1
|
McAnnis KE, Ruiz-Montenegro A, Davila PA, Laylani NA, Lee AG. Leber Hereditary Optic Neuropathy Plus Phenotype With Double Point Mutations (m.11778 G>A and m.14484T>C) and Concurrent Myelin Oligodendrocyte Glycoprotein Antibody-Associated Disease (MOGAD). J Neuroophthalmol 2024:00041327-990000000-00617. [PMID: 38587899 DOI: 10.1097/wno.0000000000002153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/10/2024]
Affiliation(s)
- Kathryn E McAnnis
- Western University of Health Sciences (KEM), Lebanon, Oregon; Tecnológico de Monterrey (AR-M), Escuela de Medicina y Ciencias de la Salud, Monterrey, México; Department of Ophthalmology (PAD, NAL, AGL), Blanton Eye Institute, Houston Methodist Hospital, Houston, Texas; Departments of Ophthalmology, Neurology, and Neurosurgery (AGL), Weill Cornell Medicine, New York, New York; Department of Ophthalmology (AGL), University of Texas Medical Branch, Galveston, Texas; University of Texas MD Anderson Cancer Center (AGL), Houston, Texas; Texas A and M College of Medicine (AGL), Bryan, Texas; and Department of Ophthalmology (AGL), The University of Iowa Hospitals and Clinics, Iowa City, Iowa
| | | | | | | | | |
Collapse
|
2
|
Eliseeva DD, Kalashnikova AK, Bryukhov VV, Andreeva NA, Zhorzholadze NV, Murakhovskaya YK, Krilova TD, Tsygankova PG, Zakharova MN, Sheremet NL. [Hereditary optic neuropathy associated with demyelinating diseases of the central nervous system]. Zh Nevrol Psikhiatr Im S S Korsakova 2023; 123:122-132. [PMID: 37560844 DOI: 10.17116/jnevro2023123072122] [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] [Indexed: 08/11/2023]
Abstract
Demyelinating optic neuritis and hereditary optic neuropathy (HON) take a leading place among the diseases, the leading clinical syndrome of which is bilateral optic neuropathy with a simultaneous or sequential significant decrease in visual acuity. Optic neuritis can occur at the onset or be one of the syndromes within multiple sclerosis (MS), neuromyelitis optica spectrum disorders (NMOSD), and myelin oligodendrocyte glycoprotein (MOG) antibody disease (MOGAD). HON are a group of neurodegenerative diseases, among which the most common variants are Leber's hereditary optic neuropathy (LHON), associated with mitochondrial DNA (mtDNA) mutations, and autosomal recessive optic neuropathy (ARON), caused by nuclear DNA (nDNA) mutations in DNAJC30. There are phenotypes of LHON «plus», one of which is the association of HON and CNS demyelination in the same patient. In such cases, the diagnosis of each of these diseases causes significant difficulties, due to the fact that in some cases there are clinical and radiological coincidences between demyelinating and hereditary mitochondrial diseases.
