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Lee SJ, Zhang X, Wu E, Sukpraphrute R, Sukpraphrute C, Ye A, Wang MM. Structural changes in NOTCH3 induced by CADASIL mutations: role of cysteine and non-cysteine alterations. J Biol Chem 2023:104838. [PMID: 37209821 PMCID: PMC10318516 DOI: 10.1016/j.jbc.2023.104838] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Revised: 05/11/2023] [Accepted: 05/12/2023] [Indexed: 05/22/2023] Open
Abstract
Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) is a cerebral small vessel disease that results from mutations in NOTCH3. How mutations in NOTCH3 ultimately result in disease is not clear, though there is a predilection for mutations to alter the number of cysteines of the gene product, supporting a model in which alterations of conserved disulfide bonds of NOTCH3 drives the disease process. We have found that recombinant proteins with CADASIL NOTCH3 EGF-domains 1-3 fused to the C-terminus of Fc are distinguished from wildtype proteins by slowed mobility in non-reducing gels. We use this gel mobility shift assay to define the effects of mutations in the first three EGF-like domains of NOTCH3 in 167 unique recombinant protein constructs. This assay permits a readout on NOTCH3 protein mobility that indicates that: 1) Any loss of cysteine mutation in the first three EGF motifs results in structural abnormalities; 2) For loss of cysteine mutants, the mutant amino acid residue plays a minimal role; 3) The majority of changes that result in a new cysteine are poorly tolerated; 4) At residue 75, cysteine, proline, and glycine, but no other amino acids, induce structural shifts; 5) Specific second mutations in conserved cysteines suppress the impact of loss of cysteine CADASIL mutations. In sum, these studies support the importance of NOTCH3 cysteines and disulfide bonds in maintaining normal protein structure. Moreover, double mutant analysis suggests that suppression of protein abnormalities can be achieved through modification of cysteine reactivity, a potential therapeutic strategy.
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Affiliation(s)
- Soo Jung Lee
- Departments of Neurology, University of Michigan, Ann Arbor, MI 48109; Neurology Service, VA Ann Arbor Healthcare System, Department of Veterans Affairs, Ann Arbor, MI 48105
| | - Xiaojie Zhang
- Departments of Neurology, University of Michigan, Ann Arbor, MI 48109; Neurology Service, VA Ann Arbor Healthcare System, Department of Veterans Affairs, Ann Arbor, MI 48105
| | - Emily Wu
- Departments of Neurology, University of Michigan, Ann Arbor, MI 48109; Neurology Service, VA Ann Arbor Healthcare System, Department of Veterans Affairs, Ann Arbor, MI 48105
| | - Richard Sukpraphrute
- Departments of Neurology, University of Michigan, Ann Arbor, MI 48109; Neurology Service, VA Ann Arbor Healthcare System, Department of Veterans Affairs, Ann Arbor, MI 48105
| | - Catherine Sukpraphrute
- Departments of Neurology, University of Michigan, Ann Arbor, MI 48109; Neurology Service, VA Ann Arbor Healthcare System, Department of Veterans Affairs, Ann Arbor, MI 48105
| | - Andrew Ye
- Departments of Neurology, University of Michigan, Ann Arbor, MI 48109; Neurology Service, VA Ann Arbor Healthcare System, Department of Veterans Affairs, Ann Arbor, MI 48105
| | - Michael M Wang
- Departments of Neurology, University of Michigan, Ann Arbor, MI 48109; Departments of Molecular and Integrative Physiology, University of Michigan, Ann Arbor, MI 48109; Neurology Service, VA Ann Arbor Healthcare System, Department of Veterans Affairs, Ann Arbor, MI 48105.
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Hu Y, Sun Q, Zhou Y, Yi F, Tang H, Yao L, Tian Y, Xie N, Luo M, Wang Z, Liao X, Xu H, Zhou L. NOTCH3 Variants and Genotype-Phenotype Features in Chinese CADASIL Patients. Front Genet 2021; 12:705284. [PMID: 34335700 PMCID: PMC8320595 DOI: 10.3389/fgene.2021.705284] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Accepted: 06/16/2021] [Indexed: 12/05/2022] Open
Abstract
Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) is a cerebral small vessel disease caused by mutations in the NOTCH3 gene. Archetypal disease-causing mutations are cysteine-affecting variants within the 34 epidermal growth factor-like repeat (EGFr) region of the Notch3 extracellular subunit. Cysteine-sparing variants and variants outside the EGFr coding region associated with CADASIL phenotype have been reported. However, the linkage between untypical variants and CADASIL is unclear. In this study, we investigated the spectrum of NOTCH3 variants in a cohort of 38 probands from unrelated families diagnosed as CADASIL. All coding exons of the NOTCH3 gene were analyzed, and clinical data were retrospectively studied. We identified 23 different NOTCH3 variants including 14 cysteine-affecting pathogenic variants, five cysteine-sparing pathogenic variants, two reported cysteine-sparing variants of unknown significance (VUS), and two novel VUS outside EGFr region. In retrospective studies of clinical data, we found that patients carrying cysteine-sparing pathogenic variants showed later symptom onset (51.36 ± 7.06 vs. 44.96 ± 8.82, p = 0.023) and milder temporal lobe involvement (1.50 ± 1.74 vs. 3.11 ± 2.32, p = 0.027) than patients carrying cysteine-affecting pathogenic variants. Our findings suggested that untypical variants comprise a significant part of NOTCH3 variants and may be associated with a distinctive phenotype.
