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Noted Tension Headache, Anxiety, and Depression in a Chinese Patient with Spinocerebellar Ataxia, Autosomal Recessive 10 Caused by a Novel Anoctamin 10 Mutation. J Transl Int Med 2023; 10:373-375. [PMID: 36860629 PMCID: PMC9969569 DOI: 10.2478/jtim-2022-0047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
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2
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Aida I, Ozawa T, Ohta K, Fujinaka H, Goto K, Nakajima T. Autosomal Recessive Spinocerebellar Ataxia Type 10: A Report of a New Case in Japan. Intern Med 2022; 61:2517-2521. [PMID: 35110481 PMCID: PMC9449628 DOI: 10.2169/internalmedicine.8608-21] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Autosomal recessive spinocerebellar ataxia of type 10 (SCAR10) is a very rare neurodegenerative disease caused by mutations in the TMEM16K (ANO10) gene. This disorder is characterized by slowly progressive cerebellar ataxia and pyramidal signs inconstantly associated with cognitive decline, polyneuropathy, epilepsy, and vesicorectal dysfunction. To date, more than 40 cases have been reported in Europe. In contrast, only three cases have been identified in Asian countries. We herein report the third Japanese case of SCAR10 harboring a novel homozygous deletion mutation (c.616delG, p.Glu206Lysfs*17). This case presented with adult-onset slowly progressive spastic ataxia with cerebellar atrophy and mild cognitive decline.
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Affiliation(s)
- Izumi Aida
- Department of Neurology, National Hospital Organization Niigata National Hospital, Japan
| | - Tetsuo Ozawa
- Department of Internal Medicine, National Hospital Organization Niigata National Hospital, Japan
- Department of Genetic Counseling, National Hospital Organization Niigata National Hospital, Japan
| | - Kentaro Ohta
- Department of Neurology, National Hospital Organization Niigata National Hospital, Japan
- Department of Genetic Counseling, National Hospital Organization Niigata National Hospital, Japan
| | - Hidehiko Fujinaka
- Department of Genetic Counseling, National Hospital Organization Niigata National Hospital, Japan
- Department of Pediatrics, National Hospital Organization Niigata National Hospital, Japan
- Department of Clinical Research, National Hospital Organization Niigata National Hospital, Japan
| | - Kiyoe Goto
- Department of Genetic Counseling, National Hospital Organization Niigata National Hospital, Japan
| | - Takashi Nakajima
- Department of Neurology, National Hospital Organization Niigata National Hospital, Japan
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3
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ANO10 Function in Health and Disease. CEREBELLUM (LONDON, ENGLAND) 2022; 22:447-467. [PMID: 35648332 PMCID: PMC10126014 DOI: 10.1007/s12311-022-01395-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 03/14/2022] [Indexed: 10/18/2022]
Abstract
Anoctamin 10 (ANO10), also known as TMEM16K, is a transmembrane protein and member of the anoctamin family characterized by functional duality. Anoctamins manifest ion channel and phospholipid scrambling activities and are involved in many physiological processes such as cell division, migration, apoptosis, cell signalling, and developmental processes. Several diseases, including neurological, muscle, blood disorders, and cancer, have been associated with the anoctamin family proteins. ANO10, which is the main focus of the present review, exhibits both scrambling and chloride channel activity; calcium availability is necessary for protein activation in either case. Additional processes implicating ANO10 include endosomal sorting, spindle assembly, and calcium signalling. Dysregulation of calcium signalling in Purkinje cells due to ANO10 defects is proposed as the main mechanism leading to spinocerebellar ataxia autosomal recessive type 10 (SCAR10), a rare, slowly progressive spinocerebellar ataxia. Regulation of the endolysosomal pathway is an additional ANO10 function linked to SCAR10 aetiology. Further functional investigation is essential to unravel the ANO10 mechanism of action and involvement in disease development.
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4
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Ásbjörnsdóttir B, Henriksen OM, Lindquist S, Møller LB, Sidaros A, Nielsen JE. Widening the spectrum of spinocerebellar ataxia autosomal recessive type 10 (SCAR10). BMJ Case Rep 2022; 15:e248228. [PMID: 35256372 PMCID: PMC8905945 DOI: 10.1136/bcr-2021-248228] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/09/2022] [Indexed: 11/04/2022] Open
Abstract
Biallelic pathogenic variants in the ANO10 gene cause spinocerebellar ataxia recessive type 10. We report two patients, both compound heterozygous for ANO10 variants, including two novel variants. Both patients had onset of cerebellar ataxia in adulthood with slow progression and presented corticospinal tract signs, eye movement abnormalities and cognitive executive impairment. One of them had temporal lobe epilepsy and she also carried a heterozygous variant in CACNB4, a potential risk gene for epilepsy. Both patients had pronounced cerebellar atrophy on cerebral magnetic resonance imaging (MRI) and reduced metabolic activity in cerebellum as well as in the frontal lobes on 2-deoxy-2-(18F)fluoro-D-glucose positron emission tomography ((18F)FDG PET) scans. We provide comprehensive clinical, radiological and genetic data on two patients carrying likely pathogenic ANO10 gene variants. Furthermore, we provide evidence for a cerebellar as well as a frontal involvement on brain (18F)FDG PET scans which has not previously been reported.
