Diagnostic patterns of very-long-chain fatty acids in plasma of patients with X-linked adrenoleukodystrophy

Management of adrenoleukodystrophy: From pre-clinical studies to the development of new therapies

X-linked adrenoleukodystrophy (X-ALD) is an inherited neurodegenerative disorder associated with mutations of the ABCD1 gene that encodes a peroxisomal transmembrane protein. It results in accumulation of very long chain fatty acids in tissues and body fluid. Along with other factors such as epigenetic and environmental involvement, ABCD1 mutation-provoked disorders can present different phenotypes including cerebral adrenoleukodystrophy (cALD), adrenomyeloneuropathy (AMN), and peripheral neuropathy. cALD is the most severe form that causes death in young childhood. Bone marrow transplantation and hematopoietic stem cell gene therapy are only effective when performed at an early stage of onsets in cALD. Nonetheless, current research and development of novel therapies are hampered by a lack of in-depth understanding disease pathophysiology and a lack of reliable cALD models. The Abcd1 and Abcd1/Abcd2 knock-out mouse models as well as the deficiency of Abcd1 rabbit models created in our lab, do not develop cALD phenotypes observed in human beings. In this review, we summarize the clinical and biochemical features of X-ALD, the progress of pre-clinical and clinical studies. Challenges and perspectives for future X-ALD studies are also discussed.

Perspectives in Pediatric Pathology, Chapter 21. Testicular Pathology in Heritable Metabolic Disease

Inborn errors of metabolism have wide and profound effects in many or all organs, and especially so in those with endocrine functions. The testes are greatly affected by systemic metabolic disorders, leading to specific histological findings that generally reveal the nature of the underlying disorder. Here we describe the main testicular changes seen in the setting of metabolic disease.

ABCD2 is a direct target of β-catenin and TCF-4: implications for X-linked adrenoleukodystrophy therapy

X-linked adrenoleukodystrophy (X-ALD) is a peroxisomal disorder caused by mutations in the ABCD1 gene that encodes the peroxisomal ATP-binding cassette (ABC) transporter subfamily D member 1 protein (ABCD1), which is referred to as the adrenoleukodystrophy protein (ALDP). Induction of the ABCD2 gene, the closest homolog of ABCD1, has been mentioned as a possible therapeutic option for the defective ABCD1 protein in X-ALD. However, little is known about the transcriptional regulation of ABCD2 gene expression. Here, through in silico analysis, we found two putative TCF-4 binding elements between nucleotide positions -360 and -260 of the promoter region of the ABCD2 gene. The transcriptional activity of the ABCD2 promoter was strongly increased by ectopic expression of β-catenin and TCF-4. In addition, mutation of either or both TCF-4 binding elements by site-directed mutagenesis decreased promoter activity. This was further validated by the finding that β-catenin and the promoter of the ABCD2 gene were pulled down with a β-catenin antibody in a chromatin immunoprecipitation assay. Moreover, real-time PCR analysis revealed that β-catenin and TCF-4 increased mRNA levels of ABCD2 in both a hepatocellular carcinoma cell line and primary fibroblasts from an X-ALD patient. Interestingly, we found that the levels of very long chain fatty acids were decreased by ectopic expression of ABCD2-GFP as well as β-catenin and TCF-4. Taken together, our results demonstrate for the first time the direct regulation of ABCD2 by β-catenin and TCF-4.

Induced pluripotent stem cell models from X-linked adrenoleukodystrophy patients

OBJECTIVE

Because of a lack of an appropriate animal model system and the inaccessibility of human oligodendrocytes in vivo, X-linked adrenoleukodystrophy (X-ALD)-induced pluripotent stem cells (iPSCs) would provide a unique cellular model for studying etiopathophysiology and development of therapeutics for X-ALD.

METHODS

We generated and characterized iPSCs of the 2 major types of X-ALD, childhood cerebral ALD (CCALD) and adrenomyeloneuropathy (AMN), and differentiated them into oligodendrocytes and neurons. We evaluated disease-relevant phenotypes by pharmacological and genetic approaches.

RESULTS

We established iPSCs from the patients with CCALD and AMN. Both CCALD and AMN iPSCs normally differentiated into oligodendrocytes, the cell type primarily affected in the X-ALD brain, indicating no developmental defect due to the ABCD1 mutations. Although low in X-ALD iPSCs, very long chain fatty acid (VLCFA) level was significantly increased after oligodendrocyte differentiation. VLCFA accumulation was much higher in CCALD oligodendrocytes than AMN oligodendrocytes but was not significantly different between CCALD and AMN neurons, indicating that the severe clinical manifestations in CCALD might be associated with abnormal VLCFA accumulation in oligodendrocytes. Furthermore, the abnormal accumulation of VLCFA in the X-ALD oligodendrocytes can be reduced by the upregulated ABCD2 gene expression after treatment with lovastatin or 4-phenylbutyrate.

INTERPRETATION

X-ALD iPSC model recapitulates the key events of disease development (ie, VLCFA accumulation in oligodendrocytes), provides new clues for better understanding of the disease, and allows for early and accurate diagnosis of the disease subtypes. X-ALD oligodendrocytes can be a useful cell model system to develop new therapeutics for treating X-ALD.

Pathophysiological roles of ASK1-MAP kinase signaling pathways

Apoptosis signal-regulating kinase 1 (ASK1) is a mitogenactivated protein kinase (MAPK) kinase kinase that activates JNK and p38 kinases. ASK1 is activated by various stresses, such as reactive oxygen species (ROS), endoplasmic reticulum (ER) stress, lipopolysaccharide (LPS) and calcium influx which are thought to be responsible for the pathogenesis or exacerbations of various human diseases. Recent studies revealed the involvement of ASK1 in ROS- or ER stressrelated diseases, suggesting that ASK1 may be a potential therapeutic target of various human diseases. In this review, we focus on the current findings for the relationship between pathogenesis and ASK1-MAPK pathways.

