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Veneri FA, Prada V, Mastrangelo R, Ferri C, Nobbio L, Passalacqua M, Milanesi M, Bianchi F, Del Carro U, Vallat JM, Duong P, Svaren J, Schenone A, Grandis M, D’Antonio M. A novel mouse model of CMT1B identifies hyperglycosylation as a new pathogenetic mechanism. Hum Mol Genet 2022; 31:4255-4274. [PMID: 35908287 PMCID: PMC9759335 DOI: 10.1093/hmg/ddac170] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Revised: 07/19/2022] [Accepted: 07/20/2022] [Indexed: 01/21/2023] Open
Abstract
Mutations in the Myelin Protein Zero gene (MPZ), encoding P0, the major structural glycoprotein of peripheral nerve myelin, are the cause of Charcot-Marie-Tooth (CMT) type 1B neuropathy, and most P0 mutations appear to act through gain-of-function mechanisms. Here, we investigated how misglycosylation, a pathomechanism encompassing several genetic disorders, may affect P0 function. Using in vitro assays, we showed that gain of glycosylation is more damaging for P0 trafficking and functionality as compared with a loss of glycosylation. Hence, we generated, via CRISPR/Cas9, a mouse model carrying the MPZD61N mutation, predicted to generate a new N-glycosylation site in P0. In humans, MPZD61N causes a severe early-onset form of CMT1B, suggesting that hyperglycosylation may interfere with myelin formation, leading to pathology. We show here that MPZD61N/+ mice develop a tremor as early as P15 which worsens with age and correlates with a significant motor impairment, reduced muscular strength and substantial alterations in neurophysiology. The pathological analysis confirmed a dysmyelinating phenotype characterized by diffuse hypomyelination and focal hypermyelination. We find that the mutant P0D61N does not cause significant endoplasmic reticulum stress, a common pathomechanism in CMT1B, but is properly trafficked to myelin where it causes myelin uncompaction. Finally, we show that myelinating dorsal root ganglia cultures from MPZD61N mice replicate some of the abnormalities seen in vivo, suggesting that they may represent a valuable tool to investigate therapeutic approaches. Collectively, our data indicate that the MPZD61N/+ mouse represents an authentic model of severe CMT1B affirming gain-of-glycosylation in P0 as a novel pathomechanism of disease.
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Affiliation(s)
- Francesca A Veneri
- Biology of Myelin Unit, Division of Genetics and Cell Biology, IRCCS Ospedale San Raffaele, 20132 Milan, Italy,Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genova, IRCCS AOU San Martino-IST, 16132 Genova, Italy
| | - Valeria Prada
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genova, IRCCS AOU San Martino-IST, 16132 Genova, Italy
| | - Rosa Mastrangelo
- Biology of Myelin Unit, Division of Genetics and Cell Biology, IRCCS Ospedale San Raffaele, 20132 Milan, Italy
| | - Cinzia Ferri
- Biology of Myelin Unit, Division of Genetics and Cell Biology, IRCCS Ospedale San Raffaele, 20132 Milan, Italy
| | - Lucilla Nobbio
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genova, IRCCS AOU San Martino-IST, 16132 Genova, Italy
| | - Mario Passalacqua
- Department of Experimental Medicine, University of Genova, 16132 Genova, Italy
| | - Maria Milanesi
- Experimental Oncology and Immunology, Department of Molecular and Translational Medicine, University of Brescia, 25123 Brescia, Italy
| | - Francesca Bianchi
- Movement Disorders Unit, Division of Neuroscience, IRCCS Ospedale San Raffaele, 20132 Milan, Italy
| | - Ubaldo Del Carro
- Movement Disorders Unit, Division of Neuroscience, IRCCS Ospedale San Raffaele, 20132 Milan, Italy
| | - Jean-Michel Vallat
- Department and Laboratory of Neurology, National Reference Center for ‘Rare Peripheral Neuropathies’, University Hospital of Limoges (CHU Limoges), Dupuytren Hospital, 87000 Limoges, France
| | - Phu Duong
- Department of Comparative Biosciences, School of Veterinary Medicine, University of Wisconsin–Madison, Madison, WI 53706, USA
| | - John Svaren
- Department of Comparative Biosciences, School of Veterinary Medicine, University of Wisconsin–Madison, Madison, WI 53706, USA
| | - Angelo Schenone
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genova, IRCCS AOU San Martino-IST, 16132 Genova, Italy,Department of Neurology, IRCCS Ospedale Policlinico San Martino, 16132 Genova, Italy
| | - Marina Grandis
- To whom correspondence should be addressed at: Department of Neurology, IRCCS Ospedale Policlinico San Martino, Largo Daneo 3, 16132 Genova, Italy. Tel: +39 010 3537562; (M.G.); San Raffaele Scientific Institute, DIBIT, via Olgettina 58, 20132 Milan, Italy. Tel: +39 02 26435307; (M.D.)
