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Gong Y, Laheji F, Berenson A, Li Y, Moser A, Qian A, Frosch M, Sadjadi R, Hahn R, Maguire CA, Eichler F. Role of Basal Forebrain Neurons in Adrenomyeloneuropathy in Mice and Humans. Ann Neurol 2024; 95:442-458. [PMID: 38062617 PMCID: PMC10949091 DOI: 10.1002/ana.26849] [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: 06/05/2023] [Revised: 11/28/2023] [Accepted: 12/05/2023] [Indexed: 12/27/2023]
Abstract
OBJECTIVE X-linked adrenoleukodystrophy is caused by mutations in the peroxisomal half-transporter ABCD1. The most common manifestation is adrenomyeloneuropathy, a hereditary spastic paraplegia of adulthood. The present study set out to understand the role of neuronal ABCD1 in mice and humans with adrenomyeloneuropathy. METHODS Neuronal expression of ABCD1 during development was assessed in mice and humans. ABCD1-deficient mice and human brain tissues were examined for corresponding pathology. Next, we silenced ABCD1 in cholinergic Sh-sy5y neurons to investigate its impact on neuronal function. Finally, we tested adeno-associated virus vector-mediated ABCD1 delivery to the brain in mice with adrenomyeloneuropathy. RESULTS ABCD1 is highly expressed in neurons located in the periaqueductal gray matter, basal forebrain and hypothalamus. In ABCD1-deficient mice (Abcd1-/y), these structures showed mild accumulations of α-synuclein. Similarly, healthy human controls had high expression of ABCD1 in deep gray nuclei, whereas X-ALD patients showed increased levels of phosphorylated tau, gliosis, and complement activation in those same regions, albeit not to the degree seen in neurodegenerative tauopathies. Silencing ABCD1 in Sh-sy5y neurons impaired expression of functional proteins and decreased acetylcholine levels, similar to observations in plasma of Abcd1-/y mice. Notably, hind limb clasping in Abcd1-/y mice was corrected through transduction of ABCD1 in basal forebrain neurons following intracerebroventricular gene delivery. INTERPRETATION Our study suggests that the basal forebrain-cortical cholinergic pathway may contribute to dysfunction in adrenomyeloneuropathy. Rescuing peroxisomal transport activity in basal forebrain neurons and supporting glial cells might represent a viable therapeutic strategy. ANN NEUROL 2024;95:442-458.
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Affiliation(s)
- Yi Gong
- Massachusetts General Hospital, Department of Neurology, Harvard Medical School, Boston
| | - Fiza Laheji
- Massachusetts General Hospital, Department of Neurology, Harvard Medical School, Boston
| | - Anna Berenson
- Massachusetts General Hospital, Department of Neurology, Harvard Medical School, Boston
| | - Yedda Li
- Massachusetts General Hospital, Department of Neurology, Harvard Medical School, Boston
| | - Ann Moser
- Peroxisome Disease Lab, Hugo W Moser Research Institute, Baltimore, MD, USA
| | - April Qian
- Massachusetts General Hospital, Department of Neurology, Harvard Medical School, Boston
| | - Matthew Frosch
- Massachusetts General Hospital, Department of Neuropathology, Harvard Medical School, Boston
| | - Reza Sadjadi
- Massachusetts General Hospital, Department of Neurology, Harvard Medical School, Boston
| | - Ryan Hahn
- Massachusetts General Hospital, Department of Neurology, Harvard Medical School, Boston
| | - Casey A. Maguire
- Massachusetts General Hospital, Department of Neurology, Harvard Medical School, Boston
| | - Florian Eichler
- Massachusetts General Hospital, Department of Neurology, Harvard Medical School, Boston
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Lotun A, Li D, Xu H, Su Q, Tuncer S, Sanmiguel J, Mooney M, Baer CE, Ulbrich R, Eyles SJ, Strittmatter L, Hayward LJ, Gessler DJ, Gao G. Renewal of oligodendrocyte lineage reverses dysmyelination and CNS neurodegeneration through corrected N-acetylaspartate metabolism. Prog Neurobiol 2023; 226:102460. [PMID: 37149081 PMCID: PMC10330635 DOI: 10.1016/j.pneurobio.2023.102460] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Revised: 03/18/2023] [Accepted: 04/28/2023] [Indexed: 05/08/2023]
Abstract
Myelinating oligodendrocytes are essential for neuronal communication and homeostasis of the central nervous system (CNS). One of the most abundant molecules in the mammalian CNS is N-acetylaspartate (NAA), which is catabolized into L-aspartate and acetate by the enzyme aspartoacylase (ASPA) in oligodendrocytes. The resulting acetate moiety is thought to contribute to myelin lipid synthesis. In addition, affected NAA metabolism has been implicated in several neurological disorders, including leukodystrophies and demyelinating diseases such as multiple sclerosis. Genetic disruption of ASPA function causes Canavan disease, which is hallmarked by increased NAA levels, myelin and neuronal loss, large vacuole formation in the CNS, and early death in childhood. Although NAA's direct role in the CNS is inconclusive, in peripheral adipose tissue, NAA-derived acetate has been found to modify histones, a mechanism known to be involved in epigenetic regulation of cell differentiation. We hypothesize that a lack of cellular differentiation in the brain contributes to the disruption of myelination and neurodegeneration in diseases with altered NAA metabolism, such as Canavan disease. Our study demonstrates that loss of functional Aspa in mice disrupts myelination and shifts the transcriptional expression of neuronal and oligodendrocyte markers towards less differentiated stages in a spatiotemporal manner. Upon re-expression of ASPA, these oligodendrocyte and neuronal lineage markers are either improved or normalized, suggesting that NAA breakdown by Aspa plays an essential role in the maturation of neurons and oligodendrocytes. Also, this effect of ASPA re-expression is blunted in old mice, potentially due to limited ability of neuronal, rather than oligodendrocyte, recovery.