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Affiliation(s)
- Birna Ásbjörnsdóttir
- Neurogenetics Clinic & Research Lab, Danish Dementia Research Centre, Department of Neurology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Otto Mølby Henriksen
- Department of Clinical Physiology, Nuclear Medicine and PET, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Suzanne Lindquist
- Neurogenetics Clinic & Research Lab, Danish Dementia Research Centre, Department of Neurology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
- Department of Genetics, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Lisbeth Birk Møller
- Department of Genetics, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Annette Sidaros
- Department of Neurology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
- Department of Clinical Neurophysiology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Jørgen Erik Nielsen
- Neurogenetics Clinic & Research Lab, Danish Dementia Research Centre, Department of Neurology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
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5
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Mei C, Dong H, Nisenbaum E, Thielhelm T, Nourbakhsh A, Yan D, Smeal M, Lundberg Y, Hoffer ME, Angeli S, Telischi F, Nie G, Blanton SH, Liu X. Genetics and the Individualized Therapy of Vestibular Disorders. Front Neurol 2021; 12:633207. [PMID: 33613440 PMCID: PMC7892966 DOI: 10.3389/fneur.2021.633207] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Accepted: 01/13/2021] [Indexed: 02/06/2023] Open
Abstract
Background: Vestibular disorders (VDs) are a clinically divergent group of conditions that stem from pathology at the level of the inner ear, vestibulocochlear nerve, or central vestibular pathway. No etiology can be identified in the majority of patients with VDs. Relatively few families have been reported with VD, and so far, no causative genes have been identified despite the fact that more than 100 genes have been identified for inherited hearing loss. Inherited VDs, similar to deafness, are genetically heterogeneous and follow Mendelian inheritance patterns with all modes of transmission, as well as multifactorial inheritance. With advances in genetic sequencing, evidence of familial clustering in VD has begun to highlight the genetic causes of these disorders, potentially opening up new avenues of treatment, particularly in Meniere's disease and disorders with comorbid hearing loss, such as Usher syndrome. In this review, we aim to present recent findings on the genetics of VDs, review the role of genetic sequencing tools, and explore the potential for individualized medicine in the treatment of these disorders. Methods: A search of the PubMed database was performed for English language studies relevant to the genetic basis of and therapies for vestibular disorders, using search terms including but not limited to: “genetics,” “genomics,” “vestibular disorders,” “hearing loss with vestibular dysfunction,” “individualized medicine,” “genome-wide association studies,” “precision medicine,” and “Meniere's syndrome.” Results: Increasing numbers of studies on vestibular disorder genetics have been published in recent years. Next-generation sequencing and new genetic tools are being utilized to unearth the significance of the genomic findings in terms of understanding disease etiology and clinical utility, with growing research interest being shown for individualized gene therapy for some disorders. Conclusions: The genetic knowledge base for vestibular disorders is still in its infancy. Identifying the genetic causes of balance problems is imperative in our understanding of the biology of normal function of the vestibule and the disease etiology and process. There is an increasing effort to use new and efficient genetic sequencing tools to discover the genetic causes for these diseases, leading to the hope for precise and personalized treatment for these patients.
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Affiliation(s)
- Christine Mei
- Department of Otolaryngology, University of Miami, Coral Gables, FL, United States
| | - Hongsong Dong
- Department of Otolaryngology, University of Miami, Coral Gables, FL, United States.,Shenzhen Second People's Hospital, Shenzhen, China
| | - Eric Nisenbaum
- Department of Otolaryngology, University of Miami, Coral Gables, FL, United States
| | - Torin Thielhelm
- Department of Otolaryngology, University of Miami, Coral Gables, FL, United States
| | - Aida Nourbakhsh
- Department of Otolaryngology, University of Miami, Coral Gables, FL, United States
| | - Denise Yan
- Department of Otolaryngology, University of Miami, Coral Gables, FL, United States
| | - Molly Smeal
- Department of Otolaryngology, University of Miami, Coral Gables, FL, United States
| | - Yesha Lundberg
- Department of Otolaryngology, Boys Town National Research Hospital, Omaha, NE, United States
| | - Michael E Hoffer
- Department of Otolaryngology, University of Miami, Coral Gables, FL, United States
| | - Simon Angeli
- Department of Otolaryngology, University of Miami, Coral Gables, FL, United States
| | - Fred Telischi
- Department of Otolaryngology, University of Miami, Coral Gables, FL, United States
| | - Guohui Nie
- Shenzhen Second People's Hospital, Shenzhen, China
| | - Susan H Blanton
- Department of Otolaryngology, University of Miami, Coral Gables, FL, United States
| | - Xuezhong Liu
- Department of Otolaryngology, University of Miami, Coral Gables, FL, United States
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Yang SL, Chen SF, Jiao YQ, Dong ZY, Dong Q, Han X. Autosomal Recessive Spinocerebellar Ataxia Caused by a Novel Homozygous ANO10 Mutation in a Consanguineous Chinese Family. J Clin Neurol 2020; 16:333-335. [PMID: 32319254 PMCID: PMC7174130 DOI: 10.3988/jcn.2020.16.2.333] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2019] [Revised: 11/27/2019] [Accepted: 11/29/2019] [Indexed: 11/17/2022] Open
Affiliation(s)
- Shi Lin Yang
- Department of Neurology, Huashan Hospital, Fudan University, Shanghai, China
| | - Shu Fen Chen
- Department of Neurology, Huashan Hospital, Fudan University, Shanghai, China
| | - Yu Qiong Jiao
- Department of Neurology, Huashan Hospital, Fudan University, Shanghai, China
| | - Zhi Yuan Dong
- Department of Neurology, Shanghai Fifth People's Hospital, Fudan University, Shanghai, China
| | - Qiang Dong
- Department of Neurology, Huashan Hospital, Fudan University, Shanghai, China
| | - Xiang Han
- Department of Neurology, Huashan Hospital, Fudan University, Shanghai, China.
