1
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Roggenbuck J, Kaschalk M, Eustace R, Vicini L, Gokun Y, Harms MB, Kolb SJ. The Answer ALS return of results study: Answering the duty to disclose. Amyotroph Lateral Scler Frontotemporal Degener 2024:1-8. [PMID: 39091255 DOI: 10.1080/21678421.2024.2385004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2024] [Revised: 07/17/2024] [Accepted: 07/22/2024] [Indexed: 08/04/2024]
Abstract
Objective: The Return of Answer ALS Results (RoAR) Study was designed to provide a mechanism for participants in Answer ALS, a large, prospectively designed natural history and biorepository study to receive select clinical genetic testing results and study participants' experience with the results disclosure. Methods: Participants consented to receive results of five ALS genes (C9orf72, SOD1, FUS, TARDP, TBK1) and/or 59 medically actionable genes as designated by the American College of Medical Genetics. Patient-reported genetic testing outcomes were measured via a post-disclosure survey. Results: Of 645 eligible Answer ALS enrollees, 143 (22%) enrolled and completed participation in RoAR. Pathogenic variants were identified in 22/143 (15.4%) participants, including 13/143 (9.0%) in ALS genes and 9/143 (6.3%) in ACMG genes. Participant-reported measures of result utility indicated the research result disclosure was as or more successful than published patient-reported outcomes of result disclosure the clinical setting. Conclusions: This study serves as a model of a "disclosure study" to share results from genomic research with participants who were not initially offered the option to receive results, and our findings can inform the design of future, large scale genomic projects to empower research participants to access their genetic information.
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Affiliation(s)
- Jennifer Roggenbuck
- Department of Neurology, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
| | - Mackenzie Kaschalk
- Department of Neurology, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
| | - Rory Eustace
- Department of Neurology, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
| | - Leah Vicini
- Genetic Counseling Graduate Program, College of Medicine, The Ohio State University, Columbus, Ohio, USA
| | - Yevgeniya Gokun
- Department of Biostatistics, The Ohio State University Medical Center, Columbus, Ohio, USA
| | - Matthew B Harms
- Department of Neurology, Columbia University Vagelos College of Physicians and Surgeons, New York, New York, USA, and
| | - Stephen J Kolb
- Department of Neurology, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
- Department of Biological Chemistry & Pharmacology, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
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2
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Bjelica B, Bartels MB, Hesebeck-Brinckmann J, Petri S. Non-motor symptoms in patients with amyotrophic lateral sclerosis: current state and future directions. J Neurol 2024; 271:3953-3977. [PMID: 38805053 PMCID: PMC11233299 DOI: 10.1007/s00415-024-12455-5] [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: 04/17/2024] [Revised: 05/14/2024] [Accepted: 05/16/2024] [Indexed: 05/29/2024]
Abstract
Amyotrophic lateral sclerosis (ALS) is a fatal neurodegenerative disease characterized by the progressive degeneration of both upper and lower motor neurons. A defining histopathological feature in approximately 97% of all ALS cases is the accumulation of phosphorylated trans-activation response (TAR) DNA-binding protein 43 protein (pTDP-43) aggregates in the cytoplasm of neurons and glial cells within the central nervous system. Traditionally, it was believed that the accumulation of TDP-43 aggregates and subsequent neurodegeneration primarily occurs in motor neurons. However, contemporary evidence suggests that as the disease progresses, other systems and brain regions are also affected. Despite this, there has been a limited number of clinical studies assessing the non-motor symptoms in ALS patients. These studies often employ various outcome measures, resulting in a wide range of reported frequencies of non-motor symptoms in ALS patients. The importance of assessing the non-motor symptoms reflects in a fact that they have a significant impact on patients' quality of life, yet they frequently go underdiagnosed and unreported during clinical evaluations. This review aims to provide an up-to-date overview of the current knowledge concerning non-motor symptoms in ALS. Furthermore, we address their diagnosis and treatment in everyday clinical practice.
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Affiliation(s)
- Bogdan Bjelica
- Department of Neurology, Hannover Medical School, 1, Carl-Neuberg-Strasse, 30625, Hannover, Germany.
| | - Maj-Britt Bartels
- Precision Neurology of Neuromuscular and Motoneuron Diseases, University of Luebeck, Lübeck, Germany
| | - Jasper Hesebeck-Brinckmann
- Neurology Department, Division for Neurodegenerative Diseases, University Medicine Mannheim, Heidelberg University, Mannheim Center for Translational Medicine, Mannheim, Germany
| | - Susanne Petri
- Department of Neurology, Hannover Medical School, 1, Carl-Neuberg-Strasse, 30625, Hannover, Germany
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3
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De La Cruz E, Esselin F, Polge A, Mouzat K, Guissart C. Most SOD1 mutations are pathogenic, and their identification can lead to early access to treatment. J Neurol Neurosurg Psychiatry 2024:jnnp-2024-333939. [PMID: 38925911 DOI: 10.1136/jnnp-2024-333939] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2024] [Accepted: 06/12/2024] [Indexed: 06/28/2024]
Affiliation(s)
- Elisa De La Cruz
- University Hospital Centre of Montpellier, Montpellier, France
- Institute for Neurosciences of Montpellier, Montpellier, France
| | - Florence Esselin
- University Hospital Centre of Montpellier, Montpellier, France
- Institute for Neurosciences of Montpellier, Montpellier, France
| | - Anne Polge
- Laboratoire de Biochimie et Biologie Moléculaire, CHU Nimes, Nimes, France
| | - Kévin Mouzat
- Institute for Neurosciences of Montpellier, Montpellier, France
- Laboratoire de Biochimie et Biologie Moléculaire, CHU Nimes, Nimes, France
| | - Claire Guissart
- Laboratoire de Biochimie et Biologie Moléculaire, CHU Nimes, Nimes, France
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4
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Trevisan L, Gaudio A, Monfrini E, Avanzino L, Di Fonzo A, Mandich P. Genetics in Parkinson's disease, state-of-the-art and future perspectives. Br Med Bull 2024; 149:60-71. [PMID: 38282031 PMCID: PMC10938543 DOI: 10.1093/bmb/ldad035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2022] [Revised: 11/30/2023] [Accepted: 12/12/2023] [Indexed: 01/30/2024]
Abstract
BACKGROUND Parkinson's disease (PD) is the second most common neurodegenerative disorder and is clinically characterized by the presence of motor (bradykinesia, rigidity, rest tremor and postural instability) and non-motor symptoms (cognitive impairment, autonomic dysfunction, sleep disorders, depression and hyposmia). The aetiology of PD is unknown except for a small but significant contribution of monogenic forms. SOURCES OF DATA No new data were generated or analyzed in support of this review. AREAS OF AGREEMENT Up to 15% of PD patients carry pathogenic variants in PD-associated genes. Some of these genes are associated with mendelian inheritance, while others act as risk factors. Genetic background influences age of onset, disease course, prognosis and therapeutic response. AREAS OF CONTROVERSY Genetic testing is not routinely offered in the clinical setting, but it may have relevant implications, especially in terms of prognosis, response to therapies and inclusion in clinical trials. Widely adopted clinical guidelines on genetic testing are still lacking and open to debate. Some new genetic associations are still awaiting confirmation, and selecting the appropriate genes to be included in diagnostic panels represents a difficult task. Finally, it is still under study whether (and to which degree) specific genetic forms may influence the outcome of PD therapies. GROWING POINTS Polygenic Risk Scores (PRS) may represent a useful tool to genetically stratify the population in terms of disease risk, prognosis and therapeutic outcomes. AREAS TIMELY FOR DEVELOPING RESEARCH The application of PRS and integrated multi-omics in PD promises to improve the personalized care of patients.
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Affiliation(s)
- L Trevisan
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics and Maternal and Child Health, University of Genoa, Largo P. Daneo 3, Genova, 16132, Italy
- IRCCS Ospedale Policlinico San Martino – SS Centro Tumori Ereditari, Largo R. Benzi 10, Genova, 16132, Italy
| | - A Gaudio
- IRCCS Ospedale Policlinico San Martino- UOC Genetica Medica, Largo R. Benzi 10, Genova, 16132, Italy
| | - E Monfrini
- Dino Ferrari Center, Neuroscience Section, Department of Pathophysiology and Transplantation, University of Milan, Via Francesco Sforza 35, Milan, 20122, Italy
- Neurology Unit, Foundation IRCCS Ca’Granda Ospedale Maggiore Policlinico, Via Festa del Perdono 7, Milan, 20122, Italy
| | - L Avanzino
- Department of Experimental Medicine, Section of Human Physiology, University of Genoa, Viale Benedetto XV/3, Genova, 16132, Italy
- IRCCS Ospedale Policlinico San Martino, Largo Rosanna Benzi 3, Genova, 16132, Italy
| | - A Di Fonzo
- Dino Ferrari Center, Neuroscience Section, Department of Pathophysiology and Transplantation, University of Milan, Via Francesco Sforza 35, Milan, 20122, Italy
- Neurology Unit, Foundation IRCCS Ca’Granda Ospedale Maggiore Policlinico, Via Festa del Perdono 7, Milan, 20122, Italy
| | - P Mandich
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics and Maternal and Child Health, University of Genoa, Largo P. Daneo 3, Genova, 16132, Italy
- IRCCS Ospedale Policlinico San Martino- UOC Genetica Medica, Largo R. Benzi 10, Genova, 16132, Italy
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Lunghi G, Di Biase E, Carsana EV, Henriques A, Callizot N, Mauri L, Ciampa MG, Mari L, Loberto N, Aureli M, Sonnino S, Spedding M, Chiricozzi E, Fazzari M. GM1 ganglioside exerts protective effects against glutamate-excitotoxicity via its oligosaccharide in wild-type and amyotrophic lateral sclerosis motor neurons. FEBS Open Bio 2023; 13:2324-2341. [PMID: 37885330 PMCID: PMC10699117 DOI: 10.1002/2211-5463.13727] [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: 07/19/2023] [Revised: 10/14/2023] [Accepted: 10/25/2023] [Indexed: 10/28/2023] Open
Abstract
Alterations in glycosphingolipid metabolism have been linked to the pathophysiological mechanisms of amyotrophic lateral sclerosis (ALS), a neurodegenerative disease affecting motor neurons. Accordingly, administration of GM1, a sialic acid-containing glycosphingolipid, is protective against neuronal damage and supports neuronal homeostasis, with these effects mediated by its bioactive component, the oligosaccharide head (GM1-OS). Here, we add new evidence to the therapeutic efficacy of GM1 in ALS: Its administration to WT and SOD1G93A motor neurons affected by glutamate-induced excitotoxicity significantly increased neuronal survival and preserved neurite networks, counteracting intracellular protein accumulation and mitochondria impairment. Importantly, the GM1-OS faithfully replicates GM1 activity, emphasizing that even in ALS the protective function of GM1 strictly depends on its pentasaccharide.
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Affiliation(s)
- Giulia Lunghi
- Department of Medical Biotechnology and Translational MedicineUniversity of MilanoSegrateItaly
| | - Erika Di Biase
- Department of Medical Biotechnology and Translational MedicineUniversity of MilanoSegrateItaly
| | - Emma Veronica Carsana
- Department of Medical Biotechnology and Translational MedicineUniversity of MilanoSegrateItaly
| | | | | | - Laura Mauri
- Department of Medical Biotechnology and Translational MedicineUniversity of MilanoSegrateItaly
| | - Maria Grazia Ciampa
- Department of Medical Biotechnology and Translational MedicineUniversity of MilanoSegrateItaly
| | - Luigi Mari
- Department of ImmunologySt. Jude Children's Research HospitalMemphisTNUSA
| | - Nicoletta Loberto
- Department of Medical Biotechnology and Translational MedicineUniversity of MilanoSegrateItaly
| | - Massimo Aureli
- Department of Medical Biotechnology and Translational MedicineUniversity of MilanoSegrateItaly
| | - Sandro Sonnino
- Department of Medical Biotechnology and Translational MedicineUniversity of MilanoSegrateItaly
| | | | - Elena Chiricozzi
- Department of Medical Biotechnology and Translational MedicineUniversity of MilanoSegrateItaly
| | - Maria Fazzari
- Department of Medical Biotechnology and Translational MedicineUniversity of MilanoSegrateItaly
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6
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Dilliott AA, Kwon S, Rouleau GA, Iqbal S, Farhan SMK. Characterizing proteomic and transcriptomic features of missense variants in amyotrophic lateral sclerosis genes. Brain 2023; 146:4608-4621. [PMID: 37394881 PMCID: PMC10629772 DOI: 10.1093/brain/awad224] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Revised: 04/28/2023] [Accepted: 06/11/2023] [Indexed: 07/04/2023] Open
Abstract
Within recent years, there has been a growing number of genes associated with amyotrophic lateral sclerosis (ALS), resulting in an increasing number of novel variants, particularly missense variants, many of which are of unknown clinical significance. Here, we leverage the sequencing efforts of the ALS Knowledge Portal (3864 individuals with ALS and 7839 controls) and Project MinE ALS Sequencing Consortium (4366 individuals with ALS and 1832 controls) to perform proteomic and transcriptomic characterization of missense variants in 24 ALS-associated genes. The two sequencing datasets were interrogated for missense variants in the 24 genes, and variants were annotated with gnomAD minor allele frequencies, ClinVar pathogenicity classifications, protein sequence features including Uniprot functional site annotations, and PhosphoSitePlus post-translational modification site annotations, structural features from AlphaFold predicted monomeric 3D structures, and transcriptomic expression levels from Genotype-Tissue Expression. We then applied missense variant enrichment and gene-burden testing following binning of variation based on the selected proteomic and transcriptomic features to identify those most relevant to pathogenicity in ALS-associated genes. Using predicted human protein structures from AlphaFold, we determined that missense variants carried by individuals with ALS were significantly enriched in β-sheets and α-helices, as well as in core, buried or moderately buried regions. At the same time, we identified that hydrophobic amino acid residues, compositionally biased protein regions and regions of interest are predominantly enriched in missense variants carried by individuals with ALS. Assessment of expression level based on transcriptomics also revealed enrichment of variants of high and medium expression across all tissues and within the brain. We further explored enriched features of interest using burden analyses and identified individual genes were indeed driving certain enrichment signals. A case study is presented for SOD1 to demonstrate proof-of-concept of how enriched features may aid in defining variant pathogenicity. Our results present proteomic and transcriptomic features that are important indicators of missense variant pathogenicity in ALS and are distinct from features associated with neurodevelopmental disorders.
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Affiliation(s)
- Allison A Dilliott
- Department of Neurology and Neurosurgery, McGill University, Montreal, Quebec H3A 0G4, Canada
- Montreal Neurological Institute-Hospital, McGill University, Montreal, Quebec H3A 2B4, Canada
| | - Seulki Kwon
- The Center for the Development of Therapeutics, Broad Institute of MIT and Harvard, Cambridge, MA 02142, USA
| | - Guy A Rouleau
- Department of Neurology and Neurosurgery, McGill University, Montreal, Quebec H3A 0G4, Canada
- Montreal Neurological Institute-Hospital, McGill University, Montreal, Quebec H3A 2B4, Canada
- Department of Human Genetics, McGill University, Montreal, Quebec, Canada
| | - Sumaiya Iqbal
- The Center for the Development of Therapeutics, Broad Institute of MIT and Harvard, Cambridge, MA 02142, USA
- Analytic and Translational Genetics Unit, Massachusetts General Hospital, Boston, MA 02114, USA
| | - Sali M K Farhan
- Department of Neurology and Neurosurgery, McGill University, Montreal, Quebec H3A 0G4, Canada
- Montreal Neurological Institute-Hospital, McGill University, Montreal, Quebec H3A 2B4, Canada
- Department of Human Genetics, McGill University, Montreal, Quebec, Canada
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7
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Roggenbuck J, Eubank BHF, Wright J, Harms MB, Kolb SJ. Evidence-based consensus guidelines for ALS genetic testing and counseling. Ann Clin Transl Neurol 2023; 10:2074-2091. [PMID: 37691292 PMCID: PMC10646996 DOI: 10.1002/acn3.51895] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2023] [Accepted: 08/12/2023] [Indexed: 09/12/2023] Open
Abstract
OBJECTIVE Advances in amyotrophic lateral sclerosis (ALS) gene discovery, ongoing gene therapy trials, and patient demand have driven increased use of ALS genetic testing. Despite this progress, the offer of genetic testing to persons with ALS is not yet "standard of care." Our primary goal is to develop clinical ALS genetic counseling and testing guidelines to improve and standardize genetic counseling and testing practice among neurologists, genetic counselors or any provider caring for persons with ALS. METHODS Core clinical questions were identified and a rapid review performed according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA-P) 2015 method. Guideline recommendations were drafted and the strength of evidence for each recommendation was assessed by combining two systems: the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) System and the Evaluation of Genomic Applications in Practice and Prevention (EGAPP). A modified Delphi approach was used to reach consensus among a group of content experts for each guideline statement. RESULTS A total of 35 guideline statements were developed. In summary, all persons with ALS should be offered single-step genetic testing, consisting of a C9orf72 assay, along with sequencing of SOD1, FUS, and TARDBP, at a minimum. The key education and genetic risk assessments that should be provided before and after testing are delineated. Specific guidance regarding testing methods and reporting for C9orf72 and other genes is provided for commercial laboratories. INTERPRETATION These evidence-based, consensus guidelines will support all stakeholders in the ALS community in navigating benefits and challenges of genetic testing.