| | - Maurizio D’Antonio
- To whom correspondence should be addressed at: Department of Neurology, IRCCS Ospedale Policlinico San Martino, Largo Daneo 3, 16132 Genova, Italy. Tel: +39 010 3537562; (M.G.); San Raffaele Scientific Institute, DIBIT, via Olgettina 58, 20132 Milan, Italy. Tel: +39 02 26435307; (M.D.)
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2
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Chen B, Zhang Z, Chen N, Li W, Pan H, Wang X, Ren Y, Shi Y, Tai H, Niu S. Two Novel Myelin Protein Zero Mutations in a Group of Chinese Patients. Front Neurol 2021; 12:734515. [PMID: 34925207 PMCID: PMC8674198 DOI: 10.3389/fneur.2021.734515] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Accepted: 11/01/2021] [Indexed: 11/13/2022] Open
Abstract
Mutations in the myelin protein zero gene are responsible for the autosomal dominant Charcot-Marie-Tooth disease (CMT). We summarized the genetic and clinical features of six unrelated Chinese families and the genetic spectrum of Chinese patients with myelin protein zero (MPZ) mutations. Our study reports data from a group of Chinese patients consisting of five males and one female with the age of disease onset ranging from 16 to 55 years. The initial symptom in all the patients was the weakness of the lower limbs. Electrophysiological presentations suggested chronic progressive sensorimotor demyelinating polyneuropathy. Overall six mutations were identified in the cohort, including four known mutations [c.103G>T (p.D35Y), c.233C>T (p.S78L), c.293G>A (p.R98H), and c.449-1G>T], and two novel mutations [c.67+4A>G with a mild CMT1B phenotype, and (c.79delG) p.A27fs with a rapidly progressive CMT1B phenotype]. According to the literature review, there are 35 Chinese families with 28 different MPZ mutations. The MPZ mutational spectrum in Chinese patients is very heterogeneous and differs from that of Japanese and Korean individuals, although they do share several common hot spot mutations.
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Affiliation(s)
- Bin Chen
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.,China National Clinical Research Center for Neurological Diseases, Beijing, China
| | - Zaiqiang Zhang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.,China National Clinical Research Center for Neurological Diseases, Beijing, China
| | - Na Chen
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.,China National Clinical Research Center for Neurological Diseases, Beijing, China
| | - Wei Li
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.,China National Clinical Research Center for Neurological Diseases, Beijing, China.,Monogenic Disease Diagnosis Center for Neurological Disorders, Precision Medicine Research Center for Neurological Disorders, Beijing, China
| | - Hua Pan
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.,China National Clinical Research Center for Neurological Diseases, Beijing, China
| | - Xingao Wang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.,China National Clinical Research Center for Neurological Diseases, Beijing, China
| | - Yuting Ren
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.,China National Clinical Research Center for Neurological Diseases, Beijing, China
| | - Yuzhi Shi
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.,China National Clinical Research Center for Neurological Diseases, Beijing, China
| | - Hongfei Tai
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.,China National Clinical Research Center for Neurological Diseases, Beijing, China
| | - Songtao Niu
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.,China National Clinical Research Center for Neurological Diseases, Beijing, China
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CNTNAP1 Mutations and Their Clinical Presentations: New Case Report and Systematic Review. Case Rep Med 2020; 2020:8795607. [PMID: 32328110 PMCID: PMC7174947 DOI: 10.1155/2020/8795607] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2019] [Revised: 03/23/2020] [Accepted: 03/27/2020] [Indexed: 01/11/2023] Open
Abstract
Lethal congenital contracture syndrome type 7 (LCCS7) and congenital hypomyelinating neuropathy type 3 (CHN3) are rare autosomal recessive diseases, characterized by severe neonatal hypotonia, polyhydramnios, arthrogryposis, facial diplegia, and severe motor paralysis, leading to death in early infancy. They are related to mutations in the CNTNAP1 (contactin associated protein 1) gene, playing an important role in myelination. Recent studies have shown that both diseases could present with a wide phenotypic spectrum, with promising survival up to early childhood. We report on a 7-year-old boy from a nonconsanguineous Lebanese family presenting with neonatal hypotonia, respiratory distress, and arthrogryposis. Molecular analysis revealed the presence of a pathogenic variant in the CNTNAP1 gene leading to a premature stop codon: NM_003632.2:c.3361C>T p.(Arg1121∗). A review of the literature is discussed.
