1
|
Fare CM, Rothstein JD. Nuclear pore dysfunction and disease: a complex opportunity. Nucleus 2024; 15:2314297. [PMID: 38383349 PMCID: PMC10883112 DOI: 10.1080/19491034.2024.2314297] [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: 11/27/2023] [Accepted: 01/30/2024] [Indexed: 02/23/2024] Open
Abstract
The separation of genetic material from bulk cytoplasm has enabled the evolution of increasingly complex organisms, allowing for the development of sophisticated forms of life. However, this complexity has created new categories of dysfunction, including those related to the movement of material between cellular compartments. In eukaryotic cells, nucleocytoplasmic trafficking is a fundamental biological process, and cumulative disruptions to nuclear integrity and nucleocytoplasmic transport are detrimental to cell survival. This is particularly true in post-mitotic neurons, where nuclear pore injury and errors to nucleocytoplasmic trafficking are strongly associated with neurodegenerative disease. In this review, we summarize the current understanding of nuclear pore biology in physiological and pathological contexts and discuss potential therapeutic approaches for addressing nuclear pore injury and dysfunctional nucleocytoplasmic transport.
Collapse
Affiliation(s)
- Charlotte M Fare
- Department of Neurology and Brain Science Institute, Johns Hopkins University, Baltimore, MD, USA
| | - Jeffrey D Rothstein
- Department of Neurology and Brain Science Institute, Johns Hopkins University, Baltimore, MD, USA
| |
Collapse
|
2
|
Kettunen P, Koistinaho J, Rolova T. Contribution of CNS and extra-CNS infections to neurodegeneration: a narrative review. J Neuroinflammation 2024; 21:152. [PMID: 38845026 PMCID: PMC11157808 DOI: 10.1186/s12974-024-03139-y] [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: 03/17/2024] [Accepted: 05/23/2024] [Indexed: 06/09/2024] Open
Abstract
Central nervous system infections have been suggested as a possible cause for neurodegenerative diseases, particularly sporadic cases. They trigger neuroinflammation which is considered integrally involved in neurodegenerative processes. In this review, we will look at data linking a variety of viral, bacterial, fungal, and protozoan infections to Alzheimer's disease, Parkinson's disease, amyotrophic lateral sclerosis, multiple sclerosis and unspecified dementia. This narrative review aims to bring together a broad range of data currently supporting the involvement of central nervous system infections in the development of neurodegenerative diseases. The idea that no single pathogen or pathogen group is responsible for neurodegenerative diseases will be discussed. Instead, we suggest that a wide range of susceptibility factors may make individuals differentially vulnerable to different infectious pathogens and subsequent pathologies.
Collapse
Affiliation(s)
- Pinja Kettunen
- Helsinki Institute of Life Science, University of Helsinki, Helsinki, Finland
| | - Jari Koistinaho
- Helsinki Institute of Life Science, University of Helsinki, Helsinki, Finland.
| | - Taisia Rolova
- Helsinki Institute of Life Science, University of Helsinki, Helsinki, Finland
| |
Collapse
|
3
|
Dilliott AA, Costanzo MC, Burtt NP, Bandres-Ciga S, Blauwendraat C, Casey B, Hoang Q, Iwaki H, Jang D, Kim JJ, Leonard HL, Levine KS, Makarious M, Nguyen TT, Rouleau GA, Singleton AB, Smadbeck P, Solle J, Vitale D, Nalls MA, Flannick J, Farhan SM. The Neurodegenerative Disease Knowledge Portal: Propelling Discovery Through the Sharing of Neurodegenerative Disease Genomic Resources. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2024:2024.05.27.24307990. [PMID: 38853922 PMCID: PMC11160810 DOI: 10.1101/2024.05.27.24307990] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2024]
Abstract
Although large-scale genetic association studies have proven opportunistic for the delineation of neurodegenerative disease processes, we still lack a full understanding of the pathological mechanisms of these diseases, resulting in few appropriate treatment options and diagnostic challenges. To mitigate these gaps, the Neurodegenerative Disease Knowledge Portal (NDKP) was created as an open-science initiative with the aim to aggregate, enable analysis, and display all available genomic datasets of neurodegenerative disease, while protecting the integrity and confidentiality of the underlying datasets. The portal contains 218 genomic datasets, including genotyping and sequencing studies, of individuals across ten different phenotypic groups, including neurological conditions such as Alzheimer's disease, amyotrophic lateral sclerosis, Lewy body dementia, and Parkinson's disease. In addition to securely hosting large genomic datasets, the NDKP provides accessible workflows and tools to effectively utilize the datasets and assist in the facilitation of customized genomic analyses. Here, we summarize the genomic datasets currently included within the portal, the bioinformatics processing of the datasets, and the variety of phenotypes captured. We also present example use-cases of the various user interfaces and integrated analytic tools to demonstrate their extensive utility in enabling the extraction of high-quality results at the source, for both genomics experts and those in other disciplines. Overall, the NDKP promotes open-science and collaboration, maximizing the potential for discovery from the large-scale datasets researchers and consortia are expending immense resources to produce and resulting in reproducible conclusions to improve diagnostic and therapeutic care for neurodegenerative disease patients.
Collapse
Affiliation(s)
- Allison A. Dilliott
- Department of Neurology and Neurosurgery, McGill University, Montreal, QC, Canada
- Montreal Neurological Institute-Hospital, McGill University, Montreal, QC, Canada
| | - Maria C. Costanzo
- Programs in Metabolism and Medical & Population Genetics, The Broad Institute of MIT and Harvard, Cambridge, MA, USA
| | - Noël P. Burtt
- Programs in Metabolism and Medical & Population Genetics, The Broad Institute of MIT and Harvard, Cambridge, MA, USA
| | - Sara Bandres-Ciga
- Center for Alzheimer’s and Related Dementias, NIH, Bethesda, MD USA
- Laboratory of Neurogenetics, NIH, Bethesda, MD, USA
| | - Cornelis Blauwendraat
- Center for Alzheimer’s and Related Dementias, NIH, Bethesda, MD USA
- Laboratory of Neurogenetics, NIH, Bethesda, MD, USA
| | - Bradford Casey
- Michael J. Fox Foundation for Parkinson’s Research, NY, NY USA
| | - Quy Hoang
- Programs in Metabolism and Medical & Population Genetics, The Broad Institute of MIT and Harvard, Cambridge, MA, USA
| | - Hirotaka Iwaki
- Center for Alzheimer’s and Related Dementias, NIH, Bethesda, MD USA
- DataTecnica LLC, Washington, DC, USA
| | - Dongkeun Jang
- Programs in Metabolism and Medical & Population Genetics, The Broad Institute of MIT and Harvard, Cambridge, MA, USA
| | - Jonggeol Jeffrey Kim
- Center for Alzheimer’s and Related Dementias, NIH, Bethesda, MD USA
- Laboratory of Neurogenetics, NIH, Bethesda, MD, USA
| | - Hampton L. Leonard
- Center for Alzheimer’s and Related Dementias, NIH, Bethesda, MD USA
- DataTecnica LLC, Washington, DC, USA
| | - Kristin S. Levine
- Center for Alzheimer’s and Related Dementias, NIH, Bethesda, MD USA
- DataTecnica LLC, Washington, DC, USA
| | - Mary Makarious
- Center for Alzheimer’s and Related Dementias, NIH, Bethesda, MD USA
- Laboratory of Neurogenetics, NIH, Bethesda, MD, USA
| | - Trang T. Nguyen
- Programs in Metabolism and Medical & Population Genetics, The Broad Institute of MIT and Harvard, Cambridge, MA, USA
| | - Guy A. Rouleau
- Department of Neurology and Neurosurgery, McGill University, Montreal, QC, Canada
- Montreal Neurological Institute-Hospital, McGill University, Montreal, QC, Canada
- Department of Human Genetics, McGill University, Montreal, QC, Canada
| | - Andrew B. Singleton
- Center for Alzheimer’s and Related Dementias, NIH, Bethesda, MD USA
- Laboratory of Neurogenetics, NIH, Bethesda, MD, USA
| | - Patrick Smadbeck
- Programs in Metabolism and Medical & Population Genetics, The Broad Institute of MIT and Harvard, Cambridge, MA, USA
| | - J Solle
- Michael J. Fox Foundation for Parkinson’s Research, NY, NY USA
| | - Dan Vitale
- Center for Alzheimer’s and Related Dementias, NIH, Bethesda, MD USA
- DataTecnica LLC, Washington, DC, USA
| | - Mike A. Nalls
- Center for Alzheimer’s and Related Dementias, NIH, Bethesda, MD USA
- Laboratory of Neurogenetics, NIH, Bethesda, MD, USA
- DataTecnica LLC, Washington, DC, USA
| | - Jason Flannick
- Programs in Metabolism and Medical & Population Genetics, The Broad Institute of MIT and Harvard, Cambridge, MA, USA
- Department of Pediatrics, Boston Children’s Hospital, Boston, MA, USA
- Department of Pediatrics, Harvard Medical School, Boston, MA, USA
| | - Sali M.K. Farhan
- Department of Neurology and Neurosurgery, McGill University, Montreal, QC, Canada
- Montreal Neurological Institute-Hospital, McGill University, Montreal, QC, Canada
- Department of Human Genetics, McGill University, Montreal, QC, Canada
| |
Collapse
|
4
|
Bradford D, Rodgers KE. Advancements and challenges in amyotrophic lateral sclerosis. Front Neurosci 2024; 18:1401706. [PMID: 38846716 PMCID: PMC11155303 DOI: 10.3389/fnins.2024.1401706] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2024] [Accepted: 05/03/2024] [Indexed: 06/09/2024] Open
Abstract
Amyotrophic lateral sclerosis (ALS) continues to pose a significant challenge due to the disease complexity and heterogeneous manifestations. Despite recent drug approvals, there remains a critical need for the development of more effective therapies. This review explores the underlying mechanisms involved; including neuroinflammation, glutamate mediated excitotoxicity, mitochondrial dysfunction, and hypermetabolism, and how researchers are trying to develop novel drugs to target these pathways. While progress has been made, the unmet need of ALS patients highlights the urgency for continued research and resource allocation in the pursuit of effective treatments.