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Affiliation(s)
- Jennifer Roggenbuck
- Division of Human Genetics, Department of Internal MedicineThe Ohio State University Wexner Medical CenterColumbusOhioUSA
- Department of NeurologyThe Ohio State University Wexner Medical CenterColumbusOhioUSA
| | - Breda H. F. Eubank
- Health & Physical Education Department, Faculty of Health, Community, & EducationMount Royal University4825 Mount Royal Gate SWCalgaryAlbertaCanada
| | - Joshua Wright
- Department of NeurologyThe Ohio State University Wexner Medical CenterColumbusOhioUSA
| | - Matthew B. Harms
- Department of NeurologyColumbia University Vagelos College of Physicians and SurgeonsNew YorkNew YorkUSA
| | - Stephen J. Kolb
- Department of NeurologyThe Ohio State University Wexner Medical CenterColumbusOhioUSA
- Department of Biological Chemistry & PharmacologyThe Ohio State University Wexner Medical CenterColumbusOhioUSA
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8
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Morichon L, Hirtz C, Tiers L, Mezghrani A, Raoul C, Esselin F, La Cruz ED, Julien JP, Camu W, Lehmann S. Ultrasensitive digital immunoassays for SOD1 conformation in amyotrophic lateral sclerosis. Bioanalysis 2023; 15:927-936. [PMID: 37650499 DOI: 10.4155/bio-2023-0103] [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] [Indexed: 09/01/2023] Open
Abstract
Aim: The aim of this study was to detect misfolded Cu/Zn SOD1 as a potential biomarker for amyotrophic lateral sclerosis (ALS). Materials & methods: Two ultrasensitive immunodetection assays were developed for the quantification of total and misfolded SOD1. Results: The detection of total and misfolded SOD1 was possible in human serum and cerebrospinal fluid. Total SOD1 was increased in cerebrospinal fluid from ALS patients. Misfolded SOD1 had low and variable expression in both control and ALS patient samples. Conclusion: These assays hold promise for improving our understanding of ALS and its detection, and could lead to more effective treatment options in the future. Further studies in larger cohorts are now required.
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Affiliation(s)
- Lisa Morichon
- LBPC-PPC, University of Montpellier, CHU Montpellier, INM INSERM, Montpellier, 34295, France
| | - Christophe Hirtz
- LBPC-PPC, University of Montpellier, CHU Montpellier, INM INSERM, Montpellier, 34295, France
| | - Laurent Tiers
- LBPC-PPC, University of Montpellier, CHU Montpellier, INM INSERM, Montpellier, 34295, France
| | | | - Cédric Raoul
- INM, University of Montpellier, INSERM, Montpellier, 34295, France
| | - Florence Esselin
- Department of Neurology, University of Montpellier, CHU Montpellier, INM, INSERM, Montpellier, 34295, France
| | - Elisa De La Cruz
- Department of Neurology, University of Montpellier, CHU Montpellier, INM, INSERM, Montpellier, 34295, France
| | - Jean-Pierre Julien
- Department of Psychiatry and Neuroscience, CERVO Brain Research Centre, University Laval, Quebec City, 23027, Canada
| | - William Camu
- Department of Neurology, University of Montpellier, CHU Montpellier, INM, INSERM, Montpellier, 34295, France
| | - Sylvain Lehmann
- LBPC-PPC, University of Montpellier, CHU Montpellier, INM INSERM, Montpellier, 34295, France
- INM, University of Montpellier, INSERM, Montpellier, 34295, France
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9
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Dilliott AA, Nasser AA, Elnageeb M, Fifita J, Henden L, Keseler IM, Lenz S, Marriott H, McCann E, Mesaros M, Opie-Martin S, Owens E, Palus B, Ross J, Wang Z, White H, Al-Chalabi A, Andersen PM, Benatar M, Blair I, Cooper-Knock J, Harrington E, Heckmann J, Landers J, Moreno C, Nel M, Rampersaud E, Roggenbuck J, Rouleau G, Traynor B, van Blitterswijk M, van Rheenen W, Veldink J, Weishaupt J, Drury L, Harms MB, Farhan SM. Clinical testing panels for ALS: global distribution, consistency, and challenges. Amyotroph Lateral Scler Frontotemporal Degener 2023; 24:420-435. [PMID: 36896705 PMCID: PMC10359019 DOI: 10.1080/21678421.2023.2173015] [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: 09/28/2022] [Accepted: 01/22/2023] [Indexed: 03/11/2023]
Abstract
Objective: In 2021, the Clinical Genome Resource (ClinGen) amyotrophic lateral sclerosis (ALS) spectrum disorders Gene Curation Expert Panel (GCEP) was established to evaluate the strength of evidence for genes previously reported to be associated with ALS. Through this endeavor, we will provide standardized guidance to laboratories on which genes should be included in clinical genetic testing panels for ALS. In this manuscript, we aimed to assess the heterogeneity in the current global landscape of clinical genetic testing for ALS. Methods: We reviewed the National Institutes of Health (NIH) Genetic Testing Registry (GTR) and members of the ALS GCEP to source frequently used testing panels and compare the genes included on the tests. Results: 14 clinical panels specific to ALS from 14 laboratories covered 4 to 54 genes. All panels report on ANG, SOD1, TARDBP, and VAPB; 50% included or offered the option of including C9orf72 hexanucleotide repeat expansion (HRE) analysis. Of the 91 genes included in at least one of the panels, 40 (44.0%) were included on only a single panel. We could not find a direct link to ALS in the literature for 14 (15.4%) included genes. Conclusions: The variability across the surveyed clinical genetic panels is concerning due to the possibility of reduced diagnostic yields in clinical practice and risk of a missed diagnoses for patients. Our results highlight the necessity for consensus regarding the appropriateness of gene inclusions in clinical genetic ALS tests to improve its application for patients living with ALS and their families.
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Affiliation(s)
- Allison A. Dilliott
- Department of Neurology and Neurosurgery, McGill University, Montreal, Canada
| | - Ahmad Al Nasser
- Schulich School of Medicine and Dentistry, Western University, London, Canada
| | - Marwa Elnageeb
- University of North Carolina, Chapel Hill, North Carolina, USA
| | - Jennifer Fifita
- Centre for MND Research, Macquarie Medical School, Macquarie University, Sydney, Australia
| | - Lyndal Henden
- Centre for MND Research, Macquarie Medical School, Macquarie University, Sydney, Australia
| | | | - Steven Lenz
- PreventionGenetics, Marshfield, Wisconsin, USA
| | - Heather Marriott
- Department of Basic and Clinical Neuroscience, King’s College London, London, UK
| | - Emily McCann
- Centre for MND Research, Macquarie Medical School, Macquarie University, Sydney, Australia
| | - Maysen Mesaros
- Medical University of South Carolina, Charleston, South Carolina, USA
| | - Sarah Opie-Martin
- Department of Basic and Clinical Neuroscience, King’s College London, London, UK
| | - Emma Owens
- University of North Carolina, Chapel Hill, North Carolina, USA
| | - Brooke Palus
- University of North Carolina, Chapel Hill, North Carolina, USA
| | - Justyne Ross
- University of North Carolina, Chapel Hill, North Carolina, USA
| | - Zhanjun Wang
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China
| | | | - Ammar Al-Chalabi
- Department of Basic and Clinical Neuroscience, King’s College London, London, UK
| | - Peter M. Andersen
- Department of Clinical Sciences, Neurosciences, Umeå University, Umeå, Sweden
| | | | - Ian Blair
- Centre for MND Research, Macquarie Medical School, Macquarie University, Sydney, Australia
| | - Johnathan Cooper-Knock
- Sheffield Institute for Translational Neuroscience (SITraN), University of Sheffield, Sheffield, UK
| | - Elizabeth Harrington
- Columbia University Vagelos College of Physicians and Surgeons, New York City, New York, USA
| | | | - John Landers
- University of Massachusetts Amherst, Amherst, Massachusetts, USA
| | | | - Melissa Nel
- University of Cape Town, Cape Town, South Africa
| | | | | | - Guy Rouleau
- Department of Neurology and Neurosurgery, McGill University, Montreal, Canada
- Department of Genetics, Montreal Neurological Institute and Hospital, McGill University, Montreal, Canada
- Montreal Neurological Institute and Hospital, McGill University, Montreal, Canada
| | - Bryan Traynor
- Neuromuscular Diseases Research Unit, Laboratory of Neurogenetics, National Institute on Aging, National Institutes of Health, Bethesda, Maryland, USA
| | | | - Wouter van Rheenen
- Department of Neurology, University Medical Center Utrecht Brain Center, Utrecht, The Netherlands
| | - Jan Veldink
- Department of Neurology, University Medical Center Utrecht Brain Center, Utrecht, The Netherlands
| | | | - Luke Drury
- PreventionGenetics, Marshfield, Wisconsin, USA
| | - Matthew B. Harms
- Columbia University Vagelos College of Physicians and Surgeons, New York City, New York, USA
| | - Sali M.K. Farhan
- Department of Genetics, Montreal Neurological Institute and Hospital, McGill University, Montreal, Canada
- Montreal Neurological Institute and Hospital, McGill University, Montreal, Canada
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10
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Bagyinszky E, Hulme J, An SSA. Studies of Genetic and Proteomic Risk Factors of Amyotrophic Lateral Sclerosis Inspire Biomarker Development and Gene Therapy. Cells 2023; 12:1948. [PMID: 37566027 PMCID: PMC10417729 DOI: 10.3390/cells12151948] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Revised: 07/21/2023] [Accepted: 07/25/2023] [Indexed: 08/12/2023] Open
Abstract
Amyotrophic lateral sclerosis (ALS) is an incurable neurodegenerative disease affecting the upper and lower motor neurons, leading to muscle weakness, motor impairments, disabilities and death. Approximately 5-10% of ALS cases are associated with positive family history (familial ALS or fALS), whilst the remainder are sporadic (sporadic ALS, sALS). At least 50 genes have been identified as causative or risk factors for ALS. Established pathogenic variants include superoxide dismutase type 1 (SOD1), chromosome 9 open reading frame 72 (c9orf72), TAR DNA Binding Protein (TARDBP), and Fused In Sarcoma (FUS); additional ALS-related genes including Charged Multivesicular Body Protein 2B (CHMP2B), Senataxin (SETX), Sequestosome 1 (SQSTM1), TANK Binding Kinase 1 (TBK1) and NIMA Related Kinase 1 (NEK1), have been identified. Mutations in these genes could impair different mechanisms, including vesicle transport, autophagy, and cytoskeletal or mitochondrial functions. So far, there is no effective therapy against ALS. Thus, early diagnosis and disease risk predictions remain one of the best options against ALS symptomologies. Proteomic biomarkers, microRNAs, and extracellular vehicles (EVs) serve as promising tools for disease diagnosis or progression assessment. These markers are relatively easy to obtain from blood or cerebrospinal fluids and can be used to identify potential genetic causative and risk factors even in the preclinical stage before symptoms appear. In addition, antisense oligonucleotides and RNA gene therapies have successfully been employed against other diseases, such as childhood-onset spinal muscular atrophy (SMA), which could also give hope to ALS patients. Therefore, an effective gene and biomarker panel should be generated for potentially "at risk" individuals to provide timely interventions and better treatment outcomes for ALS patients as soon as possible.
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Affiliation(s)
- Eva Bagyinszky
- Graduate School of Environment Department of Industrial and Environmental Engineering, Gachon University, Seongnam-si 13120, Republic of Korea;
| | - John Hulme
- Graduate School of Environment Department of Industrial and Environmental Engineering, Gachon University, Seongnam-si 13120, Republic of Korea;
| | - Seong Soo A. An
- Department of Bionano Technology, Gachon University, Seongnam-si 13120, Republic of Korea
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Torazza C, Provenzano F, Gallia E, Cerminara M, Balbi M, Bonifacino T, Tessitore S, Ravera S, Usai C, Musante I, Puliti A, Van Den Bosch L, Jafar-nejad P, Rigo F, Milanese M, Bonanno G. Genetic Downregulation of the Metabotropic Glutamate Receptor Type 5 Dampens the Reactive and Neurotoxic Phenotype of Adult ALS Astrocytes. Cells 2023; 12:1952. [PMID: 37566031 PMCID: PMC10416852 DOI: 10.3390/cells12151952] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Revised: 07/24/2023] [Accepted: 07/25/2023] [Indexed: 08/12/2023] Open
Abstract
Amyotrophic lateral sclerosis (ALS) is a fatal neurodegenerative disease characterized by progressive degeneration of motor neurons (MNs). Astrocytes display a toxic phenotype in ALS, which results in MN damage. Glutamate (Glu)-mediated excitotoxicity and group I metabotropic glutamate receptors (mGluRs) play a pathological role in the disease progression. We previously demonstrated that in vivo genetic ablation or pharmacological modulation of mGluR5 reduced astrocyte activation and MN death, prolonged survival and ameliorated the clinical progression in the SOD1G93A mouse model of ALS. This study aimed to investigate in vitro the effects of mGluR5 downregulation on the reactive spinal cord astrocytes cultured from adult late symptomatic SOD1G93A mice. We observed that mGluR5 downregulation in SOD1G93A astrocytes diminished the cytosolic Ca2+ overload under resting conditions and after mGluR5 simulation and reduced the expression of the reactive glial markers GFAP, S100β and vimentin. In vitro exposure to an anti-mGluR5 antisense oligonucleotide or to the negative allosteric modulator CTEP also ameliorated the altered reactive astrocyte phenotype. Downregulating mGluR5 in SOD1G93A mice reduced the synthesis and release of the pro-inflammatory cytokines IL-1β, IL-6 and TNF-α and ameliorated the cellular bioenergetic profile by improving the diminished oxygen consumption and ATP synthesis and by lowering the excessive lactate dehydrogenase activity. Most relevantly, mGluR5 downregulation hampered the neurotoxicity of SOD1G93A astrocytes co-cultured with spinal cord MNs. We conclude that selective reduction in mGluR5 expression in SOD1G93A astrocytes positively modulates the astrocyte reactive phenotype and neurotoxicity towards MNs, further supporting mGluR5 as a promising therapeutic target in ALS.
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Affiliation(s)
- Carola Torazza
- Department of Pharmacy (DIFAR), University of Genoa, Viale Cembrano 4, 16148 Genova, Italy; (C.T.); (F.P.); (E.G.); (M.B.); (T.B.); (S.T.); (G.B.)
| | - Francesca Provenzano
- Department of Pharmacy (DIFAR), University of Genoa, Viale Cembrano 4, 16148 Genova, Italy; (C.T.); (F.P.); (E.G.); (M.B.); (T.B.); (S.T.); (G.B.)
| | - Elena Gallia
- Department of Pharmacy (DIFAR), University of Genoa, Viale Cembrano 4, 16148 Genova, Italy; (C.T.); (F.P.); (E.G.); (M.B.); (T.B.); (S.T.); (G.B.)
| | - Maria Cerminara
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genoa, Largo Paolo Daneo, 16132 Genoa, Italy; (M.C.); (A.P.)
- UOC Genetica Medica, IRCCS Istituto Giannina Gaslini, 16147 Genoa, Italy;
| | - Matilde Balbi
- Department of Pharmacy (DIFAR), University of Genoa, Viale Cembrano 4, 16148 Genova, Italy; (C.T.); (F.P.); (E.G.); (M.B.); (T.B.); (S.T.); (G.B.)
| | - Tiziana Bonifacino
- Department of Pharmacy (DIFAR), University of Genoa, Viale Cembrano 4, 16148 Genova, Italy; (C.T.); (F.P.); (E.G.); (M.B.); (T.B.); (S.T.); (G.B.)
- Inter-University Center for the Promotion of the 3Rs Principles in Teaching & Research (Centro 3R), 56122 Pisa, Italy
| | - Sara Tessitore
- Department of Pharmacy (DIFAR), University of Genoa, Viale Cembrano 4, 16148 Genova, Italy; (C.T.); (F.P.); (E.G.); (M.B.); (T.B.); (S.T.); (G.B.)
| | - Silvia Ravera
- Department of Experimental Medicine (DIMES), University of Genoa, Via Alberti L.B. 2, 16132 Genova, Italy;
| | - Cesare Usai
- Institute of Biophysics, National Research Council (CNR), Via De Marini 6, 16149 Genoa, Italy;
| | - Ilaria Musante
- UOC Genetica Medica, IRCCS Istituto Giannina Gaslini, 16147 Genoa, Italy;
| | - Aldamaria Puliti
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genoa, Largo Paolo Daneo, 16132 Genoa, Italy; (M.C.); (A.P.)
- UOC Genetica Medica, IRCCS Istituto Giannina Gaslini, 16147 Genoa, Italy;
| | - Ludo Van Den Bosch
- Department of Neurosciences, Experimental Neurology, and Leuven Brain Institute, KU Leuven-University of Leuven, 3000 Leuven, Belgium;
- VIB-Center for Brain & Disease Research, Laboratory of Neurobiology, 3000 Leuven, Belgium
| | | | - Frank Rigo
- Ionis Pharmaceuticals, Carlsbad, CA 92010, USA; (P.J.-n.); (F.R.)
| | - Marco Milanese
- Department of Pharmacy (DIFAR), University of Genoa, Viale Cembrano 4, 16148 Genova, Italy; (C.T.); (F.P.); (E.G.); (M.B.); (T.B.); (S.T.); (G.B.)
- IRCCS Ospedale Policlinico San Martino, Largo Rosanna Benzi 10, 16132 Genoa, Italy
| | - Giambattista Bonanno
- Department of Pharmacy (DIFAR), University of Genoa, Viale Cembrano 4, 16148 Genova, Italy; (C.T.); (F.P.); (E.G.); (M.B.); (T.B.); (S.T.); (G.B.)
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McKinnon R, Lupinski I, Liang A. Security breach: peripheral nerves provide unrestricted access for toxin delivery into the central nervous system. Neural Regen Res 2023; 18:64-67. [PMID: 35799510 PMCID: PMC9241397 DOI: 10.4103/1673-5374.345472] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
We explore the hypothesis that a potential explanation for the initiation of motor neuron disease is an unappreciated vulnerability in central nervous system defense, the direct delivery of neurotoxins into motor neurons via peripheral nerve retrograde transport. This further suggests a mechanism for focal initiation of neuro-degenerative diseases in general, with subsequent spread by network degeneration as suggested by the Frost-Diamond hypothesis. We propose this vulnerability may be a byproduct of vertebrate evolution in a benign aquatic environment, where external surfaces were not exposed to concentrated neurotoxins.