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Affiliation(s)
- Yacen Hu
- Department of Geriatric Neurology, Xiangya Hospital, Central South University, Changsha, China.,National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
| | - Qiying Sun
- Department of Geriatric Neurology, Xiangya Hospital, Central South University, Changsha, China.,National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
| | - Yafang Zhou
- Department of Geriatric Neurology, Xiangya Hospital, Central South University, Changsha, China.,National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
| | - Fang Yi
- Department of Geriatric Neurology, Xiangya Hospital, Central South University, Changsha, China.,National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
| | - Haiyun Tang
- Department of Radiology, Xiangya Hospital, Central South University, Changsha, China
| | - Lingyan Yao
- Department of Geriatric Neurology, Xiangya Hospital, Central South University, Changsha, China.,National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
| | - Yun Tian
- Department of Geriatric Neurology, Xiangya Hospital, Central South University, Changsha, China.,National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
| | - Nina Xie
- Department of Geriatric Neurology, Xiangya Hospital, Central South University, Changsha, China.,National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
| | - Mengchuan Luo
- Department of Geriatric Neurology, Xiangya Hospital, Central South University, Changsha, China.,National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
| | - Zhiqin Wang
- Department of Geriatric Neurology, Xiangya Hospital, Central South University, Changsha, China.,National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
| | - Xinxin Liao
- Department of Geriatric Neurology, Xiangya Hospital, Central South University, Changsha, China.,National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
| | - Hongwei Xu
- Department of Geriatric Neurology, Xiangya Hospital, Central South University, Changsha, China.,National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
| | - Lin Zhou
- Department of Geriatric Neurology, Xiangya Hospital, Central South University, Changsha, China.,National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
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3
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Guerreiro R, Gibbons E, Tábuas-Pereira M, Kun-Rodrigues C, Santo GC, Bras J. Genetic architecture of common non-Alzheimer's disease dementias. Neurobiol Dis 2020; 142:104946. [PMID: 32439597 PMCID: PMC8207829 DOI: 10.1016/j.nbd.2020.104946] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Revised: 05/04/2020] [Accepted: 05/13/2020] [Indexed: 02/07/2023] Open
Abstract
Frontotemporal dementia (FTD), dementia with Lewy bodies (DLB) and vascular dementia (VaD) are the most common forms of dementia after Alzheimer's disease (AD). The heterogeneity of these disorders and/or the clinical overlap with other diseases hinder the study of their genetic components. Even though Mendelian dementias are rare, the study of these forms of disease can have a significant impact in the lives of patients and families and have successfully brought to the fore many of the genes currently known to be involved in FTD and VaD, starting to give us a glimpse of the molecular mechanisms underlying these phenotypes. More recently, genome-wide association studies have also pointed to disease risk-associated loci. This has been particularly important for DLB where familial forms of disease are very rarely described. In this review we systematically describe the Mendelian and risk genes involved in these non-AD dementias in an effort to contribute to a better understanding of their genetic architecture, find differences and commonalities between different dementia phenotypes, and uncover areas that would benefit from more intense research endeavors.
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Affiliation(s)
- Rita Guerreiro
- Center for Neurodegenerative Science, Van Andel Institute, Grand Rapids, MI, USA; Division of Psychiatry and Behavioral Medicine, Michigan State University College of Human Medicine, Grand Rapids, MI, USA.
| | - Elizabeth Gibbons
- Center for Neurodegenerative Science, Van Andel Institute, Grand Rapids, MI, USA
| | - Miguel Tábuas-Pereira
- Department of Neurology, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal; Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - Celia Kun-Rodrigues
- Center for Neurodegenerative Science, Van Andel Institute, Grand Rapids, MI, USA
| | - Gustavo C Santo
- Department of Neurology, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal; Center for Neuroscience and Cell Biology, University of Coimbra, Coimbra, Portugal
| | - Jose Bras
- Center for Neurodegenerative Science, Van Andel Institute, Grand Rapids, MI, USA; Division of Psychiatry and Behavioral Medicine, Michigan State University College of Human Medicine, Grand Rapids, MI, USA
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Okada T, Washida K, Irie K, Saito S, Noguchi M, Tomita T, Koga M, Toyoda K, Okazaki S, Koizumi T, Mizuta I, Mizuno T, Ihara M. Prevalence and Atypical Clinical Characteristics of NOTCH3 Mutations Among Patients Admitted for Acute Lacunar Infarctions. Front Aging Neurosci 2020; 12:130. [PMID: 32477100 PMCID: PMC7240022 DOI: 10.3389/fnagi.2020.00130] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2019] [Accepted: 04/20/2020] [Indexed: 01/12/2023] Open
Abstract
Objectives: Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) is the most common hereditary small vessel disease, with reported frequencies of 2-5/100,000 individuals. Recently, it has been reported that some patients with NOTCH3 gene mutations show atypical clinical symptoms of CADASIL. Assuming that CADASIL is underdiagnosed in some cases of lacunar infarction, this study was designed to examine the prevalence of NOTCH3 gene mutations in the patients at highest risk who were admitted for lacunar infarctions. Methods: From January 2011 to April 2018, 1,094 patients with lacunar infarctions were admitted to our hospital, of whom 31 patients without hypertension but with white matter disease (Fazekas scale 2 or 3) were selected and genetically analyzed for NOTCH3 gene mutations (Phase 1). Furthermore, 54 patients, who were 60 years or younger, were analyzed for NOTCH3 mutations (Phase 2). NOTCH3 exons 2–24, which encode the epidermal growth factor-like repeat domain of the NOTCH3 receptor, were analyzed for mutations by direct sequencing of genomic DNA. Results: Three patients presented NOTCH3 p.R75P mutations: two in the Phase 1 and one in the Phase 2 cohort. Among patients aged 60 years or younger and those without hypertension but with moderate-to-severe white matter lesions, the carrier frequency of p.R75P was 3.5% (3/85), which was significantly higher than that in the Japanese general population (4.7KJPN) (odds ratio [95% CI] = 58.2 [11.6–292.5]). All three patients with NOTCH3 mutations had family histories of stroke, and the average patient age was 51.3 years. All three patients also showed white matter lesions in the external capsule but not in the temporal pole. The CADASIL and CADASIL scale-J scores of the three patients were 6, 17, 7 (mean, 10.0) and 13, 20, 10 (mean, 14.3), respectively. Conclusion: Among patients hospitalized for lacunar infarctions, the p.R75P prevalence may be higher than previously estimated. The NOTCH3 p.R75P mutation may be underdiagnosed in patients with early-onset lacunar infarctions due to the atypical clinical and neuroimaging features of CADASIL. Early-onset, presence of family history of stroke, external capsule lesions, and absence of hypertension may help predict underlying NOTCH3 mutations despite no temporal white matter lesions.