Collapse
Affiliation(s)
| | - Kathleen E. Rodgers
- Department of Medical Pharmacology, Center for Innovation in Brain Science, University of Arizona College of Medicine, Tucson, AZ, United States
| |
Collapse
|
5
|
Evans LJ, O'Brien D, Shaw PJ. Current neuroprotective therapies and future prospects for motor neuron disease. INTERNATIONAL REVIEW OF NEUROBIOLOGY 2024; 176:327-384. [PMID: 38802178 DOI: 10.1016/bs.irn.2024.04.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/29/2024]
Abstract
Four medications with neuroprotective disease-modifying effects are now in use for motor neuron disease (MND). With FDA approvals for tofersen, relyvrio and edaravone in just the past year, 2022 ended a quarter of a century when riluzole was the sole such drug to offer to patients. The acceleration of approvals may mean we are witnessing the beginning of a step-change in how MND can be treated. Improvements in understanding underlying disease biology has led to more therapies being developed to target specific and multiple disease mechanisms. Consideration for how the pipeline of new therapeutic agents coming through in clinical and preclinical development can be more effectively evaluated with biomarkers, advances in patient stratification and clinical trial design pave the way for more successful translation for this archetypal complex neurodegenerative disease. While it must be cautioned that only slowed rates of progression have so far been demonstrated, pre-empting rapid neurodegeneration by using neurofilament biomarkers to signal when to treat, as is currently being trialled with tofersen, may be more effective for patients with known genetic predisposition to MND. Early intervention with personalized medicines could mean that for some patients at least, in future we may be able to substantially treat what is considered by many to be one of the most distressing diseases in medicine.
Collapse
Affiliation(s)
- Laura J Evans
- The Sheffield Institute for Translational Neuroscience, and the NIHR Sheffield Biomedical Research Centre, University of Sheffield, Sheffield, United Kingdom
| | - David O'Brien
- The Sheffield Institute for Translational Neuroscience, and the NIHR Sheffield Biomedical Research Centre, University of Sheffield, Sheffield, United Kingdom
| | - Pamela J Shaw
- The Sheffield Institute for Translational Neuroscience, and the NIHR Sheffield Biomedical Research Centre, University of Sheffield, Sheffield, United Kingdom.
| |
Collapse
|
6
|
Sirtori R, J Gregoire M, M Potts E, Collins A, Donatelli L, Fallini C. LINC complex alterations are a key feature of sporadic and familial ALS/FTD. Acta Neuropathol Commun 2024; 12:69. [PMID: 38664831 PMCID: PMC11046770 DOI: 10.1186/s40478-024-01778-z] [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: 04/08/2024] [Accepted: 04/10/2024] [Indexed: 04/28/2024] Open
Abstract
Amyotrophic lateral sclerosis (ALS) is a neurodegenerative disorder that primarily affects motor neurons, leading to progressive muscle weakness and loss of voluntary muscle control. While the exact cause of ALS is not fully understood, emerging research suggests that dysfunction of the nuclear envelope (NE) may contribute to disease pathogenesis and progression. The NE plays a role in ALS through several mechanisms, including nuclear pore defects, nucleocytoplasmic transport impairment, accumulation of mislocalized proteins, and nuclear morphology abnormalities. The LINC complex is the second biggest multi-protein complex in the NE and consists of the SUN1/2 proteins spanning the inner nuclear membrane and Nesprin proteins embedded in the outer membrane. The LINC complex, by interacting with both the nuclear lamina and the cytoskeleton, transmits mechanical forces to the nucleus regulating its morphology and functional homeostasis. In this study we show extensive alterations to the LINC complex in motor and cortical iPSC-derived neurons and spinal cord organoids carrying the ALS causative mutation in the C9ORF72 gene (C9). Importantly, we show that such alterations are present in vivo in a cohort of sporadic ALS and C9-ALS postmortem spinal cord and motor cortex specimens. We also found that LINC complex disruption strongly correlated with nuclear morphological alterations occurring in ALS neurons, independently of TDP43 mislocalization. Altogether, our data establish morphological and functional alterations to the LINC complex as important events in ALS pathogenic cascade, making this pathway a possible target for both biomarker and therapy development.
Collapse
Affiliation(s)
- Riccardo Sirtori
- Ryan Institute for Neuroscience, University of Rhode Island, 130 Flagg Rd, 02881, Kingston, RI, United States of America
- Department of Cell and Molecular Biology, University of Rhode Island, 120 Flagg Rd, 02881, Kingston, RI, United States of America
| | - Michelle J Gregoire
- Ryan Institute for Neuroscience, University of Rhode Island, 130 Flagg Rd, 02881, Kingston, RI, United States of America
- Department of Cell and Molecular Biology, University of Rhode Island, 120 Flagg Rd, 02881, Kingston, RI, United States of America
- Interdisciplinary Neuroscience Program, University of Rhode Island, 9 Greenhouse Road, 02881, Kingston, RI, United States of America
| | - Emily M Potts
- Ryan Institute for Neuroscience, University of Rhode Island, 130 Flagg Rd, 02881, Kingston, RI, United States of America
- Department of Cell and Molecular Biology, University of Rhode Island, 120 Flagg Rd, 02881, Kingston, RI, United States of America
- Interdisciplinary Neuroscience Program, University of Rhode Island, 9 Greenhouse Road, 02881, Kingston, RI, United States of America
| | - Alicia Collins
- Ryan Institute for Neuroscience, University of Rhode Island, 130 Flagg Rd, 02881, Kingston, RI, United States of America
- Department of Cell and Molecular Biology, University of Rhode Island, 120 Flagg Rd, 02881, Kingston, RI, United States of America
- Interdisciplinary Neuroscience Program, University of Rhode Island, 9 Greenhouse Road, 02881, Kingston, RI, United States of America
| | - Liviana Donatelli
- Ryan Institute for Neuroscience, University of Rhode Island, 130 Flagg Rd, 02881, Kingston, RI, United States of America
- Department of Cell and Molecular Biology, University of Rhode Island, 120 Flagg Rd, 02881, Kingston, RI, United States of America
- Interdisciplinary Neuroscience Program, University of Rhode Island, 9 Greenhouse Road, 02881, Kingston, RI, United States of America
| | - Claudia Fallini
- Ryan Institute for Neuroscience, University of Rhode Island, 130 Flagg Rd, 02881, Kingston, RI, United States of America.
- Department of Cell and Molecular Biology, University of Rhode Island, 120 Flagg Rd, 02881, Kingston, RI, United States of America.
- Interdisciplinary Neuroscience Program, University of Rhode Island, 9 Greenhouse Road, 02881, Kingston, RI, United States of America.
- Department of Biomedical and Pharmaceutical Sciences, University of Rhode Island, Kingston, United States of America.
| |
Collapse
|
7
|
Libonati L, Cambieri C, Colavito D, Moret F, D'Andrea E, Del Giudice E, Leon A, Inghilleri M, Ceccanti M. Genetics screening in an Italian cohort of patients with Amyotrophic Lateral Sclerosis: the importance of early testing and its implication. J Neurol 2024; 271:1921-1936. [PMID: 38112783 DOI: 10.1007/s00415-023-12142-x] [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: 09/06/2023] [Revised: 11/28/2023] [Accepted: 11/29/2023] [Indexed: 12/21/2023]
Abstract
INTRODUCTION Amyotrophic Lateral Sclerosis (ALS) is a neurodegenerative disease with an elusive etiology. While environmental factors have been considered, familial ALS cases have raised the possibility of genetic involvement. This genetic connection is increasingly evident, even in patients with sporadic ALS. We allowed access to the genetic test to all patients attending our clinic to identify the prevalence and the role of genetic variants in the development of the disease and to identify patients with potentially treatable forms of the disease. MATERIALS AND METHODS 194 patients with probable or definite ALS, were enrolled. A comprehensive genetic testing was performed, including sequencing all exons of the SOD1 gene and testing for hexanucleotide intronic repeat expansions (G4C2) in the C9orf72 gene using fluorescent repeat-primed PCR (RP-PCR). Whole Exome NGS Sequencing (WES) was performed, followed by an in silico multigene panel targeting neuromuscular diseases, spastic paraplegia, and motor distal neuropathies. We conducted statistical analyses to compare different patient groups. RESULTS Clinically significant pathogenetic variants were detected in 14.43% of cases. The highest prevalence of pathogenetic variants was observed in fALS patients, but a substantial proportion of sALS patients also displayed at least one variant, either pathogenetic or of uncertain significance (VUS). The most observed pathogenetic variant was the expansion of the C9orf72 gene, which was associated with a shorter survival. SOD1 variants were found in 1.6% of fALS and 2.5% of sALS patients. DISCUSSION The study reveals a significant number of ALS patients carrying pathogenic or likely pathogenic variants, with a higher prevalence in familial ALS cases. The expansion of the C9orf72 gene emerges as the most common genetic cause of ALS, affecting familial and sporadic cases. Additionally, SOD1 variants are detected at an unexpectedly higher rate, even in patients without a familial history of ALS, underscoring the crucial role of genetic testing in treatment decisions and potential participation in clinical trials. We also investigated variants in genes such as TARDBP, FUS, NEK1, TBK1, and DNAJC7, shedding light on their potential involvement in ALS. These findings underscore the complexity of interpreting variants of uncertain significance (VUS) and their ethical implications in patient communication and genetic counseling for patients' relatives. CONCLUSION This study emphasizes the diverse genetic basis of ALS and advocates for integrating comprehensive genetic testing into diagnostic protocols. The evolving landscape of genetic therapies requires identifying all eligible patients transcending traditional familial boundaries. The presence of VUS highlights the multifaceted nature of ALS genetics, prompting further exploration of complex interactions among genetic variants, environmental factors, and disease development.