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13
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Spargo TP, Opie-Martin S, Bowles H, Lewis CM, Iacoangeli A, Al-Chalabi A. Calculating variant penetrance from family history of disease and average family size in population-scale data. Genome Med 2022; 14:141. [PMID: 36522764 PMCID: PMC9753373 DOI: 10.1186/s13073-022-01142-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Accepted: 11/18/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Genetic penetrance is the probability of a phenotype when harbouring a particular pathogenic variant. Accurate penetrance estimates are important across biomedical fields including genetic counselling, disease research, and gene therapy. However, existing approaches for penetrance estimation require, for instance, large family pedigrees or availability of large databases of people affected and not affected by a disease. METHODS We present a method for penetrance estimation in autosomal dominant phenotypes. It examines the distribution of a variant among people affected (cases) and unaffected (controls) by a phenotype within population-scale data and can be operated using cases only by considering family disease history. It is validated through simulation studies and candidate variant-disease case studies. RESULTS Our method yields penetrance estimates which align with those obtained via existing approaches in the Parkinson's disease LRRK2 gene and pulmonary arterial hypertension BMPR2 gene case studies. In the amyotrophic lateral sclerosis case studies, examining penetrance for variants in the SOD1 and C9orf72 genes, we make novel penetrance estimates which correspond closely to understanding of the disease. CONCLUSIONS The present approach broadens the spectrum of traits for which reliable penetrance estimates can be obtained. It has substantial utility for facilitating the characterisation of disease risks associated with rare variants with an autosomal dominant inheritance pattern. The yielded estimates avoid any kinship-specific effects and can circumvent ascertainment biases common when sampling rare variants among control populations.
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Affiliation(s)
- Thomas P Spargo
- Department of Basic and Clinical Neuroscience, Maurice Wohl Clinical Neuroscience Institute, King's College London, London, SE5 9RX, UK
| | - Sarah Opie-Martin
- Department of Basic and Clinical Neuroscience, Maurice Wohl Clinical Neuroscience Institute, King's College London, London, SE5 9RX, UK
| | - Harry Bowles
- Department of Basic and Clinical Neuroscience, Maurice Wohl Clinical Neuroscience Institute, King's College London, London, SE5 9RX, UK
| | - Cathryn M Lewis
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, de Crespigny Park, London, SE5 8AF, UK
- Department of Medical and Molecular Genetics, Faculty of Life Sciences and Medicine, King's College London, London, UK
| | - Alfredo Iacoangeli
- Department of Basic and Clinical Neuroscience, Maurice Wohl Clinical Neuroscience Institute, King's College London, London, SE5 9RX, UK.
- Department of Biostatistics and Health Informatics, King's College London, London, UK.
- NIHR Maudsley Biomedical Research Centre (BRC) at South London and Maudsley NHS Foundation Trust and King's College London, London, UK.
| | - Ammar Al-Chalabi
- Department of Basic and Clinical Neuroscience, Maurice Wohl Clinical Neuroscience Institute, King's College London, London, SE5 9RX, UK.
- King's College Hospital, Bessemer Road, London, SE5 9RS, UK.
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14
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Chen QY, Wu P, Wen T, Qin X, Zhang R, Jia R, Jin J, Hu F, Xie X, Dang J. Association of cerebral spinal fluid copper imbalance in amyotrophic lateral sclerosis. Front Aging Neurosci 2022; 14:970711. [PMID: 36466599 PMCID: PMC9714432 DOI: 10.3389/fnagi.2022.970711] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Accepted: 10/28/2022] [Indexed: 10/24/2023] Open
Abstract
A plethora of environmental risk factors has been persistently implicated in the pathogenesis of amyotrophic lateral sclerosis (ALS), including metal/metalloids. This study aimed to examine potential associations between cerebral spinal fluid (CSF) metal/metalloids and ALS risks. CSF concentrations of copper (Cu), nickel (Ni), mercury (Hg), arsenic (As), manganese (Mn), and iron (Fe) in ALS (spinal- and bulbar-onset) patients and controls were measured using inductively coupled plasma mass spectrometry (ICP-MS). Results from this study revealed marked differences between control, spinal-onset, and bulbar-onset groups. We report that Cu levels were lower in the ALS and spinal-onset groups compared to the control group. Ni level were higher in the spinal-onset group compared to the control and bulbar-onset groups. In addition, associations between CSF metal/metalloid levels with disease severity, sex, and serum triglycerides were also examined to broach the potential relevance of neurotoxic metal/metalloids in ALS disease heterogeneity.
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Affiliation(s)
- Qiao Yi Chen
- Department of Cell Biology and Genetics, School of Basic Medical Sciences, Xi’an Jiaotong University, Xi’an, China
| | - Peng Wu
- Department of Cell Biology and Genetics, School of Basic Medical Sciences, Xi’an Jiaotong University, Xi’an, China
| | - Ting Wen
- Department of Cell Biology and Genetics, School of Basic Medical Sciences, Xi’an Jiaotong University, Xi’an, China
| | - Xing Qin
- Department of Neurology, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
| | - Ronghua Zhang
- Department of Neurology, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
| | - Rui Jia
- Department of Neurology, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
| | - Jiaoting Jin
- Department of Neurology, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
| | - Fangfang Hu
- Department of Neurology, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
| | - Xiaoge Xie
- Department of Cell Biology and Genetics, School of Basic Medical Sciences, Xi’an Jiaotong University, Xi’an, China
| | - Jingxia Dang
- Department of Neurology, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
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15
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Portelli S, Albanaz A, Pires DEV, Ascher DB. Identifying the molecular drivers of ALS-implicated missense mutations. J Med Genet 2022; 60:484-490. [PMID: 36180205 DOI: 10.1136/jmg-2022-108798] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Accepted: 09/01/2022] [Indexed: 11/03/2022]
Abstract
BACKGROUND Amyotrophic lateral sclerosis (ALS) is a progressively fatal, neurodegenerative disease associated with both motor and non-motor symptoms, including frontotemporal dementia. Approximately 10% of cases are genetically inherited (familial ALS), while the majority are sporadic. Mutations across a wide range of genes have been associated; however, the underlying molecular effects of these mutations and their relation to phenotypes remain poorly explored. METHODS We initially curated an extensive list (n=1343) of missense mutations identified in the clinical literature, which spanned across 111 unique genes. Of these, mutations in genes SOD1, FUS and TDP43 were analysed using in silico biophysical tools, which characterised changes in protein stability, interactions, localisation and function. The effects of pathogenic and non-pathogenic mutations within these genes were statistically compared to highlight underlying molecular drivers. RESULTS Compared with previous ALS-dedicated databases, we have curated the most extensive missense mutation database to date and observed a twofold increase in unique implicated genes, and almost a threefold increase in the number of mutations. Our gene-specific analysis identified distinct molecular drivers across the different proteins, where SOD1 mutations primarily reduced protein stability and dimer formation, and those in FUS and TDP-43 were present within disordered regions, suggesting different mechanisms of aggregate formation. CONCLUSION Using our three genes as case studies, we identified distinct insights which can drive further research to better understand ALS. The information curated in our database can serve as a resource for similar gene-specific analyses, further improving the current understanding of disease, crucial for the development of treatment strategies.
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Affiliation(s)
- Stephanie Portelli
- Computational Biology and Clinical Informatics, Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia .,SCMB, The University of Queensland, Saint Lucia Campus, Saint Lucia, Queensland, Australia.,Systems and Computational Biology, Bio21 Institute, The University of Melbourne, Parkville, Victoria, Australia
| | | | - Douglas Eduardo Valente Pires
- Computational Biology and Clinical Informatics, Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia .,School of Computing and Information Systems, University of Melbourne, Melbourne, Victoria, Australia
| | - David Benjamin Ascher
- Computational Biology and Clinical Informatics, Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia .,SCMB, The University of Queensland, Saint Lucia Campus, Saint Lucia, Queensland, Australia.,Systems and Computational Biology, Bio21 Institute, The University of Melbourne, Parkville, Victoria, Australia
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16
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Benatar M, Wuu J, Andersen PM, Bucelli RC, Andrews JA, Otto M, Farahany NA, Harrington EA, Chen W, Mitchell AA, Ferguson T, Chew S, Gedney L, Oakley S, Heo J, Chary S, Fanning L, Graham D, Sun P, Liu Y, Wong J, Fradette S. Design of a Randomized, Placebo-Controlled, Phase 3 Trial of Tofersen Initiated in Clinically Presymptomatic SOD1 Variant Carriers: the ATLAS Study. Neurotherapeutics 2022; 19:1248-1258. [PMID: 35585374 PMCID: PMC9587202 DOI: 10.1007/s13311-022-01237-4] [Citation(s) in RCA: 55] [Impact Index Per Article: 27.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/10/2022] [Indexed: 12/13/2022] Open
Abstract
Despite extensive research, amyotrophic lateral sclerosis (ALS) remains a progressive and invariably fatal neurodegenerative disease. Limited knowledge of the underlying causes of ALS has made it difficult to target upstream biological mechanisms of disease, and therapeutic interventions are usually administered relatively late in the course of disease. Genetic forms of ALS offer a unique opportunity for therapeutic development, as genetic associations may reveal potential insights into disease etiology. Genetic ALS may also be amenable to investigating earlier intervention given the possibility of identifying clinically presymptomatic, at-risk individuals with causative genetic variants. There is increasing evidence for a presymptomatic phase of ALS, with biomarker data from the Pre-Symptomatic Familial ALS (Pre-fALS) study showing that an elevation in blood neurofilament light chain (NfL) precedes phenoconversion to clinically manifest disease. Tofersen is an investigational antisense oligonucleotide designed to reduce synthesis of superoxide dismutase 1 (SOD1) protein through degradation of SOD1 mRNA. Informed by Pre-fALS and the tofersen clinical development program, the ATLAS study (NCT04856982) is designed to evaluate the impact of initiating tofersen in presymptomatic carriers of SOD1 variants associated with high or complete penetrance and rapid disease progression who also have biomarker evidence of disease activity (elevated plasma NfL). The ATLAS study will investigate whether tofersen can delay the emergence of clinically manifest ALS. To our knowledge, ATLAS is the first interventional trial in presymptomatic ALS and has the potential to yield important insights into the design and conduct of presymptomatic trials, identification, and monitoring of at-risk individuals, and future treatment paradigms in ALS.
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Affiliation(s)
- Michael Benatar
- Department of Neurology, University of Miami, 1120 NW 14th Street, Clinical Research Building, Miami, FL, 33136, USA.
| | - Joanne Wuu
- Department of Neurology, University of Miami, 1120 NW 14th Street, Clinical Research Building, Miami, FL, 33136, USA
| | - Peter M Andersen
- Department of Clinical Science, Neurosciences, Umeå University, Umeå, Sweden
| | | | - Jinsy A Andrews
- The Neurological Institute, Columbia University Irving Medical Center, New York, NY, USA
| | - Markus Otto
- Department of Neurology, Martin Luther University, Halle-Wittenberg, Halle (Saale), Germany
| | | | | | - Weiping Chen
- Biogen, 225 Binney Street, Cambridge, MA, 02142, USA
| | | | - Toby Ferguson
- Biogen, 225 Binney Street, Cambridge, MA, 02142, USA
| | - Sheena Chew
- Biogen, 225 Binney Street, Cambridge, MA, 02142, USA
| | - Liz Gedney
- Biogen, 225 Binney Street, Cambridge, MA, 02142, USA
| | - Sue Oakley
- Biogen, 225 Binney Street, Cambridge, MA, 02142, USA
| | - Jeong Heo
- Biogen, 225 Binney Street, Cambridge, MA, 02142, USA
| | - Sowmya Chary
- Biogen, 225 Binney Street, Cambridge, MA, 02142, USA
| | - Laura Fanning
- Biogen, 225 Binney Street, Cambridge, MA, 02142, USA
| | | | - Peng Sun
- Biogen, 225 Binney Street, Cambridge, MA, 02142, USA
| | - Yingying Liu
- Biogen, 225 Binney Street, Cambridge, MA, 02142, USA
| | - Janice Wong
- Biogen, 225 Binney Street, Cambridge, MA, 02142, USA
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Ahangaran M, Chiò A, D'Ovidio F, Manera U, Vasta R, Canosa A, Moglia C, Calvo A, Minaei-Bidgoli B, Jahed-Motlagh MR. Causal associations of genetic factors with clinical progression in amyotrophic lateral sclerosis. COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE 2022; 216:106681. [PMID: 35151113 DOI: 10.1016/j.cmpb.2022.106681] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/14/2021] [Revised: 01/08/2022] [Accepted: 02/02/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND AND OBJECTIVE Recent advances in the genetic causes of ALS reveals that about 10% of ALS patients have a genetic origin and that more than 30 genes are likely to contribute to this disease. However, four genes are more frequently associated with ALS: C9ORF72, TARDBP, SOD1, and FUS. The relationship between genetic factors and ALS progression rate is not clear. In this study, we carried out a causal analysis of ALS disease with a genetics perspective in order to assess the contribution of the four mentioned genes to the progression rate of ALS. METHODS In this work, we applied a novel causal learning model to the CRESLA dataset which is a longitudinal clinical dataset of ALS patients including genetic information of such patients. This study aims to discover the relationship between four mentioned genes and ALS progression rate from a causation perspective using machine learning and probabilistic methods. RESULTS The results indicate a meaningful association between genetic factors and ALS progression rate with causality viewpoint. Our findings revealed that causal relationships between ALSFRS-R items associated with bulbar regions have the strongest association with genetic factors, especially C9ORF72; and other three genes have the greatest contribution to the respiratory ALSFRS-R items with a causation point of view. CONCLUSIONS The findings revealed that genetic factors have a significant causal effect on the rate of ALS progression. Since C9ORF72 patients have higher proportion compared to those carrying other three gene mutations in the CRESLA cohort, we need a large multi-centric study to better analyze SOD1, TARDBP and FUS contribution to the ALS clinical progression. We conclude that causal associations between ALSFRS-R clinical factors is a suitable predictor for designing a prognostic model of ALS.
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Affiliation(s)
- Meysam Ahangaran
- Department of Computer Engineering, Iran University of Science and Technology, Tehran, Iran; Department of Computer Engineering, Mazandaran University of Science and Technology, Babol, Iran.
| | - Adriano Chiò
- Department of Computer Engineering, Mazandaran University of Science and Technology, Babol, Iran; 'Rita Levi Montalcini' Department of Neuroscience, University of Turin, Turin, Italy; Neurology 1, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza of Torino, Turin, Italy; National Research Council, Institute of Cognitive Sciences and Technologies, Rome, Italy.
| | - Fabrizio D'Ovidio
- 'Rita Levi Montalcini' Department of Neuroscience, University of Turin, Turin, Italy
| | - Umberto Manera
- 'Rita Levi Montalcini' Department of Neuroscience, University of Turin, Turin, Italy
| | - Rosario Vasta
- 'Rita Levi Montalcini' Department of Neuroscience, University of Turin, Turin, Italy
| | - Antonio Canosa
- 'Rita Levi Montalcini' Department of Neuroscience, University of Turin, Turin, Italy; Neurology 1, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza of Torino, Turin, Italy
| | - Cristina Moglia
- 'Rita Levi Montalcini' Department of Neuroscience, University of Turin, Turin, Italy; Neurology 1, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza of Torino, Turin, Italy
| | - Andrea Calvo
- 'Rita Levi Montalcini' Department of Neuroscience, University of Turin, Turin, Italy; Neurology 1, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza of Torino, Turin, Italy
| | - Behrouz Minaei-Bidgoli
- Department of Computer Engineering, Iran University of Science and Technology, Tehran, Iran
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18
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Davidson JM, Chung RS, Lee A. The converging roles of sequestosome-1/p62 in the molecular pathways of amyotrophic lateral sclerosis (ALS) and frontotemporal dementia (FTD). Neurobiol Dis 2022; 166:105653. [PMID: 35143965 DOI: 10.1016/j.nbd.2022.105653] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2021] [Revised: 01/18/2022] [Accepted: 02/03/2022] [Indexed: 01/03/2023] Open
Abstract
Investigations into the pathogenetic mechanisms underlying amyotrophic lateral sclerosis (ALS) and frontotemporal dementia (FTD) have provided significant insight into the disease. At the cellular level, ALS and FTD are classified as proteinopathies, which is motor neuron degeneration and death characterized by pathological protein aggregates or dysregulated proteostasis. At both the clinical and molecular level there are common signaling pathways dysregulated across the ALS and FTD spectrum (ALS/FTD). Sequestosome-1/p62 is a multifunctional scaffold protein with roles in several signaling pathways including proteostasis, protein degradation via the ubiquitin proteasome system and autophagy, the antioxidant response, inflammatory response, and apoptosis. Notably these pathways are dysregulated in ALS and FTD. Mutations in the functional domains of p62 provide links to the pathogenetic mechanisms of p62 and dyshomeostasis of p62 levels is noted in several types of ALS and FTD. We present here that the dysregulated ALS and FTD signaling pathways are linked, with p62 converging the molecular mechanisms. This review summarizes the current literature on the complex role of p62 in the pathogenesis across the ALS/FTD spectrum. The focus is on the underlying convergent molecular mechanisms of ALS and FTD-associated proteins and pathways that dysregulate p62 levels or are dysregulated by p62, with emphasis on how p62 is implicated across the ALS/FTD spectrum.
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Affiliation(s)
- Jennilee M Davidson
- Centre for Motor Neuron Disease Research, Macquarie Medical School, Faculty of Medicine, Health and Human Sciences, Macquarie University, 2 Technology Place, NSW 2109, Australia..
| | - Roger S Chung
- Centre for Motor Neuron Disease Research, Macquarie Medical School, Faculty of Medicine, Health and Human Sciences, Macquarie University, 2 Technology Place, NSW 2109, Australia..
| | - Albert Lee
- Centre for Motor Neuron Disease Research, Macquarie Medical School, Faculty of Medicine, Health and Human Sciences, Macquarie University, 2 Technology Place, NSW 2109, Australia..
