PMC5842032 DOI: 10.1016/j.ajpath.2017.10.021] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/06/2017] [Revised: 10/05/2017] [Accepted: 10/27/2017] [Indexed: 12/31/2022]
Abstract
A common form of hereditary autosomal dominant demyelinating neuropathy known as Charcot-Marie-Tooth disease type 1A (CMT1A) is linked with duplication of the peripheral myelin protein 22 (PMP22) gene. Although studies from animal models have led to better understanding of the pathobiology of these neuropathies, there continues to be a gap in the translation of findings from rodents to humans. Because PMP22 was originally identified in fibroblasts as growth arrest specific gene 3 (gas3) and is expressed broadly in the body, it was tested whether skin cells from neuropathic patients would display the cellular pathology observed in Schwann cells from rodent models. Dermal fibroblasts from two CMT1A pedigrees with confirmed PMP22 gene duplication were studied. Samples from age-matched non-neuropathic individuals were used as controls. CMT1A patient–derived cultures contain approximately 1.5-fold elevated levels of PMP22 mRNA, exhibit reduced mitotic potential, and display intracellular protein aggregates as compared to cells from unaffected individuals. The presence of cytosolic PMP22 coincides with a decrease in proteasome activity and an increase in autophagy-lysosomal proteins, including LC3-II and LAMP1. These results indicate that the abnormalities in the subcellular processing of excess PMP22 elicit a detectable response in human CMT1A fibroblasts, a phenotype that resembles Schwann cells from neuropathic mice. These findings support the use of human CMT1A fibroblasts as a platform for therapy testing.
Collapse
Affiliation(s)
- Sooyeon Lee
- Department of Neuroscience, College of Medicine, University of Florida, Gainesville, Florida
| | - Hannah Bazick
- Department of Neuroscience, College of Medicine, University of Florida, Gainesville, Florida
| | - Vinita Chittoor-Vinod
- Department of Neuroscience, College of Medicine, University of Florida, Gainesville, Florida
| | - Mohammed Omar Al Salihi
- Department of Neuroscience, College of Medicine, University of Florida, Gainesville, Florida
| | - Guangbin Xia
- Department of Neuroscience, College of Medicine, University of Florida, Gainesville, Florida; Department of Neurology, College of Medicine, University of Florida, Gainesville, Florida
| | - Lucia Notterpek
- Department of Neuroscience, College of Medicine, University of Florida, Gainesville, Florida; Department of Neurology, College of Medicine, University of Florida, Gainesville, Florida.
| |
Collapse
|
49
|
Morelli KH, Seburn KL, Schroeder DG, Spaulding EL, Dionne LA, Cox GA, Burgess RW. Severity of Demyelinating and Axonal Neuropathy Mouse Models Is Modified by Genes Affecting Structure and Function of Peripheral Nodes. Cell Rep 2017; 18:3178-3191. [PMID: 28355569 DOI: 10.1016/j.celrep.2017.03.009] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2016] [Revised: 11/11/2016] [Accepted: 03/01/2017] [Indexed: 12/22/2022] Open
Abstract
Charcot-Marie-Tooth (CMT) disease is a clinically and genetically heterogeneous group of inherited polyneuropathies. Mutations in 80 genetic loci can cause forms of CMT, resulting in demyelination and axonal dysfunction. The clinical presentation, including sensory deficits, distal muscle weakness, and atrophy, can vary greatly in severity and progression. Here, we used mouse models of CMT to demonstrate genetic interactions that result in a more severe neuropathy phenotype. The cell adhesion molecule Nrcam and the Na+ channel Scn8a (NaV1.6) are important components of nodes. Homozygous Nrcam and heterozygous Scn8a mutations synergized with both an Sh3tc2 mutation, modeling recessive demyelinating Charcot-Marie-Tooth type 4C, and mutations in Gars, modeling dominant axonal Charcot-Marie-Tooth type 2D. We conclude that genetic variants perturbing the structure and function of nodes interact with mutations affecting the cable properties of axons by thinning myelin or reducing axon diameter. Therefore, genes integral to peripheral nodes are candidate modifiers of peripheral neuropathy.
Collapse
Affiliation(s)
- Kathryn H Morelli
- The Jackson Laboratory, Bar Harbor, ME 04609, USA; Graduate School of Biomedical Science and Engineering, University of Maine, Orono, ME 04469, USA
| | | | | | - Emily L Spaulding
- The Jackson Laboratory, Bar Harbor, ME 04609, USA; Graduate School of Biomedical Science and Engineering, University of Maine, Orono, ME 04469, USA
| | | | - Gregory A Cox
- The Jackson Laboratory, Bar Harbor, ME 04609, USA; Graduate School of Biomedical Science and Engineering, University of Maine, Orono, ME 04469, USA
| | - Robert W Burgess
- The Jackson Laboratory, Bar Harbor, ME 04609, USA; Graduate School of Biomedical Science and Engineering, University of Maine, Orono, ME 04469, USA.
| |
Collapse
|
50
|
Marttila M, Kytövuori L, Helisalmi S, Kallio M, Laitinen M, Hiltunen M, Kärppä M, Majamaa K. Molecular Epidemiology of Charcot-Marie-Tooth Disease in Northern Ostrobothnia, Finland: A Population-Based Study. Neuroepidemiology 2017; 49:34-39. [PMID: 28810241 DOI: 10.1159/000478860] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2017] [Accepted: 06/14/2017] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Charcot-Marie-Tooth (CMT) disease is the most common hereditary neuromuscular disorder with a population prevalence of 9.7-82.3/100,000. In this study, we have estimated the prevalence of CMT and its subtypes in Finland and examined the frequency of molecular etiologies. METHODS A population-based survey included adult patients with peripheral neuropathy from the province of Northern Ostrobothnia, Finland. Secondary causes of peripheral polyneuropathy were excluded and patients with clinical and neurophysiological features pertinent with CMT were included. Molecular diagnostics was carried out when DNA was available. RESULTS We found 107 subjects with CMT yielding a prevalence 34.6/100,000 in Northern Ostrobothnia. The heterozygous point mutation p.His123Arg in ganglioside induced differentiation associated protein 1 (GDAP1) was found in 31.5% and peripheral myelin protein 22 (PMP22) duplication in 16.9% of the affected. Point mutations in myelin protein zero, mitofusin 2, and gap junction protein beta 1 accounted for 6.7% of the cases. In addition, 18 persons had hereditary neuropathy with liability to pressure palsies and 15 of them carried the PMP22 deletion. CONCLUSIONS The prevalence of CMT in Northern Ostrobothnia, Finland, seems to be slightly higher than those in previous studies in European populations. Founder mutation in the GDAP1 gene accounts for a large part of the genetically defined CMT2 in Finland.
Collapse
Affiliation(s)
- Maria Marttila
- Medical Research Center Oulu, University of Oulu and Oulu University Hospital, Oulu, Finland
| | | | | | | | | | | | | | | |
Collapse
|