Collapse
Affiliation(s)
- Laura Libonati
- Department of Human Neurosciences, Rare Neuromuscular Diseases Centre, Sapienza University, Viale Dell'Università 30, 00185, Rome, Italy.
| | - Chiara Cambieri
- Department of Human Neurosciences, Rare Neuromuscular Diseases Centre, Sapienza University, Viale Dell'Università 30, 00185, Rome, Italy
| | - Davide Colavito
- R & I Genetics, C.So Stati Uniti 4int.F, 35127, Padua, Italy
| | - Federica Moret
- Department of Human Neurosciences, Rare Neuromuscular Diseases Centre, Sapienza University, Viale Dell'Università 30, 00185, Rome, Italy
| | - Edoardo D'Andrea
- Department of Human Neurosciences, Rare Neuromuscular Diseases Centre, Sapienza University, Viale Dell'Università 30, 00185, Rome, Italy
| | | | - Alberta Leon
- R & I Genetics, C.So Stati Uniti 4int.F, 35127, Padua, Italy
| | - Maurizio Inghilleri
- Department of Human Neurosciences, Rare Neuromuscular Diseases Centre, Sapienza University, Viale Dell'Università 30, 00185, Rome, Italy
| | - Marco Ceccanti
- Department of Human Neurosciences, Rare Neuromuscular Diseases Centre, Sapienza University, Viale Dell'Università 30, 00185, Rome, Italy
| |
Collapse
|
8
|
Bali P, Lal P, Sivapuram MS, Kutikuppala LVS, Avti P, Chanana A, Kumar S, Anand A. Mind over Microbes: Investigating the Interplay between Lifestyle Factors, Gut Microbiota, and Brain Health. Neuroepidemiology 2024:1-23. [PMID: 38531341 DOI: 10.1159/000538416] [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: 07/31/2023] [Accepted: 03/08/2024] [Indexed: 03/28/2024] Open
Abstract
BACKGROUND The gut microbiota (GM) of the human body comprises several species of microorganisms. This microorganism plays a significant role in the physiological and pathophysiological processes of various human diseases. METHODS The literature review includes studies that describe causative factors that influence GM. The GM is sensitive to various factors like circadian rhythms, environmental agents, physical activity, nutrition, and hygiene that together impact the functioning and composition of the gut microbiome. This affects the health of the host, including the psycho-neural aspects, due to the interconnectivity between the brain and the gut. Hence, this paper examines the relationship of GM with neurodegenerative disorders in the context of these aforesaid factors. CONCLUSION Future studies that identify the regulatory pathways associated with gut microbes can provide a causal link between brain degeneration and the gut at a molecular level. Together, this review could be helpful in designing preventive and treatment strategies aimed at GM, so that neurodegenerative diseases can be treated.
Collapse
Affiliation(s)
- Parul Bali
- Department of Biophysics, Postgraduate Institute of Medical Education and Research, Chandigarh, India
- Department of Neuroscience, University of Florida, Gainesville, Florida, USA
| | - Parth Lal
- Advance Pediatric Centre, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Madhava Sai Sivapuram
- Department of General Medicine, Dr. Pinnamaneni Siddhartha Institute of Medical Sciences and Research Foundation, Peda Avutapalli, India
| | | | - Pramod Avti
- Department of Biophysics, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | | | - Saurabh Kumar
- CCRYN-Collaborative Centre for Mind Body Intervention through Yoga, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Akshay Anand
- CCRYN-Collaborative Centre for Mind Body Intervention through Yoga, Postgraduate Institute of Medical Education and Research, Chandigarh, India
- Neuroscience Research Lab, Department of Neurology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
- Centre for Cognitive Science and Phenomenology, Panjab University, Chandigarh, India
| |
Collapse
|
9
|
Sirtori R, Gregoire M, Potts E, Collins A, Donatelli L, Fallini C. LINC complex alterations are a hallmark of sporadic and familial ALS/FTD. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2024:2024.03.08.584123. [PMID: 38559165 PMCID: PMC10979905 DOI: 10.1101/2024.03.08.584123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/04/2024]
Abstract
Amyotrophic lateral sclerosis (ALS) is a neurodegenerative disorder that primarily affects motor neurons, leading to progressive muscle weakness and loss of voluntary muscle control. While the exact cause of ALS is not fully understood, emerging research suggests that dysfunction of the nuclear envelope (NE) may contribute to disease pathogenesis and progression. The NE plays a role in ALS through several mechanisms, including nuclear pore defects, nucleocytoplasmic transport impairment, accumulation of mislocalized proteins, and nuclear morphology abnormalities. The LINC complex is the second biggest multi-protein complex in the NE and consists of the SUN1/2 proteins spanning the inner nuclear membrane and Nesprin proteins embedded in the outer membrane. The LINC complex, by interacting with both the nuclear lamina and the cytoskeleton, transmits mechanical forces to the nucleus regulating its morphology and functional homeostasis. In this study we show extensive alterations to the LINC complex in motor and cortical iPSC-derived neurons and spinal cord organoids carrying the ALS causative mutation in the C9ORF72 gene (C9). Importantly, we show that such alterations are present in vivo in a cohort of sporadic ALS and C9-ALS postmortem spinal cord and motor cortex biopsies. We also found that LINC complex disruption strongly correlated with nuclear morphological alterations occurring in ALS neurons, independently of TDP43 mislocalization. Altogether, our data establish morphological and functional alterations to the LINC complex as important events in ALS pathogenic cascade, making this pathway a possible target for both biomarker and therapy development.
Collapse
|
10
|
Qneibi M, Bdir S, Bdair M, Aldwaik SA, Sandouka D, Heeh M, Idais TI. AMPA receptor neurotransmission and therapeutic applications: A comprehensive review of their multifaceted modulation. Eur J Med Chem 2024; 266:116151. [PMID: 38237342 DOI: 10.1016/j.ejmech.2024.116151] [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: 12/14/2023] [Revised: 01/02/2024] [Accepted: 01/11/2024] [Indexed: 02/05/2024]
Abstract
The neuropharmacological community has shown a strong interest in AMPA receptors as critical components of excitatory synaptic transmission during the last fifteen years. AMPA receptors, members of the ionotropic glutamate receptor family, allow rapid excitatory neurotransmission in the brain. AMPA receptors, which are permeable to sodium and potassium ions, manage the bulk of the brain's rapid synaptic communications. This study thoroughly examines the recent developments in AMPA receptor regulation, focusing on a shift from single chemical illustrations to a more extensive investigation of underlying processes. The complex interplay of these modulators in modifying the function and structure of AMPA receptors is the main focus, providing insight into their influence on the speed of excitatory neurotransmission. This research emphasizes the potential of AMPA receptor modulation as a therapy for various neurological disorders such as epilepsy and Alzheimer's disease. Analyzing these regulators' sophisticated molecular details enhances our comprehension of neuropharmacology, representing a significant advancement in using AMPA receptors for treating intricate neurological conditions.
Collapse
Affiliation(s)
- Mohammad Qneibi
- Department of Biomedical Sciences, Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine.