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19
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Salmon K, Kiernan MC, Kim SH, Andersen PM, Chio A, van den Berg LH, Van Damme P, Al-Chalabi A, Lillo P, Andrews JA, Genge A. The importance of offering early genetic testing in everyone with amyotrophic lateral sclerosis. Brain 2022; 145:1207-1210. [PMID: 35020823 PMCID: PMC9129091 DOI: 10.1093/brain/awab472] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2021] [Accepted: 12/10/2021] [Indexed: 11/13/2022] Open
Affiliation(s)
- Kristiana Salmon
- Department of Neurology & Neurosurgery, Montreal Neurological Institute-Hospital, McGill University, Montreal, Quebec, Canada
| | - Matthew C Kiernan
- Brain and Mind Centre, University of Sydney, Sydney, New South Wales, Australia.,Department of Neurology, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia
| | - Seung H Kim
- Department of Neurology, College of Medicine, Hanyang University, Seoul, South Korea
| | - Peter M Andersen
- Department of Clinical Science, Neurosciences, Umeå University, Umeå, Sweden
| | - Adriano Chio
- ALS Centre, Department of Neuroscience "Rita Levi Montalcini", University of Torino, Turin, Italy.,SC Neurologia 1 U, AOU Città della Salute e della Scienza of Torino, Turin, Italy
| | - Leonard H van den Berg
- Department of Neurology, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Philip Van Damme
- Department of Neurosciences, Laboratory for Neurobiology, KU Leuven and Center for Brain & Disease Research, VIB, Leuven Brain Institute, Leuven, Belgium.,Department of Neurology, University Hospital Leuven, Leuven, Belgium
| | - Ammar Al-Chalabi
- Department of Basic and Clinical Neuroscience, King's College London, Maurice Wohl Clinical Neuroscience Institute, London, UK
| | - Patricia Lillo
- Departamento de Neurología Sur, Facultad de Medicina, Universidad de Chile & Geroscience Center for Brain Health and Metabolism, Santiago, Chile
| | - Jinsy A Andrews
- The Eleanor and Lou Gehrig ALS Center, The Neurological Institute, New York, NY, USA
| | - Angela Genge
- Department of Neurology & Neurosurgery, Montreal Neurological Institute-Hospital, McGill University, Montreal, Quebec, Canada
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20
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Osmanovic A, Gogol I, Martens H, Widjaja M, Müller K, Schreiber-Katz O, Feuerhake F, Langhans CD, Schmidt G, Andersen PM, Ludolph AC, Weishaupt JH, Brand F, Petri S, Weber RG. Heterozygous DHTKD1 Variants in Two European Cohorts of Amyotrophic Lateral Sclerosis Patients. Genes (Basel) 2021; 13:84. [PMID: 35052424 PMCID: PMC8774751 DOI: 10.3390/genes13010084] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 12/22/2021] [Accepted: 12/23/2021] [Indexed: 01/26/2023] Open
Abstract
Amyotrophic lateral sclerosis (ALS) is a fatal neurodegenerative disorder characterized by progressive upper and lower motor neuron (LMN) loss. As ALS and other neurodegenerative diseases share genetic risk factors, we performed whole-exome sequencing in ALS patients focusing our analysis on genes implicated in neurodegeneration. Thus, variants in the DHTKD1 gene encoding dehydrogenase E1 and transketolase domain containing 1 previously linked to 2-aminoadipic and 2-oxoadipic aciduria, Charcot-Marie-Tooth (CMT) disease type 2, and spinal muscular atrophy (SMA) were identified. In two independent European ALS cohorts (n = 643 cases), 10 sporadic cases of 225 (4.4%) predominantly sporadic patients of cohort 1, and 12 familial ALS patients of 418 (2.9%) ALS families of cohort 2 harbored 14 different rare heterozygous DHTKD1 variants predicted to be deleterious. Four DHTKD1 variants were previously described pathogenic variants, seven were recurrent, and eight were located in the E1_dh dehydrogenase domain. Nonsense variants located in the E1_dh domain were significantly more prevalent in ALS patients versus controls. The phenotype of ALS patients carrying DHTKD1 variants partially overlapped with CMT and SMA by presence of sensory impairment and a higher frequency of LMN-predominant cases. Our results argue towards rare heterozygous DHTKD1 variants as potential contributors to ALS phenotype and, possibly, pathogenesis.
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Affiliation(s)
- Alma Osmanovic
- Department of Human Genetics, Hannover Medical School, 30625 Hannover, Germany; (A.O.); (I.G.); (H.M.); (M.W.); (G.S.); (F.B.)
- Department of Neurology, Hannover Medical School, 30625 Hannover, Germany;
- Essen Center for Rare Diseases (EZSE), University Hospital Essen, 45147 Essen, Germany
| | - Isabel Gogol
- Department of Human Genetics, Hannover Medical School, 30625 Hannover, Germany; (A.O.); (I.G.); (H.M.); (M.W.); (G.S.); (F.B.)
- Department of Neurology, Hannover Medical School, 30625 Hannover, Germany;
| | - Helge Martens
- Department of Human Genetics, Hannover Medical School, 30625 Hannover, Germany; (A.O.); (I.G.); (H.M.); (M.W.); (G.S.); (F.B.)
| | - Maylin Widjaja
- Department of Human Genetics, Hannover Medical School, 30625 Hannover, Germany; (A.O.); (I.G.); (H.M.); (M.W.); (G.S.); (F.B.)
- Department of Neurology, Hannover Medical School, 30625 Hannover, Germany;
| | - Kathrin Müller
- Department of Neurology, University of Ulm, 89070 Ulm, Germany; (K.M.); (A.C.L.); (J.H.W.)
| | | | - Friedrich Feuerhake
- Department of Neuropathology, Institute of Pathology, Hannover Medical School, 30625 Hannover, Germany;
| | - Claus-Dieter Langhans
- GCMS Laboratory, Dietmar Hopp Metabolic Center, University Children’s Hospital, 69120 Heidelberg, Germany;
| | - Gunnar Schmidt
- Department of Human Genetics, Hannover Medical School, 30625 Hannover, Germany; (A.O.); (I.G.); (H.M.); (M.W.); (G.S.); (F.B.)
| | - Peter M. Andersen
- Department of Clinical Sciences, Neurosciences, Umeå University, 90185 Umeå, Sweden;
| | - Albert C. Ludolph
- Department of Neurology, University of Ulm, 89070 Ulm, Germany; (K.M.); (A.C.L.); (J.H.W.)
| | - Jochen H. Weishaupt
- Department of Neurology, University of Ulm, 89070 Ulm, Germany; (K.M.); (A.C.L.); (J.H.W.)
- Division for Neurodegenerative Diseases, Department of Neurology, Medical Faculty Mannheim, University of Heidelberg, 68167 Mannheim, Germany
| | - Frank Brand
- Department of Human Genetics, Hannover Medical School, 30625 Hannover, Germany; (A.O.); (I.G.); (H.M.); (M.W.); (G.S.); (F.B.)
| | - Susanne Petri
- Department of Neurology, Hannover Medical School, 30625 Hannover, Germany;
| | - Ruthild G. Weber
- Department of Human Genetics, Hannover Medical School, 30625 Hannover, Germany; (A.O.); (I.G.); (H.M.); (M.W.); (G.S.); (F.B.)
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21
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Mesaros M, Lenz S, Lim W, Brown J, Drury L, Roggenbuck J. Investigating the Genetic Profile of the Amyotrophic Lateral Sclerosis/Frontotemporal Dementia (ALS-FTD) Continuum in Patients of Diverse Race, Ethnicity and Ancestry. Genes (Basel) 2021; 13:genes13010076. [PMID: 35052416 PMCID: PMC8775163 DOI: 10.3390/genes13010076] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Revised: 12/20/2021] [Accepted: 12/21/2021] [Indexed: 11/24/2022] Open
Abstract
Preliminary evidence suggests that commonly used genetic tests may be less likely to identify a genetic etiology for ALS-FTD in patients of underrepresented race, ethnicity, and ancestry (REA), as compared to European REA. Patients of underrepresented REA may therefore be less likely to receive accurate and specific genetic counseling information and less likely to have access to gene-targeted therapies currently in clinical trials. We compiled outcome data from 1911 ALS-FTD patients tested at a commercial laboratory over a seven-year period for C9orf72 hexanucleotide repeat expansion (HRE) alone or C9orf72 and multigene sequencing panel testing. We compared the incidence of pathogenic (P), likely pathogenic (LP), and uncertain variants in C9orf72 and other ALS-FTD genes, as well as age at testing, in patients of different REA. The diagnostic rate in patients of European REA (377/1595, 23.64%) was significantly higher than in patients of underrepresented REA (44/316, 13.92%) (p < 0.001). Patients of European REA were more likely to have the C9orf72 HRE (21.3%) than patients of underrepresented REA (10.4%) (p < 0.001). The overall distribution of positive test outcomes in all tested genes was significantly different between the two groups, with relatively more P and LP variants in genes other than C9orf72 identified in patients of underrepresented REA. The incidence of uncertain test outcomes was not significantly different between patients of European and underrepresented REA. Patients with positive test outcomes were more likely to be younger than those with negative or uncertain outcomes. Although C9orf72 HRE assay has been advocated as the first, and in some cases, only genetic test offered to patients with ALS-FTD in the clinical setting, this practice may result in the reduced ascertainment of genetic ALS-FTD in patients of diverse REA.
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Affiliation(s)
- Maysen Mesaros
- Department of Internal Medicine, The Ohio State University Wexner Medical Center, Columbus, OH 43212, USA; (J.B.); (J.R.)
- Division of Neuroscience, Medical University of South Carolina, Charleston, SC 29425, USA
- Correspondence:
| | - Steven Lenz
- PreventionGenetics, Marshfield, WI 54449, USA; (S.L.); (L.D.)
| | - Woobeen Lim
- Division of Biostatistics, College of Public Health, The Ohio State University, Columbus, OH 43210, USA;
| | - Jordan Brown
- Department of Internal Medicine, The Ohio State University Wexner Medical Center, Columbus, OH 43212, USA; (J.B.); (J.R.)
| | - Luke Drury
- PreventionGenetics, Marshfield, WI 54449, USA; (S.L.); (L.D.)
| | - Jennifer Roggenbuck
- Department of Internal Medicine, The Ohio State University Wexner Medical Center, Columbus, OH 43212, USA; (J.B.); (J.R.)
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22
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Aljabri A, Halawani A, Bin Lajdam G, Labban S, Alshehri S, Felemban R. The Safety and Efficacy of Stem Cell Therapy as an Emerging Therapy for ALS: A Systematic Review of Controlled Clinical Trials. Front Neurol 2021; 12:783122. [PMID: 34938264 PMCID: PMC8685950 DOI: 10.3389/fneur.2021.783122] [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: 09/25/2021] [Accepted: 10/26/2021] [Indexed: 11/23/2022] Open
Abstract
Amyotrophic lateral sclerosis (ALS) is a neurodegenerative disease with a heterogeneous course that ultimately leads to death. Currently, there is no cure, and new treatments that can slow the progression of the disease are needed. Stem cell (SC) transplantation is an emerging therapy that has shown a lot of potential in recent clinical trials. This review is aimed to examine the results of various clinical trials on this topic, thus assessing the safety and efficacy of SC transplantation as a potential treatment for ALS. We identified 748 studies in our search, of which 134 full-text studies were assessed for eligibility. Six studies met the inclusion criteria and were included in this review. Although some of the included studies showed the positive effect of SC transplantation, other studies found that there was no significant difference compared to the control group. We observed more positive effects with bone marrow mesenchymal stem cells (BM-MSC) treatments than Granulocyte colony-stimulating factor (G-CSF) ones. However, other factors, such as route of administration, number of doses, and number of cells per dose, could also play a role in this discrepancy. Based on this information, we conclude that more properly conducted clinical trials are needed to appreciate the benefit of this treatment.
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Affiliation(s)
- Ammar Aljabri
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia.,King Abdullah International Medical Research Center, Jeddah, Saudi Arabia
| | - Alhussain Halawani
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia.,King Abdullah International Medical Research Center, Jeddah, Saudi Arabia
| | - Ghassan Bin Lajdam
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia.,King Abdullah International Medical Research Center, Jeddah, Saudi Arabia
| | - Suhail Labban
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia.,King Abdullah International Medical Research Center, Jeddah, Saudi Arabia
| | - Samah Alshehri
- Department of Clinical Pharmacy, College of Pharmacy, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Razaz Felemban
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia.,King Abdullah International Medical Research Center, Jeddah, Saudi Arabia
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23
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Arnoux A, Ayme-Dietrich E, Dieterle S, Goy MA, Schann S, Frauli M, Monassier L, Dupuis L. Evaluation of a 5-HT 2B receptor agonist in a murine model of amyotrophic lateral sclerosis. Sci Rep 2021; 11:23582. [PMID: 34880312 PMCID: PMC8654833 DOI: 10.1038/s41598-021-02900-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Accepted: 09/24/2021] [Indexed: 12/29/2022] Open
Abstract
Degeneration of brainstem serotonin neurons has been demonstrated in ALS patients and mouse models and was found responsible for the development of spasticity. Consistent with involvement of central serotonin pathways, 5-HT2B receptor (5-HT2BR) was upregulated in microglia of ALS mice. Its deletion worsened disease outcome in the Sod1G86R mouse model and led to microglial degeneration. In ALS patients, a polymorphism in HTR2B gene leading to higher receptor expression in CNS, was associated with increased survival in patients as well as prevention of microglial degeneration. Thus, the aim of our study was to determine the effect of a 5-HT2BR agonist : BW723C86 (BW), in the Sod1G86R mouse model. Despite good pharmacokinetic and pharmacological profiles, BW did not ameliorate disease outcome or motor neuron degeneration in a fast progressing mouse model of ALS despite evidence of modulation of microglial gene expression.
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Affiliation(s)
- Alizée Arnoux
- Mécanismes Centraux et Périphériques de la Neurodégénérescence, U1118, Inserm, UMR-S1118, CRBS, Université de Strasbourg, 1 rue Eugène Boeckel, 67000, Strasbourg Cedex, France.,Laboratoire de Pharmacologie et Toxicologie Neurocardiovasculaire, UR7296, Université de Strasbourg, 67000, Strasbourg, France.,Domain Therapeutics, 67400, Illkirch-Graffenstaden, France
| | - Estelle Ayme-Dietrich
- Laboratoire de Pharmacologie et Toxicologie Neurocardiovasculaire, UR7296, Université de Strasbourg, 67000, Strasbourg, France
| | - Stéphane Dieterle
- Mécanismes Centraux et Périphériques de la Neurodégénérescence, U1118, Inserm, UMR-S1118, CRBS, Université de Strasbourg, 1 rue Eugène Boeckel, 67000, Strasbourg Cedex, France
| | - Marc-Antoine Goy
- Mécanismes Centraux et Périphériques de la Neurodégénérescence, U1118, Inserm, UMR-S1118, CRBS, Université de Strasbourg, 1 rue Eugène Boeckel, 67000, Strasbourg Cedex, France
| | - Stephan Schann
- Domain Therapeutics, 67400, Illkirch-Graffenstaden, France
| | - Mélanie Frauli
- Domain Therapeutics, 67400, Illkirch-Graffenstaden, France
| | - Laurent Monassier
- Laboratoire de Pharmacologie et Toxicologie Neurocardiovasculaire, UR7296, Université de Strasbourg, 67000, Strasbourg, France
| | - Luc Dupuis
- Mécanismes Centraux et Périphériques de la Neurodégénérescence, U1118, Inserm, UMR-S1118, CRBS, Université de Strasbourg, 1 rue Eugène Boeckel, 67000, Strasbourg Cedex, France.
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24
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Choi HW. Fasciculations in Children. Pediatr Neurol 2021; 125:40-47. [PMID: 34628142 DOI: 10.1016/j.pediatrneurol.2021.08.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2021] [Revised: 08/19/2021] [Accepted: 08/28/2021] [Indexed: 11/26/2022]
Abstract
Fasciculations are the most common form of spontaneous muscle contraction. They frequently occur in healthy individuals. However, there are a minority of situations that fasciculations are observed in association with specific neurologic disorders. Publications concerning the evaluation of pediatric patients experiencing fasciculations are limited. These children may undergo invasive or expensive diagnostic investigations that are unnecessary. Moreover, without careful consideration of differential diagnoses, rare neuromuscular disorders that present with fasciculations in the pediatric age group can be under-recognized by pediatric neurologists. This review examines the most important pediatric disorders presenting with fasciculations and other spontaneous muscle contractions to guide pediatric neurologists in evaluating these children.
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Affiliation(s)
- Hyoung Won Choi
- Division of Pediatric Neurology, University of Pittsburgh Medical Center Children's Hospital of Pittsburgh, Lemoyne, Pennsylvania.
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25
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Crook A, Jacobs C, Newton-John T, Richardson E, McEwen A. Patient and Relative Experiences and Decision-making About Genetic Testing and Counseling for Familial ALS and FTD: A Systematic Scoping Review. Alzheimer Dis Assoc Disord 2021; 35:374-385. [PMID: 34054018 DOI: 10.1097/wad.0000000000000458] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2020] [Accepted: 04/13/2021] [Indexed: 11/25/2022]
Abstract
Genetic testing and counseling is an emerging part of care for patients with amyotrophic lateral sclerosis (ALS) and frontotemporal dementia (FTD) and their families. This scoping review aimed to map patients' and relatives' experiences of genetic testing and counseling for familial ALS and FTD and the factors influencing their decision to proceed with testing or counseling. Informed by the Joanna Briggs Institute methodology, 5 databases were systematically searched. Thirty studies from 39 references were included. A descriptive numerical summary analysis and narrative synthesis was conducted. Mostly positive diagnostic testing experiences were reported, but issues arose due to progressive disease and discordant results. Predictive testing impacted at-risk relatives, regardless of the result received, and psychosocial sequelae ranged from relief to guilt, worry or contemplating suicide. Four reproductive testing experiences were reported. Personal, familial and practical factors, and the lived experience of disease, informed decision-making. Greater uncertainty and complexity may be faced in familial ALS/FTD than in other late-onset neurodegenerative diseases due to clinical and genetic heterogeneity, and testing limitations. Genetic counseling models of care should consider this difference to ensure that individuals with, or at risk of, ALS/FTD are effectively managed. Implications for research and practice are discussed.