Collapse
Affiliation(s)
| | - A K Kalashnikova
- Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | | | - N A Andreeva
- Research Institute of Eye Diseases, Moscow, Russia
| | | | | | - T D Krilova
- Research Centre for Medical Genetics, Moscow, Russia
| | | | | | - N L Sheremet
- Research Institute of Eye Diseases, Moscow, Russia
| |
Collapse
|
3
|
Sun MM, Zhou HF, Sun Q, Li HE, Liu HJ, Song HL, Yang M, Teng D, Wei SH, Xu QG. Leber’s hereditary optic neuropathy companied with multiple-related diseases. Front Hum Neurosci 2022; 16:964550. [PMID: 36405086 PMCID: PMC9669271 DOI: 10.3389/fnhum.2022.964550] [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] [Received: 06/08/2022] [Accepted: 09/20/2022] [Indexed: 11/05/2022] Open
Abstract
Objective To elucidate the clinical, radiologic characteristics of Leber’s hereditary optic neuropathy (LHON) associated with the other diseases. Materials and methods Clinical data were retrospectively collected from hospitalized patients with LHON associated with the other diseases at the Neuro-Ophthalmology Department at the Chinese People’s Liberation Army General Hospital (PLAGH) from December 2014 to October 2018. Results A total of 13 patients, 24 eyes (10 men and 3 women; mean age, 30.69 ± 12.76 years) with LHON mitochondrial DNA (mtDNA) mutations, were included in the cohort. 14502(5)11778(4)11778 &11696(1)12811(1)11696(1)3460(1). One patient was positive for aquaporin-4 antibody (AQP4-Ab), and two were positive for myelin oligodendrocyte glycoprotein antibody (MOG-Ab). Three patients were associated with idiopathic optic neuritis (ON). Two patients were with compression optic neuropathy. Three patients were with the central nervous system (CNS) diseases. One patient was with proliferative diabetic retinopathy (PDR) and one with idiopathic orbital inflammatory syndrome (IOIS). At the onset, visual acuity (VA) in eighteen eyes was below 0.1, one eye was 0.5, five eyes were above 0.5, while VA in sixteen eyes was below a 0.1 outcome, three eyes experienced moderate vision loss. MRI images showed T2 lesions and enhancement in nine patients who received corticosteroids treatment; additional immune modulators treatment was performed on two patients. None of the patients had relapse during the follow-up time. Conclusion Leber’s hereditary optic neuropathy can be accompanied with multiple-related diseases, especially different subtypes of ON, which were also exhibited with IOIS and compression optic neuropathy for the first time in this cohort. This condition may be a distinct entity with an unusual clinical and therapeutic profile.
Collapse
Affiliation(s)
- Ming-ming Sun
- Senior Department of Ophthalmology, The Third Medical Center of PLA General Hospital and Chinese PLA Medical School, Beijing, China
| | - Huan-fen Zhou
- Senior Department of Ophthalmology, The First Medical Center of PLA General Hospital and Chinese PLA Medical School, Beijing, China
| | - Qiao Sun
- Department of Ophthalmology, Shanghai Aier Eye Hospital, Shanghai, China
| | - Hong-en Li
- Senior Department of Ophthalmology, The Third Medical Center of PLA General Hospital and Chinese PLA Medical School, Beijing, China
| | - Hong-juan Liu
- Beijing Ophthalmology and Visual Sciences Key Laboratory, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Hong-lu Song
- Senior Department of Ophthalmology, The Third Medical Center of PLA General Hospital and Chinese PLA Medical School, Beijing, China
| | - Mo Yang
- Department of Neuro-Ophthalmology, Eye Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Da Teng
- Department of Ophthalmology, Beijing Tiantan Hospital, Beijing, China
| | - Shi-hui Wei
- Senior Department of Ophthalmology, The First Medical Center of PLA General Hospital and Chinese PLA Medical School, Beijing, China
- Shi-hui Wei,
| | - Quan-gang Xu
- Senior Department of Ophthalmology, The Third Medical Center of PLA General Hospital and Chinese PLA Medical School, Beijing, China
- *Correspondence: Quan-gang Xu,
| |
Collapse
|
4
|
Irani NK, O'Connor KD, Lock JH. Reader Response: Teaching NeuroImage: Leber Hereditary Optic Neuropathy With Longitudinal Spinal Cord Lesion Mimicking Spinal Cord Infarction. Neurology 2022; 99:447-448. [DOI: 10.1212/wnl.0000000000201154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
|
5
|
Lackey E, Lefland A, Eckstein C. Leber's Hereditary Optic Neuropathy Plus Causing Recurrent Myelopathy due to an MT-DN1 Mutation at G3635A. Case Rep Neurol Med 2022; 2022:1628892. [PMID: 35059225 PMCID: PMC8766175 DOI: 10.1155/2022/1628892] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Revised: 10/06/2021] [Accepted: 12/29/2021] [Indexed: 11/18/2022] Open
Abstract
A 51-year-old man with known Leber's hereditary optic neuropathy (LHON) presented with worsening lower extremity weakness and numbness. Following an episode of myelopathy two years before, he had been ambulating with a walker but over two weeks became wheelchair bound. He also developed a sensory level below the T4 dermatome to light touch, pinprick, and vibration. MRI of his cervical and thoracic spine showed a nonenhancing T2 hyperintense lesion extending from C2 to T12. At his presentation two years earlier, he was found to have a longitudinally extensive myelopathy attributed to his LHON. Genetic testing revealed a 3635 guanine to adenine mutation. MRI at that presentation demonstrated a C1-T10 lesion involving the central and posterior cord but, unlike the new lesion, did not involve the ventral and lateral horns. Given the similarity to his prior presentation and a negative evaluation for alternative etiologies, he was thought to have recurrent myelopathy secondary to Leber's Plus. To our knowledge, recurrent myelopathy due specifically to the G3635A mutation in Leber's Plus has not been reported previously.
