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Clayton EL, Huggon L, Cousin MA, Mizielinska S. Synaptopathy: presynaptic convergence in frontotemporal dementia and amyotrophic lateral sclerosis. Brain 2024; 147:2289-2307. [PMID: 38451707 PMCID: PMC11224618 DOI: 10.1093/brain/awae074] [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: 08/18/2023] [Revised: 02/02/2024] [Accepted: 02/12/2024] [Indexed: 03/09/2024] Open
Abstract
Frontotemporal dementia and amyotrophic lateral sclerosis are common forms of neurodegenerative disease that share overlapping genetics and pathologies. Crucially, no significantly disease-modifying treatments are available for either disease. Identifying the earliest changes that initiate neuronal dysfunction is important for designing effective intervention therapeutics. The genes mutated in genetic forms of frontotemporal dementia and amyotrophic lateral sclerosis have diverse cellular functions, and multiple disease mechanisms have been proposed for both. Identification of a convergent disease mechanism in frontotemporal dementia and amyotrophic lateral sclerosis would focus research for a targetable pathway, which could potentially effectively treat all forms of frontotemporal dementia and amyotrophic lateral sclerosis (both familial and sporadic). Synaptopathies are diseases resulting from physiological dysfunction of synapses, and define the earliest stages in multiple neuronal diseases, with synapse loss a key feature in dementia. At the presynapse, the process of synaptic vesicle recruitment, fusion and recycling is necessary for activity-dependent neurotransmitter release. The unique distal location of the presynaptic terminal means the tight spatio-temporal control of presynaptic homeostasis is dependent on efficient local protein translation and degradation. Recently, numerous publications have shown that mutations associated with frontotemporal dementia and amyotrophic lateral sclerosis present with synaptopathy characterized by presynaptic dysfunction. This review will describe the complex local signalling and membrane trafficking events that occur at the presynapse to facilitate neurotransmission and will summarize recent publications linking frontotemporal dementia/amyotrophic lateral sclerosis genetic mutations to presynaptic function. This evidence indicates that presynaptic synaptopathy is an early and convergent event in frontotemporal dementia and amyotrophic lateral sclerosis and illustrates the need for further research in this area, to identify potential therapeutic targets with the ability to impact this convergent pathomechanism.
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Affiliation(s)
- Emma L Clayton
- UK Dementia Research Institute at King’s College London, London SE5 9RT, UK
- Department of Basic and Clinical Neuroscience, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, Maurice Wohl Clinical Neuroscience Institute, London SE5 9RT, UK
| | - Laura Huggon
- UK Dementia Research Institute at King’s College London, London SE5 9RT, UK
- Department of Basic and Clinical Neuroscience, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, Maurice Wohl Clinical Neuroscience Institute, London SE5 9RT, UK
| | - Michael A Cousin
- Centre for Discovery Brain Sciences, University of Edinburgh, Edinburgh EH8 9XD, UK
- Muir Maxwell Epilepsy Centre, University of Edinburgh, Edinburgh EH8 9XD, UK
- Simons Initiative for the Developing Brain, University of Edinburgh, Edinburgh EH8 9XD, UK
| | - Sarah Mizielinska
- UK Dementia Research Institute at King’s College London, London SE5 9RT, UK
- Department of Basic and Clinical Neuroscience, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, Maurice Wohl Clinical Neuroscience Institute, London SE5 9RT, UK
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2
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Lindborg SR, Goyal NA, Katz J, Burford M, Li J, Kaspi H, Abramov N, Boulanger B, Berry JD, Nicholson K, Mozaffar T, Miller R, Jenkins L, Baloh RH, Lewis R, Staff NP, Owegi MA, Dagher B, Blondheim-Shraga NR, Gothelf Y, Levy YS, Kern R, Aricha R, Windebank AJ, Bowser R, Brown RH, Cudkowicz ME. Debamestrocel multimodal effects on biomarker pathways in amyotrophic lateral sclerosis are linked to clinical outcomes. Muscle Nerve 2024; 69:719-729. [PMID: 38593477 DOI: 10.1002/mus.28093] [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: 09/01/2023] [Revised: 03/16/2024] [Accepted: 03/19/2024] [Indexed: 04/11/2024]
Abstract
INTRODUCTION/AIMS Biomarkers have shown promise in amyotrophic lateral sclerosis (ALS) research, but the quest for reliable biomarkers remains active. This study evaluates the effect of debamestrocel on cerebrospinal fluid (CSF) biomarkers, an exploratory endpoint. METHODS A total of 196 participants randomly received debamestrocel or placebo. Seven CSF samples were to be collected from all participants. Forty-five biomarkers were analyzed in the overall study and by two subgroups characterized by the ALS Functional Rating Scale-Revised (ALSFRS-R). A prespecified model was employed to predict clinical outcomes leveraging biomarkers and disease characteristics. Causal inference was used to analyze relationships between neurofilament light chain (NfL) and ALSFRS-R. RESULTS We observed significant changes with debamestrocel in 64% of the biomarkers studied, spanning pathways implicated in ALS pathology (63% neuroinflammation, 50% neurodegeneration, and 89% neuroprotection). Biomarker changes with debamestrocel show biological activity in trial participants, including those with advanced ALS. CSF biomarkers were predictive of clinical outcomes in debamestrocel-treated participants (baseline NfL, baseline latency-associated peptide/transforming growth factor beta1 [LAP/TGFβ1], change galectin-1, all p < .01), with baseline NfL and LAP/TGFβ1 remaining (p < .05) when disease characteristics (p < .005) were incorporated. Change from baseline to the last measurement showed debamestrocel-driven reductions in NfL were associated with less decline in ALSFRS-R. Debamestrocel significantly reduced NfL from baseline compared with placebo (11% vs. 1.6%, p = .037). DISCUSSION Following debamestrocel treatment, many biomarkers showed increases (anti-inflammatory/neuroprotective) or decreases (inflammatory/neurodegenerative) suggesting a possible treatment effect. Neuroinflammatory and neuroprotective biomarkers were predictive of clinical response, suggesting a potential multimodal mechanism of action. These results offer preliminary insights that need to be confirmed.
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Affiliation(s)
| | - Namita A Goyal
- UCI Health ALS & Neuromuscular Center, University of California, Irvine, California, USA
| | - Jonathan Katz
- Sutter Pacific Medical Foundation, California Pacific Medical Center, San Francisco, California, USA
| | - Matthew Burford
- Department of Neurology, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Jenny Li
- Brainstorm Cell Therapeutics, Boston, Massachusetts, USA
| | | | | | - Bruno Boulanger
- Department of Statistics and Data Science, PharmaLex, Mont-Saint-Guibert, Belgium
| | - James D Berry
- Healey & AMG Center, Mass General Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Katharine Nicholson
- Healey & AMG Center, Mass General Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Tahseen Mozaffar
- UCI Health ALS & Neuromuscular Center, University of California, Irvine, California, USA
| | - Robert Miller
- Sutter Pacific Medical Foundation, California Pacific Medical Center, San Francisco, California, USA
| | - Liberty Jenkins
- Sutter Pacific Medical Foundation, California Pacific Medical Center, San Francisco, California, USA
| | - Robert H Baloh
- Department of Neurology, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Richard Lewis
- Department of Neurology, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Nathan P Staff
- Department of Neurology, Mayo Clinic College of Medicine, Rochester, Minnesota, USA
| | - Margaret Ayo Owegi
- Neurology Department, University of Massachusetts Medical School, Worcester, Massachusetts, USA
| | - Bob Dagher
- Brainstorm Cell Therapeutics, Boston, Massachusetts, USA
| | | | | | - Yossef S Levy
- Manufacturing, Brainstorm Cell Therapeutics, Tel Aviv, Israel
| | - Ralph Kern
- Brainstorm Cell Therapeutics, Boston, Massachusetts, USA
| | | | - Anthony J Windebank
- Department of Neurology, Mayo Clinic College of Medicine, Rochester, Minnesota, USA
| | - Robert Bowser
- Department of Neurology, Barrow Neurological Institute, Phoenix, Arizona, USA
| | - Robert H Brown
- Neurology Department, University of Massachusetts Medical School, Worcester, Massachusetts, USA
| | - Merit E Cudkowicz
- Healey & AMG Center, Mass General Hospital, Harvard Medical School, Boston, Massachusetts, USA
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3
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Nguyen L. Updates on Disease Mechanisms and Therapeutics for Amyotrophic Lateral Sclerosis. Cells 2024; 13:888. [PMID: 38891021 PMCID: PMC11172142 DOI: 10.3390/cells13110888] [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: 03/29/2024] [Revised: 05/08/2024] [Accepted: 05/15/2024] [Indexed: 06/20/2024] Open
Abstract
Amyotrophic lateral sclerosis (ALS), or Lou Gehrig's disease, is a motor neuron disease. In ALS, upper and lower motor neurons in the brain and spinal cord progressively degenerate during the course of the disease, leading to the loss of the voluntary movement of the arms and legs. Since its first description in 1869 by a French neurologist Jean-Martin Charcot, the scientific discoveries on ALS have increased our understanding of ALS genetics, pathology and mechanisms and provided novel therapeutic strategies. The goal of this review article is to provide a comprehensive summary of the recent findings on ALS mechanisms and related therapeutic strategies to the scientific audience. Several highlighted ALS research topics discussed in this article include the 2023 FDA approved drug for SOD1 ALS, the updated C9orf72 GGGGCC repeat-expansion-related mechanisms and therapeutic targets, TDP-43-mediated cryptic splicing and disease markers and diagnostic and therapeutic options offered by these recent discoveries.
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Affiliation(s)
- Lien Nguyen
- Department of Molecular Genetics and Microbiology, College of Medicine, University of Florida, Gainesville, FL 32610, USA;
- Center for NeuroGenetics, College of Medicine, University of Florida, Gainesville, FL 32610, USA
- Department of Neuroscience, College of Medicine, University of Florida, Gainesville, FL 32610, USA
- Genetics Institute, University of Florida, Gainesville, FL 32610, USA
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Van Daele SH, Masrori P, Van Damme P, Van Den Bosch L. The sense of antisense therapies in ALS. Trends Mol Med 2024; 30:252-262. [PMID: 38216448 DOI: 10.1016/j.molmed.2023.12.003] [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: 10/05/2023] [Revised: 12/01/2023] [Accepted: 12/07/2023] [Indexed: 01/14/2024]
Abstract
Treatment of patients with amyotrophic lateral sclerosis (ALS) has entered a new era now that encouraging results about antisense oligonucleotides (ASOs) are becoming available and a first ASO therapy for ALS has been approved by the FDA. Moreover, there is hope not only that ALS can be stopped but also that symptoms can be reversed. Until now, degrading ASOs seemed to be successful mostly for rarer forms of familial ALS. However, the first attempts to correct mis-splicing events in sporadic ALS are underway, as well as a clinical trial examining interference with a genetic modifier. In this review, we discuss the current status of using ASOs in ALS and the possibilities and pitfalls of this therapeutic strategy.
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Affiliation(s)
- Sien H Van Daele
- KU Leuven - University of Leuven, Department of Neurosciences, Leuven Brain Institute (LBI), Leuven, Belgium; Laboratory of Neurobiology, VIB Center for Brain & Disease Research, Leuven, Belgium; Department of Human Genetics, University Hospitals Leuven, Leuven, Belgium
| | - Pegah Masrori
- KU Leuven - University of Leuven, Department of Neurosciences, Leuven Brain Institute (LBI), Leuven, Belgium; Laboratory of Neurobiology, VIB Center for Brain & Disease Research, Leuven, Belgium; Department of Neurology, University Hospitals Leuven, Leuven, Belgium
| | - Philip Van Damme
- KU Leuven - University of Leuven, Department of Neurosciences, Leuven Brain Institute (LBI), Leuven, Belgium; Laboratory of Neurobiology, VIB Center for Brain & Disease Research, Leuven, Belgium; Department of Neurology, University Hospitals Leuven, Leuven, Belgium.
| | - Ludo Van Den Bosch
- KU Leuven - University of Leuven, Department of Neurosciences, Leuven Brain Institute (LBI), Leuven, Belgium; Laboratory of Neurobiology, VIB Center for Brain & Disease Research, Leuven, Belgium.
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5
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Borghero G, Pili F, Muroni A, Ercoli T, Pateri MI, Pilotto S, Maccabeo A, Defazio G. Disease survival and progression in TARDBP ALS patients from Sardinia, Italy. J Neurol 2024; 271:929-934. [PMID: 37855870 DOI: 10.1007/s00415-023-12037-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2023] [Revised: 09/28/2023] [Accepted: 09/29/2023] [Indexed: 10/20/2023]
Abstract
BACKGROUND Common genes implicated in amyotrophic lateral sclerosis (ALS) development may also influence its progression rate. The C9orf72 mutations featured a faster progression rate while the European SOD1 mutations were associated with a slower progression. In this study, we assessed the relationship between TARDBP and ALS progression/survival. METHODS ALS incident patients (2010-2019) were diagnosed by El Escorial revised criteria and staged over the disease course by the King's staging system. Disease progression was analysed by Kaplan-Meier survival curves and Cox regression models, with survival measured from symptom onset to death/tracheostomy or censor date. RESULTS The study population included 76 patients carrying TARDBP mutations (A382T/G295S), 28 patients carrying the C9orf72 GGGGCC expansion, and 158 patients who had no evidence of causative genetic mutations (nmALS group). TARDBP patients reached death/tracheostomy later than C9orf72 and nmALS patients, independently of possible prognostic indicators (sex, age at ALS onset, diagnostic delay, phenotype at onset, and family history of ALS). On King's staging, the time elapsed between disease onset (King's stage 1) and involvement of the second body region (King's stage 2B) was similar in TARDBP and nmALS patients but longer in TARDBP than in C9orf72 patients. TARDBP patients reached King's stages 3 and 4 later than C9orf72 and nmALS patients. CONCLUSIONS TARDBP patients have a better survival/prognosis than C9orf72-positive and nmALS patients. King's staging also suggested that the higher survival rate and the slower progression associated with the TARDBP mutation could mainly be attributed to the longer time elapsed between King's stages 2B to 3.
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Affiliation(s)
- Giuseppe Borghero
- Institute of Neurology, Azienda Ospedaliero Universitaria di Cagliari, Cagliari, Italy
| | - Francesca Pili
- Institute of Neurology, Azienda Ospedaliero Universitaria di Cagliari, Cagliari, Italy
| | - Antonella Muroni
- Institute of Neurology, Azienda Ospedaliero Universitaria di Cagliari, Cagliari, Italy.
| | - Tommaso Ercoli
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Maria Ida Pateri
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Silvy Pilotto
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Alessandra Maccabeo
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Giovanni Defazio
- Institute of Neurology, Azienda Ospedaliero Universitaria di Cagliari, Cagliari, Italy
- Department of Translational Biomedicine and Neurosciences, University of Bari "Aldo Moro", Bari, Italy
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6
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Rizzuti M, Sali L, Melzi V, Scarcella S, Costamagna G, Ottoboni L, Quetti L, Brambilla L, Papadimitriou D, Verde F, Ratti A, Ticozzi N, Comi GP, Corti S, Gagliardi D. Genomic and transcriptomic advances in amyotrophic lateral sclerosis. Ageing Res Rev 2023; 92:102126. [PMID: 37972860 DOI: 10.1016/j.arr.2023.102126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Revised: 11/09/2023] [Accepted: 11/10/2023] [Indexed: 11/19/2023]
Abstract
Amyotrophic lateral sclerosis (ALS) is a neurodegenerative disorder and the most common motor neuron disease. ALS shows substantial clinical and molecular heterogeneity. In vitro and in vivo models coupled with multiomic techniques have provided important contributions to unraveling the pathomechanisms underlying ALS. To date, despite promising results and accumulating knowledge, an effective treatment is still lacking. Here, we provide an overview of the literature on the use of genomics, epigenomics, transcriptomics and microRNAs to deeply investigate the molecular mechanisms developing and sustaining ALS. We report the most relevant genes implicated in ALS pathogenesis, discussing the use of different high-throughput sequencing techniques and the role of epigenomic modifications. Furthermore, we present transcriptomic studies discussing the most recent advances, from microarrays to bulk and single-cell RNA sequencing. Finally, we discuss the use of microRNAs as potential biomarkers and promising tools for molecular intervention. The integration of data from multiple omic approaches may provide new insights into pathogenic pathways in ALS by shedding light on diagnostic and prognostic biomarkers, helping to stratify patients into clinically relevant subgroups, revealing novel therapeutic targets and supporting the development of new effective therapies.
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Affiliation(s)
- Mafalda Rizzuti
- Neurology Unit, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Luca Sali
- Neurology Unit, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Valentina Melzi
- Neurology Unit, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Simone Scarcella
- Department of Pathophysiology and Transplantation, Dino Ferrari Center, Università degli Studi di Milano, Milan, Italy
| | - Gianluca Costamagna
- Department of Pathophysiology and Transplantation, Dino Ferrari Center, Università degli Studi di Milano, Milan, Italy
| | - Linda Ottoboni
- Department of Pathophysiology and Transplantation, Dino Ferrari Center, Università degli Studi di Milano, Milan, Italy
| | - Lorenzo Quetti
- Neurology Unit, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Lorenzo Brambilla
- Neurology Unit, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | | | - Federico Verde
- Department of Pathophysiology and Transplantation, Dino Ferrari Center, Università degli Studi di Milano, Milan, Italy; Department of Neurology and Laboratory of Neuroscience, IRCCS Istituto Auxologico Italiano, Milan, Italy
| | - Antonia Ratti
- Department of Neurology and Laboratory of Neuroscience, IRCCS Istituto Auxologico Italiano, Milan, Italy; Department of Medical Biotechnology and Translational Medicine, Università degli Studi di Milano, Milan, Italy
| | - Nicola Ticozzi
- Department of Pathophysiology and Transplantation, Dino Ferrari Center, Università degli Studi di Milano, Milan, Italy; Department of Neurology and Laboratory of Neuroscience, IRCCS Istituto Auxologico Italiano, Milan, Italy
| | - Giacomo Pietro Comi
- Neurology Unit, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy; Department of Pathophysiology and Transplantation, Dino Ferrari Center, Università degli Studi di Milano, Milan, Italy; Neuromuscular and Rare Diseases Unit, Department of Neuroscience, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Stefania Corti
- Neurology Unit, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy; Department of Pathophysiology and Transplantation, Dino Ferrari Center, Università degli Studi di Milano, Milan, Italy.
| | - Delia Gagliardi
- Department of Pathophysiology and Transplantation, Dino Ferrari Center, Università degli Studi di Milano, Milan, Italy.
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Corcia P, Vourc'h P, Bernard E, Cassereau J, Codron P, Fleury MC, Guy N, Mouzat K, Pradat PF, Soriani MH, Couratier P. French National Protocol for genetic of amyotrophic lateral sclerosis. Rev Neurol (Paris) 2023; 179:1020-1029. [PMID: 37735015 DOI: 10.1016/j.neurol.2023.05.005] [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: 04/06/2023] [Revised: 05/16/2023] [Accepted: 05/17/2023] [Indexed: 09/23/2023]
Abstract
Relationships between genes and amyotrophic lateral sclerosis (ALS) have been widely accepted since the first studies highlighting pathogenic mutations in the SOD1 gene 30years ago. Over the last three decades, scientific literature has clearly highlighted the central role played by genetic factors in the disease, in both clinics and pathophysiology, as well as in therapeutics. This implies that health professionals who care for patients with ALS are increasingly faced with patients and relatives eager to have answers to questions related to the role of genetic factors in the occurrence of the disease and the risk for their relatives to develop ALS. In order to address these public health issues, the French ALS network FILSLAN proposed to the Haute Autorité de santé (HAS) the drafting of a French National Protocol (PNDS) on ALS genetics. This PNDS was developed according to the "method for developing a national diagnosis and care protocol for rare diseases" published by the HAS in 2012 (methodological guide for PNDS available on the HAS website: http://www.has-sante.fr/). This document aims to provide the most recent data on the role of genes in ALS and to detail the implications for diagnosis and care.
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Affiliation(s)
- P Corcia
- CRMR SLA, CHRU Bretonneau, Tours, France; UMR 1253 iBrain, Tours, France.
| | - P Vourc'h
- UMR 1253 iBrain, Tours, France; Laboratoire de biochimie et biologie moléculaire, CHRU Bretonneau, Tours, France
| | | | | | - P Codron
- CRMR SLA, CHU d'Angers, Angers, France
| | - M-C Fleury
- CRC SLA, CHU de Strasbourg, Strasbourg, France
| | - N Guy
- CRC SLA, CHU de Clermont-Ferrand, Clermont-Ferrand, France
| | - K Mouzat
- Laboratoire de biochimie et biologie moléculaire, CHU de Nîmes, Nîmes, France
| | - P-F Pradat
- CRMR SLA, CHU Pitié-Salpêtrière, Paris, France
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Bar-Ziv R, Dutta N, Hruby A, Sukarto E, Averbukh M, Alcala A, Henderson HR, Durieux J, Tronnes SU, Ahmad Q, Bolas T, Perez J, Dishart JG, Vega M, Garcia G, Higuchi-Sanabria R, Dillin A. Glial-derived mitochondrial signals affect neuronal proteostasis and aging. SCIENCE ADVANCES 2023; 9:eadi1411. [PMID: 37831769 PMCID: PMC10575585 DOI: 10.1126/sciadv.adi1411] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Accepted: 09/12/2023] [Indexed: 10/15/2023]
Abstract
The nervous system plays a critical role in maintaining whole-organism homeostasis; neurons experiencing mitochondrial stress can coordinate the induction of protective cellular pathways, such as the mitochondrial unfolded protein response (UPRMT), between tissues. However, these studies largely ignored nonneuronal cells of the nervous system. Here, we found that UPRMT activation in four astrocyte-like glial cells in the nematode, Caenorhabditis elegans, can promote protein homeostasis by alleviating protein aggregation in neurons. Unexpectedly, we find that glial cells use small clear vesicles (SCVs) to signal to neurons, which then relay the signal to the periphery using dense-core vesicles (DCVs). This work underlines the importance of glia in establishing and regulating protein homeostasis within the nervous system, which can then affect neuron-mediated effects in organismal homeostasis and longevity.