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Affiliation(s)
- Takashi Okada
- Department of Neurology, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Kazuo Washida
- Department of Neurology, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Kenichi Irie
- Department of Neurology, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Satoshi Saito
- Department of Neurology, National Cerebral and Cardiovascular Center, Osaka, Japan.,Research Fellow of Japan Society for the Promotion of Science, Tokyo, Japan
| | - Michio Noguchi
- NCVC Biobank, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Tsutomu Tomita
- NCVC Biobank, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Masatoshi Koga
- Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Kazunori Toyoda
- Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Shuhei Okazaki
- Department of Neurology, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Takashi Koizumi
- Department of Neurology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Ikuko Mizuta
- Department of Neurology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Toshiki Mizuno
- Department of Neurology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Masafumi Ihara
- Department of Neurology, National Cerebral and Cardiovascular Center, Osaka, Japan
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Giau VV, Bagyinszky E, Youn YC, An SSA, Kim SY. Genetic Factors of Cerebral Small Vessel Disease and Their Potential Clinical Outcome. Int J Mol Sci 2019; 20:ijms20174298. [PMID: 31484286 PMCID: PMC6747336 DOI: 10.3390/ijms20174298] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2019] [Revised: 08/27/2019] [Accepted: 09/01/2019] [Indexed: 12/23/2022] Open
Abstract
Cerebral small vessel diseases (SVD) have been causally correlated with ischemic strokes, leading to cognitive decline and vascular dementia. Neuroimaging and molecular genetic tests could improve diagnostic accuracy in patients with potential SVD. Several types of monogenic, hereditary cerebral SVD have been identified: cerebral autosomal recessive arteriopathy with subcortical infarcts and leukoencephalopathy (CARASIL), cerebral autosomal-dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL), cathepsin A-related arteriopathy with strokes and leukoencephalopathy (CARASAL), hereditary diffuse leukoencephalopathy with spheroids (HDLS), COL4A1/2-related disorders, and Fabry disease. These disorders can be distinguished based on their genetics, pathological and imaging findings, clinical manifestation, and diagnosis. Genetic studies of sporadic cerebral SVD have demonstrated a high degree of heritability, particularly among patients with young-onset stroke. Common genetic variants in monogenic disease may contribute to pathological progress in several cerebral SVD subtypes, revealing distinct genetic mechanisms in different subtype of SVD. Hence, genetic molecular analysis should be used as the final gold standard of diagnosis. The purpose of this review was to summarize the recent discoveries made surrounding the genetics of cerebral SVD and their clinical significance, to provide new insights into the pathogenesis of cerebral SVD, and to highlight the possible convergence of disease mechanisms in monogenic and sporadic cerebral SVD.
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Affiliation(s)
- Vo Van Giau
- Department of Bionano Technology & Gachon Bionano Research Institute, Gachon University, Seongnam-si, Gyeonggi-do 461-701, Korea
| | - Eva Bagyinszky
- Department of Bionano Technology & Gachon Bionano Research Institute, Gachon University, Seongnam-si, Gyeonggi-do 461-701, Korea
| | - Young Chul Youn
- Department of Neurology, Chung-Ang University College of Medicine, Seoul 06973, Korea.
| | - Seong Soo A An
- Department of Bionano Technology & Gachon Bionano Research Institute, Gachon University, Seongnam-si, Gyeonggi-do 461-701, Korea.
| | - Sang Yun Kim
- Department of Neurology, Seoul National University College of Medicine & Neurocognitive Behavior Center, Seoul National University Bundang Hospital, Seoul 06973, Korea
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Sun Y, Wei YJ, Xing Y. Vascular cognitive impairment associated with NOTCH3 Exon 33 mutation: A case report. Medicine (Baltimore) 2019; 98:e16920. [PMID: 31441874 PMCID: PMC6716740 DOI: 10.1097/md.0000000000016920] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
RATIONALE Vascular cognitive impairment (VCI) is a common cause of dementia. Research suggests that hereditary factors (gene mutations) play an important role in the pathogenesis of VCI, and a mutation of the NOTCH3 locus is frequently identified in affected patients. Herein, we report the case of a patient with confirmed VCI associated with a NOTCH3 exon 33 gene mutation and review the relevant VCI literature. PATIENT CONCERNS A 48-year-old man presented to our neurology clinic with gradually progressive cognitive impairment. DIAGNOSES Brain magnetic resonance imaging revealed multiple punctate hyperintensities in the patient's periventricular white matter. Genetic analysis showed a c.6744C > T, p. Ala2223Val substitution in exon 33 of the NOTCH3 gene. We diagnosed thepatient with VCI secondary to a NOTCH3 gene mutation. INTERVENTIONS Donepezil (5 mg) and memantine (5 mg) daily. OUTCOMES The patient showed symptom improvement at his 3-month and 6-month follow-up appointments. LESSONS This patient may have a new type of mutation that is different from the one seen in cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy, although it involves a NOTCH3 defect. We propose that the entire NOTCH3 gene should be sequenced in patients with suspected hereditary VCI. This practice could facilitate the discovery of newpathogenic mutations and diseases.