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7
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Bushell SR, Pike ACW, Falzone ME, Rorsman NJG, Ta CM, Corey RA, Newport TD, Christianson JC, Scofano LF, Shintre CA, Tessitore A, Chu A, Wang Q, Shrestha L, Mukhopadhyay SMM, Love JD, Burgess-Brown NA, Sitsapesan R, Stansfeld PJ, Huiskonen JT, Tammaro P, Accardi A, Carpenter EP. The structural basis of lipid scrambling and inactivation in the endoplasmic reticulum scramblase TMEM16K. Nat Commun 2019; 10:3956. [PMID: 31477691 PMCID: PMC6718402 DOI: 10.1038/s41467-019-11753-1] [Citation(s) in RCA: 98] [Impact Index Per Article: 19.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2018] [Accepted: 08/01/2019] [Indexed: 11/20/2022] Open
Abstract
Membranes in cells have defined distributions of lipids in each leaflet, controlled by lipid scramblases and flip/floppases. However, for some intracellular membranes such as the endoplasmic reticulum (ER) the scramblases have not been identified. Members of the TMEM16 family have either lipid scramblase or chloride channel activity. Although TMEM16K is widely distributed and associated with the neurological disorder autosomal recessive spinocerebellar ataxia type 10 (SCAR10), its location in cells, function and structure are largely uncharacterised. Here we show that TMEM16K is an ER-resident lipid scramblase with a requirement for short chain lipids and calcium for robust activity. Crystal structures of TMEM16K show a scramblase fold, with an open lipid transporting groove. Additional cryo-EM structures reveal extensive conformational changes from the cytoplasmic to the ER side of the membrane, giving a state with a closed lipid permeation pathway. Molecular dynamics simulations showed that the open-groove conformation is necessary for scramblase activity. TMEM16K is a member of the TMEM16 family of integral membrane proteins that are either lipid scramblases or chloride channels. Here the authors combine cell biology, electrophysiology measurements, X-ray crystallography, cryo-EM and MD simulations to structurally characterize TMEM16K and show that it is an ER-resident lipid scramblase.
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Affiliation(s)
- Simon R Bushell
- Structural Genomics Consortium, Nuffield Department of Medicine, University of Oxford, Old Road Campus Research Building, Roosevelt Drive, Oxford, OX3 7DQ, UK
| | - Ashley C W Pike
- Structural Genomics Consortium, Nuffield Department of Medicine, University of Oxford, Old Road Campus Research Building, Roosevelt Drive, Oxford, OX3 7DQ, UK
| | - Maria E Falzone
- Department of Biochemistry, Weill Cornell Medical School, 1300 York Avenue, New York, NY, 10065, USA
| | - Nils J G Rorsman
- Department of Pharmacology, University of Oxford, Mansfield Road, Oxford, OX1 3QT, UK.,OxSyBio, Atlas Building, Harwell Campus, Didcot, Oxfordshire, OX11 0QX, UK
| | - Chau M Ta
- Department of Pharmacology, University of Oxford, Mansfield Road, Oxford, OX1 3QT, UK.,Department of Cardiology, Washington University in St. Louis, St. Louis, MO, 63110, USA
| | - Robin A Corey
- Department of Biochemistry, University of Oxford, South Parks Road, Oxford, OX1 3QT, UK
| | - Thomas D Newport
- Department of Biochemistry, University of Oxford, South Parks Road, Oxford, OX1 3QT, UK.,Oxford Nanopore Technologies, Oxford Science Park, Oxford, OX4 4DQ, UK
| | - John C Christianson
- Nuffield Department of Rheumatology, Orthopaedics and Musculoskeletal Sciences, University of Oxford, Windmill Road, Oxford, OX3 7LD, UK
| | - Lara F Scofano
- Department of Pharmacology, University of Oxford, Mansfield Road, Oxford, OX1 3QT, UK
| | - Chitra A Shintre
- Structural Genomics Consortium, Nuffield Department of Medicine, University of Oxford, Old Road Campus Research Building, Roosevelt Drive, Oxford, OX3 7DQ, UK.,Vertex Pharmaceuticals Ltd, Milton Park, Oxfordshire, OX14 4RW, UK
| | - Annamaria Tessitore
- Structural Genomics Consortium, Nuffield Department of Medicine, University of Oxford, Old Road Campus Research Building, Roosevelt Drive, Oxford, OX3 7DQ, UK.,Nuffield Division of Clinical Laboratory Sciences, Oxford University, Oxford, OX3 9DU, UK
| | - Amy Chu
- Structural Genomics Consortium, Nuffield Department of Medicine, University of Oxford, Old Road Campus Research Building, Roosevelt Drive, Oxford, OX3 7DQ, UK.,Department of Biochemistry, Oxford University, Oxford, OX1 3QT, UK
| | - Qinrui Wang
- Structural Genomics Consortium, Nuffield Department of Medicine, University of Oxford, Old Road Campus Research Building, Roosevelt Drive, Oxford, OX3 7DQ, UK.,Department of Biochemistry, University of Oxford, South Parks Road, Oxford, OX1 3QT, UK
| | - Leela Shrestha
- Structural Genomics Consortium, Nuffield Department of Medicine, University of Oxford, Old Road Campus Research Building, Roosevelt Drive, Oxford, OX3 7DQ, UK
| | - Shubhashish M M Mukhopadhyay
- Structural Genomics Consortium, Nuffield Department of Medicine, University of Oxford, Old Road Campus Research Building, Roosevelt Drive, Oxford, OX3 7DQ, UK
| | - James D Love
- Department of Biochemistry, Albert Einstein College of Medicine, 1300 Morris Park Avenue, Bronx, NY, 10461-1602, USA.,Novo Nordisk A/S, Novo Nordisk Park, 2760, Måløv, Denmark
| | - Nicola A Burgess-Brown
- Structural Genomics Consortium, Nuffield Department of Medicine, University of Oxford, Old Road Campus Research Building, Roosevelt Drive, Oxford, OX3 7DQ, UK
| | - Rebecca Sitsapesan
- Department of Pharmacology, University of Oxford, Mansfield Road, Oxford, OX1 3QT, UK
| | - Phillip J Stansfeld
- Department of Biochemistry, University of Oxford, South Parks Road, Oxford, OX1 3QT, UK
| | - Juha T Huiskonen
- Division of Structural Biology, Wellcome Centre for Human Genetics, University of Oxford, Roosevelt Drive, Oxford, OX3 7BN, UK
| | - Paolo Tammaro
- Department of Pharmacology, University of Oxford, Mansfield Road, Oxford, OX1 3QT, UK
| | - Alessio Accardi
- Department of Biochemistry, Weill Cornell Medical School, 1300 York Avenue, New York, NY, 10065, USA.,Department of Anesthesiology, Weill Cornell Medical School, 25 East 68th Street, New York, NY, 10065, USA.,Department of Physiology and Biophysics, Weill Cornell Medical School, 1300 York Avenue, New York, NY, 10065, USA
| | - Elisabeth P Carpenter
- Structural Genomics Consortium, Nuffield Department of Medicine, University of Oxford, Old Road Campus Research Building, Roosevelt Drive, Oxford, OX3 7DQ, UK.