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Affiliation(s)
- Raz Bar-Ziv
- Department of Molecular and Cellular Biology, Howard Hughes Medical Institute, The University of California, Berkeley, Berkeley, CA 94720, USA
| | - Naibedya Dutta
- Leonard Davis School of Gerontology, University of Southern California, Los Angeles, CA 90089, USA
| | - Adam Hruby
- Leonard Davis School of Gerontology, University of Southern California, Los Angeles, CA 90089, USA
| | - Edward Sukarto
- Department of Molecular and Cellular Biology, Howard Hughes Medical Institute, The University of California, Berkeley, Berkeley, CA 94720, USA
| | - Maxim Averbukh
- Leonard Davis School of Gerontology, University of Southern California, Los Angeles, CA 90089, USA
| | - Athena Alcala
- Leonard Davis School of Gerontology, University of Southern California, Los Angeles, CA 90089, USA
| | - Hope R. Henderson
- Department of Molecular and Cellular Biology, Howard Hughes Medical Institute, The University of California, Berkeley, Berkeley, CA 94720, USA
| | - Jenni Durieux
- Department of Molecular and Cellular Biology, Howard Hughes Medical Institute, The University of California, Berkeley, Berkeley, CA 94720, USA
| | - Sarah U. Tronnes
- Department of Molecular and Cellular Biology, Howard Hughes Medical Institute, The University of California, Berkeley, Berkeley, CA 94720, USA
| | - Qazi Ahmad
- Department of Molecular and Cellular Biology, Howard Hughes Medical Institute, The University of California, Berkeley, Berkeley, CA 94720, USA
| | - Theodore Bolas
- Department of Molecular and Cellular Biology, Howard Hughes Medical Institute, The University of California, Berkeley, Berkeley, CA 94720, USA
| | - Joel Perez
- Department of Molecular and Cellular Biology, Howard Hughes Medical Institute, The University of California, Berkeley, Berkeley, CA 94720, USA
| | - Julian G. Dishart
- Department of Molecular and Cellular Biology, Howard Hughes Medical Institute, The University of California, Berkeley, Berkeley, CA 94720, USA
| | - Matthew Vega
- Leonard Davis School of Gerontology, University of Southern California, Los Angeles, CA 90089, USA
| | - Gilberto Garcia
- Leonard Davis School of Gerontology, University of Southern California, Los Angeles, CA 90089, USA
| | - Ryo Higuchi-Sanabria
- Leonard Davis School of Gerontology, University of Southern California, Los Angeles, CA 90089, USA
| | - Andrew Dillin
- Department of Molecular and Cellular Biology, Howard Hughes Medical Institute, The University of California, Berkeley, Berkeley, CA 94720, USA
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9
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Estades Ayuso V, Pickles S, Todd T, Yue M, Jansen-West K, Song Y, González Bejarano J, Rawlinson B, DeTure M, Graff-Radford NR, Boeve BF, Knopman DS, Petersen RC, Dickson DW, Josephs KA, Petrucelli L, Prudencio M. TDP-43-regulated cryptic RNAs accumulate in Alzheimer's disease brains. Mol Neurodegener 2023; 18:57. [PMID: 37605276 PMCID: PMC10441763 DOI: 10.1186/s13024-023-00646-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Accepted: 08/04/2023] [Indexed: 08/23/2023] Open
Abstract
BACKGROUND Inclusions of TAR DNA-binding protein 43 kDa (TDP-43) has been designated limbic-predominant, age-related TDP-43 encephalopathy (LATE), with or without co-occurrence of Alzheimer's disease (AD). Approximately, 30-70% AD cases present TDP-43 proteinopathy (AD-TDP), and a greater disease severity compared to AD patients without TDP-43 pathology. However, it remains unclear to what extent TDP-43 dysfunction is involved in AD pathogenesis. METHODS To investigate whether TDP-43 dysfunction is a prominent feature in AD-TDP cases, we evaluated whether non-conserved cryptic exons, which serve as a marker of TDP-43 dysfunction in amyotrophic lateral sclerosis (ALS) and frontotemporal lobar degeneration (FTLD-TDP), accumulate in AD-TDP brains. We assessed a cohort of 192 post-mortem brains from three different brain regions: amygdala, hippocampus, and frontal cortex. Following RNA and protein extraction, qRT-PCR and immunoassays were performed to quantify the accumulation of cryptic RNA targets and phosphorylated TDP-43 pathology, respectively. RESULTS We detected the accumulation of misspliced cryptic or skiptic RNAs of STMN2, KCNQ2, UNC13A, CAMK2B, and SYT7 in the amygdala and hippocampus of AD-TDP cases. The topographic distribution of cryptic RNA accumulation mimicked that of phosphorylated TDP-43, regardless of TDP-43 subtype classification. Further, cryptic RNAs efficiently discriminated AD-TDP cases from controls. CONCLUSIONS Overall, our results indicate that cryptic RNAs may represent an intriguing new therapeutic and diagnostic target in AD, and that methods aimed at detecting and measuring these species in patient biofluids could be used as a reliable tool to assess TDP-43 pathology in AD. Our work also raises the possibility that TDP-43 dysfunction and related changes in cryptic splicing could represent a common molecular mechanism shared between AD-TDP and FTLD-TDP.
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Affiliation(s)
- Virginia Estades Ayuso
- Department of Neuroscience, Mayo Clinic, Jacksonville, FL, USA
- Neuroscience Graduate Program, Mayo Clinic Graduate School of Biomedical Sciences, Jacksonville, FL, USA
| | - Sarah Pickles
- Department of Neuroscience, Mayo Clinic, Jacksonville, FL, USA
- Neuroscience Graduate Program, Mayo Clinic Graduate School of Biomedical Sciences, Jacksonville, FL, USA
| | - Tiffany Todd
- Department of Neuroscience, Mayo Clinic, Jacksonville, FL, USA
- Neuroscience Graduate Program, Mayo Clinic Graduate School of Biomedical Sciences, Jacksonville, FL, USA
| | - Mei Yue
- Department of Neuroscience, Mayo Clinic, Jacksonville, FL, USA
| | | | - Yuping Song
- Department of Neuroscience, Mayo Clinic, Jacksonville, FL, USA
| | | | | | - Michael DeTure
- Department of Neuroscience, Mayo Clinic, Jacksonville, FL, USA
- Neuroscience Graduate Program, Mayo Clinic Graduate School of Biomedical Sciences, Jacksonville, FL, USA
| | | | | | | | | | - Dennis W Dickson
- Department of Neuroscience, Mayo Clinic, Jacksonville, FL, USA
- Neuroscience Graduate Program, Mayo Clinic Graduate School of Biomedical Sciences, Jacksonville, FL, USA
| | | | - Leonard Petrucelli
- Department of Neuroscience, Mayo Clinic, Jacksonville, FL, USA
- Neuroscience Graduate Program, Mayo Clinic Graduate School of Biomedical Sciences, Jacksonville, FL, USA
| | - Mercedes Prudencio
- Department of Neuroscience, Mayo Clinic, Jacksonville, FL, USA.
- Neuroscience Graduate Program, Mayo Clinic Graduate School of Biomedical Sciences, Jacksonville, FL, USA.
- Department of Research, Neuroscience, Mayo Clinic College of Medicine, 4500 San Pablo Rd, Jacksonville, FL, 32224, USA.
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10
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Bar-Ziv R, Dutta N, Hruby A, Sukarto E, Averbukh M, Alcala A, Henderson HR, Durieux J, Tronnes SU, Ahmad Q, Bolas T, Perez J, Dishart JG, Vega M, Garcia G, Higuchi-Sanabria R, Dillin A. Glial-derived mitochondrial signals impact neuronal proteostasis and aging. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2023:2023.07.20.549924. [PMID: 37609253 PMCID: PMC10441375 DOI: 10.1101/2023.07.20.549924] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/24/2023]
Abstract
The nervous system plays a critical role in maintaining whole-organism homeostasis; neurons experiencing mitochondrial stress can coordinate the induction of protective cellular pathways, such as the mitochondrial unfolded protein response (UPRMT), between tissues. However, these studies largely ignored non-neuronal cells of the nervous system. Here, we found that UPRMT activation in four, astrocyte-like glial cells in the nematode, C. elegans, can promote protein homeostasis by alleviating protein aggregation in neurons. Surprisingly, we find that glial cells utilize small clear vesicles (SCVs) to signal to neurons, which then relay the signal to the periphery using dense-core vesicles (DCVs). This work underlines the importance of glia in establishing and regulating protein homeostasis within the nervous system, which can then impact neuron-mediated effects in organismal homeostasis and longevity.
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Affiliation(s)
- Raz Bar-Ziv
- Department of Molecular & Cellular Biology, Howard Hughes Medical Institute, The University of California, Berkeley, Berkeley CA 94720, USA
| | - Naibedya Dutta
- Leonard Davis School of Gerontology, University of Southern California, Los Angeles, CA 90089, USA
| | - Adam Hruby
- Leonard Davis School of Gerontology, University of Southern California, Los Angeles, CA 90089, USA
| | - Edward Sukarto
- Department of Molecular & Cellular Biology, Howard Hughes Medical Institute, The University of California, Berkeley, Berkeley CA 94720, USA
| | - Maxim Averbukh
- Leonard Davis School of Gerontology, University of Southern California, Los Angeles, CA 90089, USA
| | - Athena Alcala
- Leonard Davis School of Gerontology, University of Southern California, Los Angeles, CA 90089, USA
| | - Hope R. Henderson
- Department of Molecular & Cellular Biology, Howard Hughes Medical Institute, The University of California, Berkeley, Berkeley CA 94720, USA
| | - Jenni Durieux
- Department of Molecular & Cellular Biology, Howard Hughes Medical Institute, The University of California, Berkeley, Berkeley CA 94720, USA
| | - Sarah U. Tronnes
- Department of Molecular & Cellular Biology, Howard Hughes Medical Institute, The University of California, Berkeley, Berkeley CA 94720, USA
| | - Qazi Ahmad
- Department of Molecular & Cellular Biology, Howard Hughes Medical Institute, The University of California, Berkeley, Berkeley CA 94720, USA
| | - Theodore Bolas
- Department of Molecular & Cellular Biology, Howard Hughes Medical Institute, The University of California, Berkeley, Berkeley CA 94720, USA
| | - Joel Perez
- Department of Molecular & Cellular Biology, Howard Hughes Medical Institute, The University of California, Berkeley, Berkeley CA 94720, USA
| | - Julian G. Dishart
- Department of Molecular & Cellular Biology, Howard Hughes Medical Institute, The University of California, Berkeley, Berkeley CA 94720, USA
| | - Matthew Vega
- Leonard Davis School of Gerontology, University of Southern California, Los Angeles, CA 90089, USA
| | - Gilberto Garcia
- Leonard Davis School of Gerontology, University of Southern California, Los Angeles, CA 90089, USA
| | - Ryo Higuchi-Sanabria
- Leonard Davis School of Gerontology, University of Southern California, Los Angeles, CA 90089, USA
| | - Andrew Dillin
- Department of Molecular & Cellular Biology, Howard Hughes Medical Institute, The University of California, Berkeley, Berkeley CA 94720, USA
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11
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Willemse SW, Harley P, van Eijk RPA, Demaegd KC, Zelina P, Pasterkamp RJ, van Damme P, Ingre C, van Rheenen W, Veldink JH, Kiernan MC, Al-Chalabi A, van den Berg LH, Fratta P, van Es MA. UNC13A in amyotrophic lateral sclerosis: from genetic association to therapeutic target. J Neurol Neurosurg Psychiatry 2023; 94:649-656. [PMID: 36737245 PMCID: PMC10359588 DOI: 10.1136/jnnp-2022-330504] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Accepted: 01/10/2023] [Indexed: 02/05/2023]
Abstract
Amyotrophic lateral sclerosis (ALS) is a fatal neurodegenerative disease with limited treatment options and an incompletely understood pathophysiology. Although genomewide association studies (GWAS) have advanced our understanding of the disease, the precise manner in which risk polymorphisms contribute to disease pathogenesis remains unclear. Of relevance, GWAS have shown that a polymorphism (rs12608932) in the UNC13A gene is associated with risk for both ALS and frontotemporal dementia (FTD). Homozygosity for the C-allele at rs12608932 modifies the ALS phenotype, as these patients are more likely to have bulbar-onset disease, cognitive impairment and FTD at baseline as well as shorter survival. UNC13A is expressed in neuronal tissue and is involved in maintaining synaptic active zones, by enabling the priming and docking of synaptic vesicles. In the absence of functional TDP-43, risk variants in UNC13A lead to the inclusion of a cryptic exon in UNC13A messenger RNA, subsequently leading to nonsense mediated decay, with loss of functional protein. Depletion of UNC13A leads to impaired neurotransmission. Recent discoveries have identified UNC13A as a potential target for therapy development in ALS, with a confirmatory trial with lithium carbonate in UNC13A cases now underway and future approaches with antisense oligonucleotides currently under consideration. Considering UNC13A is a potent phenotypic modifier, it may also impact clinical trial outcomes. This present review describes the path from the initial discovery of UNC13A as a risk gene in ALS to the current therapeutic options being explored and how knowledge of its distinct phenotype needs to be taken into account in future trials.
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Affiliation(s)
- Sean W Willemse
- Department of Neurology, UMC Utrecht Brain Center Rudolf Magnus, Utrecht, The Netherlands
| | - Peter Harley
- UCL Queen Square Motor Neuron Disease Centre, Department of Neuromuscular Diseases, UCL Queen Square Institute of Neurology, London, UK
| | - Ruben P A van Eijk
- Department of Neurology, UMC Utrecht Brain Center Rudolf Magnus, Utrecht, The Netherlands
- Biostatistics & Research Support, Julius Center for Health Sciences and Primary Care, UMC Utrecht, Utrecht, The Netherlands
| | - Koen C Demaegd
- Department of Neurology, UMC Utrecht Brain Center Rudolf Magnus, Utrecht, The Netherlands
| | - Pavol Zelina
- Department of Translational Neuroscience, UMC Utrecht Brain Center Rudolf Magnus, Utrecht, The Netherlands
| | - R Jeroen Pasterkamp
- Department of Translational Neuroscience, UMC Utrecht Brain Center Rudolf Magnus, Utrecht, The Netherlands
| | - Philip van Damme
- Department of Neurology, KU Leuven Hospital, Leuven, Belgium
- Laboratory of Neurobiology, VIB KU Leuven Center for Brain and Disease Research, Leuven, Belgium
| | - Caroline Ingre
- Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden
| | - Wouter van Rheenen
- Department of Neurology, UMC Utrecht Brain Center Rudolf Magnus, Utrecht, The Netherlands
| | - Jan H Veldink
- Department of Neurology, UMC Utrecht Brain Center Rudolf Magnus, Utrecht, The Netherlands
| | - Matthew C Kiernan
- Bushell Chair of Neurology, Brain and Mind Centre, University of Sydney, Sydney, New South Wales, Australia
- Neurology, Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia
| | | | - Leonard H van den Berg
- Department of Neurology, UMC Utrecht Brain Center Rudolf Magnus, Utrecht, The Netherlands
| | - Pietro Fratta
- UCL Queen Square Motor Neuron Disease Centre, Department of Neuromuscular Diseases, UCL Queen Square Institute of Neurology, London, UK
| | - Michael A van Es
- Department of Neurology, UMC Utrecht Brain Center Rudolf Magnus, Utrecht, The Netherlands
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12
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De Marchi F, Franjkic T, Schito P, Russo T, Nimac J, Chami AA, Mele A, Vidatic L, Kriz J, Julien JP, Apic G, Russell RB, Rogelj B, Cannon JR, Baralle M, Agosta F, Hecimovic S, Mazzini L, Buratti E, Munitic I. Emerging Trends in the Field of Inflammation and Proteinopathy in ALS/FTD Spectrum Disorder. Biomedicines 2023; 11:1599. [PMID: 37371694 PMCID: PMC10295684 DOI: 10.3390/biomedicines11061599] [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: 04/28/2023] [Revised: 05/27/2023] [Accepted: 05/29/2023] [Indexed: 06/29/2023] Open
Abstract
Proteinopathy and neuroinflammation are two main hallmarks of neurodegenerative diseases. They also represent rare common events in an exceptionally broad landscape of genetic, environmental, neuropathologic, and clinical heterogeneity present in patients. Here, we aim to recount the emerging trends in amyotrophic lateral sclerosis (ALS) and frontotemporal degeneration (FTD) spectrum disorder. Our review will predominantly focus on neuroinflammation and systemic immune imbalance in ALS and FTD, which have recently been highlighted as novel therapeutic targets. A common mechanism of most ALS and ~50% of FTD patients is dysregulation of TAR DNA-binding protein 43 (TDP-43), an RNA/DNA-binding protein, which becomes depleted from the nucleus and forms cytoplasmic aggregates in neurons and glia. This, in turn, via both gain and loss of function events, alters a variety of TDP-43-mediated cellular events. Experimental attempts to target TDP-43 aggregates or manipulate crosstalk in the context of inflammation will be discussed. Targeting inflammation, and the immune system in general, is of particular interest because of the high plasticity of immune cells compared to neurons.
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Affiliation(s)
- Fabiola De Marchi
- Department of Neurology and ALS Centre, University of Piemonte Orientale, Maggiore Della Carità Hospital, Corso Mazzini 18, 28100 Novara, Italy; (F.D.M.); (A.M.)
| | - Toni Franjkic
- Laboratory for Molecular Immunology, Department of Biotechnology, University of Rijeka, R. Matejcic 2, 51000 Rijeka, Croatia;
- Metisox, Cambridge CB24 9NL, UK;
| | - Paride Schito
- Department of Neurology & Neuropathology Unit, Institute of Experimental Neurology (INSPE), Division of Neuroscience, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy; (P.S.); (T.R.)
| | - Tommaso Russo
- Department of Neurology & Neuropathology Unit, Institute of Experimental Neurology (INSPE), Division of Neuroscience, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy; (P.S.); (T.R.)
| | - Jerneja Nimac
- Department of Biotechnology, Jozef Stefan Institute, SI-1000 Ljubljana, Slovenia; (J.N.); (B.R.)
- Graduate School of Biomedicine, Faculty of Medicine, University of Ljubljana, SI-1000 Ljubljana, Slovenia
| | - Anna A. Chami
- CERVO Research Centre, Laval University, Quebec City, QC G1J 2G3, Canada; (A.A.C.); (J.K.); (J.-P.J.)
| | - Angelica Mele
- Department of Neurology and ALS Centre, University of Piemonte Orientale, Maggiore Della Carità Hospital, Corso Mazzini 18, 28100 Novara, Italy; (F.D.M.); (A.M.)
| | - Lea Vidatic
- Laboratory for Neurodegenerative Disease Research, Division of Molecular Medicine, Ruder Boskovic Institute, 10000 Zagreb, Croatia; (L.V.); (S.H.)
| | - Jasna Kriz
- CERVO Research Centre, Laval University, Quebec City, QC G1J 2G3, Canada; (A.A.C.); (J.K.); (J.-P.J.)
| | - Jean-Pierre Julien
- CERVO Research Centre, Laval University, Quebec City, QC G1J 2G3, Canada; (A.A.C.); (J.K.); (J.-P.J.)
| | | | | | - Boris Rogelj
- Department of Biotechnology, Jozef Stefan Institute, SI-1000 Ljubljana, Slovenia; (J.N.); (B.R.)
- Faculty of Chemistry and Chemical Technology, University of Ljubljana, SI-1000 Ljubljana, Slovenia
| | - Jason R. Cannon
- School of Health Sciences, Purdue University, West Lafayette, IN 47907, USA;
- Purdue Institute for Integrative Neuroscience, Purdue University, West Lafayette, IN 47907, USA
| | | | - Federica Agosta
- Neuroimaging Research Unit, Institute of Experimental Neurology, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy;
| | - Silva Hecimovic
- Laboratory for Neurodegenerative Disease Research, Division of Molecular Medicine, Ruder Boskovic Institute, 10000 Zagreb, Croatia; (L.V.); (S.H.)
| | - Letizia Mazzini
- Department of Neurology and ALS Centre, University of Piemonte Orientale, Maggiore Della Carità Hospital, Corso Mazzini 18, 28100 Novara, Italy; (F.D.M.); (A.M.)
| | - Emanuele Buratti
- International Centre for Genetic Engineering and Biotechnology (ICGEB), Padriciano 99, 34149 Trieste, Italy
| | - Ivana Munitic
- Laboratory for Molecular Immunology, Department of Biotechnology, University of Rijeka, R. Matejcic 2, 51000 Rijeka, Croatia;
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13
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Sanchez-Tejerina D, Llaurado A, Sotoca J, Lopez-Diego V, Vidal Taboada JM, Salvado M, Juntas-Morales R. Biofluid Biomarkers in the Prognosis of Amyotrophic Lateral Sclerosis: Recent Developments and Therapeutic Applications. Cells 2023; 12:cells12081180. [PMID: 37190090 DOI: 10.3390/cells12081180] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Revised: 04/15/2023] [Accepted: 04/17/2023] [Indexed: 05/17/2023] Open
Abstract
Amyotrophic lateral sclerosis is a neurodegenerative disease characterized by the degeneration of motor neurons for which effective therapies are lacking. One of the most explored areas of research in ALS is the discovery and validation of biomarkers that can be applied to clinical practice and incorporated into the development of innovative therapies. The study of biomarkers requires an adequate theoretical and operational framework, highlighting the "fit-for-purpose" concept and distinguishing different types of biomarkers based on common terminology. In this review, we aim to discuss the current status of fluid-based prognostic and predictive biomarkers in ALS, with particular emphasis on those that are the most promising ones for clinical trial design and routine clinical practice. Neurofilaments in cerebrospinal fluid and blood are the main prognostic and pharmacodynamic biomarkers. Furthermore, several candidates exist covering various pathological aspects of the disease, such as immune, metabolic and muscle damage markers. Urine has been studied less often and should be explored for its possible advantages. New advances in the knowledge of cryptic exons introduce the possibility of discovering new biomarkers. Collaborative efforts, prospective studies and standardized procedures are needed to validate candidate biomarkers. A combined biomarkers panel can provide a more detailed disease status.
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Affiliation(s)
- Daniel Sanchez-Tejerina
- Neuromuscular Diseases Unit, Neurology Department, Vall d'Hebron Hospital Universitari, Vall d'Hebron Barcelona Hospital Campus, 08035 Barcelona, Spain
- Peripheral Nervous System Group, Vall d'Hebron Research Institut (VHIR), Vall d'Hebron Barcelona Hospital Campus, 08035 Barcelona, Spain
- European Reference Network on Rare Neuromuscular Diseases (ERN EURO-NMD), Vall d'Hebron Barcelona Hospital Campus, 08035 Barcelona, Spain
- Medicine Department, Universitat Autónoma de Barcelona, 08035 Barcelon, Spain
| | - Arnau Llaurado
- Neuromuscular Diseases Unit, Neurology Department, Vall d'Hebron Hospital Universitari, Vall d'Hebron Barcelona Hospital Campus, 08035 Barcelona, Spain
- Peripheral Nervous System Group, Vall d'Hebron Research Institut (VHIR), Vall d'Hebron Barcelona Hospital Campus, 08035 Barcelona, Spain
- European Reference Network on Rare Neuromuscular Diseases (ERN EURO-NMD), Vall d'Hebron Barcelona Hospital Campus, 08035 Barcelona, Spain
| | - Javier Sotoca
- Neuromuscular Diseases Unit, Neurology Department, Vall d'Hebron Hospital Universitari, Vall d'Hebron Barcelona Hospital Campus, 08035 Barcelona, Spain
- Peripheral Nervous System Group, Vall d'Hebron Research Institut (VHIR), Vall d'Hebron Barcelona Hospital Campus, 08035 Barcelona, Spain
- European Reference Network on Rare Neuromuscular Diseases (ERN EURO-NMD), Vall d'Hebron Barcelona Hospital Campus, 08035 Barcelona, Spain
| | - Veronica Lopez-Diego
- Neuromuscular Diseases Unit, Neurology Department, Vall d'Hebron Hospital Universitari, Vall d'Hebron Barcelona Hospital Campus, 08035 Barcelona, Spain
- Peripheral Nervous System Group, Vall d'Hebron Research Institut (VHIR), Vall d'Hebron Barcelona Hospital Campus, 08035 Barcelona, Spain
- European Reference Network on Rare Neuromuscular Diseases (ERN EURO-NMD), Vall d'Hebron Barcelona Hospital Campus, 08035 Barcelona, Spain
| | - Jose M Vidal Taboada
- Peripheral Nervous System Group, Vall d'Hebron Research Institut (VHIR), Vall d'Hebron Barcelona Hospital Campus, 08035 Barcelona, Spain
- Medicine Department, Universitat Autónoma de Barcelona, 08035 Barcelon, Spain
| | - Maria Salvado
- Neuromuscular Diseases Unit, Neurology Department, Vall d'Hebron Hospital Universitari, Vall d'Hebron Barcelona Hospital Campus, 08035 Barcelona, Spain
- Peripheral Nervous System Group, Vall d'Hebron Research Institut (VHIR), Vall d'Hebron Barcelona Hospital Campus, 08035 Barcelona, Spain
- European Reference Network on Rare Neuromuscular Diseases (ERN EURO-NMD), Vall d'Hebron Barcelona Hospital Campus, 08035 Barcelona, Spain
| | - Raul Juntas-Morales
- Neuromuscular Diseases Unit, Neurology Department, Vall d'Hebron Hospital Universitari, Vall d'Hebron Barcelona Hospital Campus, 08035 Barcelona, Spain
- Peripheral Nervous System Group, Vall d'Hebron Research Institut (VHIR), Vall d'Hebron Barcelona Hospital Campus, 08035 Barcelona, Spain
- European Reference Network on Rare Neuromuscular Diseases (ERN EURO-NMD), Vall d'Hebron Barcelona Hospital Campus, 08035 Barcelona, Spain
- Medicine Department, Universitat Autónoma de Barcelona, 08035 Barcelon, Spain
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14
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Koike Y, Pickles S, Estades Ayuso V, Jansen-West K, Qi YA, Li Z, Daughrity LM, Yue M, Zhang YJ, Cook CN, Dickson DW, Ward M, Petrucelli L, Prudencio M. TDP-43 and other hnRNPs regulate cryptic exon inclusion of a key ALS/FTD risk gene, UNC13A. PLoS Biol 2023; 21:e3002028. [PMID: 36930682 PMCID: PMC10057836 DOI: 10.1371/journal.pbio.3002028] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Revised: 03/29/2023] [Accepted: 02/08/2023] [Indexed: 03/18/2023] Open
Abstract
A major function of TAR DNA-binding protein-43 (TDP-43) is to repress the inclusion of cryptic exons during RNA splicing. One of these cryptic exons is in UNC13A, a genetic risk factor for amyotrophic lateral sclerosis (ALS) and frontotemporal dementia (FTD). The accumulation of cryptic UNC13A in disease is heightened by the presence of a risk haplotype located within the cryptic exon itself. Here, we revealed that TDP-43 extreme N-terminus is important to repress UNC13A cryptic exon inclusion. Further, we found hnRNP L, hnRNP A1, and hnRNP A2B1 bind UNC13A RNA and repress cryptic exon inclusion, independently of TDP-43. Finally, higher levels of hnRNP L protein associate with lower burden of UNC13A cryptic RNA in ALS/FTD brains. Our findings suggest that while TDP-43 is the main repressor of UNC13A cryptic exon inclusion, other hnRNPs contribute to its regulation and may potentially function as disease modifiers.