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7
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Notch3 protein expression in skin fibroblasts from CADASIL patients. J Neurol Sci 2018; 390:121-128. [PMID: 29801872 DOI: 10.1016/j.jns.2018.04.027] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2017] [Revised: 04/06/2018] [Accepted: 04/17/2018] [Indexed: 11/22/2022]
Abstract
AIM CADASIL is an inherited cerebrovascular disease caused by mutations in the NOTCH3 gene. Notch signaling is involved in a broad spectrum of function, from the cell proliferation to apoptosis. Thus far, because the molecular mechanism underlying the pathological alterations remains unclear and taking into account that fibroblasts contribute to the integrity of the vasculature, our aims was to establish whether fibroblasts, in subjects carrying different NOTCH3 mutations, show abnormalities in the protein expression. METHODS We performed the investigation on skin fibroblasts in culture obtained from three CADASIL patients and normal subjects. The patients were genetically characterized, and carried a p.R61W, a p.C174T, and p.R103X, mutation respectively. Notch3 expression was first evaluated on fibroblasts by immunofluorescence analysis, then western blot on cellular extract was utilized to validate the immunofluorescence results. RESULTS The Notch3 immunoreactivity was clearly detected along the cellular body and in the cellular nuclei of the control fibroblasts. We observed a marked, statistically significant, reduction of the fluorescence immunoreactivity in the fibroblasts from patient with the classical C174T cysteine mutation and a less pronounced reduction in the other two subject's samples with respect to the normal controls. These data were confirmed by the immunoblot analysis. CONCLUSIONS Our results show that the investigated three NOTCH3 mutations are associated with a reduction of the levels of Notch3 expression in vitro. Because the smooth muscle cells appear to be predominantly involved in this cerebrovascular disease, our result, despite the limitation of the sample size examinated, clearly suggest that also fibroblasts, directly involved in making the vascular basal lamina and in maintaining the vascular integrity, may play an important role in the mechanism responsible for the disease.
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Muiño E, Gallego-Fabrega C, Cullell N, Carrera C, Torres N, Krupinski J, Roquer J, Montaner J, Fernández-Cadenas I. Systematic Review of Cysteine-Sparing NOTCH3 Missense Mutations in Patients with Clinical Suspicion of CADASIL. Int J Mol Sci 2017; 18:E1964. [PMID: 28902129 PMCID: PMC5618613 DOI: 10.3390/ijms18091964] [Citation(s) in RCA: 57] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2017] [Revised: 09/07/2017] [Accepted: 09/10/2017] [Indexed: 11/25/2022] Open
Abstract
CADASIL (cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy) is caused by mutations in the NOTCH3 gene, affecting the number of cysteines in the extracellular domain of the receptor, causing protein misfolding and receptor aggregation. The pathogenic role of cysteine-sparing NOTCH3 missense mutations in patients with typical clinical CADASIL syndrome is unknown. The aim of this article is to describe these mutations to clarify if any could be potentially pathogenic. Articles on cysteine-sparing NOTCH3 missense mutations in patients with clinical suspicion of CADASIL were reviewed. Mutations were considered potentially pathogenic if patients had: (a) typical clinical CADASIL syndrome; (b) diffuse white matter hyperintensities; (c) the 33 NOTCH3 exons analyzed; (d) mutations that were not polymorphisms; and (e) Granular osmiophilic material (GOM) deposits in the skin biopsy. Twenty-five different mutations were listed. Four fulfill the above criteria: p.R61W; p.R75P; p.D80G; and p.R213K. Patients carrying these mutations had typical clinical CADASIL syndrome and diffuse white matter hyperintensities, mostly without anterior temporal pole involvement. Cysteine-sparing NOTCH3 missense mutations are associated with typical clinical CADASIL syndrome and typical magnetic resonance imaging (MRI) findings, although with less involvement of the anterior temporal lobe. Hence, these mutations should be further studied to confirm their pathological role in CADASIL.
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Affiliation(s)
- Elena Muiño
- Stroke Pharmacogenomics and Genetics, Fundació Docència i Recerca Mútua Terrassa, Hospital Mútua de Terrassa, 08221 Terrassa, Spain.
| | - Cristina Gallego-Fabrega
- Stroke Pharmacogenomics and Genetics, Fundació Docència i Recerca Mútua Terrassa, Hospital Mútua de Terrassa, 08221 Terrassa, Spain.
| | - Natalia Cullell
- Stroke Pharmacogenomics and Genetics, Fundació Docència i Recerca Mútua Terrassa, Hospital Mútua de Terrassa, 08221 Terrassa, Spain.
| | - Caty Carrera
- Neurovascular Research Laboratory, Vall d'Hebron Institute of Research, Hospital Vall d'Hebron, 08035 Barcelona, Spain; (C.C.).
| | - Nuria Torres
- Stroke Pharmacogenomics and Genetics, Fundació Docència i Recerca Mútua Terrassa, Hospital Mútua de Terrassa, 08221 Terrassa, Spain.
| | - Jurek Krupinski
- Neurology Service, Hospital Mútua de Terrassa, 08221 Terrassa, Spain.
| | - Jaume Roquer
- Neurology Service, Institut Hospital del Mar d'investigacions Mèdiques, IMIM-Hospital del Mar, 08003 Barcelona, Spain.
| | - Joan Montaner
- Neurovascular Research Laboratory, Vall d'Hebron Institute of Research, Hospital Vall d'Hebron, 08035 Barcelona, Spain; (C.C.).
| | - Israel Fernández-Cadenas
- Stroke Pharmacogenomics and Genetics, Fundació Docència i Recerca Mútua Terrassa, Hospital Mútua de Terrassa, 08221 Terrassa, Spain.
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Guo P, Zhang J, Wang L, Yang S, Luo G, Deng C, Wen Y, Zhang Q. Monitoring seasonal influenza epidemics by using internet search data with an ensemble penalized regression model. Sci Rep 2017; 7:46469. [PMID: 28422149 PMCID: PMC5396076 DOI: 10.1038/srep46469] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2016] [Accepted: 03/20/2017] [Indexed: 02/05/2023] Open
Abstract
Seasonal influenza epidemics cause serious public health problems in China. Search queries-based surveillance was recently proposed to complement traditional monitoring approaches of influenza epidemics. However, developing robust techniques of search query selection and enhancing predictability for influenza epidemics remains a challenge. This study aimed to develop a novel ensemble framework to improve penalized regression models for detecting influenza epidemics by using Baidu search engine query data from China. The ensemble framework applied a combination of bootstrap aggregating (bagging) and rank aggregation method to optimize penalized regression models. Different algorithms including lasso, ridge, elastic net and the algorithms in the proposed ensemble framework were compared by using Baidu search engine queries. Most of the selected search terms captured the peaks and troughs of the time series curves of influenza cases. The predictability of the conventional penalized regression models were improved by the proposed ensemble framework. The elastic net regression model outperformed the compared models, with the minimum prediction errors. We established a Baidu search engine queries-based surveillance model for monitoring influenza epidemics, and the proposed model provides a useful tool to support the public health response to influenza and other infectious diseases.