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8
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Lee B, Hong GS, Lee SH, Kim H, Kim A, Hwang EM, Kim J, Lee MG, Yang JY, Kweon MN, Tse CM, Mark D, Oh U. Anoctamin 1/TMEM16A controls intestinal Cl - secretion induced by carbachol and cholera toxin. Exp Mol Med 2019; 51:1-14. [PMID: 31383845 PMCID: PMC6802608 DOI: 10.1038/s12276-019-0287-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2017] [Revised: 03/07/2019] [Accepted: 03/11/2019] [Indexed: 12/17/2022] Open
Abstract
Calcium-activated chloride channels (CaCCs) mediate numerous physiological functions and are best known for the transport of electrolytes and water in epithelia. In the intestine, CaCC currents are considered necessary for the secretion of fluid to protect the intestinal epithelium. Although genetic ablation of ANO1/TMEM16A, a gene encoding a CaCC, reduces the carbachol-induced secretion of intestinal fluid, its mechanism of action is still unknown. Here, we confirm that ANO1 is essential for the secretion of intestinal fluid. Carbachol-induced transepithelial currents were reduced in the proximal colon of Ano1-deficient mice. Surprisingly, cholera toxin-induced and cAMP-induced fluid secretion, believed to be mediated by CFTR, were also significantly reduced in the intestine of Ano1-deficient mice. ANO1 is largely expressed in the apical membranes of intestines, as predicted for CaCCs. The Ano1-deficient colons became edematous under basal conditions and had a greater susceptibility to dextran sodium sulfate-induced colitis. However, Ano1 depletion failed to affect tumor development in a model of colorectal cancer. We thus conclude that ANO1 is necessary for cAMP- and carbachol-induced Cl− secretion in the intestine, which is essential for the protection of the intestinal epithelium from colitis. An ion channel, a membrane protein allowing ion transport, that controls the flow of chloride is needed for proper secretion of protective fluids in the intestine. Uhtaek Oh from the Korea Institute of Science & Technology in Seoul, South Korea, and colleagues showed that cells lining the intestinal surface express a calcium-activated chloride channel called anoctamin-1 (ANO1) that regulates fluid secretion in the gut. Compared to control animals, ANO1-deficient mice released less fluid into their intestines following exposure to a diarrhea-inducing toxin or to a chloride transport–stimulating signaling molecule. This fluid secretion was previously thought to be mediated via a different ion channel. The ANO1-deficient mice accumulated fluid within colonic tissues, which increased their susceptibility to colitis. The findings point to ANO1 activation as a potential therapeutic strategy for treating colitis.
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Affiliation(s)
- Byeongjun Lee
- College of Pharmacy, Seoul National University, Seoul, 08826, Korea
| | - Gyu-Sang Hong
- Brain Science Institute, Korea Institute of Science & Technology (KIST), Seoul, 02792, Korea
| | - Sung Hoon Lee
- College of Pharmacy, Chung-Ang University, Seoul, 06974, Korea
| | - Hyungsup Kim
- Brain Science Institute, Korea Institute of Science & Technology (KIST), Seoul, 02792, Korea
| | - Ajung Kim
- Brain Science Institute, Korea Institute of Science & Technology (KIST), Seoul, 02792, Korea
| | - Eun Mi Hwang
- Brain Science Institute, Korea Institute of Science & Technology (KIST), Seoul, 02792, Korea
| | - Jiyoon Kim
- Department of Pharmacology, Yonsei University College of Medicine, Seoul, 03722, Korea
| | - Min Goo Lee
- Department of Pharmacology, Yonsei University College of Medicine, Seoul, 03722, Korea
| | - Jin-Young Yang
- Mucosal Immunology Laboratory, Department of Convergence Medicine, University of Ulsan College of Medicine/Asan Medical Center, Seoul, 05505, Korea
| | - Mi-Na Kweon
- Mucosal Immunology Laboratory, Department of Convergence Medicine, University of Ulsan College of Medicine/Asan Medical Center, Seoul, 05505, Korea
| | - Chung-Ming Tse
- Departments of Physiology and Medicine, Division of Gastroenterois maintained by the opening of plasmalogy, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Donowitz Mark
- Departments of Physiology and Medicine, Division of Gastroenterois maintained by the opening of plasmalogy, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Uhtaek Oh
- College of Pharmacy, Seoul National University, Seoul, 08826, Korea. .,Brain Science Institute, Korea Institute of Science & Technology (KIST), Seoul, 02792, Korea.