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Affiliation(s)
- Yuka Koike
- Department of Neuroscience, Mayo Clinic, Jacksonville, Florida, United States of America
- Mayo Clinic Graduate School of Biomedical Sciences, Jacksonville, Florida, United States of America
| | - Sarah Pickles
- Department of Neuroscience, Mayo Clinic, Jacksonville, Florida, United States of America
- Mayo Clinic Graduate School of Biomedical Sciences, Jacksonville, Florida, United States of America
| | - Virginia Estades Ayuso
- Department of Neuroscience, Mayo Clinic, Jacksonville, Florida, United States of America
| | - Karen Jansen-West
- Department of Neuroscience, Mayo Clinic, Jacksonville, Florida, United States of America
| | - Yue A. Qi
- Center for Alzheimer’s and Related Dementias, National Institute on Aging, NIH, Bethesda, Maryland, United States of America
| | - Ziyi Li
- Center for Alzheimer’s and Related Dementias, National Institute on Aging, NIH, Bethesda, Maryland, United States of America
| | - Lillian M. Daughrity
- Department of Neuroscience, Mayo Clinic, Jacksonville, Florida, United States of America
| | - Mei Yue
- Department of Neuroscience, Mayo Clinic, Jacksonville, Florida, United States of America
| | - Yong-Jie Zhang
- Department of Neuroscience, Mayo Clinic, Jacksonville, Florida, United States of America
- Mayo Clinic Graduate School of Biomedical Sciences, Jacksonville, Florida, United States of America
| | - Casey N. Cook
- Department of Neuroscience, Mayo Clinic, Jacksonville, Florida, United States of America
- Mayo Clinic Graduate School of Biomedical Sciences, Jacksonville, Florida, United States of America
| | - Dennis W. Dickson
- Department of Neuroscience, Mayo Clinic, Jacksonville, Florida, United States of America
- Mayo Clinic Graduate School of Biomedical Sciences, Jacksonville, Florida, United States of America
| | - Michael Ward
- Center for Alzheimer’s and Related Dementias, National Institute on Aging, NIH, Bethesda, Maryland, United States of America
- National Institute of Neurological Disorders and Stroke, NIH, Bethesda, Maryland, United States of America
| | - Leonard Petrucelli
- Department of Neuroscience, Mayo Clinic, Jacksonville, Florida, United States of America
- Mayo Clinic Graduate School of Biomedical Sciences, Jacksonville, Florida, United States of America
| | - Mercedes Prudencio
- Department of Neuroscience, Mayo Clinic, Jacksonville, Florida, United States of America
- Mayo Clinic Graduate School of Biomedical Sciences, Jacksonville, Florida, United States of America
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15
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TDP-43 Proteinopathy Specific Biomarker Development. Cells 2023; 12:cells12040597. [PMID: 36831264 PMCID: PMC9954136 DOI: 10.3390/cells12040597] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Revised: 01/31/2023] [Accepted: 02/07/2023] [Indexed: 02/16/2023] Open
Abstract
TDP-43 is the primary or secondary pathological hallmark of neurodegenerative diseases, such as amyotrophic lateral sclerosis, half of frontotemporal dementia cases, and limbic age-related TDP-43 encephalopathy, which clinically resembles Alzheimer's dementia. In such diseases, a biomarker that can detect TDP-43 proteinopathy in life would help to stratify patients according to their definite diagnosis of pathology, rather than in clinical subgroups of uncertain pathology. For therapies developed to target pathological proteins that cause the disease a biomarker to detect and track the underlying pathology would greatly enhance such undertakings. This article reviews the latest developments and outlooks of deriving TDP-43-specific biomarkers from the pathophysiological processes involved in the development of TDP-43 proteinopathy and studies using biosamples from clinical entities associated with TDP-43 pathology to investigate biomarker candidates.
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16
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Yang L, Cheng Y, Zhu Y, Cui L, Li X. The Serotonergic System and Amyotrophic Lateral Sclerosis: A Review of Current Evidence. Cell Mol Neurobiol 2023:10.1007/s10571-023-01320-0. [PMID: 36729314 DOI: 10.1007/s10571-023-01320-0] [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: 08/03/2022] [Accepted: 01/18/2023] [Indexed: 02/03/2023]
Abstract
Amyotrophic lateral sclerosis (ALS) is a neurodegenerative disorder characterized by the premature death of motor neurons. Serotonin (5-HT) is a crucial neurotransmitter, and its dysfunction, whether as a contributor or by-product, has been implicated in ALS pathogenesis. Here, we summarize current evidence linking serotonergic alterations to ALS, including results from post-mortem and neuroimaging studies, biofluid testing, and studies of ALS animal models. We also discuss the possible role of 5-HT in modulating some important mechanisms of ALS (i.e. glutamate excitotoxity and neuroinflammation) and in regulating ALS phenotypes (i.e. breathing dysfunction and metabolic defects). Finally, we discuss the promise and limitations of the serotonergic system as a target for the development of ALS biomarkers and therapeutic approaches. However, due to a relative paucity of data and standardized methodologies in previous studies, proper interpretation of existing results remains a challenge. Future research is needed to unravel the mechanisms linking serotonergic pathways and ALS and to provide valid, reproducible, and translatable findings.
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Affiliation(s)
- Lu Yang
- Department of Neurology, Peking Union Medical College Hospital (PUMCH), The Transformation Medical Center of PUMC, Chinese Academy of Medical Sciences & Peking Union Medical College (CAMS & PUMC), Beijing, 100005, China
| | - Yanfei Cheng
- Department of Neurology, Peking Union Medical College Hospital (PUMCH), The Transformation Medical Center of PUMC, Chinese Academy of Medical Sciences & Peking Union Medical College (CAMS & PUMC), Beijing, 100005, China
| | - Yicheng Zhu
- Department of Neurology, Peking Union Medical College Hospital (PUMCH), The Transformation Medical Center of PUMC, Chinese Academy of Medical Sciences & Peking Union Medical College (CAMS & PUMC), Beijing, 100005, China.,Neuroscience Center, Chinese Academy of Medical Sciences & Peking Union Medical College (CAMS & PUMC), Beijing, China
| | - Liying Cui
- Department of Neurology, Peking Union Medical College Hospital (PUMCH), The Transformation Medical Center of PUMC, Chinese Academy of Medical Sciences & Peking Union Medical College (CAMS & PUMC), Beijing, 100005, China.,Neuroscience Center, Chinese Academy of Medical Sciences & Peking Union Medical College (CAMS & PUMC), Beijing, China
| | - Xiaoguang Li
- Department of Neurology, Peking Union Medical College Hospital (PUMCH), The Transformation Medical Center of PUMC, Chinese Academy of Medical Sciences & Peking Union Medical College (CAMS & PUMC), Beijing, 100005, China. .,Neuroscience Center, Chinese Academy of Medical Sciences & Peking Union Medical College (CAMS & PUMC), Beijing, China.
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17
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Manini A, Casiraghi V, Brusati A, Maranzano A, Gentile F, Colombo E, Bonetti R, Peverelli S, Invernizzi S, Gentilini D, Messina S, Verde F, Poletti B, Fogh I, Morelli C, Silani V, Ratti A, Ticozzi N. Association of the risk factor UNC13A with survival and upper motor neuron involvement in amyotrophic lateral sclerosis. Front Aging Neurosci 2023; 15:1067954. [PMID: 36819716 PMCID: PMC9931189 DOI: 10.3389/fnagi.2023.1067954] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Accepted: 01/03/2023] [Indexed: 02/04/2023] Open
Abstract
Background The UNC13A gene is an established susceptibility locus for amyotrophic lateral sclerosis (ALS) and a determinant of shorter survival after disease onset, with up to 33.0 months difference in life expectancy for carriers of the rs12608932 risk genotype. However, its overall effect on other clinical features and ALS phenotypic variability is controversial. Methods Genotype data of the UNC13A rs12608932 SNP (A-major allele; C-minor allele) was obtained from a cohort of 972 ALS patients. Demographic and clinical variables were collected, including cognitive and behavioral profiles, evaluated through the Edinburgh Cognitive and Behavioral ALS Screen (ECAS) - Italian version and the Frontal Behavioral Inventory (FBI); upper and lower motor neuron involvement, assessed by the Penn Upper Motor Neuron Score (PUMNS) and the Lower Motor Neuron Score (LMNS)/Medical Research Council (MRC) scores, respectively; the ALS Functional Rating Scale Revised (ALSFRS-R) score at evaluation and progression rate; age and site of onset; survival. The comparison between the three rs12608932 genotypes (AA, AC, and CC) was performed using the additive, dominant, and recessive genetic models. Results The rs12608932 minor allele frequency was 0.31 in our ALS cohort, in comparison to 0.33-0.41 reported in other Caucasian ALS populations. Carriers of at least one minor C allele (AC + CC genotypes) had a shorter median survival than patients with the wild-type AA genotype (-11.7 months, p = 0.013), even after adjusting for age and site of onset, C9orf72 mutational status and gender. Patients harboring at least one major A allele (AA + AC genotypes) and particularly those with the wild-type AA genotype showed a significantly higher PUMNS compared to CC carriers (p = 0.015 and padj = 0.037, respectively), thus indicating a more severe upper motor neuron involvement. Our analysis did not detect significant associations with all the other clinical parameters considered. Conclusion Overall, our findings confirm the role of UNC13A as a determinant of survival in ALS patients and show the association of this locus also with upper motor neuron involvement.
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Affiliation(s)
- Arianna Manini
- Department of Neurology and Laboratory of Neuroscience, IRCCS Istituto Auxologico Italiano, Milan, Italy,Neurology Residency Program, Università degli Studi di Milano, Milan, Italy
| | - Valeria Casiraghi
- Department of Neurology and Laboratory of Neuroscience, IRCCS Istituto Auxologico Italiano, Milan, Italy,Department of Medical Biotechnology and Molecular Medicine, Università degli Studi di Milano, Milan, Italy
| | - Alberto Brusati
- Department of Neurology and Laboratory of Neuroscience, IRCCS Istituto Auxologico Italiano, Milan, Italy,Department of Brain and Behavioral Sciences, Università degli Studi di Pavia, Pavia, Italy
| | - Alessio Maranzano
- Department of Neurology and Laboratory of Neuroscience, IRCCS Istituto Auxologico Italiano, Milan, Italy,Neurology Residency Program, Università degli Studi di Milano, Milan, Italy
| | - Francesco Gentile
- Department of Neurology and Laboratory of Neuroscience, IRCCS Istituto Auxologico Italiano, Milan, Italy,Neurology Residency Program, Università degli Studi di Milano, Milan, Italy
| | - Eleonora Colombo
- Department of Neurology and Laboratory of Neuroscience, IRCCS Istituto Auxologico Italiano, Milan, Italy
| | - Ruggero Bonetti
- Department of Neurology and Laboratory of Neuroscience, IRCCS Istituto Auxologico Italiano, Milan, Italy,Neurology Residency Program, Università degli Studi di Milano, Milan, Italy
| | - Silvia Peverelli
- Department of Neurology and Laboratory of Neuroscience, IRCCS Istituto Auxologico Italiano, Milan, Italy
| | - Sabrina Invernizzi
- Department of Neurology and Laboratory of Neuroscience, IRCCS Istituto Auxologico Italiano, Milan, Italy
| | - Davide Gentilini
- Department of Brain and Behavioral Sciences, Università degli Studi di Pavia, Pavia, Italy,Bioinformatics and Statistical Genomics Unit, IRCCS Istituto Auxologico Italiano, Milan, Italy
| | - Stefano Messina
- Department of Neurology and Laboratory of Neuroscience, IRCCS Istituto Auxologico Italiano, Milan, Italy
| | - Federico Verde
- Department of Neurology and Laboratory of Neuroscience, IRCCS Istituto Auxologico Italiano, Milan, Italy,Department of Pathophysiology and Transplantation, 'Dino Ferrari' Center, Università degli Studi di Milano, Milan, Italy
| | - Barbara Poletti
- Department of Neurology and Laboratory of Neuroscience, IRCCS Istituto Auxologico Italiano, Milan, Italy
| | - Isabella Fogh
- Maurice Wohl Clinical Neuroscience Institute, Institute of Psychiatry, Psychology and Neuroscience, King’s College, London, United Kingdom
| | - Claudia Morelli
- Department of Neurology and Laboratory of Neuroscience, IRCCS Istituto Auxologico Italiano, Milan, Italy
| | - Vincenzo Silani
- Department of Neurology and Laboratory of Neuroscience, IRCCS Istituto Auxologico Italiano, Milan, Italy,Department of Pathophysiology and Transplantation, 'Dino Ferrari' Center, Università degli Studi di Milano, Milan, Italy
| | - Antonia Ratti
- Department of Neurology and Laboratory of Neuroscience, IRCCS Istituto Auxologico Italiano, Milan, Italy,Department of Medical Biotechnology and Molecular Medicine, Università degli Studi di Milano, Milan, Italy
| | - Nicola Ticozzi
- Department of Neurology and Laboratory of Neuroscience, IRCCS Istituto Auxologico Italiano, Milan, Italy,Department of Pathophysiology and Transplantation, 'Dino Ferrari' Center, Università degli Studi di Milano, Milan, Italy,*Correspondence: Nicola Ticozzi, ✉
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18
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Udine E, Jain A, van Blitterswijk M. Advances in sequencing technologies for amyotrophic lateral sclerosis research. Mol Neurodegener 2023; 18:4. [PMID: 36635726 PMCID: PMC9838075 DOI: 10.1186/s13024-022-00593-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Accepted: 12/23/2022] [Indexed: 01/14/2023] Open
Abstract
Amyotrophic lateral sclerosis (ALS) is caused by upper and lower motor neuron loss and has a fairly rapid disease progression, leading to fatality in an average of 2-5 years after symptom onset. Numerous genes have been implicated in this disease; however, many cases remain unexplained. Several technologies are being used to identify regions of interest and investigate candidate genes. Initial approaches to detect ALS genes include, among others, linkage analysis, Sanger sequencing, and genome-wide association studies. More recently, next-generation sequencing methods, such as whole-exome and whole-genome sequencing, have been introduced. While those methods have been particularly useful in discovering new ALS-linked genes, methodological advances are becoming increasingly important, especially given the complex genetics of ALS. Novel sequencing technologies, like long-read sequencing, are beginning to be used to uncover the contribution of repeat expansions and other types of structural variation, which may help explain missing heritability in ALS. In this review, we discuss how popular and/or upcoming methods are being used to discover ALS genes, highlighting emerging long-read sequencing platforms and their role in aiding our understanding of this challenging disease.
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Affiliation(s)
- Evan Udine
- grid.417467.70000 0004 0443 9942Department of Neuroscience, Mayo Clinic, 4500 San Pablo Road S, Jacksonville, FL 32224 USA ,grid.417467.70000 0004 0443 9942Mayo Clinic Graduate School of Biomedical Sciences, 4500 San Pablo Road S, Jacksonville, FL 32224 USA
| | - Angita Jain
- grid.417467.70000 0004 0443 9942Department of Neuroscience, Mayo Clinic, 4500 San Pablo Road S, Jacksonville, FL 32224 USA ,grid.417467.70000 0004 0443 9942Mayo Clinic Graduate School of Biomedical Sciences, 4500 San Pablo Road S, Jacksonville, FL 32224 USA ,grid.417467.70000 0004 0443 9942Center for Clinical and Translational Sciences, Mayo Clinic, 4500 San Pablo Road S, Jacksonville, FL 32224 USA
| | - Marka van Blitterswijk
- Department of Neuroscience, Mayo Clinic, 4500 San Pablo Road S, Jacksonville, FL, 32224, USA.
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19
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Willemse SW, Roes KCB, Van Damme P, Hardiman O, Ingre C, Povedano M, Wray NR, Gijzen M, de Pagter MS, Demaegd KC, Janse AFC, Vink RG, Sleutjes BTHM, Chiò A, Corcia P, Reviers E, Al-Chalabi A, Kiernan MC, van den Berg LH, van Es MA, van Eijk RPA. Lithium carbonate in amyotrophic lateral sclerosis patients homozygous for the C-allele at SNP rs12608932 in UNC13A: protocol for a confirmatory, randomized, group-sequential, event-driven, double-blind, placebo-controlled trial. Trials 2022; 23:978. [PMID: 36471413 PMCID: PMC9721045 DOI: 10.1186/s13063-022-06906-5] [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: 10/05/2022] [Accepted: 11/03/2022] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Given the large genetic heterogeneity in amyotrophic lateral sclerosis (ALS), it seems likely that genetic subgroups may benefit differently from treatment. An exploratory meta-analysis identified that patients homozygous for the C-allele at SNP rs12608932, a single nucleotide polymorphism in the gene UNC13A, had a statistically significant survival benefit when treated with lithium carbonate. We aim to confirm the efficacy of lithium carbonate on the time to death or respiratory insufficiency in patients with ALS homozygous for the C-allele at SNP rs12608932 in UNC13A. METHODS A randomized, group-sequential, event-driven, double-blind, placebo-controlled trial will be conducted in 15 sites across Europe and Australia. Patients will be genotyped for UNC13A; those homozygous for the C-allele at SNP rs12608932 will be eligible. Patients must have a diagnosis of ALS according to the revised El Escorial criteria, and a TRICALS risk-profile score between -6.0 and -2.0. An expected number of 1200 patients will be screened in order to enroll a target sample size of 171 patients. Patients will be randomly allocated in a 2:1 ratio to lithium carbonate or matching placebo, and treated for a maximum duration of 24 months. The primary endpoint is the time to death or respiratory insufficiency, whichever occurs first. Key secondary endpoints include functional decline, respiratory function, quality of life, tolerability, and safety. An interim analysis for futility and efficacy will be conducted after the occurrence of 41 events. DISCUSSION Lithium carbonate has been proven to be safe and well-tolerated in patients with ALS. Given the favorable safety profile, the potential benefits are considered to outweigh the burden and risks associated with study participation. This study may provide conclusive evidence about the life-prolonging potential of lithium carbonate in a genetic ALS subgroup. TRIAL REGISTRATION EudraCT number 2020-000579-19 . Registered on 29 March 2021.
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Affiliation(s)
- Sean W Willemse
- Department of Neurology, UMC Utrecht, Utrecht, The Netherlands
| | - Kit C B Roes
- Department of Health Evidence, Radboud UMC, Nijmegen, The Netherlands
| | - Philip Van Damme
- Department of Neurology, University Hospitals Leuven, Leuven, Belgium
| | - Orla Hardiman
- Department of Neurology, National Neuroscience Centre, Beaumont Hospital, Dublin, Ireland
- FutureNeuro SFI Research Centre, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Caroline Ingre
- Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden
| | - Monica Povedano
- Functional Unit of Amyotrophic Lateral Sclerosis (UFELA), Service of Neurology, Bellvitge University Hospital, Hospitalet de Llobregat, Spain
| | - Naomi R Wray
- Institute for Molecular Bioscience, The University of Queensland, Brisbane, Australia
| | - Marleen Gijzen
- Department of Genetics, UMC Utrecht, Utrecht, The Netherlands
| | | | - Koen C Demaegd
- Department of Neurology, UMC Utrecht, Utrecht, The Netherlands
| | | | | | | | - Adriano Chiò
- 'Rita Levi Montalcini' Department of Neuroscience, University of Turin, Turin, Italy
- Neurology, AOU Città della Salute e della Scienza Hospital of Turin, Turin, Italy
| | - Philippe Corcia
- Centre Constitutif SLA, CHRU de Tours - Fédération des centres SLA Tours-Limoges, LitORALS, Tours, France
| | - Evy Reviers
- European Organization for Professionals and Patients with ALS (EUpALS) & ALS Liga Belgium, Leuven, Belgium
| | - Ammar Al-Chalabi
- Department of Basic and Clinical Neuroscience, King's College London, Maurice Wohl Clinical Neuroscience Institute, London, UK
- Department of Neurology, King's College Hospital, London, UK
| | - Matthew C Kiernan
- Department of Neurology, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia
- Brain and Mind Centre, University of Sydney, Sydney, New South Wales, Australia
| | | | | | - Ruben P A van Eijk
- Department of Neurology, UMC Utrecht, Utrecht, The Netherlands.
- Biostatistics and Research Support, Julius Centre for Health Sciences and Primary Care, Utrecht University, Utrecht, Netherlands.
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20
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Calvo A, Canosa A, Moglia C, Manera U, Grassano M, Vasta R, Palumbo F, Cugnasco P, Gallone S, Brunetti M, De Marchi F, Arena V, Pagani M, Dalgard C, Scholz SW, Chia R, Corrado L, Dalfonso S, Mazzini L, Traynor BJ, Chio A. Clinical and Metabolic Signature of UNC13A rs12608932 Variant in Amyotrophic Lateral Sclerosis. Neurol Genet 2022; 8:e200033. [PMID: 36313067 PMCID: PMC9608390 DOI: 10.1212/nxg.0000000000200033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Accepted: 07/29/2022] [Indexed: 11/07/2022]
Abstract
Background and Objectives To characterize the clinical and cognitive behavioral phenotype and brain 18F-2-fluoro-2-deoxy-d-glucose-PET (18F-FDG-PET) metabolism of patients with amyotrophic lateral sclerosis (ALS) carrying the rs12608932 variant of the UNC13A gene. Methods The study population included 1,409 patients with ALS without C9orf72, SOD1, TARDBP, and FUS mutations identified through a prospective epidemiologic ALS register. Control participants included 1,012 geographically matched, age-matched, and sex-matched participants. Clinical and cognitive differences between patients carrying the C/C rs12608932 genotype and those carrying the A/A + A/C genotype were assessed. A subset of patients underwent 18F-FDG-PET. Results The C/C genotype was associated with an increased risk of ALS (odds ratio: 1.54, 95% confidence interval 1.18–2.01, p = 0.001). Patients with the C/C genotype were older, had more frequent bulbar onset, and manifested a higher rate of weight loss. In addition, they showed significantly reduced performance in the letter fluency test, fluency domain of Edinburgh Cognitive and Behavioural ALS Screen (ECAS) and story-based empathy task (reflecting social cognition). Patients with the C/C genotype had a shorter survival (median survival time, C/C 2.25 years, interquartile range [IQR] 1.33–3.92; A/A + C/C: 2.90 years, IQR 1.74–5.41; p = 0.0001). In Cox multivariable analysis, C/C genotype resulted to be an independent prognostic factor. Finally, patients with a C/C genotype had a specific pattern of hypometabolism on brain 18F-FDG-PET extending to frontal and precentral areas of the right hemisphere. Discussion C/C rs12608932 genotype of UNC13A is associated with a specific motor and cognitive/behavioral phenotype, which reflects on 18F-FDG-PET findings. Our observations highlight the importance of adding the rs12608932 variant in UNC13A to the ALS genetic panel to refine the individual prognostic prediction and reduce heterogeneity in clinical trials.