| | - Sosana Bdir
- Department of Biomedical Sciences, Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine
| | - Mohammad Bdair
- Department of Biomedical Sciences, Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine
| | - Samia Ammar Aldwaik
- Department of Biomedical Sciences, Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine
| | - Dana Sandouka
- Department of Biomedical Sciences, Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine
| | | | - Tala Iyad Idais
- Department of Biomedical Sciences, Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine
| |
Collapse
|
11
|
Yuan Y, Bailey JM, Rivera-Lopez GM, Atchison WD. Preferential potentiation of AMPA-mediated currents in brainstem hypoglossal motoneurons by subchronic exposure of mice expressing the human superoxide dismutase 1 G93A gene mutation to neurotoxicant methylmercury in vivo. Neurotoxicology 2024; 100:72-84. [PMID: 38065418 PMCID: PMC10877233 DOI: 10.1016/j.neuro.2023.12.002] [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: 05/12/2023] [Revised: 11/28/2023] [Accepted: 12/04/2023] [Indexed: 12/18/2023]
Abstract
The exact causes of Amyotrophic lateral sclerosis (ALS), a progressive and fatal neurological disorder due to loss of upper and/or lower motoneurons, remain elusive. Gene-environment interactions are believed to be an important factor in the development of ALS. We previously showed that in vivo exposure of mice overexpressing the human superoxide dismutase 1 (hSOD1) gene mutation (hSOD1G93A; G93A), a mouse model for ALS, to environmental neurotoxicant methylmercury (MeHg) accelerated the onset of ALS-like phenotype. Here we examined the time-course of effects of MeHg on AMPA receptor (AMPAR)-mediated currents in hypoglossal motoneurons in brainstem slices prepared from G93A, hSOD1wild-type (hWT) and non-carrier WT mice following in vivo exposure to MeHg. Mice were exposed daily to 3 ppm (approximately 0.7 mg/kg/day) MeHg via drinking water beginning at postnatal day 28 (P28) and continued until P47, 64 or 84, then acute brainstem slices were prepared, and spontaneous excitatory postsynaptic currents (sEPSCs) or AMPA-evoked currents were examined using whole cell patch-clamp recording technique. Brainstem slices of untreated littermates were prepared at the same time points to serve as control. MeHg exposure had no significant effect on either sEPSCs or AMPA-evoked currents in slices from hWT or WT mice during any of those exposure time periods under our experimental conditions. MeHg also did not cause any significant effect on sEPSCs or AMPA-currents in G93A hypoglossal motoneurons at P47 and P64. However, at P84, MeHg significantly increased amplitudes of both sEPSCs and AMPA-evoked currents in hypoglossal motineurons from G93A mice (p < 0.05), but not the sEPSC frequency, suggesting a postsynaptic action on AMPARs. MeHg exposure did not cause any significant effect on GABAergic spontaneous inhibitory postsynaptic currents (sIPSCs). Therefore, MeHg exposure in vivo caused differential effects on AMPARs in hypoglossal motoneurons from mice with different genetic backgrounds. MeHg appears to preferentially stimulate the AMPAR-mediated currents in G93A hypoglossal motoneurons in an exposure time-dependent manner, which may contribute to the AMPAR-mediated motoneuron excitotoxicity, thereby facilitating development of ALS-like phenotype.
Collapse
Affiliation(s)
- Yukun Yuan
- Department of Pharmacology/Toxicology, Michigan State University, Life Sciences Building, 1355 Bogue Street, East Lansing, MI 48824-1317, USA.
| | - Jordan M Bailey
- Department of Pharmacology/Toxicology, Michigan State University, Life Sciences Building, 1355 Bogue Street, East Lansing, MI 48824-1317, USA
| | - Gretchen M Rivera-Lopez
- Department of Pharmacology/Toxicology, Michigan State University, Life Sciences Building, 1355 Bogue Street, East Lansing, MI 48824-1317, USA
| | - William D Atchison
- Department of Pharmacology/Toxicology, Michigan State University, Life Sciences Building, 1355 Bogue Street, East Lansing, MI 48824-1317, USA
| |
Collapse
|
12
|
Verdile V, Palombo R, Ferrante G, Ferri A, Amadio S, Volonté C, Paronetto MP. Dysregulation of alternative splicing underlies synaptic defects in familial amyotrophic lateral sclerosis. Prog Neurobiol 2023; 231:102529. [PMID: 37739207 DOI: 10.1016/j.pneurobio.2023.102529] [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: 03/17/2023] [Revised: 09/11/2023] [Accepted: 09/17/2023] [Indexed: 09/24/2023]
Abstract
Amyotrophic lateral sclerosis (ALS) is an incurable neurodegenerative disease characterized by the degeneration of upper and lower motor neurons, progressive wasting and paralysis of voluntary muscles. A hallmark of ALS is the frequent nuclear loss and cytoplasmic accumulation of RNA binding proteins (RBPs) in motor neurons (MN), which leads to aberrant alternative splicing regulation. However, whether altered splicing patterns are also present in familial models of ALS without mutations in RBP-encoding genes has not been investigated yet. Herein, we found that altered splicing of synaptic genes is a common trait of familial ALS MNs. Similar deregulation was also observed in hSOD1G93A MN-like cells. In silico analysis identified the potential regulators of these pre-mRNAs, including the RBP Sam68. Immunofluorescence analysis and biochemical fractionation experiments revealed that Sam68 accumulates in the cytoplasmic insoluble ribonucleoprotein fraction of MN. Remarkably, the synaptic splicing events deregulated in ALS MNs were also affected in Sam68-/- spinal cords. Recombinant expression of Sam68 protein was sufficient to rescue these splicing changes in ALS hSOD1G93A MN-like cells. Hence, our study highlights an aberrant function of Sam68, which leads to splicing changes in synaptic genes and may contribute to the MN phenotype that characterizes ALS.
Collapse
Affiliation(s)
- Veronica Verdile
- Department of Movement, Human and Health Sciences, University of Rome "Foro Italico", Piazza Lauro de Bosis 6, 00135 Rome, Italy; Division of Experimental Neuroscience, IRCCS Fondazione Santa Lucia, Via del Fosso di Fiorano 64, Rome 00143, Italy
| | - Ramona Palombo
- Department of Movement, Human and Health Sciences, University of Rome "Foro Italico", Piazza Lauro de Bosis 6, 00135 Rome, Italy
| | - Gabriele Ferrante
- Division of Experimental Neuroscience, IRCCS Fondazione Santa Lucia, Via del Fosso di Fiorano 64, Rome 00143, Italy
| | - Alberto Ferri
- Division of Experimental Neuroscience, IRCCS Fondazione Santa Lucia, Via del Fosso di Fiorano 64, Rome 00143, Italy; National Research Council (CNR), Institute of Translational Pharmacology (IFT), Rome, Italy
| | - Susanna Amadio
- Division of Experimental Neuroscience, IRCCS Fondazione Santa Lucia, Via del Fosso di Fiorano 64, Rome 00143, Italy
| | - Cinzia Volonté
- Division of Experimental Neuroscience, IRCCS Fondazione Santa Lucia, Via del Fosso di Fiorano 64, Rome 00143, Italy; National Research Council (CNR), Institute for Systems Analysis and Computer Science (IASI), Rome, Italy
| | - Maria Paola Paronetto
- Department of Movement, Human and Health Sciences, University of Rome "Foro Italico", Piazza Lauro de Bosis 6, 00135 Rome, Italy; Division of Experimental Neuroscience, IRCCS Fondazione Santa Lucia, Via del Fosso di Fiorano 64, Rome 00143, Italy.
| |
Collapse
|
13
|
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.
Collapse
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
| |
Collapse
|
14
|
White LM, Boardman J, Lilleker J, Chaouch A, Kargwell H, Ealing J, Hamdalla H. Phenotypical differences of C9ORF72 gene-positive and negative amyotrophic lateral sclerosis: a comparative case series. J Med Genet 2023; 60:1016-1020. [PMID: 37173134 DOI: 10.1136/jmg-2022-109016] [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: 10/28/2022] [Accepted: 05/01/2023] [Indexed: 05/15/2023]
Abstract
BACKGROUND Hexanucleotide repeat expansions of C9ORF72 account for a significant proportion of autosomal dominant neurodegenerative diseases in the amyotrophic lateral sclerosis (ALS)-frontotemporal dementia spectrum. In the absence of a family history, clinical identification of such patients remains difficult. We aimed to identify differences in demographics and clinical presentation between patients with C9ORF72 gene-positive ALS (C9pALS) versus C9ORF72 gene-negative ALS (C9nALS), to aid identification of these patients in the clinic and examine differences in outcomes including survival. METHODS We retrospectively reviewed the clinical presentations of 32 patients with C9pALS and compared their characteristics with a cohort of 46 patients with C9nALS from the same tertiary neurosciences centre. RESULTS Patients with C9pALS more commonly presented with mixed upper and lower motor signs (C9pALS 87.5%, C9nALS 65.2%; p=0.0352), but less frequently presented with purely upper motor neuron signs (C9pALS 3.1%, C9nALS 21.7%; p=0.0226). The C9pALS cohort had a higher frequency of cognitive impairment (C9pALS 31.3%, C9nALS 10.9%; p=0.0394) and bulbar disease (C9pALS 56.3%, C9nALS 28.3%; p=0.0186). There were no differences between cohorts in age at diagnosis, gender, limb weakness, respiratory symptoms, presentation with predominantly lower motor neuron signs or overall survival. DISCUSSION Analysis of this ALS clinic cohort at a UK tertiary neurosciences centre adds to the small but growing understanding of the unique clinical features of patients with C9pALS. In the age of precision medicine with expanding opportunities to manage genetic diseases with disease-modifying therapies, clinical identification of such patients is increasingly important as focused therapeutic strategies become available.