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9
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Nanetti L, Sarto E, Castaldo A, Magri S, Mongelli A, Rossi Sebastiano D, Canafoglia L, Grisoli M, Malaguti C, Rivieri F, D’Amico MC, Di Bella D, Franceschetti S, Mariotti C, Taroni F. ANO10 mutational screening in recessive ataxia: genetic findings and refinement of the clinical phenotype. J Neurol 2018; 266:378-385. [DOI: 10.1007/s00415-018-9141-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2018] [Revised: 11/22/2018] [Accepted: 11/24/2018] [Indexed: 12/22/2022]
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10
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Malicdan MCV, Vilboux T, Ben-Zeev B, Guo J, Eliyahu A, Pode-Shakked B, Dori A, Kakani S, Chandrasekharappa SC, Ferreira C, Shelestovich N, Marek-Yagel D, Pri-Chen H, Blatt I, Niederhuber JE, He L, Toro C, Taylor RW, Deeken J, Yardeni T, Wallace DC, Gahl WA, Anikster Y. A novel inborn error of the coenzyme Q10 biosynthesis pathway: cerebellar ataxia and static encephalomyopathy due to COQ5 C-methyltransferase deficiency. Hum Mutat 2018; 39:69-79. [PMID: 29044765 PMCID: PMC5722658 DOI: 10.1002/humu.23345] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2017] [Revised: 08/27/2017] [Accepted: 09/11/2017] [Indexed: 01/08/2023]
Abstract
Primary coenzyme Q10 (CoQ10 ; MIM# 607426) deficiencies are an emerging group of inherited mitochondrial disorders with heterogonous clinical phenotypes. Over a dozen genes are involved in the biosynthesis of CoQ10 , and mutations in several of these are associated with human disease. However, mutations in COQ5 (MIM# 616359), catalyzing the only C-methylation in the CoQ10 synthetic pathway, have not been implicated in human disease. Here, we report three female siblings of Iraqi-Jewish descent, who had varying degrees of cerebellar ataxia, encephalopathy, generalized tonic-clonic seizures, and cognitive disability. Whole-exome and subsequent whole-genome sequencing identified biallelic duplications in the COQ5 gene, leading to reduced levels of CoQ10 in peripheral white blood cells of all affected individuals and reduced CoQ10 levels in the only muscle tissue available from one affected proband. CoQ10 supplementation led to clinical improvement and increased the concentrations of CoQ10 in blood. This is the first report of primary CoQ10 deficiency caused by loss of function of COQ5, with delineation of the clinical, laboratory, histological, and molecular features, and insights regarding targeted treatment with CoQ10 supplementation.
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Affiliation(s)
- May Christine V. Malicdan
- NIH Undiagnosed Diseases Program, Common Fund, Office of the Director, NIH and National Human Genome Research Institute, NIH, Bethesda, 20892 Maryland, USA
- Medical Genetics Branch, National Human Genome Research Institute, National Institutes of Health, Bethesda, 20892 Maryland, USA
| | - Thierry Vilboux
- Medical Genetics Branch, National Human Genome Research Institute, National Institutes of Health, Bethesda, 20892 Maryland, USA
- Inova Translational Medicine Institute, Falls Church, 22042 Virginia, USA
| | - Bruria Ben-Zeev
- Pediatric Neurology Unit, Edmond and Lily Safra Children’s Hospital, Sheba Medical Center, Tel-Hashomer, 5621 Israel
- Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, 69978 Israel
- Department of Pathology, Sheba Medical Center, Tel-Hashomer, 52621, Israel
| | - Jennifer Guo
- NIH Undiagnosed Diseases Program, Common Fund, Office of the Director, NIH and National Human Genome Research Institute, NIH, Bethesda, 20892 Maryland, USA
| | - Aviva Eliyahu
- Metabolic Disease Unit, Edmond and Lily Safra Children’s Hospital, Sheba Medical Center, Tel-Hashomer, 5621 Israel
- Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, 69978 Israel
| | - Ben Pode-Shakked
- Metabolic Disease Unit, Edmond and Lily Safra Children’s Hospital, Sheba Medical Center, Tel-Hashomer, 5621 Israel
- The Dr. Pinchas Borenstein Talpiot Medical Leadership Program, Sheba Medical Center, Tel-Hashomer, 5621 Israel
- Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, 69978 Israel
| | - Amir Dori
- The Dr. Pinchas Borenstein Talpiot Medical Leadership Program, Sheba Medical Center, Tel-Hashomer, 5621 Israel
- Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, 69978 Israel
- Joseph Sagol Neuroscience Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, 69978 Israel
| | - Sravan Kakani
- Medical Genetics Branch, National Human Genome Research Institute, National Institutes of Health, Bethesda, 20892 Maryland, USA
| | - Settara C. Chandrasekharappa
- Cancer Genetics and Comparative Genomics Branch, National Human Genome Research Institute, National Institutes of Health, Bethesda, 20892 Maryland, USA
| | - Carlos Ferreira
- Medical Genetics Branch, National Human Genome Research Institute, National Institutes of Health, Bethesda, 20892 Maryland, USA
| | - Natalia Shelestovich
- Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, 69978 Israel
- Center for Mitochondrial and Epigenomic Medicine, Children’s Hospital of Philadelphia Research Institute, Philadelphia, USA
| | - Dina Marek-Yagel
- Metabolic Disease Unit, Edmond and Lily Safra Children’s Hospital, Sheba Medical Center, Tel-Hashomer, 5621 Israel
- Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, 69978 Israel
- Department of Pathology, Sheba Medical Center, Tel-Hashomer, 52621, Israel
| | - Hadass Pri-Chen
- Medical Genetics Branch, National Human Genome Research Institute, National Institutes of Health, Bethesda, 20892 Maryland, USA
- The Wohl Institute for Translational Medicine, Sheba Medical Center, Tel-Hashomer, 52621, Israel
| | - Ilan Blatt
- Department of Neurology, Sheba Medical Center, Tel-Hashomer, 5621 Israel
| | - John E. Niederhuber
- Inova Translational Medicine Institute, Falls Church, 22042 Virginia, USA