Collapse
Affiliation(s)
- Elijah Lackey
- Duke University Department of Neurology, Duke University Medical Center, 2905 40 Medicine Circle, Durham, NC 27710, USA
| | - Ariel Lefland
- Duke University Department of Neurology, Duke University Medical Center, 2905 40 Medicine Circle, Durham, NC 27710, USA
| | - Christopher Eckstein
- Duke University Department of Neurology, Duke University Medical Center, 2905 40 Medicine Circle, Durham, NC 27710, USA
| |
Collapse
|
6
|
Tian G, Sun X, Wu J. Leber Hereditary Optic Neuropathy. Neuroophthalmology 2022. [DOI: 10.1007/978-981-19-4668-4_8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
|
7
|
Sundaramurthy S, SelvaKumar A, Ching J, Dharani V, Sarangapani S, Yu-Wai-Man P. Leber hereditary optic neuropathy-new insights and old challenges. Graefes Arch Clin Exp Ophthalmol 2021; 259:2461-2472. [PMID: 33185731 DOI: 10.1007/s00417-020-04993-1] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Revised: 09/16/2020] [Accepted: 10/23/2020] [Indexed: 12/20/2022] Open
Abstract
Leber hereditary optic neuropathy (LHON) is the most common primary mitochondrial DNA (mtDNA) disorder with the majority of patients harboring one of three primary mtDNA point mutations, namely, m.3460G>A (MTND1), m.11778G>A (MTND4), and m.14484T>C (MTND6). LHON is characterized by bilateral subacute loss of vision due to the preferential loss of retinal ganglion cells (RGCs) within the inner retina, resulting in optic nerve degeneration. This review describes the clinical features associated with mtDNA LHON mutations and recent insights gained into the disease mechanisms contributing to RGC loss in this mitochondrial disorder. Although treatment options remain limited, LHON research has now entered an active translational phase with ongoing clinical trials, including gene therapy to correct the underlying pathogenic mtDNA mutation.
Collapse
Affiliation(s)
- Srilekha Sundaramurthy
- 1SN Oil and Natural Gas Corporation (ONGC) Department of Genetics & Molecular Biology, Vision Research Foundation, Chennai, India.