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Conant A, Curiel J, Pizzino A, Sabetrasekh P, Murphy J, Bloom M, Evans SH, Helman G, Taft RJ, Simons C, Whitehead MT, Moore SA, Vanderver A. Absence of Axoglial Paranodal Junctions in a Child With CNTNAP1 Mutations, Hypomyelination, and Arthrogryposis. J Child Neurol 2018; 33:642-650. [PMID: 29882456 PMCID: PMC6800098 DOI: 10.1177/0883073818776157] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Leukodystrophies and genetic leukoencephalopathies are a heterogeneous group of heritable disorders that affect the glial-axonal unit. As more patients with unsolved leukodystrophies and genetic leukoencephalopathies undergo next generation sequencing, causative mutations in genes leading to central hypomyelination are being identified. Two such individuals presented with arthrogryposis multiplex congenita, congenital hypomyelinating neuropathy, and central hypomyelination with early respiratory failure. Whole exome sequencing identified biallelic mutations in the CNTNAP1 gene: homozygous c.1163G>C (p.Arg388Pro) and compound heterozygous c.967T>C (p.Cys323Arg) and c.319C>T (p.Arg107*). Sural nerve and quadriceps muscle biopsies demonstrated progressive, severe onion bulb and axonal pathology. By ultrastructural evaluation, septate axoglial paranodal junctions were absent from nodes of Ranvier. Serial brain magnetic resonance images revealed hypomyelination, progressive atrophy, and reduced diffusion in the globus pallidus in both patients. These 2 families illustrate severe progressive peripheral demyelinating neuropathy due to the absence of septate paranodal junctions and central hypomyelination with neurodegeneration in CNTNAP1-associated arthrogryposis multiplex congenita.