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Affiliation(s)
- Anoushka Lotun
- Horae Gene Therapy Center, University of Massachusetts Chan Medical School, Worcester, MA, USA
| | - Danning Li
- Horae Gene Therapy Center, University of Massachusetts Chan Medical School, Worcester, MA, USA
| | - Hongxia Xu
- Horae Gene Therapy Center, University of Massachusetts Chan Medical School, Worcester, MA, USA; University of Science and Technology of Kunming, People's Republic of China
| | - Qin Su
- Horae Gene Therapy Center, University of Massachusetts Chan Medical School, Worcester, MA, USA
| | | | - Julio Sanmiguel
- Horae Gene Therapy Center, University of Massachusetts Chan Medical School, Worcester, MA, USA
| | - Morgan Mooney
- Horae Gene Therapy Center, University of Massachusetts Chan Medical School, Worcester, MA, USA
| | - Christina E Baer
- Sanderson Center for Optical Experimentation, University of Massachusetts Chan Medical School, Worcester, MA, USA
| | - Russell Ulbrich
- ScientiaLux LLC, Tissue-Gnostics USA-East, Worcester, MA, USA
| | - Stephen J Eyles
- Mass Spectrometry Core, University of Massachusetts, Amherst, MA, USA
| | - Lara Strittmatter
- Electron Microscopy Core, University of Massachusetts Chan Medical School, MA, USA
| | - Lawrence J Hayward
- Department of Neurology, University of Massachusetts Chan Medical School, MA, USA
| | - Dominic J Gessler
- Horae Gene Therapy Center, University of Massachusetts Chan Medical School, Worcester, MA, USA; Department of Neurosurgery, University of Minnesota, Minneapolis, MN, USA.
| | - Guangping Gao
- Horae Gene Therapy Center, University of Massachusetts Chan Medical School, Worcester, MA, USA; Li Weibo Institute for Rare Diseases Research, University of Massachusetts Chan Medical School, Worcester, MA, USA; Department of Microbiology & Physiological Systems, University of Massachusetts Chan Medical School, Worcester, MA, USA.
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Gujral J, Sethuram S. An update on the diagnosis and treatment of adrenoleukodystrophy. Curr Opin Endocrinol Diabetes Obes 2023; 30:44-51. [PMID: 36373727 DOI: 10.1097/med.0000000000000782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
PURPOSE OF REVIEW The present review summarizes recent advances in the diagnosis and management of patients with X-linked adrenoleukodystrophy (ALD). RECENT FINDINGS Although ALD screening has been on the list of Recommended Uniform Screening Panel since 2016, only 30 states in the United States are currently testing their newborns for this disease. Hematopoietic stem cell transplant (HSCT) remains the only successful treatment option available for early cerebral ALD but does not reverse neurological changes or affect the course of adrenal insufficiency. There remains a significant knowledge gap in our understanding and treatment of this disease. Novel therapies such as gene therapy and gene editing have shown promising results in animal models and are exciting potential treatment options for the future.Recently, the American Academy of Neurologists released their consensus guidelines on the diagnosis, surveillance, and management of ALD. SUMMARY Early diagnosis and HSCT are key to improving the morbidity and mortality associated with ALD. The implementation of universal newborn screening for ALD and rigorous investigations of novel diagnostic and therapeutic agents is the need of the hour.
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