| | - Ambika SelvaKumar
- Department of Neuro-Ophthalmology, Medical Research Foundation, Chennai, India
| | - Jared Ching
- Cambridge Eye Unit, Addenbrooke's Hospital, Cambridge University Hospitals, Cambridge, UK
- John Van Geest Centre for Brain Repair and MRC Mitochondrial Biology Unit, Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK
| | - Vidhya Dharani
- Department of Neuro-Ophthalmology, Medical Research Foundation, Chennai, India
| | - Sripriya Sarangapani
- 1SN Oil and Natural Gas Corporation (ONGC) Department of Genetics & Molecular Biology, Vision Research Foundation, Chennai, India
| | - Patrick Yu-Wai-Man
- Cambridge Eye Unit, Addenbrooke's Hospital, Cambridge University Hospitals, Cambridge, UK
- John Van Geest Centre for Brain Repair and MRC Mitochondrial Biology Unit, Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK
- NIHR Biomedical Research Centre, Moorfields Eye Hospital and UCL Institute of Ophthalmology, London, UK
| |
Collapse
|
8
|
Recurrent Bilateral Myelin Oligodendrocyte Glycoprotein Antibody Optic Neuritis in a Leber Hereditary Optic Neuropathy Carrier. J Neuroophthalmol 2019; 40:246-247. [DOI: 10.1097/wno.0000000000000853] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
9
|
Berardo A, Emmanuele V, Vargas W, Tanji K, Naini A, Hirano M. Leber hereditary optic neuropathy plus dystonia, and transverse myelitis due to double mutations in MT-ND4 and MT-ND6. J Neurol 2019; 267:823-829. [PMID: 31776719 DOI: 10.1007/s00415-019-09619-z] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2019] [Revised: 10/27/2019] [Accepted: 11/02/2019] [Indexed: 11/28/2022]
Abstract
Leber hereditary optic neuropathy (LHON) typically presents as painless central or centrocecal scotoma and is due to maternally inherited mitochondrial DNA (mtDNA) mutations. Over 95% of LHON cases are caused by one of three mtDNA "common" point mutations: m.3460G>A, m.11778G>A, or m.14484T>C, which are all in genes encoding structural subunits of complex I of the respiratory chain. Intriguing features of LHON include: incomplete penetrance, tissue specificity, and male predominance, indicating that additional genetic or environmental factors are modulating the phenotypic expression of the pathogenic mtDNA mutations. However, since its original description as a purely ophthalmological disorder, LHON has also been linked to multisystemic conditions with variable neurological, cardiac, and skeletal abnormalities. Although double "common" mutations have been reported to cause LHON and LHON-plus, they are extremely rare. Here, we present a patient with an unusual double point mutation (m.11778 G>A and m.14484T>C) with a multisystemic LHON-plus phenotype characterized by: optic neuropathy, ptosis, ataxia, dystonia, dysarthria, and recurrent extensive transverse myelitis.
Collapse
Affiliation(s)
- Andres Berardo
- Department of Neurology, H. Houston Merritt Neuromuscular Research Center, Columbia University Medical Center, 630 West 168th Street, P&S 4-423, New York, NY, 10032, USA
| | - Valentina Emmanuele
- Department of Neurology, H. Houston Merritt Neuromuscular Research Center, Columbia University Medical Center, 630 West 168th Street, P&S 4-423, New York, NY, 10032, USA
| | - Wendy Vargas
- Department of Neurology, H. Houston Merritt Neuromuscular Research Center, Columbia University Medical Center, 630 West 168th Street, P&S 4-423, New York, NY, 10032, USA
| | - Kurenai Tanji
- Department of Pathology and Cell Biology, Columbia University, New York, NY, USA
| | - Ali Naini
- Department of Neurology, H. Houston Merritt Neuromuscular Research Center, Columbia University Medical Center, 630 West 168th Street, P&S 4-423, New York, NY, 10032, USA.,Department of Pathology and Cell Biology, Columbia University, New York, NY, USA
| | - Michio Hirano
- Department of Neurology, H. Houston Merritt Neuromuscular Research Center, Columbia University Medical Center, 630 West 168th Street, P&S 4-423, New York, NY, 10032, USA.