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Affiliation(s)
- Pi Guo
- Department of Preventive Medicine, Shantou University Medical College, No. 22 Xinling Road, Shantou, Guangdong, 515041, People’s Republic of China
| | - Jianjun Zhang
- Department of Preventive Medicine, Shantou University Medical College, No. 22 Xinling Road, Shantou, Guangdong, 515041, People’s Republic of China
| | - Li Wang
- Department of Preventive Medicine, Shantou University Medical College, No. 22 Xinling Road, Shantou, Guangdong, 515041, People’s Republic of China
| | - Shaoyi Yang
- Department of Preventive Medicine, Shantou University Medical College, No. 22 Xinling Road, Shantou, Guangdong, 515041, People’s Republic of China
| | - Ganfeng Luo
- Department of Preventive Medicine, Shantou University Medical College, No. 22 Xinling Road, Shantou, Guangdong, 515041, People’s Republic of China
| | - Changyu Deng
- Department of Preventive Medicine, Shantou University Medical College, No. 22 Xinling Road, Shantou, Guangdong, 515041, People’s Republic of China
| | - Ye Wen
- Department of Preventive Medicine, Shantou University Medical College, No. 22 Xinling Road, Shantou, Guangdong, 515041, People’s Republic of China
| | - Qingying Zhang
- Department of Preventive Medicine, Shantou University Medical College, No. 22 Xinling Road, Shantou, Guangdong, 515041, People’s Republic of China
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10
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Maksemous N, Smith RA, Haupt LM, Griffiths LR. Targeted next generation sequencing identifies novel NOTCH3 gene mutations in CADASIL diagnostics patients. Hum Genomics 2016; 10:38. [PMID: 27881154 PMCID: PMC5122195 DOI: 10.1186/s40246-016-0093-z] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2016] [Accepted: 10/30/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) is a monogenic, hereditary, small vessel disease of the brain causing stroke and vascular dementia in adults. CADASIL has previously been shown to be caused by varying mutations in the NOTCH3 gene. The disorder is often misdiagnosed due to its significant clinical heterogeneic manifestation with familial hemiplegic migraine and several ataxia disorders as well as the location of the currently identified causative mutations. The aim of this study was to develop a new, comprehensive and efficient single assay strategy for complete molecular diagnosis of NOTCH3 mutations through the use of a custom next-generation sequencing (NGS) panel for improved routine clinical molecular diagnostic testing. RESULTS Our custom NGS panel identified nine genetic variants in NOTCH3 (p.D139V, p.C183R, p.R332C, p.Y465C, p.C597W, p.R607H, p.E813E, p.C977G and p.Y1106C). Six mutations were stereotypical CADASIL mutations leading to an odd number of cysteine residues in one of the 34 NOTCH3 gene epidermal growth factor (EGF)-like repeats, including three new typical cysteine mutations identified in exon 11 (p.C597W; c.1791C>G); exon 18 (p.C977G; c.2929T>G) and exon 20 (p.Y1106C; c.3317A>G). Interestingly, a novel missense mutation in the CACNA1A gene was also identified in one CADASIL patient. All variants identified (novel and known) were further investigated using in silico bioinformatic analyses and confirmed through Sanger sequencing. CONCLUSIONS NGS provides an improved and effective methodology for the diagnosis of CADASIL. The NGS approach reduced time and cost for comprehensive genetic diagnosis, placing genetic diagnostic testing within reach of more patients.
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Affiliation(s)
- Neven Maksemous
- Genomics Research Centre, Institute of Health and Biomedical Innovation (IHBI), School of Biomedical Sciences, Queensland University of Technology (QUT), Q Block, 60 Musk Ave, Kelvin Grove Campus, Brisbane, 4059, Queensland, Australia
| | - Robert A Smith
- Genomics Research Centre, Institute of Health and Biomedical Innovation (IHBI), School of Biomedical Sciences, Queensland University of Technology (QUT), Q Block, 60 Musk Ave, Kelvin Grove Campus, Brisbane, 4059, Queensland, Australia
| | - Larisa M Haupt
- Genomics Research Centre, Institute of Health and Biomedical Innovation (IHBI), School of Biomedical Sciences, Queensland University of Technology (QUT), Q Block, 60 Musk Ave, Kelvin Grove Campus, Brisbane, 4059, Queensland, Australia
| | - Lyn R Griffiths
- Genomics Research Centre, Institute of Health and Biomedical Innovation (IHBI), School of Biomedical Sciences, Queensland University of Technology (QUT), Q Block, 60 Musk Ave, Kelvin Grove Campus, Brisbane, 4059, Queensland, Australia.
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11
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Blood biomarkers in a mouse model of CADASIL. Brain Res 2016; 1644:118-26. [PMID: 27174004 DOI: 10.1016/j.brainres.2016.05.008] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2015] [Revised: 04/06/2016] [Accepted: 05/03/2016] [Indexed: 12/24/2022]
Abstract
Mutations in NOTCH 3 are the cause of cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL), a neurological disorder characterized by stroke, and vascular cognitive impairment and dementia. Loss of vascular smooth muscle cells (VSMC) and accumulation of granular osmiophilic material (GOM) deposits are hallmarks of CADASIL. There are no therapies for CADASIL and experimental endpoints to examine the preclinical efficacy of potential drugs are lacking. This study aims to use a mouse carrying the C455R mutation in Notch 3 to identify biomarkers associated with CADASIL. Mass spectrometry and antibody arrays were used to explore the aorta and blood proteomes of CADASIL mice, ELISA assays were utilized for biomarker validation, a ligand-dependent assay was applied to examine the relationship between Notch signaling and biomarker expression, and retinal histology was performed for quantification of VSMC loss in arteries. Two-hundred day-old mice with the C455R CADASIL mutation in Notch 3 mice display robust VSMC loss in retinal arteries and had increased plasma levels of collagen18α1/endostatin (col18α1) and high-temperature requirement A serine peptidase 1 (HTRA1) and reduced levels of Notch 3 extracellular domain (N3ECD), compared to control wild type mice. Measurements of plasma endostatin, HTRA1 and N3ECD, along with VSMC quantification in retinal arteries, may serve as surrogate endpoints for assessing efficacy in preclinical therapeutic studies of CADASIL using mice.