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Affiliation(s)
- Andrea Calvo
- "Rita Levi Montalcini" Department of Neuroscience (A. Calvo, A. Canosa, C.M., U.M., M.G., R.V., F.P., P.C., M.B., A. Chio), University of Torino, Turin, Italy; Neurology 1 (A. Calvo, A. Canosa, C.M., U.M., S.G., A. Chio), Azienda Universitario-Ospedaliera Città della Salute e della Scienza di Torino, Turin, Italy; Neuroscience Institute of Turin (NIT) (A. Calvo, A. Chio), Turin, Italy; Institute of Cognitive Sciences and Technologies (A. Canosa, M.P., A. Chio), C.N.R., Rome, Italy; ALS Center (F.D.M., L.M.), Department of Neurology, Maggiore della Carità Hospital, University of Eastern Piedmont, Novara, Italy; Positron Emission Tomography Centre AFFIDEA-IRMET S.p.A. (V.A.), Turin, Italy; Department of Medical Radiation Physics and Nuclear Medicine (M.P.), Karolinska University Hospital, Stockholm, Sweden; Department of Anatomy (C.D.), Physiology & Genetics, Uniformed Services University of the Health Sciences, Bethesda, MD; The American Genome Center (C.D.), Uniformed Services University of the Health Sciences, Bethesda, MD; Neurodegenerative Diseases Research Unit (S.W.S.), Laboratory of Neurogenetics, National Institute of Neurological Disorders and Stroke, Bethesda, MD; Department of Neurology (S.W.S., B.J.T.), Johns Hopkins University Medical Center, Baltimore, MD; Neuromuscular Diseases Research Section (R.C., B.J.T.), Laboratory of Neurogenetics, National Institute on Aging, Bethesda, MD; and Department of Health Sciences (L.C., S.D.D.), University of Eastern Piedmont, Novara, Italy
| | - Antonio Canosa
- "Rita Levi Montalcini" Department of Neuroscience (A. Calvo, A. Canosa, C.M., U.M., M.G., R.V., F.P., P.C., M.B., A. Chio), University of Torino, Turin, Italy; Neurology 1 (A. Calvo, A. Canosa, C.M., U.M., S.G., A. Chio), Azienda Universitario-Ospedaliera Città della Salute e della Scienza di Torino, Turin, Italy; Neuroscience Institute of Turin (NIT) (A. Calvo, A. Chio), Turin, Italy; Institute of Cognitive Sciences and Technologies (A. Canosa, M.P., A. Chio), C.N.R., Rome, Italy; ALS Center (F.D.M., L.M.), Department of Neurology, Maggiore della Carità Hospital, University of Eastern Piedmont, Novara, Italy; Positron Emission Tomography Centre AFFIDEA-IRMET S.p.A. (V.A.), Turin, Italy; Department of Medical Radiation Physics and Nuclear Medicine (M.P.), Karolinska University Hospital, Stockholm, Sweden; Department of Anatomy (C.D.), Physiology & Genetics, Uniformed Services University of the Health Sciences, Bethesda, MD; The American Genome Center (C.D.), Uniformed Services University of the Health Sciences, Bethesda, MD; Neurodegenerative Diseases Research Unit (S.W.S.), Laboratory of Neurogenetics, National Institute of Neurological Disorders and Stroke, Bethesda, MD; Department of Neurology (S.W.S., B.J.T.), Johns Hopkins University Medical Center, Baltimore, MD; Neuromuscular Diseases Research Section (R.C., B.J.T.), Laboratory of Neurogenetics, National Institute on Aging, Bethesda, MD; and Department of Health Sciences (L.C., S.D.D.), University of Eastern Piedmont, Novara, Italy
| | - Cristina Moglia
- "Rita Levi Montalcini" Department of Neuroscience (A. Calvo, A. Canosa, C.M., U.M., M.G., R.V., F.P., P.C., M.B., A. Chio), University of Torino, Turin, Italy; Neurology 1 (A. Calvo, A. Canosa, C.M., U.M., S.G., A. Chio), Azienda Universitario-Ospedaliera Città della Salute e della Scienza di Torino, Turin, Italy; Neuroscience Institute of Turin (NIT) (A. Calvo, A. Chio), Turin, Italy; Institute of Cognitive Sciences and Technologies (A. Canosa, M.P., A. Chio), C.N.R., Rome, Italy; ALS Center (F.D.M., L.M.), Department of Neurology, Maggiore della Carità Hospital, University of Eastern Piedmont, Novara, Italy; Positron Emission Tomography Centre AFFIDEA-IRMET S.p.A. (V.A.), Turin, Italy; Department of Medical Radiation Physics and Nuclear Medicine (M.P.), Karolinska University Hospital, Stockholm, Sweden; Department of Anatomy (C.D.), Physiology & Genetics, Uniformed Services University of the Health Sciences, Bethesda, MD; The American Genome Center (C.D.), Uniformed Services University of the Health Sciences, Bethesda, MD; Neurodegenerative Diseases Research Unit (S.W.S.), Laboratory of Neurogenetics, National Institute of Neurological Disorders and Stroke, Bethesda, MD; Department of Neurology (S.W.S., B.J.T.), Johns Hopkins University Medical Center, Baltimore, MD; Neuromuscular Diseases Research Section (R.C., B.J.T.), Laboratory of Neurogenetics, National Institute on Aging, Bethesda, MD; and Department of Health Sciences (L.C., S.D.D.), University of Eastern Piedmont, Novara, Italy
| | - Umberto Manera
- "Rita Levi Montalcini" Department of Neuroscience (A. Calvo, A. Canosa, C.M., U.M., M.G., R.V., F.P., P.C., M.B., A. Chio), University of Torino, Turin, Italy; Neurology 1 (A. Calvo, A. Canosa, C.M., U.M., S.G., A. Chio), Azienda Universitario-Ospedaliera Città della Salute e della Scienza di Torino, Turin, Italy; Neuroscience Institute of Turin (NIT) (A. Calvo, A. Chio), Turin, Italy; Institute of Cognitive Sciences and Technologies (A. Canosa, M.P., A. Chio), C.N.R., Rome, Italy; ALS Center (F.D.M., L.M.), Department of Neurology, Maggiore della Carità Hospital, University of Eastern Piedmont, Novara, Italy; Positron Emission Tomography Centre AFFIDEA-IRMET S.p.A. (V.A.), Turin, Italy; Department of Medical Radiation Physics and Nuclear Medicine (M.P.), Karolinska University Hospital, Stockholm, Sweden; Department of Anatomy (C.D.), Physiology & Genetics, Uniformed Services University of the Health Sciences, Bethesda, MD; The American Genome Center (C.D.), Uniformed Services University of the Health Sciences, Bethesda, MD; Neurodegenerative Diseases Research Unit (S.W.S.), Laboratory of Neurogenetics, National Institute of Neurological Disorders and Stroke, Bethesda, MD; Department of Neurology (S.W.S., B.J.T.), Johns Hopkins University Medical Center, Baltimore, MD; Neuromuscular Diseases Research Section (R.C., B.J.T.), Laboratory of Neurogenetics, National Institute on Aging, Bethesda, MD; and Department of Health Sciences (L.C., S.D.D.), University of Eastern Piedmont, Novara, Italy
| | - Maurizio Grassano
- "Rita Levi Montalcini" Department of Neuroscience (A. Calvo, A. Canosa, C.M., U.M., M.G., R.V., F.P., P.C., M.B., A. Chio), University of Torino, Turin, Italy; Neurology 1 (A. Calvo, A. Canosa, C.M., U.M., S.G., A. Chio), Azienda Universitario-Ospedaliera Città della Salute e della Scienza di Torino, Turin, Italy; Neuroscience Institute of Turin (NIT) (A. Calvo, A. Chio), Turin, Italy; Institute of Cognitive Sciences and Technologies (A. Canosa, M.P., A. Chio), C.N.R., Rome, Italy; ALS Center (F.D.M., L.M.), Department of Neurology, Maggiore della Carità Hospital, University of Eastern Piedmont, Novara, Italy; Positron Emission Tomography Centre AFFIDEA-IRMET S.p.A. (V.A.), Turin, Italy; Department of Medical Radiation Physics and Nuclear Medicine (M.P.), Karolinska University Hospital, Stockholm, Sweden; Department of Anatomy (C.D.), Physiology & Genetics, Uniformed Services University of the Health Sciences, Bethesda, MD; The American Genome Center (C.D.), Uniformed Services University of the Health Sciences, Bethesda, MD; Neurodegenerative Diseases Research Unit (S.W.S.), Laboratory of Neurogenetics, National Institute of Neurological Disorders and Stroke, Bethesda, MD; Department of Neurology (S.W.S., B.J.T.), Johns Hopkins University Medical Center, Baltimore, MD; Neuromuscular Diseases Research Section (R.C., B.J.T.), Laboratory of Neurogenetics, National Institute on Aging, Bethesda, MD; and Department of Health Sciences (L.C., S.D.D.), University of Eastern Piedmont, Novara, Italy
| | - Rosario Vasta
- "Rita Levi Montalcini" Department of Neuroscience (A. Calvo, A. Canosa, C.M., U.M., M.G., R.V., F.P., P.C., M.B., A. Chio), University of Torino, Turin, Italy; Neurology 1 (A. Calvo, A. Canosa, C.M., U.M., S.G., A. Chio), Azienda Universitario-Ospedaliera Città della Salute e della Scienza di Torino, Turin, Italy; Neuroscience Institute of Turin (NIT) (A. Calvo, A. Chio), Turin, Italy; Institute of Cognitive Sciences and Technologies (A. Canosa, M.P., A. Chio), C.N.R., Rome, Italy; ALS Center (F.D.M., L.M.), Department of Neurology, Maggiore della Carità Hospital, University of Eastern Piedmont, Novara, Italy; Positron Emission Tomography Centre AFFIDEA-IRMET S.p.A. (V.A.), Turin, Italy; Department of Medical Radiation Physics and Nuclear Medicine (M.P.), Karolinska University Hospital, Stockholm, Sweden; Department of Anatomy (C.D.), Physiology & Genetics, Uniformed Services University of the Health Sciences, Bethesda, MD; The American Genome Center (C.D.), Uniformed Services University of the Health Sciences, Bethesda, MD; Neurodegenerative Diseases Research Unit (S.W.S.), Laboratory of Neurogenetics, National Institute of Neurological Disorders and Stroke, Bethesda, MD; Department of Neurology (S.W.S., B.J.T.), Johns Hopkins University Medical Center, Baltimore, MD; Neuromuscular Diseases Research Section (R.C., B.J.T.), Laboratory of Neurogenetics, National Institute on Aging, Bethesda, MD; and Department of Health Sciences (L.C., S.D.D.), University of Eastern Piedmont, Novara, Italy
| | - Francesca Palumbo
- "Rita Levi Montalcini" Department of Neuroscience (A. Calvo, A. Canosa, C.M., U.M., M.G., R.V., F.P., P.C., M.B., A. Chio), University of Torino, Turin, Italy; Neurology 1 (A. Calvo, A. Canosa, C.M., U.M., S.G., A. Chio), Azienda Universitario-Ospedaliera Città della Salute e della Scienza di Torino, Turin, Italy; Neuroscience Institute of Turin (NIT) (A. Calvo, A. Chio), Turin, Italy; Institute of Cognitive Sciences and Technologies (A. Canosa, M.P., A. Chio), C.N.R., Rome, Italy; ALS Center (F.D.M., L.M.), Department of Neurology, Maggiore della Carità Hospital, University of Eastern Piedmont, Novara, Italy; Positron Emission Tomography Centre AFFIDEA-IRMET S.p.A. (V.A.), Turin, Italy; Department of Medical Radiation Physics and Nuclear Medicine (M.P.), Karolinska University Hospital, Stockholm, Sweden; Department of Anatomy (C.D.), Physiology & Genetics, Uniformed Services University of the Health Sciences, Bethesda, MD; The American Genome Center (C.D.), Uniformed Services University of the Health Sciences, Bethesda, MD; Neurodegenerative Diseases Research Unit (S.W.S.), Laboratory of Neurogenetics, National Institute of Neurological Disorders and Stroke, Bethesda, MD; Department of Neurology (S.W.S., B.J.T.), Johns Hopkins University Medical Center, Baltimore, MD; Neuromuscular Diseases Research Section (R.C., B.J.T.), Laboratory of Neurogenetics, National Institute on Aging, Bethesda, MD; and Department of Health Sciences (L.C., S.D.D.), University of Eastern Piedmont, Novara, Italy
| | - Paolo Cugnasco
- "Rita Levi Montalcini" Department of Neuroscience (A. Calvo, A. Canosa, C.M., U.M., M.G., R.V., F.P., P.C., M.B., A. Chio), University of Torino, Turin, Italy; Neurology 1 (A. Calvo, A. Canosa, C.M., U.M., S.G., A. Chio), Azienda Universitario-Ospedaliera Città della Salute e della Scienza di Torino, Turin, Italy; Neuroscience Institute of Turin (NIT) (A. Calvo, A. Chio), Turin, Italy; Institute of Cognitive Sciences and Technologies (A. Canosa, M.P., A. Chio), C.N.R., Rome, Italy; ALS Center (F.D.M., L.M.), Department of Neurology, Maggiore della Carità Hospital, University of Eastern Piedmont, Novara, Italy; Positron Emission Tomography Centre AFFIDEA-IRMET S.p.A. (V.A.), Turin, Italy; Department of Medical Radiation Physics and Nuclear Medicine (M.P.), Karolinska University Hospital, Stockholm, Sweden; Department of Anatomy (C.D.), Physiology & Genetics, Uniformed Services University of the Health Sciences, Bethesda, MD; The American Genome Center (C.D.), Uniformed Services University of the Health Sciences, Bethesda, MD; Neurodegenerative Diseases Research Unit (S.W.S.), Laboratory of Neurogenetics, National Institute of Neurological Disorders and Stroke, Bethesda, MD; Department of Neurology (S.W.S., B.J.T.), Johns Hopkins University Medical Center, Baltimore, MD; Neuromuscular Diseases Research Section (R.C., B.J.T.), Laboratory of Neurogenetics, National Institute on Aging, Bethesda, MD; and Department of Health Sciences (L.C., S.D.D.), University of Eastern Piedmont, Novara, Italy
| | - Salvatore Gallone
- "Rita Levi Montalcini" Department of Neuroscience (A. Calvo, A. Canosa, C.M., U.M., M.G., R.V., F.P., P.C., M.B., A. Chio), University of Torino, Turin, Italy; Neurology 1 (A. Calvo, A. Canosa, C.M., U.M., S.G., A. Chio), Azienda Universitario-Ospedaliera Città della Salute e della Scienza di Torino, Turin, Italy; Neuroscience Institute of Turin (NIT) (A. Calvo, A. Chio), Turin, Italy; Institute of Cognitive Sciences and Technologies (A. Canosa, M.P., A. Chio), C.N.R., Rome, Italy; ALS Center (F.D.M., L.M.), Department of Neurology, Maggiore della Carità Hospital, University of Eastern Piedmont, Novara, Italy; Positron Emission Tomography Centre AFFIDEA-IRMET S.p.A. (V.A.), Turin, Italy; Department of Medical Radiation Physics and Nuclear Medicine (M.P.), Karolinska University Hospital, Stockholm, Sweden; Department of Anatomy (C.D.), Physiology & Genetics, Uniformed Services University of the Health Sciences, Bethesda, MD; The American Genome Center (C.D.), Uniformed Services University of the Health Sciences, Bethesda, MD; Neurodegenerative Diseases Research Unit (S.W.S.), Laboratory of Neurogenetics, National Institute of Neurological Disorders and Stroke, Bethesda, MD; Department of Neurology (S.W.S., B.J.T.), Johns Hopkins University Medical Center, Baltimore, MD; Neuromuscular Diseases Research Section (R.C., B.J.T.), Laboratory of Neurogenetics, National Institute on Aging, Bethesda, MD; and Department of Health Sciences (L.C., S.D.D.), University of Eastern Piedmont, Novara, Italy
| | - Maura Brunetti
- "Rita Levi Montalcini" Department of Neuroscience (A. Calvo, A. Canosa, C.M., U.M., M.G., R.V., F.P., P.C., M.B., A. Chio), University of Torino, Turin, Italy; Neurology 1 (A. Calvo, A. Canosa, C.M., U.M., S.G., A. Chio), Azienda Universitario-Ospedaliera Città della Salute e della Scienza di Torino, Turin, Italy; Neuroscience Institute of Turin (NIT) (A. Calvo, A. Chio), Turin, Italy; Institute of Cognitive Sciences and Technologies (A. Canosa, M.P., A. Chio), C.N.R., Rome, Italy; ALS Center (F.D.M., L.M.), Department of Neurology, Maggiore della Carità Hospital, University of Eastern Piedmont, Novara, Italy; Positron Emission Tomography Centre AFFIDEA-IRMET S.p.A. (V.A.), Turin, Italy; Department of Medical Radiation Physics and Nuclear Medicine (M.P.), Karolinska University Hospital, Stockholm, Sweden; Department of Anatomy (C.D.), Physiology & Genetics, Uniformed Services University of the Health Sciences, Bethesda, MD; The American Genome Center (C.D.), Uniformed Services University of the Health Sciences, Bethesda, MD; Neurodegenerative Diseases Research Unit (S.W.S.), Laboratory of Neurogenetics, National Institute of Neurological Disorders and Stroke, Bethesda, MD; Department of Neurology (S.W.S., B.J.T.), Johns Hopkins University Medical Center, Baltimore, MD; Neuromuscular Diseases Research Section (R.C., B.J.T.), Laboratory of Neurogenetics, National Institute on Aging, Bethesda, MD; and Department of Health Sciences (L.C., S.D.D.), University of Eastern Piedmont, Novara, Italy
| | - Fabiola De Marchi
- "Rita Levi Montalcini" Department of Neuroscience (A. Calvo, A. Canosa, C.M., U.M., M.G., R.V., F.P., P.C., M.B., A. Chio), University of Torino, Turin, Italy; Neurology 1 (A. Calvo, A. Canosa, C.M., U.M., S.G., A. Chio), Azienda Universitario-Ospedaliera Città della Salute e della Scienza di Torino, Turin, Italy; Neuroscience Institute of Turin (NIT) (A. Calvo, A. Chio), Turin, Italy; Institute of Cognitive Sciences and Technologies (A. Canosa, M.P., A. Chio), C.N.R., Rome, Italy; ALS Center (F.D.M., L.M.), Department of Neurology, Maggiore della Carità Hospital, University of Eastern Piedmont, Novara, Italy; Positron Emission Tomography Centre AFFIDEA-IRMET S.p.A. (V.A.), Turin, Italy; Department of Medical Radiation Physics and Nuclear Medicine (M.P.), Karolinska University Hospital, Stockholm, Sweden; Department of Anatomy (C.D.), Physiology & Genetics, Uniformed Services University of the Health Sciences, Bethesda, MD; The American Genome Center (C.D.), Uniformed Services University of the Health Sciences, Bethesda, MD; Neurodegenerative Diseases Research Unit (S.W.S.), Laboratory of Neurogenetics, National Institute of Neurological Disorders and Stroke, Bethesda, MD; Department of Neurology (S.W.S., B.J.T.), Johns Hopkins University Medical Center, Baltimore, MD; Neuromuscular Diseases Research Section (R.C., B.J.T.), Laboratory of Neurogenetics, National Institute on Aging, Bethesda, MD; and Department of Health Sciences (L.C., S.D.D.), University of Eastern Piedmont, Novara, Italy
| | - Vincenzo Arena
- "Rita Levi Montalcini" Department of Neuroscience (A. Calvo, A. Canosa, C.M., U.M., M.G., R.V., F.P., P.C., M.B., A. Chio), University of Torino, Turin, Italy; Neurology 1 (A. Calvo, A. Canosa, C.M., U.M., S.G., A. Chio), Azienda Universitario-Ospedaliera Città della Salute e della Scienza di Torino, Turin, Italy; Neuroscience Institute of Turin (NIT) (A. Calvo, A. Chio), Turin, Italy; Institute of Cognitive Sciences and Technologies (A. Canosa, M.P., A. Chio), C.N.R., Rome, Italy; ALS Center (F.D.M., L.M.), Department of Neurology, Maggiore della Carità Hospital, University of Eastern Piedmont, Novara, Italy; Positron Emission Tomography Centre AFFIDEA-IRMET S.p.A. (V.A.), Turin, Italy; Department of Medical Radiation Physics and Nuclear Medicine (M.P.), Karolinska University Hospital, Stockholm, Sweden; Department of Anatomy (C.D.), Physiology & Genetics, Uniformed Services University of the Health Sciences, Bethesda, MD; The American Genome Center (C.D.), Uniformed Services University of the Health Sciences, Bethesda, MD; Neurodegenerative Diseases Research Unit (S.W.S.), Laboratory of Neurogenetics, National Institute of Neurological Disorders and Stroke, Bethesda, MD; Department of Neurology (S.W.S., B.J.T.), Johns Hopkins University Medical Center, Baltimore, MD; Neuromuscular Diseases Research Section (R.C., B.J.T.), Laboratory of Neurogenetics, National Institute on Aging, Bethesda, MD; and Department of Health Sciences (L.C., S.D.D.), University of Eastern Piedmont, Novara, Italy
| | - Marco Pagani
- "Rita Levi Montalcini" Department of Neuroscience (A. Calvo, A. Canosa, C.M., U.M., M.G., R.V., F.P., P.C., M.B., A. Chio), University of Torino, Turin, Italy; Neurology 1 (A. Calvo, A. Canosa, C.M., U.M., S.G., A. Chio), Azienda Universitario-Ospedaliera Città della Salute e della Scienza di Torino, Turin, Italy; Neuroscience Institute of Turin (NIT) (A. Calvo, A. Chio), Turin, Italy; Institute of Cognitive Sciences and Technologies (A. Canosa, M.P., A. Chio), C.N.R., Rome, Italy; ALS Center (F.D.M., L.M.), Department of Neurology, Maggiore della Carità Hospital, University of Eastern Piedmont, Novara, Italy; Positron Emission Tomography Centre AFFIDEA-IRMET S.p.A. (V.A.), Turin, Italy; Department of Medical Radiation Physics and Nuclear Medicine (M.P.), Karolinska University Hospital, Stockholm, Sweden; Department of Anatomy (C.D.), Physiology & Genetics, Uniformed Services University of the Health Sciences, Bethesda, MD; The American Genome Center (C.D.), Uniformed Services University of the Health Sciences, Bethesda, MD; Neurodegenerative Diseases Research Unit (S.W.S.), Laboratory of Neurogenetics, National Institute of Neurological Disorders and Stroke, Bethesda, MD; Department of Neurology (S.W.S., B.J.T.), Johns Hopkins University Medical Center, Baltimore, MD; Neuromuscular Diseases Research Section (R.C., B.J.T.), Laboratory of Neurogenetics, National Institute on Aging, Bethesda, MD; and Department of Health Sciences (L.C., S.D.D.), University of Eastern Piedmont, Novara, Italy
| | - Clifton Dalgard
- "Rita Levi Montalcini" Department of Neuroscience (A. Calvo, A. Canosa, C.M., U.M., M.G., R.V., F.P., P.C., M.B., A. Chio), University of Torino, Turin, Italy; Neurology 1 (A. Calvo, A. Canosa, C.M., U.M., S.G., A. Chio), Azienda Universitario-Ospedaliera Città della Salute e della Scienza di Torino, Turin, Italy; Neuroscience Institute of Turin (NIT) (A. Calvo, A. Chio), Turin, Italy; Institute of Cognitive Sciences and Technologies (A. Canosa, M.P., A. Chio), C.N.R., Rome, Italy; ALS Center (F.D.M., L.M.), Department of Neurology, Maggiore della Carità Hospital, University of Eastern Piedmont, Novara, Italy; Positron Emission Tomography Centre AFFIDEA-IRMET S.p.A. (V.A.), Turin, Italy; Department of Medical Radiation Physics and Nuclear Medicine (M.P.), Karolinska University Hospital, Stockholm, Sweden; Department of Anatomy (C.D.), Physiology & Genetics, Uniformed Services University of the Health Sciences, Bethesda, MD; The American Genome Center (C.D.), Uniformed Services University of the Health Sciences, Bethesda, MD; Neurodegenerative Diseases Research Unit (S.W.S.), Laboratory of Neurogenetics, National Institute of Neurological Disorders and Stroke, Bethesda, MD; Department of Neurology (S.W.S., B.J.T.), Johns Hopkins University Medical Center, Baltimore, MD; Neuromuscular Diseases Research Section (R.C., B.J.T.), Laboratory of Neurogenetics, National Institute on Aging, Bethesda, MD; and Department of Health Sciences (L.C., S.D.D.), University of Eastern Piedmont, Novara, Italy
| | - Sonja W Scholz