| |
Collapse
|
10
|
Finsterer J, Zarrouk-Mahjoub S. Involvement of the Spinal Cord in Mitochondrial Disorders. J Neurosci Rural Pract 2019; 9:245-251. [PMID: 29725177 PMCID: PMC5912032 DOI: 10.4103/jnrp.jnrp_446_17] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
This review aims at summarising and discussing the current status concerning the clinical presentation, pathogenesis, diagnosis, and treatment of spinal cord affection in mitochondrial disorders (MIDs). A literature search using the database Pubmed was carried out by application of appropriate search terms and their combinations. Involvement of the spinal cord in MIDs is more frequent than anticipated. It occurs in specific and non-specific MIDs. Among the specific MIDs it has been most frequently described in LBSL, LS, MERRF, KSS, IOSCA, MIRAS, and PCH and only rarely in MELAS, CPEO, and LHON. Clinically, spinal cord involvement manifests as monoparesis, paraparesis, quadruparesis, sensory disturbances, hypotonia, spasticity, urinary or defecation dysfunction, spinal column deformities, or as transverse syndrome. Diagnosing spinal cord involvement in MIDs requires a thoroughly taken history, clinical exam, and imaging studies. Additionally, transcranial magnetic stimulation, somato-sensory-evoked potentials, and cerebro-spinal fluid can be supportive. Treatment is generally not at variance compared to the underlying MID but occasionally surgical stabilisation of the spinal column may be necessary. It is concluded that spinal cord involvement in MIDs is more frequent than anticipated but may be missed if cerebral manifestations prevail. Spinal cord involvement in MIDs may strongly determine the mobility of these patients.
Collapse
Affiliation(s)
- Josef Finsterer
- Department of Neurology, Krankenanstalt Rudolfstiftung, Vienna, Austria
| | - Sinda Zarrouk-Mahjoub
- Pasteur Institute of Tunis, University of Tunis El Manar and Genomics Platform, Pasteur Institute of Tunis, Tunis, Tunisia
| |
Collapse
|
11
|
Jarius S, Wildemann B. Devic's index case: A critical reappraisal - AQP4-IgG-mediated neuromyelitis optica spectrum disorder, or rather MOG encephalomyelitis? J Neurol Sci 2019; 407:116396. [PMID: 31726278 DOI: 10.1016/j.jns.2019.07.014] [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: 05/15/2019] [Revised: 07/01/2019] [Accepted: 07/10/2019] [Indexed: 12/20/2022]
Abstract
In 1894, Eugène Devic (1858-1930) and his doctoral student Fernand Gault (1873-1936) reported on a patient with optic neuritis (ON) and myelitis and proposed the name "neuro-myélite optique" for this syndrome. Subsequently, Devic became the eponym of neuromyelitis optica (NMO), which was then referred to as "Devic's syndrome", "Devic's disease" or "Morbus Devic". Thereby, the case became a historical index case of NMO. For many decades little attention was paid to NMO, which most authors considered a clinical variant of multiple sclerosis. However, the discovery of pathogenic antibodies to aquaporin-4 at the beginning of the 21st century revived interest in the syndrome, and AQP4-IgG-positive NMO spectrum disorders (NMOSD) are now studied as prototypical autoimmune diseases. More recently, antibodies to full-length myelin oligodendrocyte glycoprotein (MOG) have been detected in patients with ON as well as in patients with myelitis, some of whom exhibit a clinical phenotype very similar to that described by Devic. This raises the question of whether Devic's patient might have suffered from MOG encephalomyelitis rather than classic NMOSD. In this article, we summarise and discuss the available evidence for and against that hypothesis. We also discuss differential diagnoses and the question whether Devic's patient, who worked as a hatter and had initially been admitted for nervous hyperexcitability and tremor, might have suffered from co-existing erethism ('mad hatter disease'), which is caused by chronic occupational exposure to mercury.