- Johns Hopkins University School of Medicine, 733 North Broadway Street, Baltimore, MD, USA
| | - Langping He
- Wellcome Centre for Mitochondrial Research, Institute of Neuroscience, The Medical School, Newcastle University, Newcastle upon Tyne, UK
| | - Camilo Toro
- NIH Undiagnosed Diseases Program, Common Fund, Office of the Director, NIH and National Human Genome Research Institute, NIH, Bethesda, 20892 Maryland, USA
| | - Robert W. Taylor
- Wellcome Centre for Mitochondrial Research, Institute of Neuroscience, The Medical School, Newcastle University, Newcastle upon Tyne, UK
| | - John Deeken
- Inova Translational Medicine Institute, Falls Church, 22042 Virginia, USA
| | - Tal Yardeni
- Center for Mitochondrial and Epigenomic Medicine, Children’s Hospital of Philadelphia Research Institute, Philadelphia, USA
| | - Douglas C. Wallace
- Center for Mitochondrial and Epigenomic Medicine, Children’s Hospital of Philadelphia Research Institute, Philadelphia, USA
| | - William A. Gahl
- NIH Undiagnosed Diseases Program, Common Fund, Office of the Director, NIH and National Human Genome Research Institute, NIH, Bethesda, 20892 Maryland, USA
- Medical Genetics Branch, National Human Genome Research Institute, National Institutes of Health, Bethesda, 20892 Maryland, USA
| | - Yair Anikster
- Metabolic Disease Unit, Edmond and Lily Safra Children’s Hospital, Sheba Medical Center, Tel-Hashomer, 5621 Israel
- Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, 69978 Israel
- The Wohl Institute for Translational Medicine, Sheba Medical Center, Tel-Hashomer, 52621, Israel
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11
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12
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Bogdanova-Mihaylova P, Austin N, Alexander MD, Cassidy L, Early A, Murphy RP, Murphy SM, Walsh RA. Anoctamin 10-Related Autosomal Recessive Cerebellar Ataxia: Comprehensive Clinical Phenotyping of an Irish Sibship. Mov Disord Clin Pract 2017; 4:258-262. [PMID: 30838263 DOI: 10.1002/mdc3.12396] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2016] [Revised: 04/13/2016] [Accepted: 05/16/2016] [Indexed: 11/10/2022] Open
Abstract
The autosomal recessive cerebellar ataxias are a heterogeneous group of neurodegenerative disorders. Mutations in the anoctamin 10 gene (ANO10) recently have been identified as a cause of autosomal recessive spinocerebellar ataxia type 10. Comprehensive phenotypic data are provided on 3 siblings with homozygous ANO10 mutations, including detailed ocular and cognitive assessments and bladder involvement not previously described in the literature. Data also are provided on unblinded therapy with coenzyme Q10, previously reported as a possible therapy in ANO10-related ataxia. A genetic diagnosis in this family was obtained through next-generation sequencing techniques after over 10 years of expensive sequencing of individual genes using the traditional Sanger approach. Greater commercial availability of gene panels will improve the ability to obtain a genetic diagnosis in the uncommon "non-Friedreich's" recessive ataxias. Clinical recognition of these recessive ataxic syndromes will also inevitably improve as the full phenotypic spectrum is identified.
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Affiliation(s)
- Petya Bogdanova-Mihaylova
- National Ataxia Clinic Department of Neurology Adelaide & Meath Hospital Dublin incorporating the National Children's Hospital Tallaght Dublin Ireland
| | - Neil Austin
- Department of Psychology Adelaide & Meath Hospitals incorporating the National Children's Hospital Tallaght Dublin Ireland
| | - Michael D Alexander
- Department of Neurophysiology Adelaide & Meath Hospitals incorporating the National Children's Hospital Tallaght Dublin Ireland.,Academic Unit of Neurology Trinity College Dublin Ireland
| | - Lorraine Cassidy
- Department of Ophthalmology Adelaide & Meath Hospitals incorporating the National Children's Hospital Tallaght Dublin Ireland
| | - Anne Early
- Department of Ophthalmology Adelaide & Meath Hospitals incorporating the National Children's Hospital Tallaght Dublin Ireland
| | - Raymond P Murphy
- National Ataxia Clinic Department of Neurology Adelaide & Meath Hospital Dublin incorporating the National Children's Hospital Tallaght Dublin Ireland.,Academic Unit of Neurology Trinity College Dublin Ireland
| | - Sinéad M Murphy
- National Ataxia Clinic Department of Neurology Adelaide & Meath Hospital Dublin incorporating the National Children's Hospital Tallaght Dublin Ireland.,Academic Unit of Neurology Trinity College Dublin Ireland
| | - Richard A Walsh
- National Ataxia Clinic Department of Neurology Adelaide & Meath Hospital Dublin incorporating the National Children's Hospital Tallaght Dublin Ireland.,Academic Unit of Neurology Trinity College Dublin Ireland
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13
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Mišković ND, Domingo A, Dobričić V, Max C, Braenne I, Petrović I, Grütz K, Pawlack H, Tournev I, Kalaydjieva L, Svetel M, Lohmann K, Kostić VS, Westenberger A. Seemingly dominant inheritance of a recessive ANO10 mutation in romani families with cerebellar ataxia. Mov Disord 2016; 31:1929-1931. [PMID: 27787937 DOI: 10.1002/mds.26816] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2016] [Revised: 09/01/2016] [Accepted: 09/01/2016] [Indexed: 01/12/2023] Open
Affiliation(s)
- Nataša Dragašević Mišković
- Clinic of Neurology, Faculty of Medicine, Clinical Centre of Serbia, University of Belgrade, Belgrade, Serbia
| | - Aloysius Domingo
- Institute of Neurogenetics, University of Lübeck, Lübeck, Germany.,Graduate School for Computing in Medicine and Life Science, University of Lübeck, Lübeck, Germany
| | - Valerija Dobričić
- Clinic of Neurology, Faculty of Medicine, Clinical Centre of Serbia, University of Belgrade, Belgrade, Serbia