Collapse
Affiliation(s)
- Laura Michelle White
- Manchester Centre for Clinical Neurosciences, Salford Royal Hospital, Salford, UK
| | | | - James Lilleker
- Manchester Centre for Clinical Neurosciences, Salford Royal Hospital, Salford, UK
- Centre for Musculoskeletal Research, The University of Manchester School of Biological Sciences, Manchester, UK
| | - Amina Chaouch
- Manchester Centre for Clinical Neurosciences, Salford Royal Hospital, Salford, UK
| | - Haga Kargwell
- Manchester Centre for Clinical Neurosciences, Salford Royal Hospital, Salford, UK
| | - John Ealing
- Manchester Centre for Clinical Neurosciences, Salford Royal Hospital, Salford, UK
| | - Hisham Hamdalla
- Manchester Centre for Clinical Neurosciences, Salford Royal Hospital, Salford, UK
| |
Collapse
|
15
|
Wiesenfarth M, Huppertz HJ, Dorst J, Lulé D, Ludolph AC, Müller HP, Kassubek J. Structural and microstructural neuroimaging signature of C9orf72-associated ALS: A multiparametric MRI study. Neuroimage Clin 2023; 39:103505. [PMID: 37696099 PMCID: PMC10500452 DOI: 10.1016/j.nicl.2023.103505] [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: 07/28/2023] [Revised: 09/01/2023] [Accepted: 09/03/2023] [Indexed: 09/13/2023]
Abstract
BACKGROUND ALS patients with hexanucleotide expansion in C9orf72 are characterized by a specific clinical phenotype, including more aggressive disease course and cognitive decline. Computerized multiparametric MRI with gray matter volumetry and diffusion tensor imaging (DTI) to analyze white matter structural connectivity is a potential in vivo biomarker. OBJECTIVE The objective of this study was to develop a multiparametric MRI signature in a large cohort of ALS patients with C9orf72 mutations. The aim was to investigate how morphological features of C9orf72-associated ALS differ in structural MRI and DTI compared to healthy controls and ALS patients without C9orf72 mutations. METHODS Atlas-based volumetry (ABV) and whole brain-based DTI-based analyses were performed in a cohort of n = 51 ALS patients with C9orf72 mutations and compared with both n = 51 matched healthy controls and n = 51 C9orf72 negative ALS patients, respectively. Subsequently, Spearman correlation analysis of C9orf72 ALS patients' data with clinical parameters (age of onset, sex, ALS-FRS-R, progression rate, survival) as well as ECAS and p-NfH in CSF was performed. RESULTS The whole brain voxel-by-voxel comparison of fractional anisotropy (FA) maps between C9orf72 ALS patients and controls showed significant bilateral alterations in axonal structures of the white matter at group level, primarily along the corticospinal tracts and in fibers projecting to the frontal lobes. For the frontal lobes, these alterations were also significant between C9orf72 positive and C9orf72 negative ALS patients. In ABV, patients with C9orf72 mutations showed lower volumes of the frontal, temporal, and parietal lobe, with the lowest values in the gray matter of the superior frontal and the precentral gyrus, but also in hippocampi and amygdala. Compared to C9orf72 negative ALS, the differences were shown to be significant for cerebral gray matter (p = 0.04), especially in the frontal (p = 0.01) and parietal lobe (p = 0.01), and in the thalamus (p = 0.004). A correlation analysis between ECAS and averaged regional FA values revealed significant correlations between cognitive performance in ECAS and frontal association fibers. Lower FA values in the frontal lobes were associated with worse performance in all cognitive domains measured (language, verbal fluency, executive functions, memory and spatial perception). In addition, there were significant negative correlations between age of onset and atlas-based volumetry results for gray matter. CONCLUSIONS This study demonstrates a distinct pattern of DTI alterations of the white matter and ubiquitous volume reductions of the gray matter early in the disease course of C9orf72-associated ALS. Alterations were closely linked to a more aggressive cognitive phenotype. These results are in line with an expected pTDP43 propagation pattern of cortical affection and thus strengthen the hypothesis that an underlying developmental disorder is present in ALS with C9orf72 expansions. Thus, multiparametric MRI could contribute to the assessment of the disease as an in vivo biomarker even in the early phase of the disease.
Collapse
Affiliation(s)
| | | | - Johannes Dorst
- Department of Neurology, University Hospital Ulm, Ulm, Germany; German Centre of Neurodegenerative Diseases (DZNE), Ulm, Germany
| | - Dorothée Lulé
- Department of Neurology, University Hospital Ulm, Ulm, Germany
| | - Albert C Ludolph
- Department of Neurology, University Hospital Ulm, Ulm, Germany; German Centre of Neurodegenerative Diseases (DZNE), Ulm, Germany
| | | | - Jan Kassubek
- Department of Neurology, University Hospital Ulm, Ulm, Germany; German Centre of Neurodegenerative Diseases (DZNE), Ulm, Germany.
| |
Collapse
|
16
|
Dunn E, Steinert JR, Stone A, Sahota V, Williams RSB, Snowden S, Augustin H. Medium-Chain Fatty Acids Rescue Motor Function and Neuromuscular Junction Degeneration in a Drosophila Model of Amyotrophic Lateral Sclerosis. Cells 2023; 12:2163. [PMID: 37681895 PMCID: PMC10486503 DOI: 10.3390/cells12172163] [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: 07/26/2023] [Revised: 08/21/2023] [Accepted: 08/22/2023] [Indexed: 09/09/2023] Open
Abstract
Amyotrophic lateral sclerosis (ALS) is an adult-onset neurodegenerative disease characterised by progressive degeneration of the motor neurones. An expanded GGGGCC (G4C2) hexanucleotide repeat in C9orf72 is the most common genetic cause of ALS and frontotemporal dementia (FTD); therefore, the resulting disease is known as C9ALS/FTD. Here, we employ a Drosophila melanogaster model of C9ALS/FTD (C9 model) to investigate a role for specific medium-chain fatty acids (MCFAs) in reversing pathogenic outcomes. Drosophila larvae overexpressing the ALS-associated dipeptide repeats (DPRs) in the nervous system exhibit reduced motor function and neuromuscular junction (NMJ) defects. We show that two MCFAs, nonanoic acid (NA) and 4-methyloctanoic acid (4-MOA), can ameliorate impaired motor function in C9 larvae and improve NMJ degeneration, although their mechanisms of action are not identical. NA modified postsynaptic glutamate receptor density, whereas 4-MOA restored defects in the presynaptic vesicular release. We also demonstrate the effects of NA and 4-MOA on metabolism in C9 larvae and implicate various metabolic pathways as dysregulated in our ALS model. Our findings pave the way to identifying novel therapeutic targets and potential treatments for ALS.
Collapse
Affiliation(s)
- Ella Dunn
- Centre for Biomedical Sciences, Department of Biological Sciences, Royal Holloway University of London, Egham, Surrey TW20 OEX, UK; (E.D.); (R.S.B.W.)
| | - Joern R. Steinert
- Faculty of Medicine & Health Sciences, Queen’s Medical Centre, Nottingham NG7 2UH, UK; (J.R.S.); (A.S.)
| | - Aelfwin Stone
- Faculty of Medicine & Health Sciences, Queen’s Medical Centre, Nottingham NG7 2UH, UK; (J.R.S.); (A.S.)
| | - Virender Sahota
- Centre for Biomedical Sciences, Department of Biological Sciences, Royal Holloway University of London, Egham, Surrey TW20 OEX, UK; (E.D.); (R.S.B.W.)
| | - Robin S. B. Williams
- Centre for Biomedical Sciences, Department of Biological Sciences, Royal Holloway University of London, Egham, Surrey TW20 OEX, UK; (E.D.); (R.S.B.W.)
| | - Stuart Snowden
- Centre for Biomedical Sciences, Department of Biological Sciences, Royal Holloway University of London, Egham, Surrey TW20 OEX, UK; (E.D.); (R.S.B.W.)
| | - Hrvoje Augustin
- Centre for Biomedical Sciences, Department of Biological Sciences, Royal Holloway University of London, Egham, Surrey TW20 OEX, UK; (E.D.); (R.S.B.W.)
| |
Collapse
|
17
|
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.
Collapse
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
| |
Collapse
|
18
|
De Vocht J, Van Weehaeghe D, Ombelet F, Masrori P, Lamaire N, Devrome M, Van Esch H, Moisse M, Koole M, Dupont P, Van Laere K, Van Damme P. Differences in Cerebral Glucose Metabolism in ALS Patients with and without C9orf72 and SOD1 Mutations. Cells 2023; 12:cells12060933. [PMID: 36980274 PMCID: PMC10047407 DOI: 10.3390/cells12060933] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Revised: 03/10/2023] [Accepted: 03/13/2023] [Indexed: 03/22/2023] Open
Abstract
Amyotrophic lateral sclerosis (ALS) is characterized by progressive loss of upper and lower motor neurons. In 10% of patients, the disorder runs in the family. Our aim was to study the impact of ALS-causing gene mutations on cerebral glucose metabolism. Between October 2010 and October 2022, 538 patients underwent genetic testing for mutations with strong evidence of causality for ALS and 18F-2-fluoro-2-deoxy-D-glucose-PET (FDG PET), at University Hospitals Leuven. We identified 48 C9orf72-ALS and 22 SOD1-ALS patients. After propensity score matching, two cohorts of 48 and 21 matched sporadic ALS patients, as well as 20 healthy controls were included. FDG PET images were assessed using a voxel-based and volume-of-interest approach. We observed widespread frontotemporal involvement in all ALS groups, in comparison to healthy controls. The degree of relative glucose metabolism in SOD1-ALS in motor and extra-motor regions did not differ significantly from matched sporadic ALS patients. In C9orf72-ALS, we found more pronounced hypometabolism in the peri-rolandic region and thalamus, and hypermetabolism in the medulla extending to the pons, in comparison to matched sporadic ALS patients. Our study revealed C9orf72-dependent differences in glucose metabolism in the peri-rolandic region, thalamus, and brainstem (i.e., medulla, extending to the pons) in relation to matched sporadic ALS patients.