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Genotypic and phenotypic spectrum of CADASIL in Japan: the experience at a referral center in Kumamoto University from 1997 to 2014. J Neurol 2015; 262:1828-36. [PMID: 25980907 DOI: 10.1007/s00415-015-7782-8] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2015] [Revised: 05/08/2015] [Accepted: 05/08/2015] [Indexed: 01/03/2023]
Abstract
This study elucidates the genotypic and phenotypic spectrum and histopathological findings related to cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) in Japan. For this single-center retrospective observational study, we enrolled 215 patients who were clinically suspected of having CADASIL and were examined at Kumamoto University from 1997 to 2014, and we diagnosed CADASIL in 70 patients. We found 19 different NOTCH3 mutations in the patients, with the NOTCH3 Arg133Cys mutation being found most frequently. We also found the Arg75Pro mutation, a cysteine-sparing NOTCH3 mutation. CADASIL patients with this Arg75Pro mutation were frequently found throughout Japan, and fewer patients with the Arg75Pro mutation showed MRI hyperintensity in the anterior temporal pole compared with patients with other NOTCH3 mutations. Significantly more CADASIL patients with the NOTCH3 Arg133Cys mutation had hyperintensity in the external capsule compared with CADASIL patients with the other mutations not including the NOTCH3 Arg75Pro mutation. We also showed postmortem pathological findings of the first Japanese CADASIL case with the NOTCH3 Arg133Cys mutation, and histopathological findings of fresh frozen skin biopsy specimens of CADASIL patients. In conclusions, the spectrum of NOTCH3 mutations in Japanese CADASIL patients may be partially explained by founder effects. Genotype-phenotype correlations may exist in CADASIL, which should be considered so as to make an accurate diagnosis of CADASIL in each population. Fresh frozen skin biopsy specimens may aid detection of Notch3 deposits on vascular walls for an improved diagnosis of CADASIL.
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Wollenweber FA, Hanecker P, Bayer-Karpinska A, Malik R, Bäzner H, Moreton F, Muir KW, Müller S, Giese A, Opherk C, Dichgans M, Haffner C, Duering M. Cysteine-Sparing CADASIL Mutations in
NOTCH3
Show Proaggregatory Properties In Vitro. Stroke 2015; 46:786-92. [DOI: 10.1161/strokeaha.114.007472] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background and Purpose—
Mutations in
NOTCH3
cause cerebral autosomal–dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL), the most common monogenic cause of stroke and vascular dementia. Misfolding and aggregation of NOTCH3 proteins triggered by cysteine-affecting mutations are considered to be the key disease mechanisms. However, the significance of cysteine-sparing mutations is still debated.
Methods—
We studied a family with inherited small vessel disease by standardized medical history, clinical examination, MRI, ultrastructural analysis of skin biopsies, and Sanger sequencing of all
NOTCH3
exons. In addition, we performed in vitro characterization of
NOTCH3
variants using recombinant protein fragments and a single-particle aggregation assay.
Results—
We identified a novel cysteine-sparing
NOTCH3
mutation (D80G) in 4 family members, which was absent in a healthy sibling. All mutation carriers exhibited a CADASIL typical brain imaging and clinical phenotype, whereas skin biopsy showed inconsistent results. In vitro aggregation behavior of the D80G mutant was similar compared with cysteine-affecting mutations. This was reproduced with cysteine-sparing mutations from previously reported families having a phenotype consistent with CADASIL.
Conclusions—
Our findings support the view that cysteine-sparing mutations, such as D80G, might cause CADASIL with a phenotype largely indistinguishable from cysteine mutations. The in vitro aggregation analysis of atypical
NOTCH3
mutations offers novel insights into pathomechanisms and might represent a tool for estimating their clinical significance.