- "Rita Levi Montalcini" Department of Neuroscience (A. Calvo, A. Canosa, C.M., U.M., M.G., R.V., F.P., P.C., M.B., A. Chio), University of Torino, Turin, Italy; Neurology 1 (A. Calvo, A. Canosa, C.M., U.M., S.G., A. Chio), Azienda Universitario-Ospedaliera Città della Salute e della Scienza di Torino, Turin, Italy; Neuroscience Institute of Turin (NIT) (A. Calvo, A. Chio), Turin, Italy; Institute of Cognitive Sciences and Technologies (A. Canosa, M.P., A. Chio), C.N.R., Rome, Italy; ALS Center (F.D.M., L.M.), Department of Neurology, Maggiore della Carità Hospital, University of Eastern Piedmont, Novara, Italy; Positron Emission Tomography Centre AFFIDEA-IRMET S.p.A. (V.A.), Turin, Italy; Department of Medical Radiation Physics and Nuclear Medicine (M.P.), Karolinska University Hospital, Stockholm, Sweden; Department of Anatomy (C.D.), Physiology & Genetics, Uniformed Services University of the Health Sciences, Bethesda, MD; The American Genome Center (C.D.), Uniformed Services University of the Health Sciences, Bethesda, MD; Neurodegenerative Diseases Research Unit (S.W.S.), Laboratory of Neurogenetics, National Institute of Neurological Disorders and Stroke, Bethesda, MD; Department of Neurology (S.W.S., B.J.T.), Johns Hopkins University Medical Center, Baltimore, MD; Neuromuscular Diseases Research Section (R.C., B.J.T.), Laboratory of Neurogenetics, National Institute on Aging, Bethesda, MD; and Department of Health Sciences (L.C., S.D.D.), University of Eastern Piedmont, Novara, Italy
| | - Ruth Chia
- "Rita Levi Montalcini" Department of Neuroscience (A. Calvo, A. Canosa, C.M., U.M., M.G., R.V., F.P., P.C., M.B., A. Chio), University of Torino, Turin, Italy; Neurology 1 (A. Calvo, A. Canosa, C.M., U.M., S.G., A. Chio), Azienda Universitario-Ospedaliera Città della Salute e della Scienza di Torino, Turin, Italy; Neuroscience Institute of Turin (NIT) (A. Calvo, A. Chio), Turin, Italy; Institute of Cognitive Sciences and Technologies (A. Canosa, M.P., A. Chio), C.N.R., Rome, Italy; ALS Center (F.D.M., L.M.), Department of Neurology, Maggiore della Carità Hospital, University of Eastern Piedmont, Novara, Italy; Positron Emission Tomography Centre AFFIDEA-IRMET S.p.A. (V.A.), Turin, Italy; Department of Medical Radiation Physics and Nuclear Medicine (M.P.), Karolinska University Hospital, Stockholm, Sweden; Department of Anatomy (C.D.), Physiology & Genetics, Uniformed Services University of the Health Sciences, Bethesda, MD; The American Genome Center (C.D.), Uniformed Services University of the Health Sciences, Bethesda, MD; Neurodegenerative Diseases Research Unit (S.W.S.), Laboratory of Neurogenetics, National Institute of Neurological Disorders and Stroke, Bethesda, MD; Department of Neurology (S.W.S., B.J.T.), Johns Hopkins University Medical Center, Baltimore, MD; Neuromuscular Diseases Research Section (R.C., B.J.T.), Laboratory of Neurogenetics, National Institute on Aging, Bethesda, MD; and Department of Health Sciences (L.C., S.D.D.), University of Eastern Piedmont, Novara, Italy
| | - Lucia Corrado
- "Rita Levi Montalcini" Department of Neuroscience (A. Calvo, A. Canosa, C.M., U.M., M.G., R.V., F.P., P.C., M.B., A. Chio), University of Torino, Turin, Italy; Neurology 1 (A. Calvo, A. Canosa, C.M., U.M., S.G., A. Chio), Azienda Universitario-Ospedaliera Città della Salute e della Scienza di Torino, Turin, Italy; Neuroscience Institute of Turin (NIT) (A. Calvo, A. Chio), Turin, Italy; Institute of Cognitive Sciences and Technologies (A. Canosa, M.P., A. Chio), C.N.R., Rome, Italy; ALS Center (F.D.M., L.M.), Department of Neurology, Maggiore della Carità Hospital, University of Eastern Piedmont, Novara, Italy; Positron Emission Tomography Centre AFFIDEA-IRMET S.p.A. (V.A.), Turin, Italy; Department of Medical Radiation Physics and Nuclear Medicine (M.P.), Karolinska University Hospital, Stockholm, Sweden; Department of Anatomy (C.D.), Physiology & Genetics, Uniformed Services University of the Health Sciences, Bethesda, MD; The American Genome Center (C.D.), Uniformed Services University of the Health Sciences, Bethesda, MD; Neurodegenerative Diseases Research Unit (S.W.S.), Laboratory of Neurogenetics, National Institute of Neurological Disorders and Stroke, Bethesda, MD; Department of Neurology (S.W.S., B.J.T.), Johns Hopkins University Medical Center, Baltimore, MD; Neuromuscular Diseases Research Section (R.C., B.J.T.), Laboratory of Neurogenetics, National Institute on Aging, Bethesda, MD; and Department of Health Sciences (L.C., S.D.D.), University of Eastern Piedmont, Novara, Italy
| | - Sandra Dalfonso
- "Rita Levi Montalcini" Department of Neuroscience (A. Calvo, A. Canosa, C.M., U.M., M.G., R.V., F.P., P.C., M.B., A. Chio), University of Torino, Turin, Italy; Neurology 1 (A. Calvo, A. Canosa, C.M., U.M., S.G., A. Chio), Azienda Universitario-Ospedaliera Città della Salute e della Scienza di Torino, Turin, Italy; Neuroscience Institute of Turin (NIT) (A. Calvo, A. Chio), Turin, Italy; Institute of Cognitive Sciences and Technologies (A. Canosa, M.P., A. Chio), C.N.R., Rome, Italy; ALS Center (F.D.M., L.M.), Department of Neurology, Maggiore della Carità Hospital, University of Eastern Piedmont, Novara, Italy; Positron Emission Tomography Centre AFFIDEA-IRMET S.p.A. (V.A.), Turin, Italy; Department of Medical Radiation Physics and Nuclear Medicine (M.P.), Karolinska University Hospital, Stockholm, Sweden; Department of Anatomy (C.D.), Physiology & Genetics, Uniformed Services University of the Health Sciences, Bethesda, MD; The American Genome Center (C.D.), Uniformed Services University of the Health Sciences, Bethesda, MD; Neurodegenerative Diseases Research Unit (S.W.S.), Laboratory of Neurogenetics, National Institute of Neurological Disorders and Stroke, Bethesda, MD; Department of Neurology (S.W.S., B.J.T.), Johns Hopkins University Medical Center, Baltimore, MD; Neuromuscular Diseases Research Section (R.C., B.J.T.), Laboratory of Neurogenetics, National Institute on Aging, Bethesda, MD; and Department of Health Sciences (L.C., S.D.D.), University of Eastern Piedmont, Novara, Italy
| | - Letizia Mazzini
- "Rita Levi Montalcini" Department of Neuroscience (A. Calvo, A. Canosa, C.M., U.M., M.G., R.V., F.P., P.C., M.B., A. Chio), University of Torino, Turin, Italy; Neurology 1 (A. Calvo, A. Canosa, C.M., U.M., S.G., A. Chio), Azienda Universitario-Ospedaliera Città della Salute e della Scienza di Torino, Turin, Italy; Neuroscience Institute of Turin (NIT) (A. Calvo, A. Chio), Turin, Italy; Institute of Cognitive Sciences and Technologies (A. Canosa, M.P., A. Chio), C.N.R., Rome, Italy; ALS Center (F.D.M., L.M.), Department of Neurology, Maggiore della Carità Hospital, University of Eastern Piedmont, Novara, Italy; Positron Emission Tomography Centre AFFIDEA-IRMET S.p.A. (V.A.), Turin, Italy; Department of Medical Radiation Physics and Nuclear Medicine (M.P.), Karolinska University Hospital, Stockholm, Sweden; Department of Anatomy (C.D.), Physiology & Genetics, Uniformed Services University of the Health Sciences, Bethesda, MD; The American Genome Center (C.D.), Uniformed Services University of the Health Sciences, Bethesda, MD; Neurodegenerative Diseases Research Unit (S.W.S.), Laboratory of Neurogenetics, National Institute of Neurological Disorders and Stroke, Bethesda, MD; Department of Neurology (S.W.S., B.J.T.), Johns Hopkins University Medical Center, Baltimore, MD; Neuromuscular Diseases Research Section (R.C., B.J.T.), Laboratory of Neurogenetics, National Institute on Aging, Bethesda, MD; and Department of Health Sciences (L.C., S.D.D.), University of Eastern Piedmont, Novara, Italy
| | - Bryan J Traynor
- "Rita Levi Montalcini" Department of Neuroscience (A. Calvo, A. Canosa, C.M., U.M., M.G., R.V., F.P., P.C., M.B., A. Chio), University of Torino, Turin, Italy; Neurology 1 (A. Calvo, A. Canosa, C.M., U.M., S.G., A. Chio), Azienda Universitario-Ospedaliera Città della Salute e della Scienza di Torino, Turin, Italy; Neuroscience Institute of Turin (NIT) (A. Calvo, A. Chio), Turin, Italy; Institute of Cognitive Sciences and Technologies (A. Canosa, M.P., A. Chio), C.N.R., Rome, Italy; ALS Center (F.D.M., L.M.), Department of Neurology, Maggiore della Carità Hospital, University of Eastern Piedmont, Novara, Italy; Positron Emission Tomography Centre AFFIDEA-IRMET S.p.A. (V.A.), Turin, Italy; Department of Medical Radiation Physics and Nuclear Medicine (M.P.), Karolinska University Hospital, Stockholm, Sweden; Department of Anatomy (C.D.), Physiology & Genetics, Uniformed Services University of the Health Sciences, Bethesda, MD; The American Genome Center (C.D.), Uniformed Services University of the Health Sciences, Bethesda, MD; Neurodegenerative Diseases Research Unit (S.W.S.), Laboratory of Neurogenetics, National Institute of Neurological Disorders and Stroke, Bethesda, MD; Department of Neurology (S.W.S., B.J.T.), Johns Hopkins University Medical Center, Baltimore, MD; Neuromuscular Diseases Research Section (R.C., B.J.T.), Laboratory of Neurogenetics, National Institute on Aging, Bethesda, MD; and Department of Health Sciences (L.C., S.D.D.), University of Eastern Piedmont, Novara, Italy
| | - Adriano Chio
- "Rita Levi Montalcini" Department of Neuroscience (A. Calvo, A. Canosa, C.M., U.M., M.G., R.V., F.P., P.C., M.B., A. Chio), University of Torino, Turin, Italy; Neurology 1 (A. Calvo, A. Canosa, C.M., U.M., S.G., A. Chio), Azienda Universitario-Ospedaliera Città della Salute e della Scienza di Torino, Turin, Italy; Neuroscience Institute of Turin (NIT) (A. Calvo, A. Chio), Turin, Italy; Institute of Cognitive Sciences and Technologies (A. Canosa, M.P., A. Chio), C.N.R., Rome, Italy; ALS Center (F.D.M., L.M.), Department of Neurology, Maggiore della Carità Hospital, University of Eastern Piedmont, Novara, Italy; Positron Emission Tomography Centre AFFIDEA-IRMET S.p.A. (V.A.), Turin, Italy; Department of Medical Radiation Physics and Nuclear Medicine (M.P.), Karolinska University Hospital, Stockholm, Sweden; Department of Anatomy (C.D.), Physiology & Genetics, Uniformed Services University of the Health Sciences, Bethesda, MD; The American Genome Center (C.D.), Uniformed Services University of the Health Sciences, Bethesda, MD; Neurodegenerative Diseases Research Unit (S.W.S.), Laboratory of Neurogenetics, National Institute of Neurological Disorders and Stroke, Bethesda, MD; Department of Neurology (S.W.S., B.J.T.), Johns Hopkins University Medical Center, Baltimore, MD; Neuromuscular Diseases Research Section (R.C., B.J.T.), Laboratory of Neurogenetics, National Institute on Aging, Bethesda, MD; and Department of Health Sciences (L.C., S.D.D.), University of Eastern Piedmont, Novara, Italy
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Sturmey E, Malaspina A. Blood biomarkers in ALS: challenges, applications and novel frontiers. Acta Neurol Scand 2022; 146:375-388. [PMID: 36156207 PMCID: PMC9828487 DOI: 10.1111/ane.13698] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Revised: 08/15/2022] [Accepted: 08/19/2022] [Indexed: 01/12/2023]
Abstract
Amyotrophic lateral sclerosis (ALS) is the most common motor neuron disease among adults. With diagnosis reached relatively late into the disease process, extensive motor cell loss narrows the window for therapeutic opportunities. Clinical heterogeneity in ALS and the lack of disease-specific biomarkers have so far led to large-sized clinical trials with long follow-up needed to define clinical outcomes. In advanced ALS patients, there is presently limited scope to use imaging or invasive cerebrospinal fluid (CSF) collection as a source of disease biomarkers. The development of more patient-friendly and accessible blood biomarker assays is hampered by analytical hurdles like the matrix effect of blood components. However, blood also provides the opportunity to identify disease-specific adaptive changes of the stoichiometry and conformation of target proteins and the endogenous immunological response to low-abundance brain peptides, such as neurofilaments (Nf). Among those biomarkers under investigation in ALS, the change in concentration before or after diagnosis of Nf has been shown to aid prognostication and to allow the a priori stratification of ALS patients into smaller sized and clinically more homogeneous cohorts, supporting more affordable clinical trials. Here, we discuss the technical hurdles affecting reproducible and sensitive biomarker measurement in blood. We also summarize the state of the art of non-CSF biomarkers in the study of prognosis, disease progression, and treatment response. We will then address the potential as disease-specific biomarkers of the newly discovered cryptic peptides which are formed down-stream of TDP-43 loss of function, the hallmark of ALS pathobiology.
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Affiliation(s)
- Ellie Sturmey
- Centre of Neuroscience, Surgery and Trauma, Queen Mary University of London, London, UK
| | - Andrea Malaspina
- Centre of Neuroscience, Surgery and Trauma, Queen Mary University of London, London, UK.,Queen Square Institute of Neurology, University College London, London, UK
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22
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Johnson SA, Fang T, De Marchi F, Neel D, Van Weehaeghe D, Berry JD, Paganoni S. Pharmacotherapy for Amyotrophic Lateral Sclerosis: A Review of Approved and Upcoming Agents. Drugs 2022; 82:1367-1388. [PMID: 36121612 DOI: 10.1007/s40265-022-01769-1] [Citation(s) in RCA: 30] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/17/2022] [Indexed: 11/03/2022]
Abstract
Amyotrophic lateral sclerosis (ALS) is a rapidly progressive neurodegenerative disorder involving loss of upper and lower motor neurons, with most cases ending in death within 3-5 years of onset. Several molecular and cellular pathways have been identified to cause ALS; however, treatments to stop or reverse disease progression are yet to be found. Riluzole, a neuroprotective agent offering only a modest survival benefit, has long been the sole disease-modifying therapy for ALS. Edaravone, which demonstrated statistically significant slowing of ALS disease progression, is gaining approval in an increasing number of countries since its first approval in 2015. Sodium phenylbutyrate and taurursodiol (PB-TURSO) was conditionally approved in Canada in 2022, having shown significant slowing of disease progression and prolonged survival. Most clinical trials have focused on testing small molecules affecting common cellular pathways in ALS: targeting glutamatergic, apoptotic, inflammatory, and oxidative stress mechanisms among others. More recently, clinical trials utilizing stem cell transplantation and other biologics have emerged. This rich and ever-growing pipeline of investigational products, along with innovative clinical trial designs, collaborative trial networks, and an engaged ALS community', provide renewed hope to finding a cure for ALS. This article reviews existing ALS therapies and the current clinical drug development pipeline.
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Affiliation(s)
- Stephen A Johnson
- Neurological Clinical Research Institute (NCRI), Healey & AMG Center for ALS, Massachusetts General Hospital, 165 Cambridge St, Suite 600, Boston, MA, 02114, USA
| | - Ton Fang
- University of Massachusetts Medical School, Worcester, MA, USA
| | - Fabiola De Marchi
- Department of Neurology, ALS Centre, Maggiore della Carità Hospital, Novara, Italy
- Department of Translational Medicine, University of Piemonte Orientale, 28100, Novara, Italy
| | | | - Donatienne Van Weehaeghe
- Nuclear Medicine Subdivision, Department of Imaging and Pathology, University Hospital Leuven, Leuven, Belgium
| | - James D Berry
- Neurological Clinical Research Institute (NCRI), Healey & AMG Center for ALS, Massachusetts General Hospital, 165 Cambridge St, Suite 600, Boston, MA, 02114, USA
| | - Sabrina Paganoni
- Neurological Clinical Research Institute (NCRI), Healey & AMG Center for ALS, Massachusetts General Hospital, 165 Cambridge St, Suite 600, Boston, MA, 02114, USA.
- Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Boston, MA, USA.
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23
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Su WM, Gu XJ, Duan QQ, Jiang Z, Gao X, Shang HF, Chen YP. Genetic factors for survival in amyotrophic lateral sclerosis: an integrated approach combining a systematic review, pairwise and network meta-analysis. BMC Med 2022; 20:209. [PMID: 35754054 PMCID: PMC9235235 DOI: 10.1186/s12916-022-02411-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Accepted: 05/18/2022] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND The time of survival in patients with amyotrophic lateral sclerosis (ALS) varies greatly, and the genetic factors that contribute to the survival of ALS are not well studied. There is a lack of a comprehensive study to elucidate the role of genetic factors in the survival of ALS. METHODS The published studies were systematically searched and obtained from PubMed, EMBASE, and the Cochrane Library without any language restrictions from inception to Oct 27, 2021. A network meta-analysis for ALS causative/risk genes and a systematic review and pairwise meta-analysis for other genetic modifiers were conducted. The PROSPERO registration number: CRD42022311646. RESULTS A total of 29,764 potentially relevant references were identified, and 71 papers were eligible for analysis based on pre-decided criteria, including 35 articles in network meta-analysis for 9 ALS causative/risk genes, 17 articles in pairwise meta-analysis for four genetic modifiers, and 19 articles described in the systematic review. Variants in three genes, including ATXN2 (HR: 3.6), C9orf72 (HR: 1.6), and FUS (HR:1.8), were associated with short survival of ALS, but such association was not identified in SOD1, TARDBP, TBK1, NEK1, UBQLN2, and CCNF. In addition, UNC13A rs12608932 CC genotype and ZNF521B rs2275294 C allele also caused a shorter survival of ALS; however, APOE ε4 allele and KIFAP3 rs1541160 did not be found to have any effect on the survival of ALS. CONCLUSIONS Our study summarized and contrasted evidence for prognostic genetic factors in ALS and would help to understand ALS pathogenesis and guide clinical trials and drug development.
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Affiliation(s)
- Wei-Ming Su
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China.,Lab of Neurodegenerative Disorders, Institute of Inflammation and Immunology (III), Frontiers Science Center for Disease-Related Molecular Network, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China.,Centre for Rare Diseases, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China
| | - Xiao-Jing Gu
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China.,Lab of Neurodegenerative Disorders, Institute of Inflammation and Immunology (III), Frontiers Science Center for Disease-Related Molecular Network, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China.,Centre for Rare Diseases, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China
| | - Qing-Qing Duan
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China.,Lab of Neurodegenerative Disorders, Institute of Inflammation and Immunology (III), Frontiers Science Center for Disease-Related Molecular Network, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China.,Centre for Rare Diseases, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China
| | - Zheng Jiang
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China.,Lab of Neurodegenerative Disorders, Institute of Inflammation and Immunology (III), Frontiers Science Center for Disease-Related Molecular Network, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China.,Centre for Rare Diseases, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China
| | - Xia Gao
- Department of Geriatrics, Dazhou Central Hospital, Dazhou, Sichuan, China
| | - Hui-Fang Shang
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China.,Lab of Neurodegenerative Disorders, Institute of Inflammation and Immunology (III), Frontiers Science Center for Disease-Related Molecular Network, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China.,Centre for Rare Diseases, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China
| | - Yong-Ping Chen
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China. .,Lab of Neurodegenerative Disorders, Institute of Inflammation and Immunology (III), Frontiers Science Center for Disease-Related Molecular Network, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China. .,Centre for Rare Diseases, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China.
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24
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Akiyama T, Koike Y, Petrucelli L, Gitler AD. Cracking the cryptic code in amyotrophic lateral sclerosis and frontotemporal dementia: Towards therapeutic targets and biomarkers. Clin Transl Med 2022; 12:e818. [PMID: 35567447 PMCID: PMC9098226 DOI: 10.1002/ctm2.818] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Accepted: 03/29/2022] [Indexed: 12/19/2022] Open
Abstract
Amyotrophic lateral sclerosis (ALS) and frontotemporal dementia (FTD) are two devastating human neurodegenerative diseases. A hallmark pathological feature of both diseases is the depletion of the RNA-binding protein TDP-43 from the nucleus in the brain and spinal cord of patients. A major function of TDP-43 is to repress the inclusion of cryptic exons during RNA splicing. When it becomes depleted from the nucleus in disease, this function is lost, and recently, several key cryptic splicing targets of TDP-43 have emerged, including STMN2, UNC13A, and others. UNC13A is a major ALS/FTD risk gene, and the genetic variations that increase the risk for disease seem to do so by making the gene more susceptible to cryptic exon inclusion when TDP-43 function is impaired. Here, we discuss the prospects and challenges of harnessing these cryptic splicing events as novel therapeutic targets and biomarkers. Deciphering this new cryptic code may be a touchstone for ALS and FTD diagnosis and treatment.