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Affiliation(s)
- Ashley Crook
- Graduate School of Health, University of Technology Sydney, Chippendale
- Department of Biomedical Science, Centre for MND Research
- Department of Clinical Medicine, Faculty of Medicine and Health Sciences, Macquarie University, Sydney, NSW, Australia
| | - Chris Jacobs
- Graduate School of Health, University of Technology Sydney, Chippendale
| | - Toby Newton-John
- Graduate School of Health, University of Technology Sydney, Chippendale
| | - Ebony Richardson
- Graduate School of Health, University of Technology Sydney, Chippendale
| | - Alison McEwen
- Graduate School of Health, University of Technology Sydney, Chippendale
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26
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Laneve P, Tollis P, Caffarelli E. RNA Deregulation in Amyotrophic Lateral Sclerosis: The Noncoding Perspective. Int J Mol Sci 2021; 22:10285. [PMID: 34638636 PMCID: PMC8508793 DOI: 10.3390/ijms221910285] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Revised: 09/17/2021] [Accepted: 09/22/2021] [Indexed: 12/18/2022] Open
Abstract
RNA metabolism is central to cellular physiopathology. Almost all the molecular pathways underpinning biological processes are affected by the events governing the RNA life cycle, ranging from transcription to degradation. The deregulation of these processes contributes to the onset and progression of human diseases. In recent decades, considerable efforts have been devoted to the characterization of noncoding RNAs (ncRNAs) and to the study of their role in the homeostasis of the nervous system (NS), where they are highly enriched. Acting as major regulators of gene expression, ncRNAs orchestrate all the steps of the differentiation programs, participate in the mechanisms underlying neural functions, and are crucially implicated in the development of neuronal pathologies, among which are neurodegenerative diseases. This review aims to explore the link between ncRNA dysregulation and amyotrophic lateral sclerosis (ALS), the most frequent motoneuron (MN) disorder in adults. Notably, defective RNA metabolism is known to be largely associated with this pathology, which is often regarded as an RNA disease. We also discuss the potential role that these transcripts may play as diagnostic biomarkers and therapeutic targets.
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Affiliation(s)
- Pietro Laneve
- Institute of Molecular Biology and Pathology, National Research Council, 00185 Rome, Italy
| | - Paolo Tollis
- Department of Biology and Biotechnology Charles Darwin, Sapienza University of Rome, 00185 Rome, Italy;
| | - Elisa Caffarelli
- Institute of Molecular Biology and Pathology, National Research Council, 00185 Rome, Italy
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27
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Violi F, Solovyev N, Vinceti M, Mandrioli J, Lucio M, Michalke B. The study of levels from redox-active elements in cerebrospinal fluid of amyotrophic lateral sclerosis patients carrying disease-related gene mutations shows potential copper dyshomeostasis. Metallomics 2021; 12:668-681. [PMID: 32373852 DOI: 10.1039/d0mt00051e] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
Amyotrophic lateral sclerosis is a progressive neurodegenerative disease characterized by a loss of function of motor neurons. The etiology of this disorder is still largely unknown. Gene-environment interaction arises as a possible key factor in the development of amyotrophic lateral sclerosis. We assessed the levels of trace metals, copper (Cu), iron (Fe), and manganese (Mn), of 9 amyotrophic lateral sclerosis cases and 40 controls by measuring their content in cerebrospinal fluid. The following trace element species were quantified using ion chromatography-inductively coupled plasma mass spectrometry: univalent copper (Cu-I), divalent Cu (Cu-II), divalent Fe (Fe-II), trivalent Fe (Fe-III), divalent Mn (Mn-II), trivalent Mn (Mn-III), and also unidentified Mn species (Mn-unknown) were present in some samples. When computing the relative risks for amyotrophic lateral sclerosis through an unconditional logistic regression model, we observed a weak and imprecise positive association for iron (Fe III, adjusted odds ratio 1.48, 95% CI 0.46-4.76) and manganese (total-Mn and Mn-II; adjusted odds ratio 1.11, 95% CI 0.74-1.67, and 1.13, 95% CI 0.79-1.61, respectively). Increased risk for copper was found both in the crude analysis (odds ratio 1.14, 95% CI 0.99-1.31) and in multivariable analysis after adjusting for sex, age, and year of storage (1.09, 95% CI 0.90-1.32). Our results suggest a possible positive association between Cu and genetic amyotrophic lateral sclerosis, while they give little indication of involvement of Fe and Mn in disease, though some correlations found also for these elements deserve further investigation.
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Affiliation(s)
- Federica Violi
- CREAGEN Research Center of Environmental, Genetic and Nutritional Epidemiology, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
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28
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Milanese M, Bonifacino T, Torazza C, Provenzano F, Kumar M, Ravera S, Zerbo AR, Frumento G, Balbi M, Nguyen TPN, Bertola N, Ferrando S, Viale M, Profumo A, Bonanno G. Blocking glutamate mGlu 5 receptors with the negative allosteric modulator CTEP improves disease course in SOD1 G93A mouse model of amyotrophic lateral sclerosis. Br J Pharmacol 2021; 178:3747-3764. [PMID: 33931856 PMCID: PMC8457068 DOI: 10.1111/bph.15515] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Revised: 02/22/2021] [Accepted: 04/20/2021] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND AND PURPOSE The pathogenesis of amyotrophic lateral sclerosis (ALS) is not fully clarified, although excessive glutamate (Glu) transmission and the downstream cytotoxic cascades are major mechanisms for motor neuron death. Two metabotropic glutamate receptors (mGlu1 and mGlu5 ) are overexpressed in ALS and regulate cellular disease processes. Expression and function of mGlu5 receptors are altered at early symptomatic stages in the SOD1G93A mouse model of ALS and knockdown of mGlu5 receptors in SOD1G93A mice improved disease progression. EXPERIMENTAL APPROACH We treated male and female SOD1G93A mice with 2-chloro-4-((2,5-dimethyl-1-(4-(trifluoromethoxy)phenyl)-1H-imidazol-4-yl)ethynyl)pyridine (CTEP), an orally available mGlu5 receptor negative allosteric modulator (NAM), using doses of 2 mg·kg-1 per 48 h or 4 mg·kg-1 per 24 h from Day 90, an early symptomatic disease stage. Disease progression was studied by behavioural and histological approaches. KEY RESULTS CTEP dose-dependently ameliorated clinical features in SOD1G93A mice. The lower dose increased survival and improved motor skills in female mice, with barely positive effects in male mice. Higher doses significantly ameliorated disease symptoms and survival in both males and females, females being more responsive. CTEP also reduced motor neuron death, astrocyte and microglia activation, and abnormal glutamate release in the spinal cord, with equal effects in male and female mice. No differences were also observed in CTEP access to the brain. CONCLUSION AND IMPLICATIONS Our results suggest that mGlu5 receptors are promising targets for the treatment of ALS and highlight mGlu5 receptor NAMs as effective pharmacological tools with translational potential.
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Affiliation(s)
- Marco Milanese
- Department of Pharmacy, Pharmacology and Toxicology Unit, University of Genoa, Genoa, Italy.,Inter-University Center for the Promotion of the 3Rs Principles in Teaching & Research (Centro 3R), Genoa, Italy
| | - Tiziana Bonifacino
- Department of Pharmacy, Pharmacology and Toxicology Unit, University of Genoa, Genoa, Italy.,Inter-University Center for the Promotion of the 3Rs Principles in Teaching & Research (Centro 3R), Genoa, Italy
| | - Carola Torazza
- Department of Pharmacy, Pharmacology and Toxicology Unit, University of Genoa, Genoa, Italy
| | - Francesca Provenzano
- Department of Pharmacy, Pharmacology and Toxicology Unit, University of Genoa, Genoa, Italy.,Department of Neurodegenerative Diseases, Hertie Institute for Clinical Brain Research, University of Tübingen and German Center for Neurodegenerative Diseases (DZNE), Tübingen, Germany
| | - Mandeep Kumar
- Department of Pharmacy, Pharmacology and Toxicology Unit, University of Genoa, Genoa, Italy
| | - Silvia Ravera
- Department of Experimental Medicine, University of Genoa, Genoa, Italy
| | - Arianna Roberta Zerbo
- Department of Pharmacy, Pharmacology and Toxicology Unit, University of Genoa, Genoa, Italy
| | - Giulia Frumento
- Department of Pharmacy, Pharmacology and Toxicology Unit, University of Genoa, Genoa, Italy
| | - Matilde Balbi
- Department of Pharmacy, Pharmacology and Toxicology Unit, University of Genoa, Genoa, Italy
| | - T P Nhung Nguyen
- Department of Pharmacy, Pharmacology and Toxicology Unit, University of Genoa, Genoa, Italy
| | - Nadia Bertola
- Department of Experimental Medicine, University of Genoa, Genoa, Italy
| | - Sara Ferrando
- Department of Earth, Environmental and Life Science, University of Genoa, Genoa, Italy
| | | | - Aldo Profumo
- IRCCS Ospedale policlinico San Martino, Genoa, Italy
| | - Giambattista Bonanno
- Department of Pharmacy, Pharmacology and Toxicology Unit, University of Genoa, Genoa, Italy.,IRCCS Ospedale policlinico San Martino, Genoa, Italy
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Cairns LM, Rankin J, Hamad A, Cooper N, Merrifield K, Jain V, Rosser E, Rogers M, Buston S, Stopford C, Jones G, Lefroy H, Németh AH, Holden S, Douglas AGL. Genetic testing in motor neuron disease and frontotemporal dementia: a 5-year multicentre evaluation. J Med Genet 2021; 59:544-548. [PMID: 33963046 DOI: 10.1136/jmedgenet-2021-107776] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Revised: 04/20/2021] [Accepted: 04/27/2021] [Indexed: 11/03/2022]
Abstract
INTRODUCTION Motor neuron disease (MND) and frontotemporal dementia (FTD) comprise a neurodegenerative disease spectrum. Genetic testing and counselling is complex in MND/FTD owing to incomplete penetrance, variable phenotype and variants of uncertain significance. Affected patients and unaffected relatives are commonly referred to clinical genetics to consider genetic testing. However, no consensus exists regarding how such genetic testing should best be undertaken and on which patients. OBJECTIVE We sought to ascertain UK clinical genetics testing practice in MND/FTD referrals, with the aim of helping inform guideline development. METHODS MND/FTD clinical genetics referrals comprising both affected patients and unaffected relatives between 2012 and 2016 were identified and a standardised proforma used to collate data from clinical records. RESULTS 301 referrals (70 affected, 231 unaffected) were reviewed across 10 genetics centres. Previously identified familial variants were known in 107 cases and 58% subsequently underwent testing (8 of 8 diagnostic and 54 of 99 predictive). The median number of genetic counselling appointments was 2 for diagnostic and 4 for predictive testing. Importantly, application of current UK Genomic Test Directory eligibility criteria would not have resulted in detection of all pathogenic variants observed in this cohort. CONCLUSION We propose pragmatic MND/FTD genetic testing guidelines based on appropriate genetic counselling.
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Affiliation(s)
- Lauren M Cairns
- Wessex Clinical Genetics Service, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Julia Rankin
- Peninsula Clinical Genetics, Royal Devon and Exeter NHS Foundation Trust, Exeter, UK
| | - Asma Hamad
- Clinical Genetics Unit, Birmingham Women's and Children's NHS Foundation Trust, Birmingham, UK
| | - Nicola Cooper
- Clinical Genetics Unit, Birmingham Women's and Children's NHS Foundation Trust, Birmingham, UK
| | - Katrina Merrifield
- Clinical Genetics Unit, Birmingham Women's and Children's NHS Foundation Trust, Birmingham, UK
| | - Vani Jain
- All Wales Medical Genetics Service, University Hospital Wales, Cardiff, UK
| | - Elisabeth Rosser
- Clinical Genetics Unit, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - Megan Rogers
- Bristol Regional Clinical Genetics Service, University Hospitals Bristol NHS Foundation Trust, Bristol, UK
| | - Sarah Buston
- Bristol Regional Clinical Genetics Service, University Hospitals Bristol NHS Foundation Trust, Bristol, UK
| | - Cheryl Stopford
- Yorkshire Regional Genetics Service, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - Gabriela Jones
- Clinical Genetics Service, Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - Henrietta Lefroy
- Oxford Centre for Genomic Medicine, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - Andrea H Németh
- Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, University of Oxford, Oxford, UK
| | - Simon Holden
- Clinical Genetics, Addenbrooke's Treatment Centre, Cambridge, UK
| | - Andrew G L Douglas
- Wessex Clinical Genetics Service, University Hospital Southampton NHS Foundation Trust, Southampton, UK .,Human Development and Health, University of Southampton, Southampton, UK
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Leite Neto L, França Júnior MC, Chun RYS. Speech intelligibility in people with Amyotrophic Lateral Sclerosis (ALS). Codas 2021; 33:e20190214. [PMID: 33533830 DOI: 10.1590/2317-1782/20202019214] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2019] [Accepted: 02/06/2020] [Indexed: 11/22/2022] Open
Abstract
PURPOSE To evaluate speech intelligibility and dysarthria, correlated to the functional assessment of Amyotrophic Lateral Sclerosis (ALS). METHODS Quantitative-descriptive study approved by REC under No. CAAE 62912416.4.0000.5404, comprised of 19 individuals with sporadic or familiar ALS. Data were collected using the Dysarthria Protocol and the Revised Amyotrophic Lateral Sclerosis Functional Rating Scale (ALSFRS-Re). We used visual analogue scale (VAS) to assess speech intelligibility and summary measures; and Spearman's coefficients of correlation for the instruments with significance level of 5%. RESULTS Speech intelligibility is compromised (41.37±39.73) in varied degrees with positive correlation with the general degree of dysarthria (p=<.0001), and with all the analyzed speech parameters, indicating impact on the speech deterioration of the studied group. There is negative correlation between speech intelligibility and the results of the bulbar sections - speech and deglutition (p=0.0166), arm - activities with the upper limb (p=0.0064) and leg - activities with the lower limb (p=0.0391). Breathing (p=0.0178), phonation (p=0.0334) and resonance (p=0.0053) parameters showed a negative correlation with the item "speech" of the ALSFRS-Re. CONCLUSION Results show impaired speech intelligibility and dysarthria, and evidence breathing, phonation and resonance as important markers of the disease progression. A thorough and early evaluation of the oral motor production allows for a better management of alterations in ALS.
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Affiliation(s)
- Lavoisier Leite Neto
- Programa de Pós-graduação Saúde, Interdisciplinaridade e Reabilitação, Faculdade de Ciências Médicas, Universidade Estadual de Campinas - UNICAMP - Campinas (SP), Brasil
| | | | - Regina Yu Shon Chun
- Programa de Pós-graduação Saúde, Interdisciplinaridade e Reabilitação, Faculdade de Ciências Médicas, Universidade Estadual de Campinas - UNICAMP - Campinas (SP), Brasil
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Choi ES, Dokholyan NV. SOD1 oligomers in amyotrophic lateral sclerosis. Curr Opin Struct Biol 2021; 66:225-230. [PMID: 33465527 DOI: 10.1016/j.sbi.2020.12.002] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Revised: 11/30/2020] [Accepted: 12/03/2020] [Indexed: 11/18/2022]
Abstract
Identifying nonnative, trimeric forms of SOD1 trimers as the toxic species, rather than large aggregates revolutionizes our understanding of ALS pathophysiology. Large protein aggregates, what was previously thought as the central cause of neurodegeneration, play protective role and are not responsible for neuronal death. SOD1 trimers are implicated at the molecular, cellular, and organismal level. Understanding the formation of the nonnative trimer and its role in the cell, leading to cell death, holds the key to developing a new standard of therapeutics for ALS and for other neurodegenerative diseases. This review highlights recent advances of knowledge for the role of SOD1 oligomers in ALS.
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Affiliation(s)
- Esther S Choi
- Department of Pharmacology, Penn State College of Medicine, Hershey, PA, USA; Medical Scientist Training Program, Penn State College of Medicine, Hershey, PA, USA.
| | - Nikolay V Dokholyan
- Department of Pharmacology, Penn State College of Medicine, Hershey, PA, USA; Department of Biochemistry and Molecular Biology, Penn State College of Medicine, Hershey, PA, USA.
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Amador MDM, Gargiulo M, Boucher C, Herson A, Staraci S, Salachas F, Clot F, Cazeneuve C, Le Ber I, Durr A. Who and Why? Requests for Presymptomatic Genetic Testing for Amyotrophic Lateral Sclerosis/Frontotemporal Dementia vs Huntington Disease. NEUROLOGY-GENETICS 2020; 7:e538. [PMID: 33376800 PMCID: PMC7768924 DOI: 10.1212/nxg.0000000000000538] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Accepted: 10/20/2020] [Indexed: 11/15/2022]
Abstract
Objective We aimed to describe the population of subjects seeking presymptomatic counseling for amyotrophic lateral sclerosis and/or frontotemporal dementia (ALS/FTD) and compared them with those demanding the well-established presymptomatic test for Huntington disease (HD). Methods We retrospectively examined the requests of a cohort of individuals at risk of familial ALS/FTD and 1 at risk of HD over the same time frame of 11 years. The individuals were seen in the referral center of our neurogenetics unit. Results Of the 106 presymptomatic testing (PT) requests from subjects at risk of ALS/FTD, 65% were seen in the last 3 years. Over two-thirds of the subjects were at risk of carrying mutations responsible for ALS, FTD, or both. Sixty-two percent of the subjects came from families with a known hexanucleotide repeat expansion in C9ORF72. During the same period, we counseled 840 subjects at risk of HD. Subjects at risk of ALS/FTD had the presymptomatic test significantly sooner after being aware of their risk, but were older than those at risk of HD. The youngest subjects requesting the test had the highest disease load in the family (p < 0.05). Conclusions Demands for PT for ALS/FTD have been increasingly growing, particularly since the discovery of the C9ORF72 gene. The major specificity of the genetic counseling for these diseases is the unpredictability of the clinical phenotype for most of the genes involved. Awareness of this added uncertainty does not prevent individuals from taking the test, as the dropout rate is not higher than that for HD.