Patterns of Plasma Fatty Acids in Rat Models with Adenovirus Infection

Adenoviral vectors are among the most promising vectors available for human gene therapy. However, the use of recombinant adenoviral vectors, including replicationcompetent adenovirus (RCA), raises a variety of safety concerns in relation to the development of new therapies based on gene therapy. To examine how organic compounds change in rat plasma following the injection of adenovirus, beta-galactosidase expressing recombinant adenovirus (designated rAdLacZ) or RCA, we investigated the content of fatty acids (FAs), which are important biochemical indicators in pathological conditions. Pattern recognition analysis on the level of FAs in rat plasma is described for the visual discrimination of adenovirus infection groups from normal controls. Plasma FAs from four control rats (normal group), and from four rats with rAdLacZ infection and six rats with RCA infection (the two abnormal groups), were examined by gas chromatography-mass spectrometry in selected ion monitoring modes as their tert-butyldimethylsilyl derivatives. In total, 20 FAs were positively detected and quantified. The results of the Studentos t-test on the normal mean of two abnormal groups, the levels of three FAs (p< 0.05) from rAdLacZ group and eleven FAs (p < 0.05) from RCA group were significantly different. When star symbol plotting was applied to the group mean values of 20 FAs after normalization to the corresponding normal mean values, the resulting eicosagonal star patterns of the two infected groups were distorted into similar shapes, but were distinguishable from each other. Thus, these approaches will be useful for screening and monitoring of diagnostic markers for the effects of infection following the use of adenoviral vectors in gene therapy.

Urinary polyamines and N-acetylated polyamines in four patients with Alzheimer's disease as their N-ethoxycarbonyl-N-pentafluoropropionyl derivatives by gas chromatography-mass spectrometry in selected ion monitoring mode

Simultaneous determination of putrescine, cadaverine, spermidine, spermine, N1-acetylputrescine, N1-acetylcadaverine, N1-acetylspermidine, N8-acetylspermidine and N1-acetylspermine in aqueous samples was achieved as their N-ethoxycarbonyl-N-pentafluoropropionyl derivatives by gas chromatography-mass spectrometry (GC-MS) in selected ion monitoring (SIM) mode. The overall GC-SIM-MS method was linear (r> or =0.9987), repetitive (% relative standard deviation=1.3-6.4), and accurate (% relative error=-2.1-8.6). As compared to normal subjects, the levels of putrescine, N1-acetylspermine and spermine were significantly elevated while the levels of N1-acetylputrescine, N1-acetylcadaverine and N1-acetylspermidine were markedly reduced in all four Alzheimer's disease (AD) patients. When star symbol plotting was applied to the normalized levels of nine polyamines relative to the corresponding normal mean values, each star pattern of the AD patients was deformed, thus being readily distinguishable from the nonagon shape of the normal group average.

Exploration of anthropological specimens by GC-MS and chemometrics

Anthropological specimens combine a variety of unfavorable characteristics, rendering their evaluation an analytical challenge. Their remarkable status is primarily based on two characteristics: (i) these very rare samples of human origin are testimonies of human history and are, therefore, available only in minute amounts for analytical purposes, and (ii) the analysis of these samples is extremely limited by the decomposition of molecules, which are easily detected in living organisms, such as nucleic acids and proteins, but are subject to rapid post-mortem decay. In this article, we review the methods and results of archaeometry, emphasizing the role of MS combined with chemometrics. Focusing on experimental results for fatty acid profiles, specimens from mummies from different civilizations were compared. Considering in particular the Tyrolean Iceman, the application of chemometric methods to GC-MS data recovers essential information about the preservation and the storage conditions of mummies.

Nervonic acid is transferred from the maternal diet to milk and tissues of suckling rat pups

Three experiments were designed to investigate the metabolism of dietary nervonic acid (24:1n-9, NA) during reproduction in the rat. The first experiment determined the effect of early development on the sphingomyelin (SM) composition of rat heart and liver tissues. Rats were fed a standard chow diet and the SM fatty acid composition of the hearts and livers were analyzed of 18-20 day old fetuses, 14 day old sucklings and adult rats. The 18:0 content of SM decreases with age, while 23:0 and iso 24:0 increase with age. In the second experiment pregnant rats were fed diets supplemented with either canola, corn or peanut oil to determine the effect of diets high in 24:1n-9 and 24:0 on liver and heart SM at birth and after 14 days of suckling. Pups from the dams fed the corn oil diet had elevated 24:2n-6 in SM from heart and liver at birth, but the content of NA was not altered by dietary fat type. In the third experiment oil mixtures were designed to provide elevated levels of 22:1 and 24:1 (canola-N25), 22:0 and 24:0 (peanut-flax) or <0.01% of these fatty acids (olive-flax) and were supplemented to the diets of lactating rats. Canola-N25 oil supplemented to lactating rats resulted in increased 24:1n-9 and 24:1/24:0 with decreased 22:0 and 24:0 in milk SM relative to the other groups. The SM composition of livers of the suckling rats showed significant changes reflecting the changes in milk SM composition after 6 days of milk consumption. These experiments suggest that dietary NA and is not readily transferred across the placental barrier but does readily cross the mammary epithelium and is incorporated into milk SM. In addition, NA in milk appears to cross the intestinal epithelium where it is incorporated into the SM of heart and liver of suckling rats.