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Affiliation(s)
- Tetsuya Akiyama
- Department of Genetics, Stanford University School of Medicine, Stanford, California, USA
| | - Yuka Koike
- Department of Neuroscience, Mayo Clinic, Jacksonville, Florida, USA
| | | | - Aaron D Gitler
- Department of Genetics, Stanford University School of Medicine, Stanford, California, USA.,Chan Zuckerberg Biohub, San Francisco, California, USA
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25
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Zhang S, Cooper-Knock J, Weimer AK, Shi M, Moll T, Marshall JNG, Harvey C, Nezhad HG, Franklin J, Souza CDS, Ning K, Wang C, Li J, Dilliott AA, Farhan S, Elhaik E, Pasniceanu I, Livesey MR, Eitan C, Hornstein E, Kenna KP, Veldink JH, Ferraiuolo L, Shaw PJ, Snyder MP. Genome-wide identification of the genetic basis of amyotrophic lateral sclerosis. Neuron 2022; 110:992-1008.e11. [PMID: 35045337 PMCID: PMC9017397 DOI: 10.1016/j.neuron.2021.12.019] [Citation(s) in RCA: 41] [Impact Index Per Article: 20.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Revised: 10/07/2021] [Accepted: 12/13/2021] [Indexed: 02/01/2023]
Abstract
Amyotrophic lateral sclerosis (ALS) is a complex disease that leads to motor neuron death. Despite heritability estimates of 52%, genome-wide association studies (GWASs) have discovered relatively few loci. We developed a machine learning approach called RefMap, which integrates functional genomics with GWAS summary statistics for gene discovery. With transcriptomic and epigenetic profiling of motor neurons derived from induced pluripotent stem cells (iPSCs), RefMap identified 690 ALS-associated genes that represent a 5-fold increase in recovered heritability. Extensive conservation, transcriptome, network, and rare variant analyses demonstrated the functional significance of candidate genes in healthy and diseased motor neurons and brain tissues. Genetic convergence between common and rare variation highlighted KANK1 as a new ALS gene. Reproducing KANK1 patient mutations in human neurons led to neurotoxicity and demonstrated that TDP-43 mislocalization, a hallmark pathology of ALS, is downstream of axonal dysfunction. RefMap can be readily applied to other complex diseases.
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Affiliation(s)
- Sai Zhang
- Department of Genetics, Center for Genomics and Personalized Medicine, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Johnathan Cooper-Knock
- Sheffield Institute for Translational Neuroscience, University of Sheffield, Sheffield, S10 2HQ, UK
| | - Annika K Weimer
- Department of Genetics, Center for Genomics and Personalized Medicine, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Minyi Shi
- Department of Genetics, Center for Genomics and Personalized Medicine, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Tobias Moll
- Sheffield Institute for Translational Neuroscience, University of Sheffield, Sheffield, S10 2HQ, UK
| | - Jack N G Marshall
- Sheffield Institute for Translational Neuroscience, University of Sheffield, Sheffield, S10 2HQ, UK
| | - Calum Harvey
- Sheffield Institute for Translational Neuroscience, University of Sheffield, Sheffield, S10 2HQ, UK
| | - Helia Ghahremani Nezhad
- Sheffield Institute for Translational Neuroscience, University of Sheffield, Sheffield, S10 2HQ, UK
| | - John Franklin
- Sheffield Institute for Translational Neuroscience, University of Sheffield, Sheffield, S10 2HQ, UK
| | - Cleide Dos Santos Souza
- Sheffield Institute for Translational Neuroscience, University of Sheffield, Sheffield, S10 2HQ, UK
| | - Ke Ning
- Sheffield Institute for Translational Neuroscience, University of Sheffield, Sheffield, S10 2HQ, UK
| | - Cheng Wang
- The Eli and Edythe Broad Center of Regeneration Medicine and Stem Cell Research, the Bakar Computational Health Sciences Institute, the Parker Institute for Cancer Immunotherapy, and the Department of Neurology, School of Medicine, University of California, San Francisco, San Francisco, CA 94143, USA
| | - Jingjing Li
- The Eli and Edythe Broad Center of Regeneration Medicine and Stem Cell Research, the Bakar Computational Health Sciences Institute, the Parker Institute for Cancer Immunotherapy, and the Department of Neurology, School of Medicine, University of California, San Francisco, San Francisco, CA 94143, USA
| | - Allison A Dilliott
- Department of Neurology and Neurosurgery, the Montreal Neurological Institute, McGill University, Montreal, QC H3A 1A1, Canada
| | - Sali Farhan
- Department of Neurology and Neurosurgery, the Montreal Neurological Institute, McGill University, Montreal, QC H3A 1A1, Canada
| | - Eran Elhaik
- Department of Biology, Lunds Universitet, Lund 223 62, Sweden
| | - Iris Pasniceanu
- Sheffield Institute for Translational Neuroscience, University of Sheffield, Sheffield, S10 2HQ, UK
| | - Matthew R Livesey
- Sheffield Institute for Translational Neuroscience, University of Sheffield, Sheffield, S10 2HQ, UK
| | - Chen Eitan
- Department of Molecular Genetics, Weizmann Institute of Science, Rehovot 7610001, Israel
| | - Eran Hornstein
- Department of Molecular Genetics, Weizmann Institute of Science, Rehovot 7610001, Israel
| | - Kevin P Kenna
- Department of Neurology, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht 3584 CX, the Netherlands
| | - Jan H Veldink
- Department of Neurology, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht 3584 CX, the Netherlands
| | - Laura Ferraiuolo
- Sheffield Institute for Translational Neuroscience, University of Sheffield, Sheffield, S10 2HQ, UK
| | - Pamela J Shaw
- Sheffield Institute for Translational Neuroscience, University of Sheffield, Sheffield, S10 2HQ, UK
| | - Michael P Snyder
- Department of Genetics, Center for Genomics and Personalized Medicine, Stanford University School of Medicine, Stanford, CA 94305, USA.
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26
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Brown AL, Wilkins OG, Keuss MJ, Hill SE, Zanovello M, Lee WC, Bampton A, Lee FCY, Masino L, Qi YA, Bryce-Smith S, Gatt A, Hallegger M, Fagegaltier D, Phatnani H, Newcombe J, Gustavsson EK, Seddighi S, Reyes JF, Coon SL, Ramos D, Schiavo G, Fisher EMC, Raj T, Secrier M, Lashley T, Ule J, Buratti E, Humphrey J, Ward ME, Fratta P. TDP-43 loss and ALS-risk SNPs drive mis-splicing and depletion of UNC13A. Nature 2022; 603:131-137. [PMID: 35197628 PMCID: PMC8891020 DOI: 10.1038/s41586-022-04436-3] [Citation(s) in RCA: 174] [Impact Index Per Article: 87.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Accepted: 01/18/2022] [Indexed: 12/12/2022]
Abstract
Variants of UNC13A, a critical gene for synapse function, increase the risk of amyotrophic lateral sclerosis and frontotemporal dementia1-3, two related neurodegenerative diseases defined by mislocalization of the RNA-binding protein TDP-434,5. Here we show that TDP-43 depletion induces robust inclusion of a cryptic exon in UNC13A, resulting in nonsense-mediated decay and loss of UNC13A protein. Two common intronic UNC13A polymorphisms strongly associated with amyotrophic lateral sclerosis and frontotemporal dementia risk overlap with TDP-43 binding sites. These polymorphisms potentiate cryptic exon inclusion, both in cultured cells and in brains and spinal cords from patients with these conditions. Our findings, which demonstrate a genetic link between loss of nuclear TDP-43 function and disease, reveal the mechanism by which UNC13A variants exacerbate the effects of decreased TDP-43 function. They further provide a promising therapeutic target for TDP-43 proteinopathies.
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Affiliation(s)
- Anna-Leigh Brown
- UCL Queen Square Motor Neuron Disease Centre, Department of Neuromuscular Diseases, UCL Queen Square Institute of Neurology, UCL, London, UK
| | - Oscar G Wilkins
- UCL Queen Square Motor Neuron Disease Centre, Department of Neuromuscular Diseases, UCL Queen Square Institute of Neurology, UCL, London, UK
- The Francis Crick Institute, London, UK
| | - Matthew J Keuss
- UCL Queen Square Motor Neuron Disease Centre, Department of Neuromuscular Diseases, UCL Queen Square Institute of Neurology, UCL, London, UK
| | - Sarah E Hill
- National Institute of Neurological Disorders and Stroke, NIH, Bethesda, MD, USA
| | - Matteo Zanovello
- UCL Queen Square Motor Neuron Disease Centre, Department of Neuromuscular Diseases, UCL Queen Square Institute of Neurology, UCL, London, UK
| | - Weaverly Colleen Lee
- UCL Queen Square Motor Neuron Disease Centre, Department of Neuromuscular Diseases, UCL Queen Square Institute of Neurology, UCL, London, UK
| | - Alexander Bampton
- Queen Square Brain Bank, UCL Queen Square Institute of Neurology, University College London, London, UK
- Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, University College London, London, UK
| | - Flora C Y Lee
- UCL Queen Square Motor Neuron Disease Centre, Department of Neuromuscular Diseases, UCL Queen Square Institute of Neurology, UCL, London, UK
- The Francis Crick Institute, London, UK
| | | | - Yue A Qi
- Center for Alzheimer's and Related Dementias, National Institutes of Health, Bethesda, MD, USA
| | - Sam Bryce-Smith
- UCL Queen Square Motor Neuron Disease Centre, Department of Neuromuscular Diseases, UCL Queen Square Institute of Neurology, UCL, London, UK
| | - Ariana Gatt
- Queen Square Brain Bank, UCL Queen Square Institute of Neurology, University College London, London, UK
- Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, University College London, London, UK
| | - Martina Hallegger
- UCL Queen Square Motor Neuron Disease Centre, Department of Neuromuscular Diseases, UCL Queen Square Institute of Neurology, UCL, London, UK
- The Francis Crick Institute, London, UK
| | - Delphine Fagegaltier
- Center for Genomics of Neurodegenerative Disease, New York Genome Center (NYGC), New York, NY, USA
| | - Hemali Phatnani
- Center for Genomics of Neurodegenerative Disease, New York Genome Center (NYGC), New York, NY, USA
| | - Jia Newcombe
- NeuroResource, Department of Neuroinflammation, UCL Queen Square Institute of Neurology, London, UK
| | - Emil K Gustavsson
- Queen Square Brain Bank, UCL Queen Square Institute of Neurology, University College London, London, UK
- Great Ormond Street Institute of Child Health, Genetics and Genomic Medicine, University College London, London, UK
| | - Sahba Seddighi
- National Institute of Neurological Disorders and Stroke, NIH, Bethesda, MD, USA
- Medical Scientist Training Program, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Joel F Reyes
- National Institute of Neurological Disorders and Stroke, NIH, Bethesda, MD, USA
| | - Steven L Coon
- Molecular Genomics Core, Eunice Kennedy Shriver National Institute of Child Health and Human Development, NIH, Bethesda, MD, USA
| | - Daniel Ramos
- National Institute of Neurological Disorders and Stroke, NIH, Bethesda, MD, USA
- Center for Alzheimer's and Related Dementias, National Institutes of Health, Bethesda, MD, USA
| | - Giampietro Schiavo
- UCL Queen Square Motor Neuron Disease Centre, Department of Neuromuscular Diseases, UCL Queen Square Institute of Neurology, UCL, London, UK
- UK Dementia Research Institute, University College London, London, UK
| | - Elizabeth M C Fisher
- UCL Queen Square Motor Neuron Disease Centre, Department of Neuromuscular Diseases, UCL Queen Square Institute of Neurology, UCL, London, UK
| | - Towfique Raj
- Nash Family Department of Neuroscience and Friedman Brain Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Ronald M. Loeb Center for Alzheimer's Disease, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Genetics and Genomic Sciences and Icahn Institute for Data Science and Genomic Technology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Estelle and Daniel Maggin Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Maria Secrier
- Department of Genetics, Evolution and Environment, UCL Genetics Institute, University College London, London, UK
| | - Tammaryn Lashley
- Queen Square Brain Bank, UCL Queen Square Institute of Neurology, University College London, London, UK
- Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, University College London, London, UK
| | - Jernej Ule
- UCL Queen Square Motor Neuron Disease Centre, Department of Neuromuscular Diseases, UCL Queen Square Institute of Neurology, UCL, London, UK
- The Francis Crick Institute, London, UK
- Department of Molecular Biology and Nanobiotechnology, National Institute of Chemistry, Ljubljana, Slovenia
| | - Emanuele Buratti
- Molecular Pathology Lab, International Centre for Genetic Engineering and Biotechnology (ICGEB), Trieste, Italy
| | - Jack Humphrey
- Nash Family Department of Neuroscience and Friedman Brain Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Ronald M. Loeb Center for Alzheimer's Disease, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Genetics and Genomic Sciences and Icahn Institute for Data Science and Genomic Technology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Estelle and Daniel Maggin Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Michael E Ward
- National Institute of Neurological Disorders and Stroke, NIH, Bethesda, MD, USA.
| | - Pietro Fratta
- UCL Queen Square Motor Neuron Disease Centre, Department of Neuromuscular Diseases, UCL Queen Square Institute of Neurology, UCL, London, UK.
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27
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Ma XR, Prudencio M, Koike Y, Vatsavayai SC, Kim G, Harbinski F, Briner A, Rodriguez CM, Guo C, Akiyama T, Schmidt HB, Cummings BB, Wyatt DW, Kurylo K, Miller G, Mekhoubad S, Sallee N, Mekonnen G, Ganser L, Rubien JD, Jansen-West K, Cook CN, Pickles S, Oskarsson B, Graff-Radford NR, Boeve BF, Knopman DS, Petersen RC, Dickson DW, Shorter J, Myong S, Green EM, Seeley WW, Petrucelli L, Gitler AD. TDP-43 represses cryptic exon inclusion in the FTD-ALS gene UNC13A. Nature 2022; 603:124-130. [PMID: 35197626 PMCID: PMC8891019 DOI: 10.1038/s41586-022-04424-7] [Citation(s) in RCA: 186] [Impact Index Per Article: 93.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Accepted: 01/13/2022] [Indexed: 02/08/2023]
Abstract
A hallmark pathological feature of the neurodegenerative diseases amyotrophic lateral sclerosis (ALS) and frontotemporal dementia (FTD) is the depletion of RNA-binding protein TDP-43 from the nucleus of neurons in the brain and spinal cord1. A major function of TDP-43 is as a repressor of cryptic exon inclusion during RNA splicing2-4. Single nucleotide polymorphisms in UNC13A are among the strongest hits associated with FTD and ALS in human genome-wide association studies5,6, but how those variants increase risk for disease is unknown. Here we show that TDP-43 represses a cryptic exon-splicing event in UNC13A. Loss of TDP-43 from the nucleus in human brain, neuronal cell lines and motor neurons derived from induced pluripotent stem cells resulted in the inclusion of a cryptic exon in UNC13A mRNA and reduced UNC13A protein expression. The top variants associated with FTD or ALS risk in humans are located in the intron harbouring the cryptic exon, and we show that they increase UNC13A cryptic exon splicing in the face of TDP-43 dysfunction. Together, our data provide a direct functional link between one of the strongest genetic risk factors for FTD and ALS (UNC13A genetic variants), and loss of TDP-43 function.
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Affiliation(s)
- X Rosa Ma
- Department of Genetics, Stanford University School of Medicine, Stanford, CA, USA
| | - Mercedes Prudencio
- Department of Neuroscience, Mayo Clinic, Jacksonville, FL, USA
- Neuroscience Graduate Program, Mayo Clinic Graduate School of Biomedical Sciences, Jacksonville, FL, USA
| | - Yuka Koike
- Department of Neuroscience, Mayo Clinic, Jacksonville, FL, USA
- Neuroscience Graduate Program, Mayo Clinic Graduate School of Biomedical Sciences, Jacksonville, FL, USA
| | - Sarat C Vatsavayai
- Department of Neurology, University of California San Francisco, San Francisco, CA, USA
- Department of Pathology, University of California San Francisco, San Francisco, CA, USA
| | - Garam Kim
- Department of Genetics, Stanford University School of Medicine, Stanford, CA, USA
- Neurosciences Interdepartmental Program, Stanford University School of Medicine, Stanford, CA, USA
| | | | - Adam Briner
- Department of Genetics, Stanford University School of Medicine, Stanford, CA, USA
- Clem Jones Centre for Ageing Dementia Research (CJCADR), Queensland Brain Institute (QBI), The University of Queensland, Brisbane, Queensland, Australia
| | - Caitlin M Rodriguez
- Department of Genetics, Stanford University School of Medicine, Stanford, CA, USA
| | - Caiwei Guo
- Department of Genetics, Stanford University School of Medicine, Stanford, CA, USA
| | - Tetsuya Akiyama
- Department of Genetics, Stanford University School of Medicine, Stanford, CA, USA
| | - H Broder Schmidt
- Department of Biochemistry, Stanford University School of Medicine, Stanford, CA, USA
| | | | | | | | | | | | | | - Gemechu Mekonnen
- Program in Cell, Molecular, Developmental Biology, and Biophysics, Johns Hopkins University, Baltimore, MD, USA
- Department of Biology, Johns Hopkins University, Baltimore, MD, USA
| | - Laura Ganser
- Department of Biophysics, Johns Hopkins University, Baltimore, MD, USA
| | - Jack D Rubien
- Department of Biochemistry and Biophysics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | | | - Casey N Cook
- Department of Neuroscience, Mayo Clinic, Jacksonville, FL, USA
- Neuroscience Graduate Program, Mayo Clinic Graduate School of Biomedical Sciences, Jacksonville, FL, USA
| | - Sarah Pickles
- Department of Neuroscience, Mayo Clinic, Jacksonville, FL, USA
- Neuroscience Graduate Program, Mayo Clinic Graduate School of Biomedical Sciences, Jacksonville, FL, USA
| | | | | | | | | | | | - Dennis W Dickson
- Department of Neuroscience, Mayo Clinic, Jacksonville, FL, USA
- Neuroscience Graduate Program, Mayo Clinic Graduate School of Biomedical Sciences, Jacksonville, FL, USA
| | - James Shorter
- Department of Biochemistry and Biophysics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Sua Myong
- Program in Cell, Molecular, Developmental Biology, and Biophysics, Johns Hopkins University, Baltimore, MD, USA
- Department of Biology, Johns Hopkins University, Baltimore, MD, USA
- Department of Biophysics, Johns Hopkins University, Baltimore, MD, USA
| | | | - William W Seeley
- Department of Neurology, University of California San Francisco, San Francisco, CA, USA
- Department of Pathology, University of California San Francisco, San Francisco, CA, USA
| | - Leonard Petrucelli
- Department of Neuroscience, Mayo Clinic, Jacksonville, FL, USA.
- Neuroscience Graduate Program, Mayo Clinic Graduate School of Biomedical Sciences, Jacksonville, FL, USA.
| | - Aaron D Gitler
- Department of Genetics, Stanford University School of Medicine, Stanford, CA, USA.
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29
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Pampalakis G, Angelis G, Zingkou E, Vekrellis K, Sotiropoulou G. A chemogenomic approach is required for effective treatment of amyotrophic lateral sclerosis. Clin Transl Med 2022; 12:e657. [PMID: 35064780 PMCID: PMC8783349 DOI: 10.1002/ctm2.657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2021] [Revised: 11/04/2021] [Accepted: 11/11/2021] [Indexed: 11/10/2022] Open
Abstract
ALS is a fatal untreatable disease involving degeneration of motor neurons. Μultiple causative genes encoding proteins with versatile functions have been identified indicating that diverse biological pathways lead to ALS. Chemical entities still represent a promising choice to delay ALS progression, attenuate symptoms and/or increase life expectancy, but also gene-based and stem cell-based therapies are in the process of development, and some are tested in clinical trials. Various compounds proved effective in transgenic models overexpressing distinct ALS causative genes unfortunately though, they showed no efficacy in clinical trials. Notably, while animal models provide a uniform genetic background for preclinical testing, ALS patients are not stratified, and the distinct genetic forms of ALS are treated as one group, which could explain the observed discrepancies between treating genetically homogeneous mice and quite heterogeneous patient cohorts. We suggest that chemical entity-genotype correlation should be exploited to guide patient stratification for pharmacotherapy, that is administered drugs should be selected based on the ALS genetic background.
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Affiliation(s)
- Georgios Pampalakis
- Department of Pharmacology - Pharmacognosy, School of Pharmacy, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Georgios Angelis
- Department of Pharmacology - Pharmacognosy, School of Pharmacy, Aristotle University of Thessaloniki, Thessaloniki, Greece
- Department of Pharmacy, School of Health Sciences, University of Patras, Rion-Patras, Greece
| | - Eleni Zingkou
- Department of Pharmacy, School of Health Sciences, University of Patras, Rion-Patras, Greece
| | - Kostas Vekrellis
- Biomedical Research Foundation, Academy of Athens, Athens, Greece
| | - Georgia Sotiropoulou
- Department of Pharmacy, School of Health Sciences, University of Patras, Rion-Patras, Greece
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30
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Cooper-Knock J, Harvey C, Zhang S, Moll T, Timpanaro IS, Kenna KP, Iacoangeli A, Veldink JH. Advances in the genetic classification of amyotrophic lateral sclerosis. Curr Opin Neurol 2021; 34:756-764. [PMID: 34343141 PMCID: PMC7612116 DOI: 10.1097/wco.0000000000000986] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE OF REVIEW Amyotrophic lateral sclerosis (ALS) is an archetypal complex disease wherein disease risk and severity are, for the majority of patients, the product of interaction between multiple genetic and environmental factors. We are in a period of unprecedented discovery with new large-scale genome-wide association study (GWAS) and accelerating discovery of risk genes. However, much of the observed heritability of ALS is undiscovered and we are not yet approaching elucidation of the total genetic architecture, which will be necessary for comprehensive disease subclassification. RECENT FINDINGS We summarize recent developments and discuss the future. New machine learning models will help to address nonlinear genetic interactions. Statistical power for genetic discovery may be boosted by reducing the search-space using cell-specific epigenetic profiles and expanding our scope to include genetically correlated phenotypes. Structural variation, somatic heterogeneity and consideration of environmental modifiers represent significant challenges which will require integration of multiple technologies and a multidisciplinary approach, including clinicians, geneticists and pathologists. SUMMARY The move away from fully penetrant Mendelian risk genes necessitates new experimental designs and new standards for validation. The challenges are significant, but the potential reward for successful disease subclassification is large-scale and effective personalized medicine.
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Affiliation(s)
- Johnathan Cooper-Knock
- Sheffield Institute for Translational Neuroscience (SITraN), University of Sheffield, Sheffield, UK
| | - Calum Harvey
- Sheffield Institute for Translational Neuroscience (SITraN), University of Sheffield, Sheffield, UK
| | - Sai Zhang
- Department of Genetics
- Center for Genomics and Personalized Medicine, Stanford University School of Medicine, Stanford, California, USA
| | - Tobias Moll
- Sheffield Institute for Translational Neuroscience (SITraN), University of Sheffield, Sheffield, UK
| | - Ilia Sarah Timpanaro
- Department of Neurology, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Kevin P Kenna
- Department of Neurology, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Alfredo Iacoangeli
- Maurice Wohl Clinical Neuroscience Institute, Department of Basic and Clinical Neuroscience
- Department of Biostatistics and Health Informatics, Institute of Psychiatry, Psychology and Neuroscience, King's College London
- National Institute for Health Research Biomedical Research Centre and Dementia Unit, South London and Maudsley NHS Foundation Trust and King's College London, London, UK
| | - Jan H Veldink
- Department of Neurology, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
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Braems E, Tziortzouda P, Van Den Bosch L. Exploring the alternative: Fish, flies and worms as preclinical models for ALS. Neurosci Lett 2021; 759:136041. [PMID: 34118308 DOI: 10.1016/j.neulet.2021.136041] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2020] [Revised: 04/15/2021] [Accepted: 06/01/2021] [Indexed: 12/22/2022]
Abstract
Amyotrophic lateral sclerosis (ALS) is an incurable neurodegenerative disorder characterized by the loss of upper and lower motor neurons. In general, patients succumb to respiratory insufficiency due to respiratory muscle weakness. Despite many promising therapeutic strategies primarily identified in rodent models, patient trials remain rather unsuccessful. There is a clear need for alternative approaches, which could provide directions towards the justified use of rodents and which increase the likelihood to identify new promising clinical candidates. In the last decades, the use of fast genetic approaches and the development of high-throughput screening platforms in the nematode Caenorhabditis elegans, in the fruit fly (Drosophila melanogaster) and in zebrafish (Danio rerio) have contributed to new insights into ALS pathomechanisms, disease modifiers and therapeutic targets. In this mini-review, we provide an overview of these alternative small animal studies, modeling the most common ALS genes and discuss the most recent preclinical discoveries. We conclude that small animal models will not replace rodent models, yet they clearly represent an important asset for preclinical studies.