Collapse
Affiliation(s)
- S Jarius
- Molecular Neuroimmunology Group, Department of Neurology, University of Heidelberg, Germany.
| | - B Wildemann
- Molecular Neuroimmunology Group, Department of Neurology, University of Heidelberg, Germany.
| |
Collapse
|
12
|
Bursle C, Riney K, Stringer J, Moore D, Gole G, Kearns LS, Mackey DA, Coman D. Leber Hereditary Optic Neuropathy and Longitudinally Extensive Transverse Myelitis. JIMD Rep 2017; 42:53-60. [PMID: 29249004 PMCID: PMC6226398 DOI: 10.1007/8904_2017_79] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2017] [Revised: 11/02/2017] [Accepted: 11/27/2017] [Indexed: 12/23/2022] Open
Abstract
Leber Hereditary Optic Neuropathy is an inherited optic neuropathy caused by mitochondrial DNA point mutations leading to sudden, painless loss of vision. We report a case of an 8-year-old boy presenting with a radiological phenotype of longitudinally extensive transverse myelitis on a background of severe visual impairment secondary to Leber Hereditary Optic Neuropathy (LHON). He was found to have dual mitochondrial DNA mutations at 14484 (MTND6 gene) and 4160 (MTND1 gene) in a family with a severe form of LHON characterised by not only an unusually high penetrance of optic neuropathy, but also severe extra-ocular neurological complications. The m.14484T>C mutation is a common LHON mutation, but the m.4160T>C mutation is to our knowledge not reported outside this family and appears to drive the neurological manifestations. To our knowledge there have been no previous reports of spinal cord lesions in children with LHON.
Collapse
Affiliation(s)
- C Bursle
- Neurosciences Unit, The Lady Cilento Children's Hospital, Brisbane, QLD, Australia
- School of Medicine, The University of Queensland, Brisbane, QLD, Australia
| | - K Riney
- Neurosciences Unit, The Lady Cilento Children's Hospital, Brisbane, QLD, Australia
- School of Medicine, The University of Queensland, Brisbane, QLD, Australia
| | - J Stringer
- Neurosciences Unit, The Lady Cilento Children's Hospital, Brisbane, QLD, Australia
| | - D Moore
- Department of Paediatrics, The Wesley Hospital, Brisbane, QLD, Australia
| | - G Gole
- Department of Ophthalmology, The Lady Cilento Children's Hospital, Brisbane, QLD, Australia
| | - L S Kearns
- Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, East Melbourne, VIC, Australia
- Ophthalmology, Department of Surgery, University of Melbourne, Parkville, VIC, Australia
| | - D A Mackey
- Lions Eye Institute, Centre for Ophthalmology and Visual Science, University of Western Australia, Perth, WA, Australia
- School of Medicine, Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, Australia
| | - D Coman
- Neurosciences Unit, The Lady Cilento Children's Hospital, Brisbane, QLD, Australia.
- UnitingCare Clinical School, The Wesley Hospital, Brisbane, QLD, Australia.
- School of Medicine, The University of Queensland, Brisbane, QLD, Australia.
- Department of Paediatrics, The Wesley Hospital, Brisbane, QLD, Australia.
| |
Collapse
|
13
|
A neurodegenerative perspective on mitochondrial optic neuropathies. Acta Neuropathol 2016; 132:789-806. [PMID: 27696015 PMCID: PMC5106504 DOI: 10.1007/s00401-016-1625-2] [Citation(s) in RCA: 120] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2016] [Revised: 09/24/2016] [Accepted: 09/25/2016] [Indexed: 12/15/2022]
Abstract
Mitochondrial optic neuropathies constitute an important cause of chronic visual morbidity and registrable blindness in both the paediatric and adult population. It is a genetically heterogeneous group of disorders caused by both mitochondrial DNA (mtDNA) mutations and a growing list of nuclear genetic defects that invariably affect a critical component of the mitochondrial machinery. The two classical paradigms are Leber hereditary optic neuropathy (LHON), which is a primary mtDNA disorder, and autosomal dominant optic atrophy (DOA) secondary to pathogenic mutations within the nuclear gene OPA1 that encodes for a mitochondrial inner membrane protein. The defining neuropathological feature is the preferential loss of retinal ganglion cells (RGCs) within the inner retina but, rather strikingly, the smaller calibre RGCs that constitute the papillomacular bundle are particularly vulnerable, whereas melanopsin-containing RGCs are relatively spared. Although the majority of patients with LHON and DOA will present with isolated optic nerve involvement, some individuals will also develop additional neurological complications pointing towards a greater vulnerability of the central nervous system (CNS) in susceptible mutation carriers. These so-called “plus” phenotypes are mechanistically important as they put the loss of RGCs within the broader perspective of neuronal loss and mitochondrial dysfunction, highlighting common pathways that could be modulated to halt progressive neurodegeneration in other related CNS disorders. The management of patients with mitochondrial optic neuropathies still remains largely supportive, but the development of effective disease-modifying treatments is now within tantalising reach helped by major advances in drug discovery and delivery, and targeted genetic manipulation.