Collapse
Affiliation(s)
- Joke De Vocht
- Division of Psychiatry, Division of Neurology, University Hospitals Leuven, VIB-KULeuven Center for Brain & Disease Research, Laboratory of Neurobiology, Department of Neurosciences, Leuven Brain Institute (LBI), Katholieke Universiteit Leuven, 3000 Leuven, Belgium
- Correspondence: ; Tel.: +32-16-34-13-73
| | | | - Fouke Ombelet
- Division of Neurology, University Hospitals Leuven, VIB-KULeuven Center for Brain & Disease Research, Laboratory of Neurobiology, Department of Neurosciences, Leuven Brain Institute (LBI), Katholieke Universiteit Leuven, 3000 Leuven, Belgium
| | - Pegah Masrori
- Division of Neurology, University Hospitals Leuven, VIB-KULeuven Center for Brain & Disease Research, Laboratory of Neurobiology, Department of Neurosciences, Leuven Brain Institute (LBI), Katholieke Universiteit Leuven, 3000 Leuven, Belgium
| | - Nikita Lamaire
- Division of Neurology, University Hospitals Leuven, VIB-KULeuven Center for Brain & Disease Research, Laboratory of Neurobiology, Department of Neurosciences, Leuven Brain Institute (LBI), Katholieke Universiteit Leuven, 3000 Leuven, Belgium
| | - Martijn Devrome
- Department of Imaging and Pathology, Nuclear Medicine and Molecular Imaging, Katholieke Universiteit Leuven, 3000 Leuven, Belgium
| | - Hilde Van Esch
- Center for Human Genetics, University Hospitals Leuven, 3000 Leuven, Belgium
| | - Mathieu Moisse
- VIB-KU Leuven Center for Brain & Disease Research, Laboratory of Neurobiology, Department of Neurosciences, Leuven Brain Institute (LBI), Katholieke Universiteit Leuven, 3000 Leuven, Belgium
| | - Michel Koole
- Department of Imaging and Pathology, Nuclear Medicine and Molecular Imaging, Katholieke Universiteit Leuven, 3000 Leuven, Belgium
| | - Patrick Dupont
- Laboratory of Cognitive Neurology, Department of Neurosciences, Leuven Brain Institute (LBI), Katholieke Universiteit Leuven, 3000 Leuven, Belgium
| | - Koen Van Laere
- Department of Imaging and Pathology, Nuclear Medicine and Molecular Imaging, Katholieke Universiteit Leuven, 3000 Leuven, Belgium
| | - Philip Van Damme
- Division of Neurology, University Hospitals Leuven, VIB-KULeuven Center for Brain & Disease Research, Laboratory of Neurobiology, Department of Neurosciences, Leuven Brain Institute (LBI), Katholieke Universiteit Leuven, 3000 Leuven, Belgium
| |
Collapse
|
19
|
Motor, cognitive and behavioural profiles of C9orf72 expansion-related amyotrophic lateral sclerosis. J Neurol 2023; 270:898-908. [PMID: 36308529 PMCID: PMC9886586 DOI: 10.1007/s00415-022-11433-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Revised: 10/16/2022] [Accepted: 10/17/2022] [Indexed: 02/03/2023]
Abstract
INTRODUCTION Amyotrophic lateral sclerosis (ALS) individuals carrying the hexanucleotide repeat expansion (HRE) in the C9orf72 gene (C9Pos) have been described as presenting distinct features compared to the general ALS population (C9Neg). We aim to identify the phenotypic traits more closely associated with the HRE and analyse the role of the repeat length as a modifier factor. METHODS We studied a cohort of 960 ALS patients (101 familial and 859 sporadic cases). Motor phenotype was determined using the MRC scale, the lower motor neuron score (LMNS) and the Penn upper motor neuron score (PUMNS). Neuropsychological profile was studied using the Italian version of the Edinburgh Cognitive and Behavioral ALS Screen (ECAS), the Frontal Behavioral Inventory (FBI), the Beck Depression Inventory-II (BDI-II) and the State-Trait Anxiety Inventory (STAI). A two-step PCR protocol and Southern blotting were performed to determine the presence and the size of C9orf72 HRE, respectively. RESULTS C9orf72 HRE was detected in 55/960 ALS patients. C9Pos patients showed a younger onset, higher odds of bulbar onset, increased burden of UMN signs, reduced survival and higher frequency of concurrent dementia. We found an inverse correlation between the HRE length and the performance at ECAS ALS-specific tasks (P = 0.031). Patients also showed higher burden of behavioural disinhibition (P = 1.6 × 10-4), lower degrees of depression (P = 0.015) and anxiety (P = 0.008) compared to C9Neg cases. CONCLUSIONS Our study provides an extensive characterization of motor, cognitive and behavioural features of C9orf72-related ALS, indicating that the C9orf72 HRE size may represent a modifier of the cognitive phenotype.
Collapse
|
20
|
Factors predicting disease progression in C9ORF72 ALS patients. J Neurol 2023; 270:877-890. [PMID: 36280624 DOI: 10.1007/s00415-022-11426-y] [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: 07/13/2022] [Revised: 10/10/2022] [Accepted: 10/13/2022] [Indexed: 02/03/2023]
Abstract
OBJECTIVE To unveil clinical features, comorbidities, disease progression and prognostic factors in a population-based cohort of ALS patients carrying C9ORF72 expansion (C9 + ALS). METHODS This is a retrospective observational study on ALS patients residing in Emilia Romagna and Piedmont-Valle D'Aosta regions whose data are available through population based registers. We analysed patients who underwent genetic testing, focusing on C9 + ALS subgroup. RESULTS Among 2204 genotyped patients of the two registers, 150 were C9 + ALS. In comparison with patients without mutation, a higher proportion of family history (12.85 vs 68%, p < 0.001) and frontotemporal dementia (3.93% vs 10.67%, p < 0.001) was detected in C9 + ALS. C9 + ALS presented a faster disease progression as measured by monthly decline in ALS Functional Rating Scale-Revised (1.86 ± 3.30 vs 1.45 ± 2.35, p < 0.01) and in forced vital capacity (5.90 ± 5.24 vs 2.97 ± 3.47, p < 0.01), a shorter diagnostic delay (8.93 ± 6.74 vs 12.68 ± 12.86 months, p < 0.01) and earlier onset (58.91 ± 9.02 vs 65.04 ± 11.55 years, p < 0.01). Consistently, they reached death or tracheostomy earlier than other patients (31 vs 37 months, HR = 1.52, 95% C.I. 1.27-1.82, p < 0.001). With respect to other genotyped patients, C9 + ALS patients did not present a significantly higher prevalence of concomitant diseases. Independent prognostic factors of survival of C9 + ALS included sex, age, progression rate, presence of frontotemporal dementia and thyroid disorders, with the latter being associated with prolonged ALS survival (43 vs 29 months, HR = 0.42, 95% C.I. 0.24-0.74, p = 0.003). CONCLUSION Even in the context of a more aggressive disease, C9 + ALS had a longer survival in presence of thyroid disorders. This finding may suggest protective pathogenic pathways in C9 + ALS to be explored, looking for therapeutic strategies to slow disease course.
Collapse
|
21
|
Jeon YM, Kwon Y, Lee S, Kim HJ. Potential roles of the endoplasmic reticulum stress pathway in amyotrophic lateral sclerosis. Front Aging Neurosci 2023; 15:1047897. [PMID: 36875699 PMCID: PMC9974850 DOI: 10.3389/fnagi.2023.1047897] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Accepted: 01/16/2023] [Indexed: 02/17/2023] Open
Abstract
The endoplasmic reticulum (ER) is a major organelle involved in protein quality control and cellular homeostasis. ER stress results from structural and functional dysfunction of the organelle, along with the accumulation of misfolded proteins and changes in calcium homeostasis, it leads to ER stress response pathway such as unfolded protein response (UPR). Neurons are particularly sensitive to the accumulation of misfolded proteins. Thus, the ER stress is involved in neurodegenerative diseases such as Alzheimer's disease, Parkinson's disease, prion disease and motor neuron disease (MND). Recently, the complex involvement of ER stress pathways has been demonstrated in experimental models of amyotrophic lateral sclerosis (ALS)/MND using pharmacological and genetic manipulation of the unfolded protein response (UPR), an adaptive response to ER stress. Here, we aim to provide recent evidence demonstrating that the ER stress pathway is an essential pathological mechanism of ALS. In addition, we also provide therapeutic strategies that can help treat diseases by targeting the ER stress pathway.
Collapse
Affiliation(s)
- Yu-Mi Jeon
- Dementia Research Group, Korea Brain Research Institute, Daegu, Republic of Korea
| | - Younghwi Kwon
- Dementia Research Group, Korea Brain Research Institute, Daegu, Republic of Korea
| | - Shinrye Lee
- Dementia Research Group, Korea Brain Research Institute, Daegu, Republic of Korea
| | - Hyung-Jun Kim
- Dementia Research Group, Korea Brain Research Institute, Daegu, Republic of Korea.,Department of Brain and Cognitive Sciences, Daegu Gyeongbuk Institute of Science and Technology (DGIST), Daegu, Republic of Korea
| |
Collapse
|
22
|
Ramamoorthy D, Severson K, Ghosh S, Sachs K, Glass JD, Fournier CN, Herrington TM, Berry JD, Ng K, Fraenkel E. Identifying patterns in amyotrophic lateral sclerosis progression from sparse longitudinal data. NATURE COMPUTATIONAL SCIENCE 2022; 2:605-616. [PMID: 38177466 PMCID: PMC10766562 DOI: 10.1038/s43588-022-00299-w] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/07/2021] [Accepted: 07/14/2022] [Indexed: 01/06/2024]
Abstract
The clinical presentation of amyotrophic lateral sclerosis (ALS), a fatal neurodegenerative disease, varies widely across patients, making it challenging to determine if potential therapeutics slow progression. We sought to determine whether there were common patterns of disease progression that could aid in the design and analysis of clinical trials. We developed an approach based on a mixture of Gaussian processes to identify clusters of patients sharing similar disease progression patterns, modeling their average trajectories and the variability in each cluster. We show that ALS progression is frequently nonlinear, with periods of stable disease preceded or followed by rapid decline. We also show that our approach can be extended to Alzheimer's and Parkinson's diseases. Our results advance the characterization of disease progression of ALS and provide a flexible modeling approach that can be applied to other progressive diseases.