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Affiliation(s)
- Frank Arne Wollenweber
- From the Institute for Stroke and Dementia Research, Klinikum der Universität München (F.A.W., P.H., A.B.-K., R.M., C.O., M.D., C.H., M.D.), Institute for Pathology (S.M.), and Center for Neuropathology and Prion Research (A.G.), Ludwig-Maximilians-University, Munich, Germany; Department of Neurology, Klinikum Stuttgart, Stuttgart, Germany (H.B.); Institute of Neuroscience and Psychology, University of Glasgow, Glasgow, United Kingdom (F.M., K.W.M.); Department of Neurology, Klinikum am
| | - Patrizia Hanecker
- From the Institute for Stroke and Dementia Research, Klinikum der Universität München (F.A.W., P.H., A.B.-K., R.M., C.O., M.D., C.H., M.D.), Institute for Pathology (S.M.), and Center for Neuropathology and Prion Research (A.G.), Ludwig-Maximilians-University, Munich, Germany; Department of Neurology, Klinikum Stuttgart, Stuttgart, Germany (H.B.); Institute of Neuroscience and Psychology, University of Glasgow, Glasgow, United Kingdom (F.M., K.W.M.); Department of Neurology, Klinikum am
| | - Anna Bayer-Karpinska
- From the Institute for Stroke and Dementia Research, Klinikum der Universität München (F.A.W., P.H., A.B.-K., R.M., C.O., M.D., C.H., M.D.), Institute for Pathology (S.M.), and Center for Neuropathology and Prion Research (A.G.), Ludwig-Maximilians-University, Munich, Germany; Department of Neurology, Klinikum Stuttgart, Stuttgart, Germany (H.B.); Institute of Neuroscience and Psychology, University of Glasgow, Glasgow, United Kingdom (F.M., K.W.M.); Department of Neurology, Klinikum am
| | - Rainer Malik
- From the Institute for Stroke and Dementia Research, Klinikum der Universität München (F.A.W., P.H., A.B.-K., R.M., C.O., M.D., C.H., M.D.), Institute for Pathology (S.M.), and Center for Neuropathology and Prion Research (A.G.), Ludwig-Maximilians-University, Munich, Germany; Department of Neurology, Klinikum Stuttgart, Stuttgart, Germany (H.B.); Institute of Neuroscience and Psychology, University of Glasgow, Glasgow, United Kingdom (F.M., K.W.M.); Department of Neurology, Klinikum am
| | - Hansjörg Bäzner
- From the Institute for Stroke and Dementia Research, Klinikum der Universität München (F.A.W., P.H., A.B.-K., R.M., C.O., M.D., C.H., M.D.), Institute for Pathology (S.M.), and Center for Neuropathology and Prion Research (A.G.), Ludwig-Maximilians-University, Munich, Germany; Department of Neurology, Klinikum Stuttgart, Stuttgart, Germany (H.B.); Institute of Neuroscience and Psychology, University of Glasgow, Glasgow, United Kingdom (F.M., K.W.M.); Department of Neurology, Klinikum am
| | - Fiona Moreton
- From the Institute for Stroke and Dementia Research, Klinikum der Universität München (F.A.W., P.H., A.B.-K., R.M., C.O., M.D., C.H., M.D.), Institute for Pathology (S.M.), and Center for Neuropathology and Prion Research (A.G.), Ludwig-Maximilians-University, Munich, Germany; Department of Neurology, Klinikum Stuttgart, Stuttgart, Germany (H.B.); Institute of Neuroscience and Psychology, University of Glasgow, Glasgow, United Kingdom (F.M., K.W.M.); Department of Neurology, Klinikum am
| | - Keith W. Muir
- From the Institute for Stroke and Dementia Research, Klinikum der Universität München (F.A.W., P.H., A.B.-K., R.M., C.O., M.D., C.H., M.D.), Institute for Pathology (S.M.), and Center for Neuropathology and Prion Research (A.G.), Ludwig-Maximilians-University, Munich, Germany; Department of Neurology, Klinikum Stuttgart, Stuttgart, Germany (H.B.); Institute of Neuroscience and Psychology, University of Glasgow, Glasgow, United Kingdom (F.M., K.W.M.); Department of Neurology, Klinikum am
| | - Susanna Müller
- From the Institute for Stroke and Dementia Research, Klinikum der Universität München (F.A.W., P.H., A.B.-K., R.M., C.O., M.D., C.H., M.D.), Institute for Pathology (S.M.), and Center for Neuropathology and Prion Research (A.G.), Ludwig-Maximilians-University, Munich, Germany; Department of Neurology, Klinikum Stuttgart, Stuttgart, Germany (H.B.); Institute of Neuroscience and Psychology, University of Glasgow, Glasgow, United Kingdom (F.M., K.W.M.); Department of Neurology, Klinikum am
| | - Armin Giese
- From the Institute for Stroke and Dementia Research, Klinikum der Universität München (F.A.W., P.H., A.B.-K., R.M., C.O., M.D., C.H., M.D.), Institute for Pathology (S.M.), and Center for Neuropathology and Prion Research (A.G.), Ludwig-Maximilians-University, Munich, Germany; Department of Neurology, Klinikum Stuttgart, Stuttgart, Germany (H.B.); Institute of Neuroscience and Psychology, University of Glasgow, Glasgow, United Kingdom (F.M., K.W.M.); Department of Neurology, Klinikum am
| | - Christian Opherk
- From the Institute for Stroke and Dementia Research, Klinikum der Universität München (F.A.W., P.H., A.B.-K., R.M., C.O., M.D., C.H., M.D.), Institute for Pathology (S.M.), and Center for Neuropathology and Prion Research (A.G.), Ludwig-Maximilians-University, Munich, Germany; Department of Neurology, Klinikum Stuttgart, Stuttgart, Germany (H.B.); Institute of Neuroscience and Psychology, University of Glasgow, Glasgow, United Kingdom (F.M., K.W.M.); Department of Neurology, Klinikum am
| | - Martin Dichgans
- From the Institute for Stroke and Dementia Research, Klinikum der Universität München (F.A.W., P.H., A.B.-K., R.M., C.O., M.D., C.H., M.D.), Institute for Pathology (S.M.), and Center for Neuropathology and Prion Research (A.G.), Ludwig-Maximilians-University, Munich, Germany; Department of Neurology, Klinikum Stuttgart, Stuttgart, Germany (H.B.); Institute of Neuroscience and Psychology, University of Glasgow, Glasgow, United Kingdom (F.M., K.W.M.); Department of Neurology, Klinikum am
| | - Christof Haffner
- From the Institute for Stroke and Dementia Research, Klinikum der Universität München (F.A.W., P.H., A.B.-K., R.M., C.O., M.D., C.H., M.D.), Institute for Pathology (S.M.), and Center for Neuropathology and Prion Research (A.G.), Ludwig-Maximilians-University, Munich, Germany; Department of Neurology, Klinikum Stuttgart, Stuttgart, Germany (H.B.); Institute of Neuroscience and Psychology, University of Glasgow, Glasgow, United Kingdom (F.M., K.W.M.); Department of Neurology, Klinikum am
| | - Marco Duering
- From the Institute for Stroke and Dementia Research, Klinikum der Universität München (F.A.W., P.H., A.B.-K., R.M., C.O., M.D., C.H., M.D.), Institute for Pathology (S.M.), and Center for Neuropathology and Prion Research (A.G.), Ludwig-Maximilians-University, Munich, Germany; Department of Neurology, Klinikum Stuttgart, Stuttgart, Germany (H.B.); Institute of Neuroscience and Psychology, University of Glasgow, Glasgow, United Kingdom (F.M., K.W.M.); Department of Neurology, Klinikum am