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Affiliation(s)
- Elke Braems
- KU Leuven - University of Leuven, Department of Neurosciences, Experimental Neurology, and Leuven Brain Institute (LBI), Leuven, Belgium; VIB, Center for Brain & Disease Research, Laboratory of Neurobiology, Leuven, Belgium
| | - Paraskevi Tziortzouda
- KU Leuven - University of Leuven, Department of Neurosciences, Experimental Neurology, and Leuven Brain Institute (LBI), Leuven, Belgium; VIB, Center for Brain & Disease Research, Laboratory of Neurobiology, Leuven, Belgium
| | - Ludo Van Den Bosch
- KU Leuven - University of Leuven, Department of Neurosciences, Experimental Neurology, and Leuven Brain Institute (LBI), Leuven, Belgium; VIB, Center for Brain & Disease Research, Laboratory of Neurobiology, Leuven, Belgium.
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32
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Lake J, Storm CS, Makarious MB, Bandres-Ciga S. Genetic and Transcriptomic Biomarkers in Neurodegenerative Diseases: Current Situation and the Road Ahead. Cells 2021; 10:1030. [PMID: 33925602 PMCID: PMC8170880 DOI: 10.3390/cells10051030] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Revised: 04/21/2021] [Accepted: 04/24/2021] [Indexed: 12/19/2022] Open
Abstract
Neurodegenerative diseases are etiologically and clinically heterogeneous conditions, often reflecting a spectrum of disease rather than well-defined disorders. The underlying molecular complexity of these diseases has made the discovery and validation of useful biomarkers challenging. The search of characteristic genetic and transcriptomic indicators for preclinical disease diagnosis, prognosis, or subtyping is an area of ongoing effort and interest. The next generation of biomarker studies holds promise by implementing meaningful longitudinal and multi-modal approaches in large scale biobank and healthcare system scale datasets. This work will only be possible in an open science framework. This review summarizes the current state of genetic and transcriptomic biomarkers in Parkinson's disease, Alzheimer's disease, and amyotrophic lateral sclerosis, providing a comprehensive landscape of recent literature and future directions.
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Affiliation(s)
- Julie Lake
- Laboratory of Neurogenetics, National Institute on Aging, National Institutes of Health, Bethesda, MD 20892, USA; (J.L.); (M.B.M.)
| | - Catherine S. Storm
- Department of Clinical and Movement Neurosciences, UCL Queen Square Institute of Neurology, London WC1N 3BG, UK;
- UCL Movement Disorders Centre, University College London, London WC1E 6BT, UK
| | - Mary B. Makarious
- Laboratory of Neurogenetics, National Institute on Aging, National Institutes of Health, Bethesda, MD 20892, USA; (J.L.); (M.B.M.)
| | - Sara Bandres-Ciga
- Laboratory of Neurogenetics, National Institute on Aging, National Institutes of Health, Bethesda, MD 20892, USA; (J.L.); (M.B.M.)
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33
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You Y, Katti S, Yu B, Igumenova TI, Das J. Probing the Diacylglycerol Binding Site of Presynaptic Munc13-1. Biochemistry 2021; 60:1286-1298. [PMID: 33818064 DOI: 10.1021/acs.biochem.1c00165] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Munc13-1 is a presynaptic active zone protein that acts as a master regulator of synaptic vesicle priming and neurotransmitter release in the brain. It has been implicated in the pathophysiology of several neurodegenerative diseases. Diacylglycerol and phorbol ester activate Munc13-1 by binding to its C1 domain. The objective of this study is to identify the structural determinants of ligand binding activity of the Munc13-1 C1 domain. Molecular docking suggested that residues Trp-588, Ile-590, and Arg-592 of Munc13-1 are involved in ligand interactions. To elucidate the role of these three residues in ligand binding, we generated W588A, I590A, and R592A mutants in full-length Munc13-1, expressed them as GFP-tagged proteins in HT22 cells, and measured their ligand-induced membrane translocation by confocal microscopy and immunoblotting. The extent of 1,2-dioctanoyl-sn-glycerol (DOG)- and phorbol ester-induced membrane translocation decreased in the following order: wild type > I590A > W588A > R592A and wild type > W588A > I590A > R592A, respectively. To understand the effect of the mutations on ligand binding, we also measured the DOG binding affinity of the isolated wild-type C1 domain and its mutants in membrane-mimicking micelles using nuclear magnetic resonance methods. The DOG binding affinity decreased in the following order: wild type > I590A > R592A. No binding was detected for W588A with DOG in micelles. This study shows that Trp-588, Ile-590, and Arg-592 are essential determinants for the activity of Munc13-1 and the effects of the three residues on the activity are ligand-dependent. This study bears significance for the development of selective modulators of Munc13-1.
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Affiliation(s)
- Youngki You
- Department of Pharmacological & Pharmaceutical Sciences, College of Pharmacy, Health 2, University of Houston, Houston, Texas 77204, United States
| | - Sachin Katti
- Department of Biochemistry and Biophysics, Texas A&M University, 300 Olsen Boulevard, College Station, Texas 77843, United States
| | - Binhan Yu
- Department of Biochemistry and Biophysics, Texas A&M University, 300 Olsen Boulevard, College Station, Texas 77843, United States
| | - Tatyana I Igumenova
- Department of Biochemistry and Biophysics, Texas A&M University, 300 Olsen Boulevard, College Station, Texas 77843, United States
| | - Joydip Das
- Department of Pharmacological & Pharmaceutical Sciences, College of Pharmacy, Health 2, University of Houston, Houston, Texas 77204, United States
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Theunissen F, Anderton RS, Mastaglia FL, Flynn LL, Winter SJ, James I, Bedlack R, Hodgetts S, Fletcher S, Wilton SD, Laing NG, MacShane M, Needham M, Saunders A, Mackay-Sim A, Melamed Z, Ravits J, Cleveland DW, Akkari PA. Novel STMN2 Variant Linked to Amyotrophic Lateral Sclerosis Risk and Clinical Phenotype. Front Aging Neurosci 2021; 13:658226. [PMID: 33841129 PMCID: PMC8033025 DOI: 10.3389/fnagi.2021.658226] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Accepted: 03/02/2021] [Indexed: 12/19/2022] Open
Abstract
Objective There is a critical need to establish genetic markers that explain the complex phenotypes and pathogenicity of ALS. This study identified a polymorphism in the Stathmin-2 gene and investigated its association with sporadic ALS (sALS) disease risk, age-of onset and survival duration. Methods The candidate CA repeat was systematically analyzed using PCR, Sanger sequencing and high throughput capillary separation for genotyping. Stathmin-2 expression was investigated using RT-PCR in patient olfactory neurosphere-derived (ONS) cells and RNA sequencing in laser-captured spinal motor neurons. Results In a case-control analysis of a combined North American sALS cohort (n = 321) and population control group (n = 332), long/long CA genotypes were significantly associated with disease risk (p = 0.042), and most strongly when one allele was a 24 CA repeat (p = 0.0023). In addition, longer CA allele length was associated with earlier age-of-onset (p = 0.039), and shorter survival duration in bulbar-onset cases (p = 0.006). In an Australian longitudinal sALS cohort (n = 67), ALS functional rating scale scores were significantly lower in carriers of the long/long genotype (p = 0.034). Stathmin-2 mRNA expression was reduced in sporadic patient ONS cells. Additionally, sALS patients and controls exhibited variable expression of Stathmin-2 mRNA according to CA genotype in laser-captured spinal motor neurons. Conclusions We report a novel non-coding CA repeat in Stathmin-2 which is associated with sALS disease risk and has disease modifying effects. The potential value of this variant as a disease marker and tool for cohort enrichment in clinical trials warrants further investigation.
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Affiliation(s)
- Frances Theunissen
- Perron Institute for Neurological and Translational Science, Nedlands, WA, Australia.,Centre for Molecular Medicine and Innovative Therapeutics, Murdoch University, Perth, WA, Australia
| | - Ryan S Anderton
- Perron Institute for Neurological and Translational Science, Nedlands, WA, Australia.,Centre for Neuromuscular and Neurological Disorders, University of Western Australia, Nedlands, WA, Australia.,School of Health Sciences, Institute for Health Research, The University of Notre Dame Australia, Fremantle, WA, Australia
| | - Frank L Mastaglia
- Perron Institute for Neurological and Translational Science, Nedlands, WA, Australia.,Centre for Neuromuscular and Neurological Disorders, University of Western Australia, Nedlands, WA, Australia
| | - Loren L Flynn
- Perron Institute for Neurological and Translational Science, Nedlands, WA, Australia.,Centre for Molecular Medicine and Innovative Therapeutics, Murdoch University, Perth, WA, Australia.,Centre for Neuromuscular and Neurological Disorders, University of Western Australia, Nedlands, WA, Australia
| | - Samantha J Winter
- Perron Institute for Neurological and Translational Science, Nedlands, WA, Australia.,School of Health Sciences, Institute for Health Research, The University of Notre Dame Australia, Fremantle, WA, Australia
| | - Ian James
- Institute for Immunology and Infectious Disease, Murdoch University, Perth, WA, Australia
| | - Richard Bedlack
- Department of Neurology, Duke University, Durham, NC, United States
| | - Stuart Hodgetts
- Perron Institute for Neurological and Translational Science, Nedlands, WA, Australia.,School of Human Sciences, University of Western Australia, Nedlands, WA, Australia
| | - Sue Fletcher
- Centre for Molecular Medicine and Innovative Therapeutics, Murdoch University, Perth, WA, Australia.,Centre for Neuromuscular and Neurological Disorders, University of Western Australia, Nedlands, WA, Australia
| | - Steve D Wilton
- Perron Institute for Neurological and Translational Science, Nedlands, WA, Australia.,Centre for Molecular Medicine and Innovative Therapeutics, Murdoch University, Perth, WA, Australia.,Centre for Neuromuscular and Neurological Disorders, University of Western Australia, Nedlands, WA, Australia
| | - Nigel G Laing
- Centre for Medical Research, Harry Perkins Institute of Medical Research, The University of Western Australia, Perth, WA, Australia
| | - Mandi MacShane
- Centre for Medical Research, Harry Perkins Institute of Medical Research, The University of Western Australia, Perth, WA, Australia
| | - Merrilee Needham
- Centre for Molecular Medicine and Innovative Therapeutics, Murdoch University, Perth, WA, Australia.,Faculty of Medicine, The University of Notre Dame Australia, Fremantle, WA, Australia.,Department of Neurology, Fiona Stanley Hospital, Murdoch, WA, Australia
| | - Ann Saunders
- Zinfandel Pharmaceuticals, Chapel Hill, NC, United States
| | - Alan Mackay-Sim
- Perron Institute for Neurological and Translational Science, Nedlands, WA, Australia.,Griffith Institute for Drug Discovery, Griffith University, Nathan, QLD, Australia
| | - Ze'ev Melamed
- Ludwig Institute for Cancer Research, University of California, San Diego, La Jolla, CA, United States.,Department of Cellular and Molecular Medicine, University of California, San Diego, La Jolla, CA, United States
| | - John Ravits
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States
| | - Don W Cleveland
- Ludwig Institute for Cancer Research, University of California, San Diego, La Jolla, CA, United States.,Department of Cellular and Molecular Medicine, University of California, San Diego, La Jolla, CA, United States.,Department of Neurosciences, University of California, San Diego, La Jolla, CA, United States
| | - P Anthony Akkari
- Perron Institute for Neurological and Translational Science, Nedlands, WA, Australia.,Centre for Molecular Medicine and Innovative Therapeutics, Murdoch University, Perth, WA, Australia.,Centre for Neuromuscular and Neurological Disorders, University of Western Australia, Nedlands, WA, Australia.,Department of Neurology, Duke University, Durham, NC, United States
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35
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Amyotrophic Lateral Sclerosis and Frontotemporal Lobar Degenerations: Similarities in Genetic Background. Diagnostics (Basel) 2021; 11:diagnostics11030509. [PMID: 33805659 PMCID: PMC7998502 DOI: 10.3390/diagnostics11030509] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Revised: 03/06/2021] [Accepted: 03/11/2021] [Indexed: 12/27/2022] Open
Abstract
Amyotrophic lateral sclerosis (ALS) is a devastating, uniformly lethal progressive degenerative disorder of motor neurons that overlaps with frontotemporal lobar degeneration (FTLD) clinically, morphologically, and genetically. Although many distinct mutations in various genes are known to cause amyotrophic lateral sclerosis, it remains poorly understood how they selectively impact motor neuron biology and whether they converge on common pathways to cause neuronal degeneration. Many of the gene mutations are in proteins that share similar functions. They can be grouped into those associated with cell axon dynamics and those associated with cellular phagocytic machinery, namely protein aggregation and metabolism, apoptosis, and intracellular nucleic acid transport. Analysis of pathways implicated by mutant ALS genes has provided new insights into the pathogenesis of both familial forms of ALS (fALS) and sporadic forms (sALS), although, regrettably, this has not yet yielded definitive treatments. Many genes play an important role, with TARDBP, SQSTM1, VCP, FUS, TBK1, CHCHD10, and most importantly, C9orf72 being critical genetic players in these neurological disorders. In this mini-review, we will focus on the molecular mechanisms of these two diseases.
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36
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Oliveira D, Verjovski-Almeida S, Zatz M. Phenotypic heterogeneity in amyotrophic lateral sclerosis type 8 and modifying mechanisms of neurodegeneration. Neural Regen Res 2021; 16:1776-1778. [PMID: 33510073 PMCID: PMC8328791 DOI: 10.4103/1673-5374.303030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Affiliation(s)
- Danyllo Oliveira
- Human Genome and Stem Cell Research Center, Department of Genetics and Evolutionary Biology, Institute of Biosciences, University of São Paulo, São Paulo, SP, Brazil
| | - Sergio Verjovski-Almeida
- Laboratório de Expressão Gênica em Eucariotos, Instituto Butantan; Departmento de Bioquímica, Instituto de Química, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Mayana Zatz
- Human Genome and Stem Cell Research Center, Department of Genetics and Evolutionary Biology, Institute of Biosciences, University of São Paulo, São Paulo, SP, Brazil
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37
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Morello G, Salomone S, D’Agata V, Conforti FL, Cavallaro S. From Multi-Omics Approaches to Precision Medicine in Amyotrophic Lateral Sclerosis. Front Neurosci 2020; 14:577755. [PMID: 33192262 PMCID: PMC7661549 DOI: 10.3389/fnins.2020.577755] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Accepted: 10/13/2020] [Indexed: 12/12/2022] Open
Abstract
Amyotrophic lateral sclerosis (ALS) is a devastating and fatal neurodegenerative disorder, caused by the degeneration of upper and lower motor neurons for which there is no truly effective cure. The lack of successful treatments can be well explained by the complex and heterogeneous nature of ALS, with patients displaying widely distinct clinical features and progression patterns, and distinct molecular mechanisms underlying the phenotypic heterogeneity. Thus, stratifying ALS patients into consistent and clinically relevant subgroups can be of great value for the development of new precision diagnostics and targeted therapeutics for ALS patients. In the last years, the use and integration of high-throughput "omics" approaches have dramatically changed our thinking about ALS, improving our understanding of the complex molecular architecture of ALS, distinguishing distinct patient subtypes and providing a rational foundation for the discovery of biomarkers and new individualized treatments. In this review, we discuss the most significant contributions of omics technologies in unraveling the biological heterogeneity of ALS, highlighting how these approaches are revealing diagnostic, prognostic and therapeutic targets for future personalized interventions.
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Affiliation(s)
- Giovanna Morello
- Institute for Research and Biomedical Innovation (IRIB), Italian National Research Council (CNR), Catania, Italy
- Section of Pharmacology, Department of Biomedical and Biotechnological Sciences, University of Catania, Catania, Italy
| | - Salvatore Salomone
- Section of Pharmacology, Department of Biomedical and Biotechnological Sciences, University of Catania, Catania, Italy
| | - Velia D’Agata
- Human Anatomy and Histology, University of Catania, Catania, Italy
| | | | - Sebastiano Cavallaro
- Institute for Research and Biomedical Innovation (IRIB), Italian National Research Council (CNR), Catania, Italy
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38
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Shatunov A, Al-Chalabi A. The genetic architecture of ALS. Neurobiol Dis 2020; 147:105156. [PMID: 33130222 DOI: 10.1016/j.nbd.2020.105156] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Revised: 10/27/2020] [Accepted: 10/27/2020] [Indexed: 12/12/2022] Open
Affiliation(s)
- Aleksey Shatunov
- Department of Basic & Clinical Neuroscience, Maurice Wohl Clinical Neuroscience Institute, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London SE5 9RX, UK
| | - Ammar Al-Chalabi
- Department of Basic & Clinical Neuroscience, Maurice Wohl Clinical Neuroscience Institute, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London SE5 9RX, UK; Department of Neurology, King's College Hospital, London SE5 9RS, UK.
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Abstract
PURPOSE OF REVIEW The current review will provide recent updates in the clinical management of amyotrophic lateral sclerosis (ALS). RECENT FINDINGS Although there is no cure for ALS, there are new treatments, growing knowledge of genetics, development of clinical staging systems, and the recent coronavirus disease 2019 pandemic that have recently impacted the clinical management of ALS. Increased understanding of genetics has helped provide insights into pathophysiology, the staging systems and clinical measures help to provide tools for monitoring disease clinically, and the recent coronavirus disease 2019 pandemic has provided opportunities to develop telemedicine and remote monitoring of disease thereby increasing accessibility to care and reducing burden of travel to centers for people living with the disease and their caregivers. SUMMARY ALS is a progressive neurodegenerative disease that causes degeneration of the motor neurons which leads to paralysis and respiratory failure. Despite the lack of a cure, multidisciplinary care, proactive respiratory management, nutritional care and management of symptoms as well as pharmacological interventions that can improve quality of life and survival.
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40
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Janse van Mantgem MR, van Eijk RPA, van der Burgh HK, Tan HHG, Westeneng HJ, van Es MA, Veldink JH, van den Berg LH. Prognostic value of weight loss in patients with amyotrophic lateral sclerosis: a population-based study. J Neurol Neurosurg Psychiatry 2020; 91:867-875. [PMID: 32576612 DOI: 10.1136/jnnp-2020-322909] [Citation(s) in RCA: 41] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Revised: 03/24/2020] [Accepted: 04/07/2020] [Indexed: 12/18/2022]
Abstract
OBJECTIVE To determine the prevalence and prognostic value of weight loss (WL) prior to diagnosis in patients with amyotrophic lateral sclerosis (ALS). METHODS We enrolled patients diagnosed with ALS between 2010 and 2018 in a population-based setting. At diagnosis, detailed information was obtained regarding the patient's disease characteristics, anthropological changes, ALS-related genotypes and cognitive functioning. Complete survival data were obtained. Cox proportional hazard models were used to assess the association between WL and the risk of death during follow-up. RESULTS The data set comprised 2420 patients of whom 67.5% reported WL at diagnosis. WL occurred in 71.8% of the bulbar-onset and in 64.2% of the spinal-onset patients; the mean loss of body weight was 6.9% (95% CI 6.8 to 6.9) and 5.5% (95% CI 5.5 to 5.6), respectively (p<0.001). WL occurred in 35.1% of the patients without any symptom of dysphagia. WL is a strong independent predictor of survival, with a dose response relationship between the amount of WL and the risk of death: the risk of death during follow-up increased by 23% for every 10% increase in WL relative to body weight (HR 1.23, 95% CI 1.13 to 1.51, p<0.001). CONCLUSIONS This population-based study shows that two-thirds of the patients with ALS have WL at diagnosis, which also occurs independent of dysphagia, and is related to survival. Our results suggest that WL is a multifactorial process that may differ from patient to patient. Gaining further insight in its underlying factors could prove essential for future therapeutic measures.
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Affiliation(s)
| | - Ruben P A van Eijk
- Neurology, University Medical Centre Utrecht Brain Centre, Utrecht, The Netherlands.,Biostatistics and Research Support, Julius Center for Health Sciences and Primary Care, Utrecht, The Netherlands
| | | | - Harold H G Tan
- Neurology, University Medical Centre Utrecht Brain Centre, Utrecht, The Netherlands
| | - Henk-Jan Westeneng
- Neurology, University Medical Centre Utrecht Brain Centre, Utrecht, The Netherlands
| | - Michael A van Es
- Neurology, University Medical Centre Utrecht Brain Centre, Utrecht, The Netherlands
| | - Jan H Veldink
- Neurology, University Medical Centre Utrecht Brain Centre, Utrecht, The Netherlands
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41
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Tan HHG, Westeneng HJ, van der Burgh HK, van Es MA, Bakker LA, van Veenhuijzen K, van Eijk KR, van Eijk RPA, Veldink JH, van den Berg LH. The Distinct Traits of the UNC13A Polymorphism in Amyotrophic Lateral Sclerosis. Ann Neurol 2020; 88:796-806. [PMID: 32627229 PMCID: PMC7540607 DOI: 10.1002/ana.25841] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Revised: 07/03/2020] [Accepted: 07/03/2020] [Indexed: 12/11/2022]
Abstract
Objective The rs12608932 single nucleotide polymorphism in UNC13A is associated with amyotrophic lateral sclerosis (ALS) and frontotemporal dementia (FTD) susceptibility, and may underlie differences in treatment response. We aimed to characterize the clinical, cognitive, behavioral, and neuroimaging phenotype of UNC13A in patients with ALS. Methods We included 2,216 patients with ALS without a C9orf72 mutation to identify clinical characteristics associated with the UNC13A polymorphism. A subcohort of 428 patients with ALS was used to study cognitive and behavioral profiles, and 375 patients to study neuroimaging characteristics. Associations were analyzed under an additive genetic model. Results Genotyping rs12608932 resulted in 854 A/A, 988 A/C, and 374 C/C genotypes. The C allele was associated with a higher age at symptom onset (median years A/A 63.5, A/C 65.6, and C/C 65.5; p < 0.001), more frequent bulbar onset (A/A 29.6%, A/C 31.8%, and C/C 43.1%; p < 0.001), higher incidences of ALS‐FTD (A/A 4.3%, A/C 5.2%, and C/C 9.5%; p = 0.003), lower forced vital capacity at diagnosis (median percentage A/A 92.0, A/C 90.0, and C/C 86.5; p < 0.001), and a shorter survival (median in months A/A 33.3, A.C 30.7, and C/C 26.6; p < 0.001). UNC13A was associated with lower scores on ALS‐specific cognition tests (means A/A 79.5, A/C 78.1, and C/C 76.6; p = 0.037), and more frequent behavioral disturbances (A/A 16.7%, A/C 24.4%, and C/C 27.7%; p = 0.045). Thinner left inferior temporal and right fusiform cortex were associated with the UNC13A single nucleotide polymorphism (SNP; p = 0.045 and p = 0.036). Interpretation Phenotypical distinctions associated with UNC13A make it an important factor to take into account in clinical trial design, studies on cognition and behavior, and prognostic counseling. ANN NEUROL 2020;88:796–806
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Affiliation(s)
- Harold H G Tan
- Department of Neurology, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Henk-Jan Westeneng
- Department of Neurology, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Hannelore K van der Burgh
- Department of Neurology, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Michael A van Es
- Department of Neurology, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Leonhard A Bakker
- Department of Neurology, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.,Center of Excellence for Rehabilitation Medicine, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht University and De Hoogstraat Rehabilitation, Utrecht, The Netherlands
| | - Kevin van Veenhuijzen
- Department of Neurology, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Kristel R van Eijk
- Department of Neurology, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Ruben P A van Eijk
- Department of Neurology, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.,Biostatistics and Research Support, Julius Centre for Health Sciences and Primary Care, University Medical Centre Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Jan H Veldink
- Department of Neurology, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Leonard H van den Berg
- Department of Neurology, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
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42
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Masrori P, Van Damme P. Amyotrophic lateral sclerosis: a clinical review. Eur J Neurol 2020; 27:1918-1929. [PMID: 32526057 PMCID: PMC7540334 DOI: 10.1111/ene.14393] [Citation(s) in RCA: 397] [Impact Index Per Article: 99.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2019] [Accepted: 06/04/2020] [Indexed: 12/13/2022]
Abstract
Amyotrophic lateral sclerosis (ALS) is a neurodegenerative disorder affecting primarily the motor system, but in which extra-motor manifestations are increasingly recognized. The loss of upper and lower motor neurons in the motor cortex, the brain stem nuclei and the anterior horn of the spinal cord gives rise to progressive muscle weakness and wasting. ALS often has a focal onset but subsequently spreads to different body regions, where failure of respiratory muscles typically limits survival to 2-5 years after disease onset. In up to 50% of cases, there are extra-motor manifestations such as changes in behaviour, executive dysfunction and language problems. In 10%-15% of patients, these problems are severe enough to meet the clinical criteria of frontotemporal dementia (FTD). In 10% of ALS patients, the family history suggests an autosomal dominant inheritance pattern. The remaining 90% have no affected family members and are classified as sporadic ALS. The causes of ALS appear to be heterogeneous and are only partially understood. To date, more than 20 genes have been associated with ALS. The most common genetic cause is a hexanucleotide repeat expansion in the C9orf72 gene, responsible for 30%-50% of familial ALS and 7% of sporadic ALS. These expansions are also a frequent cause of frontotemporal dementia, emphasizing the molecular overlap between ALS and FTD. To this day there is no cure or effective treatment for ALS and the cornerstone of treatment remains multidisciplinary care, including nutritional and respiratory support and symptom management. In this review, different aspects of ALS are discussed, including epidemiology, aetiology, pathogenesis, clinical features, differential diagnosis, investigations, treatment and future prospects.