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Affiliation(s)
- Maria Del Mar Amador
- Maria del Mar Amador, Département de Neurologie (M.d.M.A., F.S.), Centre de Référence SLA de Paris, Assistance Publique-Hôpitaux de Paris, Sorbonne Université Hospital Pitié-Salpêtrière, Paris, France; Département de Génétique (M.d.M.A., M.G., C.B., A.H., S.S., A.D.), Assistance Publique-Hôpitaux de Paris, Sorbonne Université, Sorbonne Université Hospital Pitié-Salpêtrière, Paris, France; Laboratory of Clinical Psychology (M.G.), Psychopathology and Psychoanalysis PCPP, EA 4056, University Paris Descartes, Sorbonne Paris City, Psychology Institute, Boulogne-Billancourt, France; Département de Génétique (F.C., C.C.), UF de Neurogénétique, Assistance Publique-Hôpitaux de Paris, Sorbonne Université Hospital Pitié-Salpêtrière; Centre de Référence des Démences Rares ou Précoces (I.L.B.), IM2A, Département de Neurologie, Assistance Publique-Hôpitaux de Paris, Sorbonne Université Hospital Pitié-Salpêtrière, Paris, France; and Sorbonne Université, Institut du Cerveau et de la Moelle épinière (ICM) (I.L.B., A.D.), Assistance Publique-Hôpitaux de Paris, INSERM, CNRS, Sorbonne Université Hospital Pitié-Salpêtrière, Paris, France
| | - Marcela Gargiulo
- Maria del Mar Amador, Département de Neurologie (M.d.M.A., F.S.), Centre de Référence SLA de Paris, Assistance Publique-Hôpitaux de Paris, Sorbonne Université Hospital Pitié-Salpêtrière, Paris, France; Département de Génétique (M.d.M.A., M.G., C.B., A.H., S.S., A.D.), Assistance Publique-Hôpitaux de Paris, Sorbonne Université, Sorbonne Université Hospital Pitié-Salpêtrière, Paris, France; Laboratory of Clinical Psychology (M.G.), Psychopathology and Psychoanalysis PCPP, EA 4056, University Paris Descartes, Sorbonne Paris City, Psychology Institute, Boulogne-Billancourt, France; Département de Génétique (F.C., C.C.), UF de Neurogénétique, Assistance Publique-Hôpitaux de Paris, Sorbonne Université Hospital Pitié-Salpêtrière; Centre de Référence des Démences Rares ou Précoces (I.L.B.), IM2A, Département de Neurologie, Assistance Publique-Hôpitaux de Paris, Sorbonne Université Hospital Pitié-Salpêtrière, Paris, France; and Sorbonne Université, Institut du Cerveau et de la Moelle épinière (ICM) (I.L.B., A.D.), Assistance Publique-Hôpitaux de Paris, INSERM, CNRS, Sorbonne Université Hospital Pitié-Salpêtrière, Paris, France
| | - Christilla Boucher
- Maria del Mar Amador, Département de Neurologie (M.d.M.A., F.S.), Centre de Référence SLA de Paris, Assistance Publique-Hôpitaux de Paris, Sorbonne Université Hospital Pitié-Salpêtrière, Paris, France; Département de Génétique (M.d.M.A., M.G., C.B., A.H., S.S., A.D.), Assistance Publique-Hôpitaux de Paris, Sorbonne Université, Sorbonne Université Hospital Pitié-Salpêtrière, Paris, France; Laboratory of Clinical Psychology (M.G.), Psychopathology and Psychoanalysis PCPP, EA 4056, University Paris Descartes, Sorbonne Paris City, Psychology Institute, Boulogne-Billancourt, France; Département de Génétique (F.C., C.C.), UF de Neurogénétique, Assistance Publique-Hôpitaux de Paris, Sorbonne Université Hospital Pitié-Salpêtrière; Centre de Référence des Démences Rares ou Précoces (I.L.B.), IM2A, Département de Neurologie, Assistance Publique-Hôpitaux de Paris, Sorbonne Université Hospital Pitié-Salpêtrière, Paris, France; and Sorbonne Université, Institut du Cerveau et de la Moelle épinière (ICM) (I.L.B., A.D.), Assistance Publique-Hôpitaux de Paris, INSERM, CNRS, Sorbonne Université Hospital Pitié-Salpêtrière, Paris, France
| | - Ariane Herson
- Maria del Mar Amador, Département de Neurologie (M.d.M.A., F.S.), Centre de Référence SLA de Paris, Assistance Publique-Hôpitaux de Paris, Sorbonne Université Hospital Pitié-Salpêtrière, Paris, France; Département de Génétique (M.d.M.A., M.G., C.B., A.H., S.S., A.D.), Assistance Publique-Hôpitaux de Paris, Sorbonne Université, Sorbonne Université Hospital Pitié-Salpêtrière, Paris, France; Laboratory of Clinical Psychology (M.G.), Psychopathology and Psychoanalysis PCPP, EA 4056, University Paris Descartes, Sorbonne Paris City, Psychology Institute, Boulogne-Billancourt, France; Département de Génétique (F.C., C.C.), UF de Neurogénétique, Assistance Publique-Hôpitaux de Paris, Sorbonne Université Hospital Pitié-Salpêtrière; Centre de Référence des Démences Rares ou Précoces (I.L.B.), IM2A, Département de Neurologie, Assistance Publique-Hôpitaux de Paris, Sorbonne Université Hospital Pitié-Salpêtrière, Paris, France; and Sorbonne Université, Institut du Cerveau et de la Moelle épinière (ICM) (I.L.B., A.D.), Assistance Publique-Hôpitaux de Paris, INSERM, CNRS, Sorbonne Université Hospital Pitié-Salpêtrière, Paris, France
| | - Stéphanie Staraci
- Maria del Mar Amador, Département de Neurologie (M.d.M.A., F.S.), Centre de Référence SLA de Paris, Assistance Publique-Hôpitaux de Paris, Sorbonne Université Hospital Pitié-Salpêtrière, Paris, France; Département de Génétique (M.d.M.A., M.G., C.B., A.H., S.S., A.D.), Assistance Publique-Hôpitaux de Paris, Sorbonne Université, Sorbonne Université Hospital Pitié-Salpêtrière, Paris, France; Laboratory of Clinical Psychology (M.G.), Psychopathology and Psychoanalysis PCPP, EA 4056, University Paris Descartes, Sorbonne Paris City, Psychology Institute, Boulogne-Billancourt, France; Département de Génétique (F.C., C.C.), UF de Neurogénétique, Assistance Publique-Hôpitaux de Paris, Sorbonne Université Hospital Pitié-Salpêtrière; Centre de Référence des Démences Rares ou Précoces (I.L.B.), IM2A, Département de Neurologie, Assistance Publique-Hôpitaux de Paris, Sorbonne Université Hospital Pitié-Salpêtrière, Paris, France; and Sorbonne Université, Institut du Cerveau et de la Moelle épinière (ICM) (I.L.B., A.D.), Assistance Publique-Hôpitaux de Paris, INSERM, CNRS, Sorbonne Université Hospital Pitié-Salpêtrière, Paris, France
| | - François Salachas
- Maria del Mar Amador, Département de Neurologie (M.d.M.A., F.S.), Centre de Référence SLA de Paris, Assistance Publique-Hôpitaux de Paris, Sorbonne Université Hospital Pitié-Salpêtrière, Paris, France; Département de Génétique (M.d.M.A., M.G., C.B., A.H., S.S., A.D.), Assistance Publique-Hôpitaux de Paris, Sorbonne Université, Sorbonne Université Hospital Pitié-Salpêtrière, Paris, France; Laboratory of Clinical Psychology (M.G.), Psychopathology and Psychoanalysis PCPP, EA 4056, University Paris Descartes, Sorbonne Paris City, Psychology Institute, Boulogne-Billancourt, France; Département de Génétique (F.C., C.C.), UF de Neurogénétique, Assistance Publique-Hôpitaux de Paris, Sorbonne Université Hospital Pitié-Salpêtrière; Centre de Référence des Démences Rares ou Précoces (I.L.B.), IM2A, Département de Neurologie, Assistance Publique-Hôpitaux de Paris, Sorbonne Université Hospital Pitié-Salpêtrière, Paris, France; and Sorbonne Université, Institut du Cerveau et de la Moelle épinière (ICM) (I.L.B., A.D.), Assistance Publique-Hôpitaux de Paris, INSERM, CNRS, Sorbonne Université Hospital Pitié-Salpêtrière, Paris, France
| | - Fabienne Clot
- Maria del Mar Amador, Département de Neurologie (M.d.M.A., F.S.), Centre de Référence SLA de Paris, Assistance Publique-Hôpitaux de Paris, Sorbonne Université Hospital Pitié-Salpêtrière, Paris, France; Département de Génétique (M.d.M.A., M.G., C.B., A.H., S.S., A.D.), Assistance Publique-Hôpitaux de Paris, Sorbonne Université, Sorbonne Université Hospital Pitié-Salpêtrière, Paris, France; Laboratory of Clinical Psychology (M.G.), Psychopathology and Psychoanalysis PCPP, EA 4056, University Paris Descartes, Sorbonne Paris City, Psychology Institute, Boulogne-Billancourt, France; Département de Génétique (F.C., C.C.), UF de Neurogénétique, Assistance Publique-Hôpitaux de Paris, Sorbonne Université Hospital Pitié-Salpêtrière; Centre de Référence des Démences Rares ou Précoces (I.L.B.), IM2A, Département de Neurologie, Assistance Publique-Hôpitaux de Paris, Sorbonne Université Hospital Pitié-Salpêtrière, Paris, France; and Sorbonne Université, Institut du Cerveau et de la Moelle épinière (ICM) (I.L.B., A.D.), Assistance Publique-Hôpitaux de Paris, INSERM, CNRS, Sorbonne Université Hospital Pitié-Salpêtrière, Paris, France
| | - Cécile Cazeneuve
- Maria del Mar Amador, Département de Neurologie (M.d.M.A., F.S.), Centre de Référence SLA de Paris, Assistance Publique-Hôpitaux de Paris, Sorbonne Université Hospital Pitié-Salpêtrière, Paris, France; Département de Génétique (M.d.M.A., M.G., C.B., A.H., S.S., A.D.), Assistance Publique-Hôpitaux de Paris, Sorbonne Université, Sorbonne Université Hospital Pitié-Salpêtrière, Paris, France; Laboratory of Clinical Psychology (M.G.), Psychopathology and Psychoanalysis PCPP, EA 4056, University Paris Descartes, Sorbonne Paris City, Psychology Institute, Boulogne-Billancourt, France; Département de Génétique (F.C., C.C.), UF de Neurogénétique, Assistance Publique-Hôpitaux de Paris, Sorbonne Université Hospital Pitié-Salpêtrière; Centre de Référence des Démences Rares ou Précoces (I.L.B.), IM2A, Département de Neurologie, Assistance Publique-Hôpitaux de Paris, Sorbonne Université Hospital Pitié-Salpêtrière, Paris, France; and Sorbonne Université, Institut du Cerveau et de la Moelle épinière (ICM) (I.L.B., A.D.), Assistance Publique-Hôpitaux de Paris, INSERM, CNRS, Sorbonne Université Hospital Pitié-Salpêtrière, Paris, France
| | - Isabelle Le Ber
- Maria del Mar Amador, Département de Neurologie (M.d.M.A., F.S.), Centre de Référence SLA de Paris, Assistance Publique-Hôpitaux de Paris, Sorbonne Université Hospital Pitié-Salpêtrière, Paris, France; Département de Génétique (M.d.M.A., M.G., C.B., A.H., S.S., A.D.), Assistance Publique-Hôpitaux de Paris, Sorbonne Université, Sorbonne Université Hospital Pitié-Salpêtrière, Paris, France; Laboratory of Clinical Psychology (M.G.), Psychopathology and Psychoanalysis PCPP, EA 4056, University Paris Descartes, Sorbonne Paris City, Psychology Institute, Boulogne-Billancourt, France; Département de Génétique (F.C., C.C.), UF de Neurogénétique, Assistance Publique-Hôpitaux de Paris, Sorbonne Université Hospital Pitié-Salpêtrière; Centre de Référence des Démences Rares ou Précoces (I.L.B.), IM2A, Département de Neurologie, Assistance Publique-Hôpitaux de Paris, Sorbonne Université Hospital Pitié-Salpêtrière, Paris, France; and Sorbonne Université, Institut du Cerveau et de la Moelle épinière (ICM) (I.L.B., A.D.), Assistance Publique-Hôpitaux de Paris, INSERM, CNRS, Sorbonne Université Hospital Pitié-Salpêtrière, Paris, France
| | - Alexandra Durr
- Maria del Mar Amador, Département de Neurologie (M.d.M.A., F.S.), Centre de Référence SLA de Paris, Assistance Publique-Hôpitaux de Paris, Sorbonne Université Hospital Pitié-Salpêtrière, Paris, France; Département de Génétique (M.d.M.A., M.G., C.B., A.H., S.S., A.D.), Assistance Publique-Hôpitaux de Paris, Sorbonne Université, Sorbonne Université Hospital Pitié-Salpêtrière, Paris, France; Laboratory of Clinical Psychology (M.G.), Psychopathology and Psychoanalysis PCPP, EA 4056, University Paris Descartes, Sorbonne Paris City, Psychology Institute, Boulogne-Billancourt, France; Département de Génétique (F.C., C.C.), UF de Neurogénétique, Assistance Publique-Hôpitaux de Paris, Sorbonne Université Hospital Pitié-Salpêtrière; Centre de Référence des Démences Rares ou Précoces (I.L.B.), IM2A, Département de Neurologie, Assistance Publique-Hôpitaux de Paris, Sorbonne Université Hospital Pitié-Salpêtrière, Paris, France; and Sorbonne Université, Institut du Cerveau et de la Moelle épinière (ICM) (I.L.B., A.D.), Assistance Publique-Hôpitaux de Paris, INSERM, CNRS, Sorbonne Université Hospital Pitié-Salpêtrière, Paris, France
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Grandis M, Obici L, Luigetti M, Briani C, Benedicenti F, Bisogni G, Canepa M, Cappelli F, Danesino C, Fabrizi GM, Fenu S, Ferrandes G, Gemelli C, Manganelli F, Mazzeo A, Melchiorri L, Perfetto F, Pradotto LG, Rimessi P, Tini G, Tozza S, Trevisan L, Pareyson D, Mandich P. Recommendations for pre-symptomatic genetic testing for hereditary transthyretin amyloidosis in the era of effective therapy: a multicenter Italian consensus. Orphanet J Rare Dis 2020; 15:348. [PMID: 33317601 PMCID: PMC7734774 DOI: 10.1186/s13023-020-01633-z] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Accepted: 11/27/2020] [Indexed: 12/13/2022] Open
Abstract
Hereditary transthyretin amyloidosis (ATTRv, v for variant) is a late-onset, autosomal dominant disease caused by progressive extracellular deposition of transthyretin amyloid fibrils, leading to organ damage and death. For other late-onset fatal diseases, as Huntington’s disease, protocols for pre-symptomatic genetic testing (PST) are available since decades. For ATTRv, limited experience has been reported to date, mostly gathered before the availability of approved therapies. We aimed at developing recommendations for a safe and feasible PST protocol in ATTRv in the era of emerging treatments, taking also into account Italian patients’ characteristics and healthcare system rules. After an initial survey on ongoing approaches to PST for ATTRv in Italy, two roundtable meetings were attended by 24 experts from 16 Italian centers involved in the diagnosis and care of this disease. Minimal requirements for PST offer and potential critical issues were highlighted. By November 2019, 457 families affected by ATTRv with 209 molecularly confirmed pre-symptomatic carriers were counted. The median age at PST was 41.3 years of age, regardless of the specific mutation. Half of the Italian centers had a multidisciplinary team, including a neurologist, an internist, a cardiologist, a medical geneticist and a psychologist, although in most cases not all the specialists were available in the same center. A variable number of visits was performed at each site. Experts agreed that PST should be offered only in the context of genetic counselling to at risk individuals aged 18 or older. Advertised commercial options for DNA testing should be avoided. The protocol should consist of several steps, including a preliminary clinical examination, a pre-test information session, an interval time, the genetic test and a post-test session with the disclosure of the test results, in the context of an experienced multidisciplinary team. Recommendations for best timing were also defined. Protocols for PST in the context of ATTRv can be refined to offer at risk individuals the best chance for early diagnosis and timely treatment start, while respecting autonomous decisions and promoting safe psychological adjustment to the genetic result.