Collapse
|
14
|
Zare-Shahabadi A, Rashidian A, Sahraian MA, Rezaei N. Potential role of immunoglobulin replacement therapy on MRI measures in multiple sclerosis: a systematic review. Expert Rev Clin Immunol 2015; 11:1291-5. [PMID: 26488634 DOI: 10.1586/1744666x.2015.1102059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Multiple sclerosis is a chronic immune-mediated disease of the nervous system. In the early disease course, axonal loss and neurodegeneration occurs that could possibly lead to irreversible neurological impairments. Preventing brain atrophy may have important clinical implications affecting treatment decisions in the future. In recent years, research efforts have directed towards finding agents to modify the disease and reduce brain volume loss. Intravenous immunoglobulin (IVIg) may have some potential roles in this regard.
Collapse
Affiliation(s)
- Ameneh Zare-Shahabadi
- a Molecular Immunology Research Center, Department of Immunology, School of Medicine , Tehran University of Medical Sciences , Tehran , Iran.,b MS Research Center, Neuroscience Institute , Tehran University of Medical Sciences , Tehran , Iran.,c Psychiatry and Psychology Research Center , Tehran University of Medical Sciences , Tehran , Iran
| | - Arash Rashidian
- d Department of Health Management and Economics, School of Public Health , Tehran University of Medical Sciences , Tehran , Iran.,e Knowledge Utilization Research Center , Tehran University of Medical Sciences , Tehran , Iran
| | - Mohammad Ali Sahraian
- b MS Research Center, Neuroscience Institute , Tehran University of Medical Sciences , Tehran , Iran
| | - Nima Rezaei
- a Molecular Immunology Research Center, Department of Immunology, School of Medicine , Tehran University of Medical Sciences , Tehran , Iran.,f Universal Scientific Education and Research Network (USERN) , Tehran , Iran.,g Research Center for Immunodeficiencies, Pediatrics Center of Excellence, Children's Medical Center , Tehran University of Medical Sciences , Tehran , Iran
| |
Collapse
|
15
|
Dujmovic I, Jancic J, Dobricic V, Jankovic M, Novakovic I, Comabella M, Drulovic J. Are Leber's mitochondial DNA mutations associated with aquaporin-4 autoimmunity? Mult Scler 2015. [PMID: 26209590 DOI: 10.1177/1352458515590649] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- I Dujmovic
- Clinic of Neurology, Clinical Centre of Serbia, University of Belgrade School of Medicine, Belgrade, Serbia
| | - J Jancic
- Clinic of Neurology and Psychiatry for Children and Youth, University of Belgrade School of Medicine, Belgrade, Serbia
| | - V Dobricic
- Clinic of Neurology, Clinical Centre of Serbia, Belgrade, Serbia
| | - M Jankovic
- Clinic of Neurology, Clinical Centre of Serbia, Belgrade, Serbia
| | - I Novakovic
- Institute for Human Genetics, University of Belgrade School of Medicine, Belgrade, Serbia
| | - M Comabella
- Servei de Neurologia-Neuroimmunologia, Centre d'Esclerosi Múltiple de Catalunya (Cemcat), Institut de Receca Vall d'Hebron (VHIR), Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - J Drulovic
- Clinic of Neurology, Clinical Centre of Serbia, University of Belgrade School of Medicine, Belgrade, Serbia
| |
Collapse
|