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Affiliation(s)
- Alexander Conant
- 1 Department of Neurology, Children's National Health System, Washington, DC, USA
| | - Julian Curiel
- 2 Department of Neurology, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Amy Pizzino
- 1 Department of Neurology, Children's National Health System, Washington, DC, USA
| | - Parisa Sabetrasekh
- 1 Department of Neurology, Children's National Health System, Washington, DC, USA
| | - Jennifer Murphy
- 3 National Human Genome Research Institute, National Institutes of Health, Bethesda, MD, USA
| | - Miriam Bloom
- 4 Department of Pediatric Hospitalist Medicine, Children's National Health System, Washington, DC, USA
| | - Sarah H Evans
- 5 Department of Physical Medicine and Rehabilitation, Children's National Health System, Washington, DC, USA
| | - Guy Helman
- 1 Department of Neurology, Children's National Health System, Washington, DC, USA.,6 Center for Genetic Medicine, Children's National Health System, Washington DC, USA.,7 Murdoch Children's Research Institute, Parkville, Melbourne, Australia
| | - Ryan J Taft
- 8 Illumina, San Diego, CA, USA.,9 Institute for Molecular Bioscience, University of Queensland, St. Lucia, Queensland, Australia
| | - Cas Simons
- 7 Murdoch Children's Research Institute, Parkville, Melbourne, Australia.,9 Institute for Molecular Bioscience, University of Queensland, St. Lucia, Queensland, Australia
| | - Matthew T Whitehead
- 10 Neuroradiology Department, Children's National Health System, Washington, DC, USA.,11 George Washington University School of Medicine, Washington, DC, USA
| | - Steven A Moore
- 12 Department of Pathology, University of Iowa Carver College of Medicine and Paul D. Wellstone Muscular Dystrophy Cooperative Research Center, Iowa City, IA, USA
| | - Adeline Vanderver
- 1 Department of Neurology, Children's National Health System, Washington, DC, USA.,2 Department of Neurology, Children's Hospital of Philadelphia, Philadelphia, PA, USA.,3 National Human Genome Research Institute, National Institutes of Health, Bethesda, MD, USA.,11 George Washington University School of Medicine, Washington, DC, USA
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Low KJ, Stals K, Caswell R, Wakeling M, Clayton-Smith J, Donaldson A, Foulds N, Norman A, Splitt M, Urankar K, Vijayakumar K, Majumdar A, Study D, Ellard S, Smithson SF. Phenotype of CNTNAP1: a study of patients demonstrating a specific severe congenital hypomyelinating neuropathy with survival beyond infancy. Eur J Hum Genet 2018; 26:796-807. [PMID: 29511323 PMCID: PMC5974240 DOI: 10.1038/s41431-018-0110-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2017] [Revised: 01/10/2018] [Accepted: 01/16/2018] [Indexed: 11/18/2022] Open
Abstract
CHN is genetically heterogeneous and its genetic basis is difficult to determine on features alone. CNTNAP1 encodes CASPR, integral in the paranodal junction high molecular mass complex. Nineteen individuals with biallelic variants have been described in association with severe congenital hypomyelinating neuropathy, respiratory compromise, profound intellectual disability and death within the first year. We report 7 additional patients ascertained through exome sequencing. We identified 9 novel CNTNAP1 variants in 6 families: three missense variants, four nonsense variants, one frameshift variant and one splice site variant. Significant polyhydramnios occurred in 6/7 pregnancies. Severe respiratory compromise was seen in 6/7 (tracheostomy in 5). A complex neurological phenotype was seen in all patients who had marked brain hypomyelination/demyelination and profound developmental delay. Additional neurological findings included cranial nerve compromise: orobulbar dysfunction in 5/7, facial nerve weakness in 4/7 and vocal cord paresis in 5/7. Dystonia occurred in 2/7 patients and limb contractures in 5/7. All had severe gastroesophageal reflux, and a gastrostomy was required in 5/7. In contrast to most previous reports, only one patient died in the first year of life. Protein modelling was performed for all detected CNTNAP1 variants. We propose a genotype-phenotype correlation, whereby hypomorphic missense variants partially ameliorate the phenotype, prolonging survival. This study suggests that biallelic variants in CNTNAP1 cause a distinct recognisable syndrome, which is not caused by other genes associated with CHN. Neonates presenting with this phenotype will benefit from early genetic definition to inform clinical management and enable essential genetic counselling for their families.