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Affiliation(s)
- M Grandis
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics and Maternal and Child Health (DINOGMI), Section of Medical Genetics, University of Genoa, c/o DIMI Viale Benedetto XV, 6, 16132, Genova, Italy.,IRCCS Policlinico San Martino, Genova, Italy
| | - L Obici
- Amyloidosis Research and Treatment Center, IRCCS Fondazione Policlinico San Matteo, Pavia, Italy
| | - M Luigetti
- UOC Neurologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.,Università Cattolica del Sacro Cuore, Rome, Italy
| | - C Briani
- Department of Neuroscience, University of Padova, Padova, Italy
| | - F Benedicenti
- Medical Genetics, Azienda Sanitaria Dell'Alto Adige, Bolzano, Italy
| | - G Bisogni
- Centro Clinico Nemo Adulti-Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - M Canepa
- Cardiovascular Disease Unit, IRCCS Policlinico San Martino, Genova, and IRCCS Italian Cardiovascular Network, Department of Internal Medicine, University of Genova, Genova, Italy
| | - F Cappelli
- Tuscan Regional Amyloidosis Center, Careggi University Hospital, Firenze, Italy
| | - C Danesino
- Molecular Medicine Department, University of Pavia, Pavia, Italy
| | - G M Fabrizi
- Department of Neurosciences, Biomedicine and Movement Sciences, Section of Neurology, University of Verona and University Hospital GB Rossi, Verona, Italy
| | - S Fenu
- Unit of Rare Neurodegenerative and Neurometabolic Diseases, Department of Clinical Neurosciences, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - G Ferrandes
- IRCCS Policlinico San Martino, Genova, Italy
| | - C Gemelli
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics and Maternal and Child Health (DINOGMI), Section of Medical Genetics, University of Genoa, c/o DIMI Viale Benedetto XV, 6, 16132, Genova, Italy.,Neuromuscular Omnicentre (NEMO)-Fondazione Serena Onlus, Arenzano, GE, Italy
| | - F Manganelli
- Department of Neuroscience, Reproductive and Odontostomatological Sciences, University of Naples "Federico II", Napoli, Italy
| | - A Mazzeo
- Unit of Neurology and Neuromuscular Diseases, Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - L Melchiorri
- Medical Genetics Unit, Azienda Ospedaliero Universitaria Di Ferrara, Ferrara, Italy
| | - F Perfetto
- Tuscan Regional Amyloidosis Center, Careggi University Hospital, Firenze, Italy
| | - L G Pradotto
- Department of Neurosciences, University of Turin, Torino, Italy.,Division of Neurology and Neurorehabilitazion, IRCCS Istituto Auxologico Italiano, Piancavallo, VB, Italy
| | - P Rimessi
- Medical Genetics Unit, Azienda Ospedaliero Universitaria Di Ferrara, Ferrara, Italy
| | - G Tini
- Cardiovascular Disease Unit, IRCCS Policlinico San Martino, Genova, and IRCCS Italian Cardiovascular Network, Department of Internal Medicine, University of Genova, Genova, Italy
| | - S Tozza
- Department of Neuroscience, Reproductive and Odontostomatological Sciences, University of Naples "Federico II", Napoli, Italy
| | - L Trevisan
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics and Maternal and Child Health (DINOGMI), Section of Medical Genetics, University of Genoa, c/o DIMI Viale Benedetto XV, 6, 16132, Genova, Italy.,IRCCS Policlinico San Martino, Genova, Italy
| | - D Pareyson
- Unit of Rare Neurodegenerative and Neurometabolic Diseases, Department of Clinical Neurosciences, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - P Mandich
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics and Maternal and Child Health (DINOGMI), Section of Medical Genetics, University of Genoa, c/o DIMI Viale Benedetto XV, 6, 16132, Genova, Italy. .,IRCCS Policlinico San Martino, Genova, Italy.
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Lattante S, Marangi G, Doronzio PN, Conte A, Bisogni G, Zollino M, Sabatelli M. High-Throughput Genetic Testing in ALS: The Challenging Path of Variant Classification Considering the ACMG Guidelines. Genes (Basel) 2020; 11:genes11101123. [PMID: 32987860 PMCID: PMC7600768 DOI: 10.3390/genes11101123] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Revised: 09/15/2020] [Accepted: 09/22/2020] [Indexed: 12/17/2022] Open
Abstract
The development of high-throughput sequencing technologies and screening of big patient cohorts with familial and sporadic amyotrophic lateral sclerosis (ALS) led to the identification of a significant number of genetic variants, which are sometimes difficult to interpret. The American College of Medical Genetics and Genomics (ACMG) provided guidelines to help molecular geneticists and pathologists to interpret variants found in laboratory testing. We assessed the application of the ACMG criteria to ALS-related variants, combining data from literature with our experience. We analyzed a cohort of 498 ALS patients using massive parallel sequencing of ALS-associated genes and identified 280 variants with a minor allele frequency < 1%. Examining all variants using the ACMG criteria, thus considering the type of variant, inheritance, familial segregation, and possible functional studies, we classified 20 variants as “pathogenic”. In conclusion, ALS’s genetic complexity, such as oligogenic inheritance, presence of genes acting as risk factors, and reduced penetrance, needs to be considered when interpreting variants. The goal of this work is to provide helpful suggestions to geneticists and clinicians dealing with ALS.
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Affiliation(s)
- Serena Lattante
- Section of Genomic Medicine, Department of Life Sciences and Public Health, Faculty of Medicine and Surgery, Catholic University of the Sacred Heart, 00168 Roma, Italy; (S.L.); (P.N.D.); (M.Z.)
- Complex Operational Unit of Medical Genetics, Department of Laboratory and Infectious Disease Sciences, A. Gemelli University Hospital Foundation IRCCS, 00168 Roma, Italy
| | - Giuseppe Marangi
- Section of Genomic Medicine, Department of Life Sciences and Public Health, Faculty of Medicine and Surgery, Catholic University of the Sacred Heart, 00168 Roma, Italy; (S.L.); (P.N.D.); (M.Z.)
- Complex Operational Unit of Medical Genetics, Department of Laboratory and Infectious Disease Sciences, A. Gemelli University Hospital Foundation IRCCS, 00168 Roma, Italy
- Correspondence: ; Tel.: +39-0630154606
| | - Paolo Niccolò Doronzio
- Section of Genomic Medicine, Department of Life Sciences and Public Health, Faculty of Medicine and Surgery, Catholic University of the Sacred Heart, 00168 Roma, Italy; (S.L.); (P.N.D.); (M.Z.)
- Complex Operational Unit of Medical Genetics, Department of Laboratory and Infectious Disease Sciences, A. Gemelli University Hospital Foundation IRCCS, 00168 Roma, Italy
| | - Amelia Conte
- Adult NEMO Clinical Center, Complex Operational Unit of Neurology, Department of Aging, Neurological, Orthopedic and Head-Neck Sciences, A. Gemelli University Hospital Foundation IRCCS, 00168 Roma, Italy; (A.C.); (G.B.); (M.S.)
| | - Giulia Bisogni
- Adult NEMO Clinical Center, Complex Operational Unit of Neurology, Department of Aging, Neurological, Orthopedic and Head-Neck Sciences, A. Gemelli University Hospital Foundation IRCCS, 00168 Roma, Italy; (A.C.); (G.B.); (M.S.)
| | - Marcella Zollino
- Section of Genomic Medicine, Department of Life Sciences and Public Health, Faculty of Medicine and Surgery, Catholic University of the Sacred Heart, 00168 Roma, Italy; (S.L.); (P.N.D.); (M.Z.)
- Complex Operational Unit of Medical Genetics, Department of Laboratory and Infectious Disease Sciences, A. Gemelli University Hospital Foundation IRCCS, 00168 Roma, Italy
| | - Mario Sabatelli
- Adult NEMO Clinical Center, Complex Operational Unit of Neurology, Department of Aging, Neurological, Orthopedic and Head-Neck Sciences, A. Gemelli University Hospital Foundation IRCCS, 00168 Roma, Italy; (A.C.); (G.B.); (M.S.)
- Section of Neurology, Department of Neuroscience, Faculty of Medicine and Surgery, Catholic University of the Sacred Heart, 00168 Roma, Italy
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Decreased Mitochondrial Function, Biogenesis, and Degradation in Peripheral Blood Mononuclear Cells from Amyotrophic Lateral Sclerosis Patients as a Potential Tool for Biomarker Research. Mol Neurobiol 2020; 57:5084-5102. [PMID: 32840822 PMCID: PMC7541388 DOI: 10.1007/s12035-020-02059-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Accepted: 08/07/2020] [Indexed: 12/11/2022]
Abstract
Amyotrophic lateral sclerosis (ALS) is a multifactorial and progressive neurodegenerative disease of unknown etiology. Due to ALS’s unpredictable onset and progression rate, the search for biomarkers that allow the detection and tracking of its development and therapeutic efficacy would be of significant medical value. Considering that alterations of energy supply are one of ALS’s main hallmarks and that a correlation has been established between gene expression in human brain tissue and peripheral blood mononuclear cells (PBMCs), the present work investigates whether changes in mitochondrial function could be used to monitor ALS. To achieve this goal, PBMCs from ALS patients and control subjects were used; blood sampling is a quite non-invasive method and is cost-effective. Different parameters were evaluated, namely cytosolic calcium levels, mitochondrial membrane potential, oxidative stress, and metabolic compounds levels, as well as mitochondrial dynamics and degradation. Altogether, we observed lower mitochondrial calcium uptake/retention, mitochondria depolarization, and redox homeostasis deregulation, in addition to a decrease in critical metabolic genes, a diminishment in mitochondrial biogenesis, and an augmentation in mitochondrial fission and autophagy-related gene expression. All of these changes can contribute to the decreased ATP and pyruvate levels observed in ALS PBMCs. Our data indicate that PBMCs from ALS patients show a significant mitochondrial dysfunction, resembling several findings from ALS’ neural cells/models, which could be exploited as a powerful tool in ALS research. Our findings can also guide future studies on new pharmacological interventions for ALS since assessments of brain samples are challenging and represent a relevant limited strategy. Graphical abstract ![]()
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Perrone B, Conforti FL. Common mutations of interest in the diagnosis of amyotrophic lateral sclerosis: how common are common mutations in ALS genes? Expert Rev Mol Diagn 2020; 20:703-714. [PMID: 32497448 DOI: 10.1080/14737159.2020.1779060] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
INTRODUCTION Amyotrophic lateral sclerosis (ALS) is a complex neurodegenerative disease predominantly affecting upper and lower motor neurons. Diagnosis of this devastating pathology is very difficult because the high degree of clinical heterogeneity with which it occurs and until now, no truly effective treatment exists. AREAS COVERED Molecular diagnosis may be a valuable tool for dissecting out ALS complex heterogeneity and for identifying new molecular mechanisms underlying the characteristic selective degeneration and death of motor neurons. To date, pathogenic variants in ALS genes are known to be present in up to 70% of familial and 10% of apparently sporadic ALS cases and can be associated with risks for ALS only or risks for other neurodegenerative diseases. This paper shows the procedure currently used in diagnostic laboratories to investigate most frequent mutations in ALS and evaluating the utility of involved molecular techniques as potential tools to discriminate 'common mutations' in ALS patients. EXPERT OPINION Genetic testing may allow for establishing an accurate pathological diagnosis and a more precise stratification of patient groups in future drug trials.
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Affiliation(s)
- Benedetta Perrone
- Department of Pharmacy, Health and Nutritional Sciences, University of Calabria , Arcavacata di Rende (Cosenza), Italy
| | - Francesca Luisa Conforti
- Department of Pharmacy, Health and Nutritional Sciences, University of Calabria , Arcavacata di Rende (Cosenza), Italy
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Corcia P, Lumbroso S, Cazeneuve C, Mouzat K, Camu W, Vourc'h P. Pre-symptomatic diagnosis in ALS. Rev Neurol (Paris) 2020; 176:166-169. [PMID: 31932031 DOI: 10.1016/j.neurol.2019.07.027] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2019] [Revised: 07/10/2019] [Accepted: 07/16/2019] [Indexed: 12/11/2022]
Abstract
Pathophysiology of amyotrophic lateral sclerosis (ALS) remains partially understood even though it is accepted worldwide that motor neuron death results from a pluri-factorial process with a variable role of genetic factors. Although not distinguishable from a clinical point of view, familial forms of ALS (fALS, 10% of cases) and sporadic forms (sALS, 90% of cases) can be described. Since the identification of superoxide dismutase 1 gene (SOD1) mutations, more than 30 genes have been linked to fALS. Among these genes, five (C9ORF72, SOD1, TARDBP, FUS, TBK1) seem predominant with mutation frequencies of 40%, 20%, 5%, <5%, <5% in fALS and 6%, 3%, and <1% for the last three in sALS, respectively. The situation that classically leads to request genetic screening is the presence of a familial history of motor neuron disorders (MND) or fronto-temporal lobar dementia (FTLD). However, this dichotomy between fALS and sALS based on familial history can lead to mistakes since illegitimacy, ignorance of MND, FTD or psychiatric disorders within the family due to a familial censorship or lack of familial relationship, or a recessive autosomal inheritance could wrongly lead to failing to recognize a familial form. The significant development of genetic research and easier access to genetic tests in fALS increase the number of situations for which gene mutations are identified. The consequence is an increase in genetic requests from relatives of ALS patients who are eager to know their own genetic status and their own individual risk to develop ALS. Pre-symptomatic testing is thus becoming a daily issue in ALS Centers. This led us to propose a framework for such pre-symptomatic genetic testing for people at risk for developing ALS.
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Affiliation(s)
- P Corcia
- Centre Constitutif SLA, CHU Bretonneau, Tours, France; UMR 1253, iBrain, Université de Tours, Inserm, Tours, France.
| | - S Lumbroso
- Motoneuron Disease: Pathophysiology and Therapy, INM, University Montpellier, Montpellier, France; Laboratoire de Biochimie et Biologie Moléculaire, CHU Nîmes, Nîmes, France
| | - C Cazeneuve
- Unité Fonctionnelle de Neurogénétique Moléculaire et Cellulaire, Groupe Hospitalier Pitié-Salpêtrière, Assistance Publique-Hôpitaux de Paris, France
| | - K Mouzat
- Motoneuron Disease: Pathophysiology and Therapy, INM, University Montpellier, Montpellier, France; Laboratoire de Biochimie et Biologie Moléculaire, CHU Nîmes, Nîmes, France
| | - W Camu
- Centre Consitutif SLA, Hopital Guy de Chauliac, Montpellier, France
| | - P Vourc'h
- Motoneuron Disease: Pathophysiology and Therapy, INM, University Montpellier, Montpellier, France; Laboratoire de Biochimie et Biologie Moléculaire, CHU Nîmes, Nîmes, France; Service de Biochimie et Biologie Moléculaire, CHRU Tours, France
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Bonifacino T, Rebosio C, Provenzano F, Torazza C, Balbi M, Milanese M, Raiteri L, Usai C, Fedele E, Bonanno G. Enhanced Function and Overexpression of Metabotropic Glutamate Receptors 1 and 5 in the Spinal Cord of the SOD1 G93A Mouse Model of Amyotrophic Lateral Sclerosis during Disease Progression. Int J Mol Sci 2019; 20:ijms20184552. [PMID: 31540330 PMCID: PMC6774337 DOI: 10.3390/ijms20184552] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2019] [Revised: 08/26/2019] [Accepted: 09/12/2019] [Indexed: 12/11/2022] Open
Abstract
Glutamate (Glu)-mediated excitotoxicity is a major cause of amyotrophic lateral sclerosis (ALS) and our previous work highlighted that abnormal Glu release may represent a leading mechanism for excessive synaptic Glu. We demonstrated that group I metabotropic Glu receptors (mGluR1, mGluR5) produced abnormal Glu release in SOD1G93A mouse spinal cord at a late disease stage (120 days). Here, we studied this phenomenon in pre-symptomatic (30 and 60 days) and early-symptomatic (90 days) SOD1G93A mice. The mGluR1/5 agonist (S)-3,5-Dihydroxyphenylglycine (3,5-DHPG) concentration dependently stimulated the release of [3H]d-Aspartate ([3H]d-Asp), which was comparable in 30- and 60-day-old wild type mice and SOD1G93A mice. At variance, [3H]d-Asp release was significantly augmented in 90-day-old SOD1G93A mice and both mGluR1 and mGluR5 were involved. The 3,5-DHPG-induced [3H]d-Asp release was exocytotic, being of vesicular origin and mediated by intra-terminal Ca2+ release. mGluR1 and mGluR5 expression was increased in Glu spinal cord axon terminals of 90-day-old SOD1G93A mice, but not in the whole axon terminal population. Interestingly, mGluR1 and mGluR5 were significantly augmented in total spinal cord tissue already at 60 days. Thus, function and expression of group I mGluRs are enhanced in the early-symptomatic SOD1G93A mouse spinal cord, possibly participating in excessive Glu transmission and supporting their implication in ALS. Please define all abbreviations the first time they appear in the abstract, the main text, and the first figure or table caption.
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Affiliation(s)
- Tiziana Bonifacino
- Department of Pharmacy, Unit of Pharmacology and Toxicology, University of Genoa, 16148 Genova, Italy.
| | - Claudia Rebosio
- Department of Pharmacy, Unit of Pharmacology and Toxicology, University of Genoa, 16148 Genova, Italy.
| | - Francesca Provenzano
- Department of Pharmacy, Unit of Pharmacology and Toxicology, University of Genoa, 16148 Genova, Italy.
| | - Carola Torazza
- Department of Pharmacy, Unit of Pharmacology and Toxicology, University of Genoa, 16148 Genova, Italy.
| | - Matilde Balbi
- Department of Pharmacy, Unit of Pharmacology and Toxicology, University of Genoa, 16148 Genova, Italy.
| | - Marco Milanese
- Department of Pharmacy, Unit of Pharmacology and Toxicology and Center of Excellence for Biomedical Research (CEBR), University of Genoa, 16132 Genova, Italy.
| | - Luca Raiteri
- Department of Pharmacy, Unit of Pharmacology and Toxicology and Center of Excellence for Biomedical Research (CEBR), University of Genoa, 16132 Genova, Italy.
| | - Cesare Usai
- Institute of Biophysics, National Research Council (CNR), 16149 Genova, Italy.
| | - Ernesto Fedele
- Department of Pharmacy, Unit of Pharmacology and Toxicology and Center of Excellence for Biomedical Research (CEBR), University of Genoa, 16132 Genova, Italy.
- Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Ospedale Policlinico San Martino, 16132 Genova, Italy.
| | - Giambattista Bonanno
- Department of Pharmacy, Unit of Pharmacology and Toxicology and Center of Excellence for Biomedical Research (CEBR), University of Genoa, 16132 Genova, Italy.
- Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Ospedale Policlinico San Martino, 16132 Genova, Italy.
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Neuroprotective Effects of Genistein in a SOD1-G93A Transgenic Mouse Model of Amyotrophic Lateral Sclerosis. J Neuroimmune Pharmacol 2019; 14:688-696. [PMID: 31321663 DOI: 10.1007/s11481-019-09866-x] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2019] [Accepted: 07/11/2019] [Indexed: 12/13/2022]
Abstract
Oxidant toxicity has been implicated in the pathogenesis of amyotrophic lateral sclerosis (ALS), an insidiously progressive neurodegenerative disorder involving upper and lower motor neurons. Here, we investigated the cellular and molecular mechanisms underlying the neuroprotective effects of an anti-oxidant genistein in SOD1-G93A transgenic mouse model of ALS. Rotarod test, hanging wire test and hindlimb clasping test were used to determined disease onset and assess motor performance. Immunostaining together with neuronal size measurement were used to count viable motor neurons. In addition, immunostaining procedure and ELISA kit were used to assess the inflammatory response in the spinal cord. Our results showed that Genistein administration suppressed the production of pro-inflammatory cytokines and alleviated gliosis in the spinal cord of SOD1-G93A mice. In addition, genistein administration induced autophagic processes and enhanced the viability of spinal motor neurons. As a result, genistein alleviated ALS-related symptoms and slightly prolonged the lifespan of SOD1-G93A mice. Taken together, our results indicate that genistein is neuroprotective in SOD1-G93A mice, suggesting genistein could be a promising treatment for human ALS. Graphical Abstract Genistein protects impariments in SOD1-G93A transgenic mouse model.