| | - Christoph Max
- Institute of Neurogenetics, University of Lübeck, Lübeck, Germany
| | - Ingrid Braenne
- Institute for Integrative and Experimental Genomics, University of Lübeck, Lübeck, Germany
| | - Igor Petrović
- Clinic of Neurology, Faculty of Medicine, Clinical Centre of Serbia, University of Belgrade, Belgrade, Serbia
| | - Karen Grütz
- Institute of Neurogenetics, University of Lübeck, Lübeck, Germany
| | - Heike Pawlack
- Institute of Neurogenetics, University of Lübeck, Lübeck, Germany
| | - Ivailo Tournev
- Clinic of Nervous Diseases, University Hospital Aleksandrovska, Department of Neurology, Sofia Medical University, Sofia.,Department of Cognitive Science and Psychology, New Bulgarian University, Sofia
| | - Luba Kalaydjieva
- Harry Perkins Institute of Medical Research and Centre for Medical Research, The University of Western Australia, Perth, Australia
| | - Marina Svetel
- Clinic of Neurology, Faculty of Medicine, Clinical Centre of Serbia, University of Belgrade, Belgrade, Serbia
| | - Katja Lohmann
- Institute of Neurogenetics, University of Lübeck, Lübeck, Germany
| | - Vladimir S Kostić
- Clinic of Neurology, Faculty of Medicine, Clinical Centre of Serbia, University of Belgrade, Belgrade, Serbia
| | - Ana Westenberger
- Institute of Neurogenetics, University of Lübeck, Lübeck, Germany
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14
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Tanaka F, Doi H, Kunii M. Autosomal recessive spinocerebellar ataxias in Japan. Rinsho Shinkeigaku 2016; 56:395-9. [PMID: 27181749 DOI: 10.5692/clinicalneurol.cn-000879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Recent new sequencing techniques allow the identification of novel responsible genes for autosomal recessive spinocerebellar ataxias (ARCAs). However, the same phenotypes are sometimes attributed to the different responsible genes in ARCAs. On the contrary, the same responsible genes may cause heterogeneous phenotypes with respect to the age at onset, symptoms, and the severity of the disease progression. In addition, it is an important issue to clarify whether the gene mutations identified in Caucasian patients with infantile-onset ARCAs are also observed in Japanese patients with adult-onset ARCAs. In this article we review the characteristics of several ARCAs, the existence of which has been recently identified or confirmed in Japan.
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Affiliation(s)
- Fumiaki Tanaka
- Department of Neurology and Stroke Medicine, Yokohama City University Graduate School of Medicine
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15
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Yoshida K, Miyatake S, Kinoshita T, Doi H, Tsurusaki Y, Miyake N, Saitsu H, Matsumoto N. 'Cortical cerebellar atrophy' dwindles away in the era of next-generation sequencing. J Hum Genet 2014; 59:589-90. [PMID: 25209172 PMCID: PMC4521292 DOI: 10.1038/jhg.2014.75] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Affiliation(s)
- Kunihiro Yoshida
- Division of Neurogenetics, Department of Brain Disease Research, Shinshu University School of Medicine, Matsumoto, Japan
| | - Satoko Miyatake
- Department of Human Genetics, Graduate School of Medicine, Yokohama City University, Yokohama, Japan
| | - Tomomi Kinoshita
- Department of Medicine (Neurology and Rheumatology), Shinshu University School of Medicine, Matsumoto, Japan
| | - Hiroshi Doi
- Department of Human Genetics, Graduate School of Medicine, Yokohama City University, Yokohama, Japan
- Department of Clinical Neurology and Stroke Medicine, Graduate School of Medicine, Yokohama City University, Yokohama, Japan
| | - Yoshinori Tsurusaki
- Department of Human Genetics, Graduate School of Medicine, Yokohama City University, Yokohama, Japan
| | - Noriko Miyake
- Department of Human Genetics, Graduate School of Medicine, Yokohama City University, Yokohama, Japan
| | - Hirotomo Saitsu
- Department of Human Genetics, Graduate School of Medicine, Yokohama City University, Yokohama, Japan
| | - Naomichi Matsumoto
- Department of Human Genetics, Graduate School of Medicine, Yokohama City University, Yokohama, Japan
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16
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Balreira A, Boczonadi V, Barca E, Pyle A, Bansagi B, Appleton M, Graham C, Hargreaves IP, Rasic VM, Lochmüller H, Griffin H, Taylor RW, Naini A, Chinnery PF, Hirano M, Quinzii CM, Horvath R. ANO10 mutations cause ataxia and coenzyme Q₁₀ deficiency. J Neurol 2014; 261:2192-8. [PMID: 25182700 PMCID: PMC4221650 DOI: 10.1007/s00415-014-7476-7] [Citation(s) in RCA: 62] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2014] [Revised: 08/14/2014] [Accepted: 08/19/2014] [Indexed: 11/29/2022]
Abstract
Inherited ataxias are heterogeneous
disorders affecting both children and adults, with over 40 different causative genes, making molecular genetic diagnosis challenging. Although recent advances in next-generation sequencing have significantly improved mutation detection, few treatments exist for patients with inherited ataxia. In two patients with adult-onset cerebellar ataxia and coenzyme Q10 (CoQ10) deficiency in muscle, whole exome sequencing revealed mutations in ANO10, which encodes anoctamin 10, a member of a family of putative calcium-activated chloride channels, and the causative gene for autosomal recessive spinocerebellar ataxia-10 (SCAR10). Both patients presented with slowly progressive ataxia and dysarthria leading to severe disability in the sixth decade. Epilepsy and learning difficulties were also present in one patient, while retinal degeneration and cataract were present in the other. The detection of mutations in ANO10 in our patients indicate that ANO10 defects cause secondary low CoQ10 and SCAR10 patients may benefit from CoQ10 supplementation.