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Staniloiu A, Woermann FG, Markowitsch HJ. Impairments in Episodic-Autobiographical Memory and Emotional and Social Information Processing in CADASIL during Mid-Adulthood. Front Behav Neurosci 2014; 8:227. [PMID: 25009481 PMCID: PMC4069576 DOI: 10.3389/fnbeh.2014.00227] [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: 02/27/2014] [Accepted: 06/05/2014] [Indexed: 11/24/2022] Open
Abstract
Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) - is the most common genetic source of vascular dementia in adults, being caused by a mutation in NOTCH3 gene. Spontaneous de novo mutations may occur, but their frequency is largely unknown. Ischemic strokes and cognitive impairments are the most frequent manifestations, but seizures affect up to 10% of the patients. Herein, we describe a 47-year-old male scholar with a genetically confirmed diagnosis of CADASIL (Arg133Cys mutation in the NOTCH3 gene) and a seemingly negative family history of CADASIL illness, who was investigated with a comprehensive neuropsychological testing battery and neuroimaging methods. The patient demonstrated on one hand severe and accelerated deteriorations in multiple cognitive domains such as concentration, long-term memory (including the episodic-autobiographical memory domain), problem solving, cognitive flexibility and planning, affect recognition, discrimination and matching, and social cognition (theory of mind). Some of these impairments were even captured by abbreviated instruments for investigating suspicion of dementia. On the other hand the patient still possessed high crystallized (verbal) intelligence and a capacity to put forth a façade of well-preserved intellectual functioning. Although no definite conclusions can be drawn from a single case study, our findings point to the presence of additional cognitive changes in CADASIL in middle adulthood, in particular to impairments in the episodic-autobiographical memory domain and social information processing (e.g., social cognition). Whether these identified impairments are related to the patient's specific phenotype or to an ascertainment bias (e.g., a paucity of studies investigating these cognitive functions) requires elucidation by larger scale research.
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Affiliation(s)
- Angelica Staniloiu
- Physiological Psychology, University of Bielefeld, Bielefeld, Germany
- Hanse Institute of Advanced Science, Delmenhorst, Germany
| | | | - Hans J. Markowitsch
- Physiological Psychology, University of Bielefeld, Bielefeld, Germany
- Center of Excellence “Cognitive Interaction Technology” (CITEC), University of Bielefeld, Bielefeld, Germany
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15
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Rutten JW, Haan J, Terwindt GM, van Duinen SG, Boon EMJ, Lesnik Oberstein SAJ. Interpretation ofNOTCH3mutations in the diagnosis of CADASIL. Expert Rev Mol Diagn 2014; 14:593-603. [DOI: 10.1586/14737159.2014.922880] [Citation(s) in RCA: 78] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
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16
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Caplan LR, Arenillas J, Cramer SC, Joutel A, Lo EH, Meschia J, Savitz S, Tournier-Lasserve E. Stroke-related translational research. ACTA ACUST UNITED AC 2011; 68:1110-23. [PMID: 21555605 DOI: 10.1001/archneurol.2011.99] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
Stroke-related translational research is multifaceted. Herein, we highlight genome-wide association studies and genetic studies of cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy, COL4A1 mutations, and cerebral cavernous malformations; advances in molecular biology and biomarkers; newer brain imaging research; and recovery from stroke emphasizing cell-based and other rehabilitative modalities.
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Affiliation(s)
- Louis R Caplan
- Department of Neurology, Beth Israel Deaconess Medical Center, Boston, MA 02215, USA.
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Hypomorphic Notch 3 alleles link Notch signaling to ischemic cerebral small-vessel disease. Proc Natl Acad Sci U S A 2011; 108:E128-35. [PMID: 21555590 DOI: 10.1073/pnas.1101964108] [Citation(s) in RCA: 99] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
The most common monogenic cause of small-vessel disease leading to ischemic stroke and vascular dementia is the neurodegenerative syndrome cerebral autosomal-dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL), which is associated with mutations in the Notch 3 receptor. CADASIL pathology is characterized by vascular smooth muscle cell degeneration and accumulation of diagnostic granular osmiophilic material (GOM) in vessels. The functional nature of the Notch 3 mutations causing CADASIL and their mechanistic connection to small-vessel disease and GOM accumulation remain enigmatic. To gain insight into how Notch 3 function is linked to CADASIL pathophysiology, we studied two phenotypically distinct mutations, C455R and R1031C, respectively associated with early and late onset of stroke, by using hemodynamic analyses in transgenic mouse models, receptor activity assays in cell culture, and proteomic examination of postmortem human tissue. We demonstrate that the C455R and R1031C mutations define different hypomorphic activity states of Notch 3, a property linked to ischemic stroke susceptibility in mouse models we generated. Importantly, these mice develop osmiophilic deposits and other age-dependent phenotypes that parallel remarkably the human condition. Proteomic analysis of human brain vessels, carrying the same CADASIL mutations, identified clusterin and collagen 18 α1/endostatin as GOM components. Our findings link loss of Notch signaling with ischemic cerebral small-vessel disease, a prevalent human condition. We determine that CADASIL pathophysiology is associated with hypomorphic Notch 3 function in vascular smooth muscle cells and implicate the accumulation of clusterin and collagen 18 α1/endostatin in brain vessel pathology.
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19
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Pless ML, Chen YB, Copen WA, Frosch MP. Case records of the Massachusetts General Hospital. Case 9-2010. A 37-year-old woman with paresthesias and ataxia. N Engl J Med 2010; 362:1129-38. [PMID: 20335590 DOI: 10.1056/nejmcpc0910092] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Affiliation(s)
- Misha L Pless
- Department of Neurology, Massachusetts General Hospital, USA
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