Collapse
Affiliation(s)
| | - Kristen Severson
- Center for Computational Health and MIT-IBM Watson AI Lab, IBM Research, Cambridge, MA, USA
| | - Soumya Ghosh
- Center for Computational Health and MIT-IBM Watson AI Lab, IBM Research, Cambridge, MA, USA
| | - Karen Sachs
- Department of Biological Engineering, MIT, Cambridge, MA, USA
- Next Generation Analytics, Palo Alto, CA, USA
| | - Jonathan D Glass
- Department of Neurology, Emory University School of Medicine, Atlanta, GA, USA
| | | | - Todd M Herrington
- Department of Neurology, Massachusetts General Hospital, Boston, MA, USA
- Department of Neurology, Harvard Medical School, Boston, MA, USA
| | - James D Berry
- Department of Neurology, Massachusetts General Hospital, Boston, MA, USA
| | - Kenney Ng
- Center for Computational Health and MIT-IBM Watson AI Lab, IBM Research, Cambridge, MA, USA
| | - Ernest Fraenkel
- Department of Biological Engineering, MIT, Cambridge, MA, USA.
| |
Collapse
|
23
|
Sista SRS, Shelly S, Oskarsson B, Rubin DI, Martinez-Thompson JM, Parra-Cantu C, Staff NP, Laughlin RS. Clinical and electrophysiological findings in C9ORF72 ALS. Muscle Nerve 2022; 66:270-275. [PMID: 35727129 DOI: 10.1002/mus.27665] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2022] [Revised: 06/13/2022] [Accepted: 06/15/2022] [Indexed: 11/10/2022]
Abstract
INTRODUCTION/AIMS Amyotrophic lateral sclerosis (ALS) is a progressive, fatal, neurodegenerative disorder of motor neurons in which the cause is mostly unknown. Early identification of genetic ALS cases, of which C9ORF72 (C9ALS) is the most frequent, can have important implications for evaluation, prognosis, and therapeutics. Here, we aimed to characterize the clinical and electrophysiological hallmarks of C9ALS and investigate differences from C9ORF72 negative ALS (non-C9ALS). METHODS We retrospectively reviewed clinical and electrodiagnostic (EDX) data for all genetically confirmed C9ALS cases seen between 1/1/2012 and 10/1/2020 who met Gold Coast criteria and compared them 1:1 with non-C9ALS patients within the same time frame. RESULTS A total of 99 C9ALS and 99 non-C9ALS cases were identified. Compared to non-C9ALS, C9ALS demonstrated higher prevalence in women, lesser racial variability, stronger family history of ALS, and higher frequency of upper motor neuron signs. EDX testing of C9ALS showed higher median sensory nerve and lower fibular compound muscle action potential amplitudes. DISCUSSION Although the differences between C9ALS and non-C9ALS reached statistical significance in certain nerve conduction parameters, they were not sufficient to discriminate between groups on a case-by-case basis. Genetic testing is required to identify C9ALS patients.
Collapse
Affiliation(s)
| | - Shahar Shelly
- Department of Neurology, Mayo Clinic, Rochester, Minnesota, USA.,Department of Neurology, Sheba Medical Center, Tel HaShomer, Sackler Faculty of Medicine, Tel Aviv University, Middle East, Israel
| | - Björn Oskarsson
- Department of Neurology, Mayo Clinic, Jacksonville, Florida, USA
| | - Devon I Rubin
- Department of Neurology, Mayo Clinic, Jacksonville, Florida, USA
| | | | | | - Nathan P Staff
- Department of Neurology, Mayo Clinic, Rochester, Minnesota, USA
| | | |
Collapse
|
24
|
Su WM, Gu XJ, Duan QQ, Jiang Z, Gao X, Shang HF, Chen YP. Genetic factors for survival in amyotrophic lateral sclerosis: an integrated approach combining a systematic review, pairwise and network meta-analysis. BMC Med 2022; 20:209. [PMID: 35754054 PMCID: PMC9235235 DOI: 10.1186/s12916-022-02411-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Accepted: 05/18/2022] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND The time of survival in patients with amyotrophic lateral sclerosis (ALS) varies greatly, and the genetic factors that contribute to the survival of ALS are not well studied. There is a lack of a comprehensive study to elucidate the role of genetic factors in the survival of ALS. METHODS The published studies were systematically searched and obtained from PubMed, EMBASE, and the Cochrane Library without any language restrictions from inception to Oct 27, 2021. A network meta-analysis for ALS causative/risk genes and a systematic review and pairwise meta-analysis for other genetic modifiers were conducted. The PROSPERO registration number: CRD42022311646. RESULTS A total of 29,764 potentially relevant references were identified, and 71 papers were eligible for analysis based on pre-decided criteria, including 35 articles in network meta-analysis for 9 ALS causative/risk genes, 17 articles in pairwise meta-analysis for four genetic modifiers, and 19 articles described in the systematic review. Variants in three genes, including ATXN2 (HR: 3.6), C9orf72 (HR: 1.6), and FUS (HR:1.8), were associated with short survival of ALS, but such association was not identified in SOD1, TARDBP, TBK1, NEK1, UBQLN2, and CCNF. In addition, UNC13A rs12608932 CC genotype and ZNF521B rs2275294 C allele also caused a shorter survival of ALS; however, APOE ε4 allele and KIFAP3 rs1541160 did not be found to have any effect on the survival of ALS. CONCLUSIONS Our study summarized and contrasted evidence for prognostic genetic factors in ALS and would help to understand ALS pathogenesis and guide clinical trials and drug development.
Collapse
Affiliation(s)
- Wei-Ming Su
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China
- Lab of Neurodegenerative Disorders, Institute of Inflammation and Immunology (III), Frontiers Science Center for Disease-Related Molecular Network, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China
- Centre for Rare Diseases, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China
| | - Xiao-Jing Gu
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China
- Lab of Neurodegenerative Disorders, Institute of Inflammation and Immunology (III), Frontiers Science Center for Disease-Related Molecular Network, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China
- Centre for Rare Diseases, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China
| | - Qing-Qing Duan
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China
- Lab of Neurodegenerative Disorders, Institute of Inflammation and Immunology (III), Frontiers Science Center for Disease-Related Molecular Network, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China
- Centre for Rare Diseases, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China
| | - Zheng Jiang
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China
- Lab of Neurodegenerative Disorders, Institute of Inflammation and Immunology (III), Frontiers Science Center for Disease-Related Molecular Network, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China
- Centre for Rare Diseases, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China
| | - Xia Gao
- Department of Geriatrics, Dazhou Central Hospital, Dazhou, Sichuan, China
| | - Hui-Fang Shang
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China
- Lab of Neurodegenerative Disorders, Institute of Inflammation and Immunology (III), Frontiers Science Center for Disease-Related Molecular Network, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China
- Centre for Rare Diseases, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China
| | - Yong-Ping Chen
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China.
- Lab of Neurodegenerative Disorders, Institute of Inflammation and Immunology (III), Frontiers Science Center for Disease-Related Molecular Network, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China.
- Centre for Rare Diseases, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China.
| |
Collapse
|
25
|
Laaksovirta H, Launes J, Jansson L, Traynor BJ, Kaivola K, Tienari PJ. ALS in Finland. Neurol Genet 2022; 8:e665. [PMID: 35295181 PMCID: PMC8922337 DOI: 10.1212/nxg.0000000000000665] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Accepted: 01/26/2022] [Indexed: 11/15/2022]
Abstract
Background and Objectives To analyze the frequencies of major genetic variants and the clinical features in Finnish patients with amyotrophic lateral sclerosis (ALS) with or without the C9orf72 hexanucleotide repeat expansion. Methods A cohort of patients with motor neuron disease was recruited between 1993 and 2020 at the Helsinki University Hospital and 2 second-degree outpatient clinics in Helsinki. Finnish ancestry patients with ALS fulfilled the diagnosis according to the revised El Escorial criteria and the Awaji-criteria. Two categories of familial ALS (FALS) were used. A patient was defined FALS-A if at least 1 first- or second-degree family member had ALS, and FALS-NP, if family members had additional neurologic or psychiatric endophenotypes. Results Of the 815 patients, 25% had FALS-A and 45% FALS-NP. C9orf72 expansion (C9pos) was found in 256 (31%) of all patients, in 58% of FALS-A category, in 48% of FALS-NP category, and in 23 or 17% of sporadic cases using the FALS-A or FALS-NP definition. C9pos or SOD1 p.D91A homozygosity was found in 328 (40%) of the 815 patients. We compared demographic and clinical characteristics between C9pos and patients with unknown cause of ALS (Unk). We found that the age at onset was significantly earlier and survival markedly shorter in the C9pos vs Unk patients with ALS. The shortest survival was found in bulbar-onset male C9pos patients, whereas the longest survival was found in Unk limb-onset males. Older age at onset associated consistently with shorter survival in C9pos and Unk patients in both limb-onset and bulbar-onset groups. There were no significant differences in the frequencies of bulbar-onset and limb-onset patients in C9pos and Unk groups. ALS-frontotemporal dementia (FTD) was more common in C9pos (17%) than in Unk (4%) patients, and of all patients with ALS-FTD, 70% were C9pos. Discussion These results provide further evidence for the short survival of C9orf72-associated ALS. A prominent role of the C9orf72 and SOD1 variants was found in the Finnish population. An unusually high frequency of C9pos was also found among patients with sporadic ALS. The enrichment of these 2 variants likely contributes to the high incidence of ALS in Finland.