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Affiliation(s)
- P Masrori
- Department of Neurosciences, Experimental Neurology, KU Leuven - University of Leuven, Leuven, Belgium.,Laboratory of Neurobiology, Center for Brain and Disease Research, VIB, Leuven, Belgium.,Department of Neurology, University Hospitals Leuven, Leuven, Belgium
| | - P Van Damme
- Department of Neurosciences, Experimental Neurology, KU Leuven - University of Leuven, Leuven, Belgium.,Laboratory of Neurobiology, Center for Brain and Disease Research, VIB, Leuven, Belgium.,Department of Neurology, University Hospitals Leuven, Leuven, Belgium
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43
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QTL Mapping of Intestinal Neutrophil Variation in Threespine Stickleback Reveals Possible Gene Targets Connecting Intestinal Inflammation and Systemic Health. G3-GENES GENOMES GENETICS 2020; 10:613-622. [PMID: 31843804 PMCID: PMC7003091 DOI: 10.1534/g3.119.400685] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Selection, via host immunity, is often required to foster beneficial microbial symbionts and suppress deleterious pathogens. In animals, the host immune system is at the center of this relationship. Failed host immune system-microbial interactions can result in a persistent inflammatory response in which the immune system indiscriminately attacks resident microbes, and at times the host cells themselves, leading to diseases such as Ulcerative Colitis, Crohn’s Disease, and Psoriasis. Host genetic variation has been linked to both microbiome diversity and to severity of such inflammatory disease states in humans. However, the microbiome and inflammatory states manifest as quantitative traits, which encompass many genes interacting with one another and the environment. The mechanistic relationships among all of these interacting components are still not clear. Developing natural genetic models of host-microbe interactions is therefore fundamental to understanding the complex genetics of these and other diseases. Threespine stickleback (Gasterosteus aculeatus) fish are a tractable model for attacking this problem because of abundant population-level genetic and phenotypic variation in the gut inflammatory response. Previous work in our laboratory identified genetically divergent stickleback populations exhibiting differences in intestinal neutrophil activity. We took advantage of this diversity to genetically map variation in an emblematic element of gut inflammation - intestinal neutrophil recruitment - using an F2-intercross mapping framework. We identified two regions of the genome associated with increased intestinal inflammation containing several promising candidate genes. Within these regions we found candidates in the Coagulation/Complement System, NFkB and MAPK pathways along with several genes associated with intestinal diseases and neurological diseases commonly accompanying intestinal inflammation as a secondary symptom. These findings highlight the utility of using naturally genetically diverse ‘evolutionary mutant models’ such as threespine stickleback to better understand interactions among host genetic diversity and microbiome variation in health and disease states.
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44
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Mejzini R, Flynn LL, Pitout IL, Fletcher S, Wilton SD, Akkari PA. ALS Genetics, Mechanisms, and Therapeutics: Where Are We Now? Front Neurosci 2019; 13:1310. [PMID: 31866818 PMCID: PMC6909825 DOI: 10.3389/fnins.2019.01310] [Citation(s) in RCA: 433] [Impact Index Per Article: 86.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2019] [Accepted: 11/22/2019] [Indexed: 12/11/2022] Open
Abstract
The scientific landscape surrounding amyotrophic lateral sclerosis (ALS) continues to shift as the number of genes associated with the disease risk and pathogenesis, and the cellular processes involved, continues to grow. Despite decades of intense research and over 50 potentially causative or disease-modifying genes identified, etiology remains unexplained and treatment options remain limited for the majority of ALS patients. Various factors have contributed to the slow progress in understanding and developing therapeutics for this disease. Here, we review the genetic basis of ALS, highlighting factors that have contributed to the elusiveness of genetic heritability. The most commonly mutated ALS-linked genes are reviewed with an emphasis on disease-causing mechanisms. The cellular processes involved in ALS pathogenesis are discussed, with evidence implicating their involvement in ALS summarized. Past and present therapeutic strategies and the benefits and limitations of the model systems available to ALS researchers are discussed with future directions for research that may lead to effective treatment strategies outlined.
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Affiliation(s)
- Rita Mejzini
- Centre for Molecular Medicine and Innovative Therapeutics, Murdoch University, Perth, WA, Australia
- The Perron Institute for Neurological and Translational Science, Perth, WA, Australia
| | - Loren L. Flynn
- Centre for Molecular Medicine and Innovative Therapeutics, Murdoch University, Perth, WA, Australia
- The Perron Institute for Neurological and Translational Science, Perth, WA, Australia
- Centre for Neuromuscular and Neurological Disorders, The University of Western Australia, Perth, WA, Australia
| | - Ianthe L. Pitout
- Centre for Molecular Medicine and Innovative Therapeutics, Murdoch University, Perth, WA, Australia
- The Perron Institute for Neurological and Translational Science, Perth, WA, Australia
- Centre for Neuromuscular and Neurological Disorders, The University of Western Australia, Perth, WA, Australia
| | - Sue Fletcher
- Centre for Molecular Medicine and Innovative Therapeutics, Murdoch University, Perth, WA, Australia
- The Perron Institute for Neurological and Translational Science, Perth, WA, Australia
- Centre for Neuromuscular and Neurological Disorders, The University of Western Australia, Perth, WA, Australia
| | - Steve D. Wilton
- Centre for Molecular Medicine and Innovative Therapeutics, Murdoch University, Perth, WA, Australia
- The Perron Institute for Neurological and Translational Science, Perth, WA, Australia
- Centre for Neuromuscular and Neurological Disorders, The University of Western Australia, Perth, WA, Australia
| | - P. Anthony Akkari
- Centre for Molecular Medicine and Innovative Therapeutics, Murdoch University, Perth, WA, Australia
- The Perron Institute for Neurological and Translational Science, Perth, WA, Australia
- Centre for Neuromuscular and Neurological Disorders, The University of Western Australia, Perth, WA, Australia
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45
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Li X, Qiu S, Shi J, Wang S, Wang M, Xu Y, Nie Z, Liu C, Liu C. A new function of copper zinc superoxide dismutase: as a regulatory DNA-binding protein in gene expression in response to intracellular hydrogen peroxide. Nucleic Acids Res 2019; 47:5074-5085. [PMID: 31162603 PMCID: PMC6547762 DOI: 10.1093/nar/gkz256] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2018] [Revised: 03/28/2019] [Accepted: 03/31/2019] [Indexed: 12/13/2022] Open
Abstract
In microorganisms, a number of metalloproteins including PerR are found to regulate gene expression in response to environmental reactive oxygen species (ROS) changes. However, discovery of similar regulatory mechanisms remains elusive within mammalian cells. As an antioxidant metalloenzyme that maintains intracellular ROS homeostasis, copper zinc superoxide dismutase (SOD1) has high affinity for DNA in solution and in cells. Here, we explored the regulatory roles of SOD1 in the expression of genes in response to ROS changes within mammalian cells. SOD1-occupied DNA sites with distinct sequence preference were identified. Changing ROS levels both were found to impact DNA–SOD1 interactions in solution and within HeLa cells. GGA was one of the base triplets that had direct contact with SOD1. DNA–SOD1 interactions were observed to regulate the ROS-responsive expression of functional genes including oncogenes and amyotrophic lateral sclerosis-linked genes in transcriptional phases. Our results confirm another function of SOD1, acting as a H2O2-responsive regulatory protein in the expression of numerous mammalian genes.
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Affiliation(s)
- Xiang Li
- Key Laboratory of Pesticide and Chemical Biology of Ministry of Education, International Joint Research Center for Intelligent Biosensing Technology and Health, School of Chemistry, Central China Normal University, Wuhan 430079, Hubei, PR China
| | - Shuang Qiu
- Key Laboratory of Pesticide and Chemical Biology of Ministry of Education, International Joint Research Center for Intelligent Biosensing Technology and Health, School of Chemistry, Central China Normal University, Wuhan 430079, Hubei, PR China
| | - Jiayuan Shi
- Key Laboratory of Pesticide and Chemical Biology of Ministry of Education, International Joint Research Center for Intelligent Biosensing Technology and Health, School of Chemistry, Central China Normal University, Wuhan 430079, Hubei, PR China
| | - Shanshan Wang
- Key Laboratory of Pesticide and Chemical Biology of Ministry of Education, International Joint Research Center for Intelligent Biosensing Technology and Health, School of Chemistry, Central China Normal University, Wuhan 430079, Hubei, PR China
| | - Mingfang Wang
- Key Laboratory of Pesticide and Chemical Biology of Ministry of Education, International Joint Research Center for Intelligent Biosensing Technology and Health, School of Chemistry, Central China Normal University, Wuhan 430079, Hubei, PR China
| | - Yulin Xu
- Key Laboratory of Pesticide and Chemical Biology of Ministry of Education, International Joint Research Center for Intelligent Biosensing Technology and Health, School of Chemistry, Central China Normal University, Wuhan 430079, Hubei, PR China
| | - Zefeng Nie
- Key Laboratory of Pesticide and Chemical Biology of Ministry of Education, International Joint Research Center for Intelligent Biosensing Technology and Health, School of Chemistry, Central China Normal University, Wuhan 430079, Hubei, PR China
| | - Chunrong Liu
- Key Laboratory of Pesticide and Chemical Biology of Ministry of Education, International Joint Research Center for Intelligent Biosensing Technology and Health, School of Chemistry, Central China Normal University, Wuhan 430079, Hubei, PR China
| | - Changlin Liu
- Key Laboratory of Pesticide and Chemical Biology of Ministry of Education, International Joint Research Center for Intelligent Biosensing Technology and Health, School of Chemistry, Central China Normal University, Wuhan 430079, Hubei, PR China
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46
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Limanaqi F, Biagioni F, Ryskalin L, Busceti CL, Fornai F. Molecular Mechanisms Linking ALS/FTD and Psychiatric Disorders, the Potential Effects of Lithium. Front Cell Neurosci 2019; 13:450. [PMID: 31680867 PMCID: PMC6797817 DOI: 10.3389/fncel.2019.00450] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2019] [Accepted: 09/20/2019] [Indexed: 12/12/2022] Open
Abstract
Altered proteostasis, endoplasmic reticulum (ER) stress, abnormal unfolded protein response (UPR), mitochondrial dysfunction and autophagy impairment are interconnected events, which contribute to the pathogenesis of amyotrophic lateral sclerosis (ALS)/frontotemporal dementia (FTD). In recent years, the mood stabilizer lithium was shown to potentially modify ALS/FTD beyond mood disorder-related pathology. The effects of lithium are significant in ALS patients carrying genetic variations in the UNC13 presynaptic protein, which occur in ALS/FTD and psychiatric disorders as well. In the brain, lithium modulates a number of biochemical pathways involved in synaptic plasticity, proteostasis, and neuronal survival. By targeting UPR-related events, namely ER stress, excitotoxicity and autophagy dysfunction, lithium produces plastic effects. These are likely to relate to neuroprotection, which was postulated for mood and motor neuron disorders. In the present manuscript, we try to identify and discuss potential mechanisms through which lithium copes concomitantly with ER stress, UPR and autophagy dysfunctions related to UNC13 synaptic alterations and aberrant RNA and protein processing. This may serve as a paradigm to provide novel insights into the neurobiology of ALS/FTD featuring early psychiatric disturbances.
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Affiliation(s)
- Fiona Limanaqi
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
| | | | - Larisa Ryskalin
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
| | | | - Francesco Fornai
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy.,IRCCS Neuromed, Pozzilli, Italy
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47
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Ragagnin AMG, Shadfar S, Vidal M, Jamali MS, Atkin JD. Motor Neuron Susceptibility in ALS/FTD. Front Neurosci 2019; 13:532. [PMID: 31316328 PMCID: PMC6610326 DOI: 10.3389/fnins.2019.00532] [Citation(s) in RCA: 119] [Impact Index Per Article: 23.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2019] [Accepted: 05/08/2019] [Indexed: 12/11/2022] Open
Abstract
Amyotrophic lateral sclerosis (ALS) is a neurodegenerative disease characterized by the death of both upper and lower motor neurons (MNs) in the brain, brainstem and spinal cord. The neurodegenerative mechanisms leading to MN loss in ALS are not fully understood. Importantly, the reasons why MNs are specifically targeted in this disorder are unclear, when the proteins associated genetically or pathologically with ALS are expressed ubiquitously. Furthermore, MNs themselves are not affected equally; specific MNs subpopulations are more susceptible than others in both animal models and human patients. Corticospinal MNs and lower somatic MNs, which innervate voluntary muscles, degenerate more readily than specific subgroups of lower MNs, which remain resistant to degeneration, reflecting the clinical manifestations of ALS. In this review, we discuss the possible factors intrinsic to MNs that render them uniquely susceptible to neurodegeneration in ALS. We also speculate why some MN subpopulations are more vulnerable than others, focusing on both their molecular and physiological properties. Finally, we review the anatomical network and neuronal microenvironment as determinants of MN subtype vulnerability and hence the progression of ALS.
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Affiliation(s)
- Audrey M G Ragagnin
- Centre for Motor Neuron Disease Research, Department of Biomedical Sciences, Faculty of Medicine and Health Sciences, Macquarie University, Sydney, NSW, Australia
| | - Sina Shadfar
- Centre for Motor Neuron Disease Research, Department of Biomedical Sciences, Faculty of Medicine and Health Sciences, Macquarie University, Sydney, NSW, Australia
| | - Marta Vidal
- Centre for Motor Neuron Disease Research, Department of Biomedical Sciences, Faculty of Medicine and Health Sciences, Macquarie University, Sydney, NSW, Australia
| | - Md Shafi Jamali
- Centre for Motor Neuron Disease Research, Department of Biomedical Sciences, Faculty of Medicine and Health Sciences, Macquarie University, Sydney, NSW, Australia
| | - Julie D Atkin
- Centre for Motor Neuron Disease Research, Department of Biomedical Sciences, Faculty of Medicine and Health Sciences, Macquarie University, Sydney, NSW, Australia.,Department of Biochemistry and Genetics, La Trobe Institute for Molecular Science, La Trobe University, Melbourne, VIC, Australia
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48
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Blanco FA, Czikora A, Kedei N, You Y, Mitchell GA, Pany S, Ghosh A, Blumberg PM, Das J. Munc13 Is a Molecular Target of Bryostatin 1. Biochemistry 2019; 58:3016-3030. [PMID: 31243993 PMCID: PMC6620733 DOI: 10.1021/acs.biochem.9b00427] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
![]()
Bryostatin
1 is a natural macrolide shown to improve neuronal connections and
enhance memory in mice. Its mechanism of action is largely attributed
to the modulation of novel and conventional protein kinase Cs (PKCs)
by binding to their regulatory C1 domains. Munc13-1 is a C1 domain-containing
protein that shares common endogenous and exogenous activators with
novel and conventional PKC subtypes. Given the essential role of Munc13-1
in the priming of synaptic vesicles and neuronal transmission overall,
we explored the potential interaction between bryostatin 1 and Munc13-1.
Our results indicate that in vitro bryostatin 1 binds
to both the isolated C1 domain of Munc13-1 (Ki = 8.07 ± 0.90 nM) and the full-length Munc13-1 protein
(Ki = 0.45 ± 0.04 nM). Furthermore,
confocal microscopy and immunoblot analysis demonstrated that in intact
HT22 cells bryostatin 1 mimics the actions of phorbol esters, a previously
established class of Munc13-1 activators, and induces plasma membrane
translocation of Munc13-1, a hallmark of its activation. Consistently,
bryostatin 1 had no effect on the Munc13-1H567K construct
that is insensitive to phorbol esters. Effects of bryostatin 1 on
the other Munc13 family members, ubMunc13-2 and bMunc13-2, resembled
those of Munc13-1 for translocation. Lastly, we observed an increased
level of expression of Munc13-1 following a 24 h incubation with bryostatin
1 in both HT22 and primary mouse hippocampal cells. This study characterizes
Munc13-1 as a molecular target of bryostatin 1. Considering the crucial
role of Munc13-1 in neuronal function, these findings provide strong
support for the potential role of Munc13s in the actions of bryostatin
1.
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Affiliation(s)
- Francisco A Blanco
- Department of Pharmacological & Pharmaceutical Sciences, College of Pharmacy , University of Houston , Houston , Texas 77204 , United States
| | - Agnes Czikora
- Laboratory of Cancer Biology and Genetics, Center for Cancer Research, National Cancer Institute , National Institutes of Health , Bethesda , Maryland 20892 , United States
| | - Noemi Kedei
- Laboratory of Cancer Biology and Genetics, Center for Cancer Research, National Cancer Institute , National Institutes of Health , Bethesda , Maryland 20892 , United States
| | - Youngki You
- Department of Pharmacological & Pharmaceutical Sciences, College of Pharmacy , University of Houston , Houston , Texas 77204 , United States
| | - Gary A Mitchell
- Laboratory of Cancer Biology and Genetics, Center for Cancer Research, National Cancer Institute , National Institutes of Health , Bethesda , Maryland 20892 , United States
| | - Satyabrata Pany
- Department of Pharmacological & Pharmaceutical Sciences, College of Pharmacy , University of Houston , Houston , Texas 77204 , United States
| | - Anamitra Ghosh
- Department of Pharmacological & Pharmaceutical Sciences, College of Pharmacy , University of Houston , Houston , Texas 77204 , United States
| | - Peter M Blumberg
- Laboratory of Cancer Biology and Genetics, Center for Cancer Research, National Cancer Institute , National Institutes of Health , Bethesda , Maryland 20892 , United States
| | - Joydip Das
- Department of Pharmacological & Pharmaceutical Sciences, College of Pharmacy , University of Houston , Houston , Texas 77204 , United States
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49
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Yang B, Jiang H, Wang F, Li S, Wu C, Bao J, Zhu Y, Xu Z, Liu B, Ren H, Yang X. UNC13A variant rs12608932 is associated with increased risk of amyotrophic lateral sclerosis and reduced patient survival: a meta-analysis. Neurol Sci 2019; 40:2293-2302. [PMID: 31201598 DOI: 10.1007/s10072-019-03951-y] [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: 03/26/2019] [Accepted: 05/24/2019] [Indexed: 02/07/2023]
Abstract
BACKGROUND Amyotrophic lateral sclerosis (ALS) is a neurodegenerative disease associated with both genetic and environmental risk factors. Previous studies trying to find an association between ALS and unc-13 homolog A (UNC13A) gene variants have shown inconsistent results. This study aimed to conduct a meta-analysis of the association between the C allele of rs12608932, a single-nucleotide polymorphism located in an intron of UNC13A, and risk of ALS and patient survival. METHODS PubMed, Web of Science, Embase, Chinese National Knowledge Infrastructure, Wanfang, and SinoMed databases were systematically searched for genome-wide association studies or case-control studies published up to January 2019 on the association between this variant in UNC13A and risk and/or prognosis of ALS. Data from eligible studies were extracted and analyzed. RESULTS The pooled data (28,072 patients with sporadic ALS and 56,545 controls) showed that rs12608932(C) was associated with an increased risk of ALS (OR = 1.13, 95%CI 1.07-1.20). Subgroup analysis revealed that rs12608932(C) increased the risk of sporadic ALS in non-Asian individuals, including those from the USA and Europe (OR 1.17, 95%CI 1.10-1.25, P < 0.000), but not in Japanese or Chinese subjects (OR 1.01, 95%CI 0.92-1.10, P = 0.85). The available data demonstrated that the CC genotype decreased the survival time of patients with ALS (OR 1.33, 95%CI 1.19-1.49, P < 0.001). CONCLUSION The present meta-analysis suggests that rs12608932(C) is associated with increased ALS susceptibility, especially in Caucasian and European subjects, and that the CC genotype of rs12608932 is associated with reduced ALS patient survival.
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Affiliation(s)
- Baiyuan Yang
- Department of Neurology, Seventh People's Hospital of Chengdu, Chengdu, 690041, Sichuan Province, People's Republic of China
| | - Haixia Jiang
- Department of Anesthesia, First Affiliated Hospital of Kunming Medical University, Kunming, 650032, Yunnan Province, People's Republic of China
| | - Fang Wang
- Department of Geriatric Neurology, First Affiliated Hospital of Kunming Medical University, Kunming, 650032, Yunnan Province, People's Republic of China
| | - Shimei Li
- Department of Anesthesia, Kunming Xishan District People's Hospital, Kunming, 650100, Yunnan Province, People's Republic of China
| | - Chongmin Wu
- Department of Geriatric Neurology, First Affiliated Hospital of Kunming Medical University, Kunming, 650032, Yunnan Province, People's Republic of China
| | - Jianjian Bao
- Department of Geriatric Neurology, First Affiliated Hospital of Kunming Medical University, Kunming, 650032, Yunnan Province, People's Republic of China
| | - Yongyun Zhu
- Department of Geriatric Neurology, First Affiliated Hospital of Kunming Medical University, Kunming, 650032, Yunnan Province, People's Republic of China
| | - Zhong Xu
- Department of Geriatric Neurology, First Affiliated Hospital of Kunming Medical University, Kunming, 650032, Yunnan Province, People's Republic of China
| | - Bin Liu
- Department of Geriatric Neurology, First Affiliated Hospital of Kunming Medical University, Kunming, 650032, Yunnan Province, People's Republic of China
| | - Hui Ren
- Department of Geriatric Neurology, First Affiliated Hospital of Kunming Medical University, Kunming, 650032, Yunnan Province, People's Republic of China
| | - Xinglong Yang
- Department of Geriatric Neurology, First Affiliated Hospital of Kunming Medical University, Kunming, 650032, Yunnan Province, People's Republic of China.
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50
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Pampalakis G, Mitropoulos K, Xiromerisiou G, Dardiotis E, Deretzi G, Anagnostouli M, Katsila T, Rentzos M, Patrinos GP. New molecular diagnostic trends and biomarkers for amyotrophic lateral sclerosis. Hum Mutat 2019; 40:361-373. [DOI: 10.1002/humu.23697] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2018] [Revised: 12/11/2018] [Accepted: 12/13/2018] [Indexed: 12/11/2022]
Affiliation(s)
- Georgios Pampalakis
- Department of PharmacyAristotle University of Thessaloniki Thessaloniki Greece
| | | | | | | | | | - Maria Anagnostouli
- University of Athens School of MedicineAiginition Hospital Athens Greece
| | - Theodora Katsila
- Department of PharmacySchool of Health SciencesUniversity of Patras Patras Greece
| | - Michail Rentzos
- University of Athens School of MedicineAiginition Hospital Athens Greece
| | - George P. Patrinos
- Department of PharmacySchool of Health SciencesUniversity of Patras Patras Greece
- Department of PharmacyCollege of Medicine and Health SciencesUnited Arab Emirates University Al Ain UAE
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