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Affiliation(s)
- K J Low
- Department of Clinical Genetics, St Michaels Hospital, Bristol, UK
- School of Clinical Sciences, University of Bristol, Bristol, UK
| | - K Stals
- Department of Molecular Genetics, Royal Devon & Exeter NHS Foundation Trust, Exeter, UK
| | - R Caswell
- Institute for Biomedical and Clinical Science, University of Exeter Medical School, Exeter, UK
| | - M Wakeling
- Institute for Biomedical and Clinical Science, University of Exeter Medical School, Exeter, UK
| | - J Clayton-Smith
- Manchester Centre for Genomic Medicine, St Marys' Hospital, Manchester, UK
- Institute of Human Development, University of Manchester, Manchester, UK
| | - A Donaldson
- Department of Clinical Genetics, St Michaels Hospital, Bristol, UK
| | - N Foulds
- Wessex Clinical Genetics Service, Southampton, UK
| | - A Norman
- Department of Clinical Genetics, St Michaels Hospital, Bristol, UK
| | - M Splitt
- Northern Genetics Service, Institute of Genetics Medicine, Newcastle upon Tyne, UK
| | - K Urankar
- Department of Neuropathology, North Bristol NHS Trust, Bristol, UK
| | - K Vijayakumar
- Paediatric Neuromuscular Service, Bristol Royal Hospital for Children, Bristol, UK
| | - A Majumdar
- Paediatric Neuromuscular Service, Bristol Royal Hospital for Children, Bristol, UK
| | - Ddd Study
- Wellcome Trust Sanger Institute, Cambridge, UK
| | - S Ellard
- Department of Molecular Genetics, Royal Devon & Exeter NHS Foundation Trust, Exeter, UK
- Institute for Biomedical and Clinical Science, University of Exeter Medical School, Exeter, UK
| | - S F Smithson
- Department of Clinical Genetics, St Michaels Hospital, Bristol, UK.
- School of Clinical Sciences, University of Bristol, Bristol, UK.
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Mehta P, Küspert M, Bale T, Brownstein CA, Towne MC, De Girolami U, Shi J, Beggs AH, Darras BT, Wegner M, Piao X, Agrawal PB. Novel mutation in CNTNAP1 results in congenital hypomyelinating neuropathy. Muscle Nerve 2017; 55:761-765. [PMID: 27668699 DOI: 10.1002/mus.25416] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/23/2016] [Indexed: 01/29/2023]
Abstract
INTRODUCTION Congenital hypomyelinating neuropathy (CHN) is a rare congenital neuropathy that presents in the neonatal period and has been linked previously to mutations in several genes associated with myelination. A recent study has linked 4 homozygous frameshift mutations in the contactin-associated protein 1 (CNTNAP1) gene with this condition. METHODS We report a neonate with CHN who was found to have absent sensory nerve and compound muscle action potentials and hypomyelination on nerve biopsy. RESULTS On whole exome sequencing, we identified a novel CNTNAP1 homozygous missense mutation (p.Arg388Pro) in the proband, and both parents were carriers. Molecular modeling suggests that this variant disrupts a β-strand to cause an unstable structure and likely significant changes in protein function. CONCLUSIONS This report links a missense CNTNAP1 variant to the disease phenotype previously associated only with frameshift mutations. Muscle Nerve 55: 761-765, 2017.
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Affiliation(s)
- Paulomi Mehta
- Division of Newborn Medicine, Department of Medicine, Boston Children's Hospital, 300 Longwood Avenue, Harvard Medical School, Boston, Massachusetts, 02115, USA
| | - Melanie Küspert
- Institut für Biochemie, Emil-Fischer-Zentrum, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Tejus Bale
- Department of Pathology, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Catherine A Brownstein
- Division of Genetics and Genomics, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA
- The Manton Center for Orphan Disease Research, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Meghan C Towne
- Division of Genetics and Genomics, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA
- The Manton Center for Orphan Disease Research, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Umberto De Girolami
- Department of Pathology, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Jiahai Shi
- Department of Biomedical Sciences, City University of Hong Kong, Hong Kong
| | - Alan H Beggs
- Division of Genetics and Genomics, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA
- The Manton Center for Orphan Disease Research, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Basil T Darras
- Department of Neurology, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Michael Wegner
- Institut für Biochemie, Emil-Fischer-Zentrum, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Xianhua Piao
- Division of Newborn Medicine, Department of Medicine, Boston Children's Hospital, 300 Longwood Avenue, Harvard Medical School, Boston, Massachusetts, 02115, USA
| | - Pankaj B Agrawal
- Division of Newborn Medicine, Department of Medicine, Boston Children's Hospital, 300 Longwood Avenue, Harvard Medical School, Boston, Massachusetts, 02115, USA
- Division of Genetics and Genomics, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA
- The Manton Center for Orphan Disease Research, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA
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