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Affiliation(s)
- Andrea Balreira
- Department of Neurology, Columbia University Medical Center, New York, NY USA
| | - Veronika Boczonadi
- Institute of Genetic Medicine, Newcastle University, Newcastle upon Tyne, UK
| | - Emanuele Barca
- Department of Neurology, Columbia University Medical Center, New York, NY USA
| | - Angela Pyle
- Institute of Genetic Medicine, Newcastle University, Newcastle upon Tyne, UK
| | - Boglarka Bansagi
- Institute of Genetic Medicine, Newcastle University, Newcastle upon Tyne, UK
| | - Marie Appleton
- Wellcome Trust Centre for Mitochondrial Research, Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, UK
| | - Claire Graham
- Institute of Genetic Medicine, Newcastle University, Newcastle upon Tyne, UK
| | - Iain P. Hargreaves
- Department of Molecular Neuroscience, UCL Institute of Neurology, London, UK
| | - Vedrana Milic Rasic
- Clinic for Neurology and Psychiatry for Children and Youth, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Hanns Lochmüller
- Institute of Genetic Medicine, Newcastle University, Newcastle upon Tyne, UK
| | - Helen Griffin
- Institute of Genetic Medicine, Newcastle University, Newcastle upon Tyne, UK
| | - Robert W. Taylor
- Wellcome Trust Centre for Mitochondrial Research, Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, UK
| | - Ali Naini
- Department of Pathology and Cell Biology, Columbia University Medical Center, New York, NY USA
| | - Patrick F. Chinnery
- Institute of Genetic Medicine, Newcastle University, Newcastle upon Tyne, UK
- Wellcome Trust Centre for Mitochondrial Research, Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, UK
| | - Michio Hirano
- Department of Neurology, Columbia University Medical Center, New York, NY USA
| | - Catarina M. Quinzii
- Department of Neurology, Columbia University Medical Center, New York, NY USA
| | - Rita Horvath
- Institute of Genetic Medicine, Newcastle University, Newcastle upon Tyne, UK
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17
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Anoctamins support calcium-dependent chloride secretion by facilitating calcium signaling in adult mouse intestine. Pflugers Arch 2014; 467:1203-13. [PMID: 24974903 DOI: 10.1007/s00424-014-1559-2] [Citation(s) in RCA: 56] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2014] [Revised: 06/12/2014] [Accepted: 06/17/2014] [Indexed: 12/13/2022]
Abstract
Intestinal epithelial electrolyte secretion is activated by increase in intracellular cAMP or Ca(2+) and opening of apical Cl(-) channels. In infants and young animals, but not in adults, Ca(2+)-activated chloride channels may cause secretory diarrhea during rotavirus infection. While detailed knowledge exists concerning the contribution of cAMP-activated cystic fibrosis transmembrane conductance regulator (CFTR) channels, analysis of the role of Ca(2+)-dependent Cl(-) channels became possible through identification of the anoctamin (TMEM16) family of proteins. We demonstrate expression of several anoctamin paralogues in mouse small and large intestines. Using intestinal-specific mouse knockout models for anoctamin 1 (Ano1) and anoctamin 10 (Ano10) and a conventional knockout model for anoctamin 6 (Ano6), we demonstrate the role of anoctamins for Ca(2+)-dependent Cl(-) secretion induced by the muscarinic agonist carbachol (CCH). Ano1 is preferentially expressed in the ileum and large intestine, where it supports Ca(2+)-activated Cl(-) secretion. In contrast, Ano10 is essential for Ca(2+)-dependent Cl(-) secretion in jejunum, where expression of Ano1 was not detected. Although broadly expressed, Ano6 has no role in intestinal cholinergic Cl(-) secretion. Ano1 is located in a basolateral compartment/membrane rather than in the apical membrane, where it supports CCH-induced Ca(2+) increase, while the essential and possibly only apical Cl(-) channel is CFTR. These results define a new role of Ano1 for intestinal Ca(2+)-dependent Cl(-) secretion and demonstrate for the first time a contribution of Ano10 to intestinal transport.
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18
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Votsi C, Christodoulou K. Molecular diagnosis of autosomal recessive cerebellar ataxia in the whole exome/genome sequencing era. World J Neurol 2013; 3:115-128. [DOI: 10.5316/wjn.v3.i4.115] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2013] [Revised: 08/30/2013] [Accepted: 10/16/2013] [Indexed: 02/06/2023] Open
Abstract
Autosomal recessive cerebellar ataxias (ARCA) are a clinically and genetically heterogeneous group of rare neurodegenerative disorders characterized by autosomal recessive inheritance and an early age of onset. Progressive ataxia is usually the prominent symptom and is often associated with other neurological or additional features. ARCA classification still remains controversial even though different approaches have been proposed over the years. Furthermore, ARCA molecular diagnosis has been a challenge due to phenotypic overlap and increased genetic heterogeneity observed within this group of disorders. Friedreich’s ataxia and ataxia telangiectasia have been reported as the most frequent and well-studied forms of ARCA. Significant progress in understanding the genetic etiologies of the ARCA has been achieved during the last 15 years. The methodological revolution that has been observed in genetics over the last few years has contributed significantly to the molecular diagnosis of rare diseases including the ARCAs. Development of high throughput technologies has resulted in the identification of new ARCA genes and novel mutations in known ARCA genes. Therefore, an improvement in the molecular diagnosis of ARCA is expected. Moreover, based on the fact that many patients still remain undiagnosed, additional forms of ataxia are expected to be identified. We hereby review the current knowledge on the ARCAs, focused on the genetic findings of the most common forms that were molecularly characterized before the whole exome/genome era, as well as the most recently described forms that have been elucidated with the use of these novel technologies. The significant contribution of whole-exome sequencing or whole-genome sequencing in the molecular diagnosis of ARCAs is discussed.
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