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Yang B, Jiang H, Wang F, Li S, Wu C, Bao J, Zhu Y, Xu Z, Liu B, Ren H, Yang X. UNC13A variant rs12608932 is associated with increased risk of amyotrophic lateral sclerosis and reduced patient survival: a meta-analysis. Neurol Sci 2019; 40:2293-2302. [PMID: 31201598 DOI: 10.1007/s10072-019-03951-y] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2019] [Accepted: 05/24/2019] [Indexed: 02/07/2023]
Abstract
BACKGROUND Amyotrophic lateral sclerosis (ALS) is a neurodegenerative disease associated with both genetic and environmental risk factors. Previous studies trying to find an association between ALS and unc-13 homolog A (UNC13A) gene variants have shown inconsistent results. This study aimed to conduct a meta-analysis of the association between the C allele of rs12608932, a single-nucleotide polymorphism located in an intron of UNC13A, and risk of ALS and patient survival. METHODS PubMed, Web of Science, Embase, Chinese National Knowledge Infrastructure, Wanfang, and SinoMed databases were systematically searched for genome-wide association studies or case-control studies published up to January 2019 on the association between this variant in UNC13A and risk and/or prognosis of ALS. Data from eligible studies were extracted and analyzed. RESULTS The pooled data (28,072 patients with sporadic ALS and 56,545 controls) showed that rs12608932(C) was associated with an increased risk of ALS (OR = 1.13, 95%CI 1.07-1.20). Subgroup analysis revealed that rs12608932(C) increased the risk of sporadic ALS in non-Asian individuals, including those from the USA and Europe (OR 1.17, 95%CI 1.10-1.25, P < 0.000), but not in Japanese or Chinese subjects (OR 1.01, 95%CI 0.92-1.10, P = 0.85). The available data demonstrated that the CC genotype decreased the survival time of patients with ALS (OR 1.33, 95%CI 1.19-1.49, P < 0.001). CONCLUSION The present meta-analysis suggests that rs12608932(C) is associated with increased ALS susceptibility, especially in Caucasian and European subjects, and that the CC genotype of rs12608932 is associated with reduced ALS patient survival.
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Affiliation(s)
- Baiyuan Yang
- Department of Neurology, Seventh People's Hospital of Chengdu, Chengdu, 690041, Sichuan Province, People's Republic of China
| | - Haixia Jiang
- Department of Anesthesia, First Affiliated Hospital of Kunming Medical University, Kunming, 650032, Yunnan Province, People's Republic of China
| | - Fang Wang
- Department of Geriatric Neurology, First Affiliated Hospital of Kunming Medical University, Kunming, 650032, Yunnan Province, People's Republic of China
| | - Shimei Li
- Department of Anesthesia, Kunming Xishan District People's Hospital, Kunming, 650100, Yunnan Province, People's Republic of China
| | - Chongmin Wu
- Department of Geriatric Neurology, First Affiliated Hospital of Kunming Medical University, Kunming, 650032, Yunnan Province, People's Republic of China
| | - Jianjian Bao
- Department of Geriatric Neurology, First Affiliated Hospital of Kunming Medical University, Kunming, 650032, Yunnan Province, People's Republic of China
| | - Yongyun Zhu
- Department of Geriatric Neurology, First Affiliated Hospital of Kunming Medical University, Kunming, 650032, Yunnan Province, People's Republic of China
| | - Zhong Xu
- Department of Geriatric Neurology, First Affiliated Hospital of Kunming Medical University, Kunming, 650032, Yunnan Province, People's Republic of China
| | - Bin Liu
- Department of Geriatric Neurology, First Affiliated Hospital of Kunming Medical University, Kunming, 650032, Yunnan Province, People's Republic of China
| | - Hui Ren
- Department of Geriatric Neurology, First Affiliated Hospital of Kunming Medical University, Kunming, 650032, Yunnan Province, People's Republic of China
| | - Xinglong Yang
- Department of Geriatric Neurology, First Affiliated Hospital of Kunming Medical University, Kunming, 650032, Yunnan Province, People's Republic of China.
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Arthur KC, Doyle C, Chiò A, Traynor BJ. Use of Genetic Testing in Amyotrophic Lateral Sclerosis by Neurologists. JAMA Neurol 2019; 74:125-126. [PMID: 27893008 DOI: 10.1001/jamaneurol.2016.4540] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Affiliation(s)
- Karissa C Arthur
- Neuromuscular Diseases Research Section, Laboratory of Neurogenetics, National Institute on Aging, National Institutes of Health, Bethesda, Maryland
| | - Carly Doyle
- The Northeast ALS Consortium, Boston, Massachusetts
| | - Adriano Chiò
- 'Rita Levi Montalcini' Department of Neuroscience, University of Torino, Turin, Italy
| | - Bryan J Traynor
- Neuromuscular Diseases Research Section, Laboratory of Neurogenetics, National Institute on Aging, National Institutes of Health, Bethesda, Maryland
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Crook A, McEwen A, Fifita JA, Zhang K, Kwok JB, Halliday G, Blair IP, Rowe DB. The C9orf72 hexanucleotide repeat expansion presents a challenge for testing laboratories and genetic counseling. Amyotroph Lateral Scler Frontotemporal Degener 2019; 20:310-316. [PMID: 30907153 DOI: 10.1080/21678421.2019.1588904] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
C9orf72 hexanucleotide repeat expansions are the most common known cause of amyotrophic lateral sclerosis (ALS) and frontotemporal dementia (FTD). Genetic testing for C9orf72 expansions in patients with ALS and/or FTD and their relatives has become increasingly available since hexanucleotide repeat expansions were first reported in 2011. The repeat number is highly variable and the threshold at which repeat size leads to neurodegeneration remains unknown. We present the case of an ALS patient who underwent genetic testing through our Motor Neurone Disease Clinic. We highlight current limitations to analysing and interpreting C9orf72 expansion test results and describe how this resulted in discordant reports of pathogenicity between testing laboratories that confounded the genetic counselling process. We conclude that patients with ALS or FTD and their at-risk family members, need to be adequately counselled about the limitations of current knowledge to ensure they are making informed decisions about genetic testing for C9orf72. Greater collaboration between clinicians, testing laboratories and researchers is required to ensure risks to patients and their families are minimised.
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Affiliation(s)
- Ashley Crook
- a Department of Clinical Medicine, Faculty of Medicine and Health Sciences , Macquarie University , Sydney , Australia.,b Centre for MND Research, Department of Biomedical Science, Faculty of Medicine and Health Sciences , Macquarie University , Sydney , Australia.,c Graduate School of Health , University of Technology Sydney , Ultimo , Australia
| | - Alison McEwen
- c Graduate School of Health , University of Technology Sydney , Ultimo , Australia
| | - Jennifer A Fifita
- b Centre for MND Research, Department of Biomedical Science, Faculty of Medicine and Health Sciences , Macquarie University , Sydney , Australia
| | - Katharine Zhang
- b Centre for MND Research, Department of Biomedical Science, Faculty of Medicine and Health Sciences , Macquarie University , Sydney , Australia
| | - John B Kwok
- d Central Clinical School and Brain and Mind Centre , The University of Sydney , Sydney , Australia.,e School of Medical Sciences , University of New South Wales , Sydney , Australia
| | - Glenda Halliday
- d Central Clinical School and Brain and Mind Centre , The University of Sydney , Sydney , Australia
| | - Ian P Blair
- b Centre for MND Research, Department of Biomedical Science, Faculty of Medicine and Health Sciences , Macquarie University , Sydney , Australia
| | - Dominic B Rowe
- a Department of Clinical Medicine, Faculty of Medicine and Health Sciences , Macquarie University , Sydney , Australia.,b Centre for MND Research, Department of Biomedical Science, Faculty of Medicine and Health Sciences , Macquarie University , Sydney , Australia
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Zucchi E, Ticozzi N, Mandrioli J. Psychiatric Symptoms in Amyotrophic Lateral Sclerosis: Beyond a Motor Neuron Disorder. Front Neurosci 2019; 13:175. [PMID: 30914912 PMCID: PMC6421303 DOI: 10.3389/fnins.2019.00175] [Citation(s) in RCA: 55] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2018] [Accepted: 02/14/2019] [Indexed: 12/11/2022] Open
Abstract
The historical view that Amyotrophic Lateral Sclerosis (ALS) as a pure motor disorder has been increasingly challenged by the discovery of cognitive and behavioral changes in the spectrum of Frontotemporal Dementia (FTD). Less recognized and still significant comorbidities that ALS patients may present are prior or concomitant psychiatric illness, such as psychosis and schizophrenia, or mood disorders. These non-motor symptoms disturbances have a close time relationship with disease onset, may constitute part of a larger framework of network disruption in motor neuron disorders, and may impact ALS patients and families, with regards to ethical choices and end-of-life decisions. This review aims at identifying the most common psychiatric alterations related to ALS and its prognosis, looking at a common genetic background and shared structural brain pathology.
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Affiliation(s)
- Elisabetta Zucchi
- Department of Neuroscience, Azienda Ospedaliero Universitaria di Modena, University of Modena and Reggio Emilia, Modena, Italy
| | - Nicola Ticozzi
- Department of Neurology and Laboratory of Neuroscience, Istituto Auxologico Italiano, Istituto di Ricovero e Cura a Carattere Scientifico, Milan, Italy.,Department of Pathophysiology and Transplantation, 'Dino Ferrari' Center, Università degli Studi di Milano, Milan, Italy
| | - Jessica Mandrioli
- Department of Neuroscience, Azienda Ospedaliera Universitaria Modena, St. Agostino- Estense Hospital, Modena, Italy
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Mesenchymal Stem Cells: A Potential Therapeutic Approach for Amyotrophic Lateral Sclerosis? Stem Cells Int 2019; 2019:3675627. [PMID: 30956667 PMCID: PMC6431432 DOI: 10.1155/2019/3675627] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2018] [Revised: 12/24/2018] [Accepted: 02/01/2019] [Indexed: 02/07/2023] Open
Abstract
Amyotrophic lateral sclerosis (ALS) is a neurodegenerative disease characterized by the degeneration of both upper and lower motor neurons. Patients show both motor and extra-motor symptoms. A cure is not available at this time, and the disease leads to death within 3-5 years, mainly due to respiratory failure. Stem cell therapy is arising as a new promising approach for the treatment of neurodegenerative disorders. In particular, mesenchymal stem cells (MSCs) seem the most suitable type of stem cells, thanks to their demonstrated beneficial effects in different experimental models, to the easy availability, and to the lack of ethical problems. In this review, we focused on the studies involving ALS rodent models and clinical trials in order to understand the potential beneficial effects of MSC transplantation. In different ALS rodent models, the administration of MSCs induced a delay in disease progression and at least a partial recovery of the motor function. In addition, clinical trials evidenced the feasibility and safety of MSC transplantation in ALS patients, given that no major adverse events were recorded. However, only partial improvements were shown. For this reason, more studies and trials are needed to clarify the real effectiveness of MSC-based therapy in ALS.
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Affiliation(s)
- Jeffrey Rosenfeld
- Department of Neurology, Loma Linda University School of Medicine, Loma Linda, CA.
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Khairoalsindi OA, Abuzinadah AR. Maximizing the Survival of Amyotrophic Lateral Sclerosis Patients: Current Perspectives. Neurol Res Int 2018; 2018:6534150. [PMID: 30159171 PMCID: PMC6109498 DOI: 10.1155/2018/6534150] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2018] [Accepted: 07/26/2018] [Indexed: 01/08/2023] Open
Abstract
Amyotrophic lateral sclerosis is a neurodegenerative disease that leads to loss of the upper and lower motor neurons. Almost 90% of all cases occur in the sporadic form, with the rest occurring in the familial form. The disease has a poor prognosis, with only two disease-modifying drugs approved by the United States Food and Drug Administration (FDA). The approved drugs for the disease have very limited survival benefits. Edaravone is a new FDA-approved medication that may slow the disease progression by 33% in a selected subgroup of ALS patients. This paper covers the various interventions that may provide survival benefits, such as early diagnosis, medications, gene therapy, stem cell therapy, diet, nutritional supplements, multidisciplinary clinics, and mechanical invasive and noninvasive ventilation. The recent data on masitinib, the role of enteral feeding, gene therapy, and stem cell therapy is discussed.
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Affiliation(s)
| | - Ahmad R. Abuzinadah
- King Abdulaziz University, Internal Medicine Department, Neurology Division, Jeddah, Saudi Arabia
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Wang M, Saw HP, Cui FF, Lin SY, Chang HT, Chiu CD. pLG72 induces superoxide radicals via interaction and aggregation with SOD1. Free Radic Res 2018; 52:970-976. [PMID: 30037290 DOI: 10.1080/10715762.2018.1504293] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
G72 has been characterised as a susceptibility gene that can have wide-ranging effects in a number of neurodegenerative diseases, including schizophrenia and major depression. Indeed, its product, pLG72, is a potential serum biomarker for schizophrenia. Previous transcriptomic and biochemical studies have indicated that pLG72 may induce the production of mitochondrial reactive oxygen species (ROS), resulting in cell damage. Here, we investigated the mechanism of pLG72 by transfecting a human U87 glioblastoma cell line with a G72 construct. By employing ROS-specific scavengers, we discovered that superoxide radicals were specifically induced in the pLG72-expressing cells. We also found that pLG72 interacted and co-localised with superoxide dismutase 1 (SOD1), resulting in aggregation of SOD1 with a concomitant 23% or 74% reduction of total SOD activity, depending on the amount of G72 transfection plasmid. Finally, we found that transfection of U87 cells with the G72 construct caused a 29% decrease in cell proliferation. The observed loss of SOD1 function in pLG72-expressing cells may explain the elevated ROS levels and inhibition of U87 cell proliferation and has implications for understanding the onset of neurodegenerative diseases in humans.
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Affiliation(s)
- Maofeng Wang
- a Department of Biomedical Science Laboratory , Affiliated Dongyang Hospital of Wenzhou Medical University , Dongyang , Zhejiang , China
| | - Hean-Pat Saw
- b Institute of Medicine , Chung Shan Medical University , Taichung , Taiwan.,c Chung Kang Branch, Cheng Ching General Hospital , Taichung , Taiwan
| | - Fei-Fei Cui
- a Department of Biomedical Science Laboratory , Affiliated Dongyang Hospital of Wenzhou Medical University , Dongyang , Zhejiang , China
| | - Sheng-Yi Lin
- d School of Medicine, China Medical University , Taichung , Taiwan.,e Graduate Institute of Biomedical Science , China Medical University , Taichung , Taiwan.,f Stroke Center, China Medical University Hospital , Taichung , Taiwan
| | - Hao-Teng Chang
- a Department of Biomedical Science Laboratory , Affiliated Dongyang Hospital of Wenzhou Medical University , Dongyang , Zhejiang , China
| | - Cheng-Di Chiu
- d School of Medicine, China Medical University , Taichung , Taiwan.,e Graduate Institute of Biomedical Science , China Medical University , Taichung , Taiwan.,f Stroke Center, China Medical University Hospital , Taichung , Taiwan.,g Department of Neurosurgery , China Medical University Hospital , Taichung , Taiwan
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Abstract
Amyotrophic lateral sclerosis (ALS) is the most frequent motor neuron disease, affecting the upper and/or lower motor neurons. However, extramotor symptoms can also occur; cognitive deficits are present in more than 40% of patients and 5–8% of ALS patients develop frontotemporal dementia. There is no effective treatment for ALS and median survival is 2–3 years after onset. Amyotrophic lateral sclerosis is a genetically heterogeneous disorder with monogenic forms as well as complex genetic etiology. Currently, complex genetic risk factors are of minor interest for routine diagnostic testing or counseling of patients and their families. By contrast, a monogenic cause can be identified in 70% of familial and 10% of sporadic ALS cases. The most frequent genetic cause is a noncoding hexanucleotide repeat expansion in the C9orf72 gene. In recent years, high-throughput sequencing technologies have helped to identify additional monogenic and complex risk factors of ALS. Genetic counseling should be offered to all ALS patients and their first- and possibly second-degree relatives, and should include information about the possibilities and limitations of genetic testing. Routine diagnostic testing should at least encompass the most frequently mutated disease genes (C9orf72, SOD1, TDP-43, FUS). Targeted sequencing approaches including further disease genes may be applied. Caution is warranted as the C9orf72 repeat expansion cannot be detected by routine sequencing technologies and testing by polymerase chain reaction (PCR) is failure-prone. Predictive testing is possible in families in which a genetic cause has been identified, but the limitations of genetic testing (i. e., the problems of incomplete penetrance, variable expressivity and possible oligogenic inheritance) have to be explained to the families.
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Battaglia G, Bruno V. Metabotropic glutamate receptor involvement in the pathophysiology of amyotrophic lateral sclerosis: new potential drug targets for therapeutic applications. Curr Opin Pharmacol 2018. [DOI: 10.1016/j.coph.2018.02.007] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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Abstract
Patients and their family members often ask about genetic testing for asymptomatic individuals who are at risk for developing a genetic disorder. Ordering a genetic test is a complex process involving consideration of many basic ethical principles including autonomy, beneficence, and nonmaleficence, as well as the physician's duty to act in the patient's best interest. Physicians have many choices regarding what tests to order, and they must develop the knowledge and skills to best discuss genetic testing with their patients. Integration of core ethical principles into these processes will permit physicians to best serve their patients when obtaining informed consent, considering advantages and harms of potential results, disclosing those results, and providing follow-up.
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