Collapse
|
26
|
Cathcart SJ, Appel SH, Peterson LE, Greene EP, Powell SZ, Arumanayagam AS, Rivera AL, Cykowski MD. Fast Progression in Amyotrophic Lateral Sclerosis Is Associated With Greater TDP-43 Burden in Spinal Cord. J Neuropathol Exp Neurol 2021; 80:754-763. [PMID: 34383907 PMCID: PMC8433592 DOI: 10.1093/jnen/nlab061] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
Upper and lower motor neuron pathologies are critical to the autopsy diagnosis of amyotrophic lateral sclerosis (ALS). Further investigation is needed to determine how the relative burden of these pathologies affects the disease course. We performed a blinded, retrospective study of 38 ALS patients, examining the association between pathologic measures in motor cortex, hypoglossal nucleus, and lumbar cord with clinical data, including progression rate and disease duration, site of symptom onset, and upper and lower motor neuron signs. The most critical finding in our study was that TAR DNA-binding protein 43 kDa (TDP-43) pathologic burden in lumbar cord and hypoglossal nucleus was significantly associated with a faster progression rate with reduced survival (p < 0.02). There was no correlation between TDP-43 burden and the severity of cell loss, and no significant clinical associations were identified for motor cortex TDP-43 burden or severity of cell loss in motor cortex. C9orf72 expansion was associated with shorter disease duration (p < 0.001) but was not significantly associated with pathologic measures in these regions. The association between lower motor neuron TDP-43 burden and fast progression with reduced survival in ALS provides further support for the study of TDP-43 as a disease biomarker.
Collapse
Affiliation(s)
- Sahara J Cathcart
- From the Department of Pathology and Genomic Medicine, Houston Methodist Hospital, Houston, Texas, USA (SJC, SZP, ASA, ALR, MDC); University of Nebraska Medical Center, Omaha, Nebraska, USA (SJC); Stanley H. Appel Department of Neurology, Houston Methodist Hospital, Houston, Texas, USA (SHA, EPG, MDC); Institute of Academic Medicine at the Houston Methodist Research Institute, Houston Methodist Hospital, Houston, Texas, USA (SHA, EPG, SZP, ALR, MDC); Houston Methodist Neurological Institute, Houston Methodist Hospital, Houston, Texas, USA (SHA, EPG, SZP, ALR); NXG Logic, LLC, Houston, Texas, USA (LEP)
| | - Stanley H Appel
- From the Department of Pathology and Genomic Medicine, Houston Methodist Hospital, Houston, Texas, USA (SJC, SZP, ASA, ALR, MDC); University of Nebraska Medical Center, Omaha, Nebraska, USA (SJC); Stanley H. Appel Department of Neurology, Houston Methodist Hospital, Houston, Texas, USA (SHA, EPG, MDC); Institute of Academic Medicine at the Houston Methodist Research Institute, Houston Methodist Hospital, Houston, Texas, USA (SHA, EPG, SZP, ALR, MDC); Houston Methodist Neurological Institute, Houston Methodist Hospital, Houston, Texas, USA (SHA, EPG, SZP, ALR); NXG Logic, LLC, Houston, Texas, USA (LEP)
| | - Leif E Peterson
- From the Department of Pathology and Genomic Medicine, Houston Methodist Hospital, Houston, Texas, USA (SJC, SZP, ASA, ALR, MDC); University of Nebraska Medical Center, Omaha, Nebraska, USA (SJC); Stanley H. Appel Department of Neurology, Houston Methodist Hospital, Houston, Texas, USA (SHA, EPG, MDC); Institute of Academic Medicine at the Houston Methodist Research Institute, Houston Methodist Hospital, Houston, Texas, USA (SHA, EPG, SZP, ALR, MDC); Houston Methodist Neurological Institute, Houston Methodist Hospital, Houston, Texas, USA (SHA, EPG, SZP, ALR); NXG Logic, LLC, Houston, Texas, USA (LEP)
| | - Ericka P Greene
- From the Department of Pathology and Genomic Medicine, Houston Methodist Hospital, Houston, Texas, USA (SJC, SZP, ASA, ALR, MDC); University of Nebraska Medical Center, Omaha, Nebraska, USA (SJC); Stanley H. Appel Department of Neurology, Houston Methodist Hospital, Houston, Texas, USA (SHA, EPG, MDC); Institute of Academic Medicine at the Houston Methodist Research Institute, Houston Methodist Hospital, Houston, Texas, USA (SHA, EPG, SZP, ALR, MDC); Houston Methodist Neurological Institute, Houston Methodist Hospital, Houston, Texas, USA (SHA, EPG, SZP, ALR); NXG Logic, LLC, Houston, Texas, USA (LEP)
| | - Suzanne Z Powell
- From the Department of Pathology and Genomic Medicine, Houston Methodist Hospital, Houston, Texas, USA (SJC, SZP, ASA, ALR, MDC); University of Nebraska Medical Center, Omaha, Nebraska, USA (SJC); Stanley H. Appel Department of Neurology, Houston Methodist Hospital, Houston, Texas, USA (SHA, EPG, MDC); Institute of Academic Medicine at the Houston Methodist Research Institute, Houston Methodist Hospital, Houston, Texas, USA (SHA, EPG, SZP, ALR, MDC); Houston Methodist Neurological Institute, Houston Methodist Hospital, Houston, Texas, USA (SHA, EPG, SZP, ALR); NXG Logic, LLC, Houston, Texas, USA (LEP)
| | - Anithachristy S Arumanayagam
- From the Department of Pathology and Genomic Medicine, Houston Methodist Hospital, Houston, Texas, USA (SJC, SZP, ASA, ALR, MDC); University of Nebraska Medical Center, Omaha, Nebraska, USA (SJC); Stanley H. Appel Department of Neurology, Houston Methodist Hospital, Houston, Texas, USA (SHA, EPG, MDC); Institute of Academic Medicine at the Houston Methodist Research Institute, Houston Methodist Hospital, Houston, Texas, USA (SHA, EPG, SZP, ALR, MDC); Houston Methodist Neurological Institute, Houston Methodist Hospital, Houston, Texas, USA (SHA, EPG, SZP, ALR); NXG Logic, LLC, Houston, Texas, USA (LEP)
| | - Andreana L Rivera
- From the Department of Pathology and Genomic Medicine, Houston Methodist Hospital, Houston, Texas, USA (SJC, SZP, ASA, ALR, MDC); University of Nebraska Medical Center, Omaha, Nebraska, USA (SJC); Stanley H. Appel Department of Neurology, Houston Methodist Hospital, Houston, Texas, USA (SHA, EPG, MDC); Institute of Academic Medicine at the Houston Methodist Research Institute, Houston Methodist Hospital, Houston, Texas, USA (SHA, EPG, SZP, ALR, MDC); Houston Methodist Neurological Institute, Houston Methodist Hospital, Houston, Texas, USA (SHA, EPG, SZP, ALR); NXG Logic, LLC, Houston, Texas, USA (LEP)
| | - Matthew D Cykowski
- From the Department of Pathology and Genomic Medicine, Houston Methodist Hospital, Houston, Texas, USA (SJC, SZP, ASA, ALR, MDC); University of Nebraska Medical Center, Omaha, Nebraska, USA (SJC); Stanley H. Appel Department of Neurology, Houston Methodist Hospital, Houston, Texas, USA (SHA, EPG, MDC); Institute of Academic Medicine at the Houston Methodist Research Institute, Houston Methodist Hospital, Houston, Texas, USA (SHA, EPG, SZP, ALR, MDC); Houston Methodist Neurological Institute, Houston Methodist Hospital, Houston, Texas, USA (SHA, EPG, SZP, ALR); NXG Logic, LLC, Houston, Texas, USA (LEP)
| |
Collapse
|
27
|
Roggenbuck J, Rich KA, Vicini L, Palettas M, Schroeder J, Zaleski C, Lincoln T, Drury L, Glass JD. Amyotrophic Lateral Sclerosis Genetic Access Program: Paving the Way for Genetic Characterization of ALS in the Clinic. NEUROLOGY-GENETICS 2021; 7:e615. [PMID: 34386583 PMCID: PMC8356701 DOI: 10.1212/nxg.0000000000000615] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Accepted: 05/20/2021] [Indexed: 11/16/2022]
Abstract
Objective To report the frequency of amyotrophic lateral sclerosis (ALS) genetic variants in a nationwide cohort of clinic-based patients with ALS with a family history of ALS (fALS), dementia (dALS), or both ALS and dementia (fALS/dALS). Methods A multicenter, prospective cohort of 573 patients with fALS, dALS, or fALS/dALS, underwent genetic testing in the ALS Genetic Access Program (ALS GAP), a clinical program for clinics of the Northeast ALS Consortium. Patients with dALS underwent C9orf72 hexanucleotide repeat expansion (HRE) testing; those with fALS or fALS/dALS underwent C9orf72 HRE testing, followed by sequencing of SOD1, FUS, TARDBP, TBK1, and VCP. Results A pathogenic (P) or likely pathogenic (LP) variant was identified in 171/573 (30%) of program participants. About half of patients with fALS or fALS/dALS (138/301, 45.8%) had either a C9orf72 HRE or a P or LP variant identified in SOD1, FUS, TARDBP, TBK1, or VCP. The use of a targeted, 5-gene sequencing panel resulted in far fewer uncertain test outcomes in familial cases compared with larger panels used in other in clinic-based cohorts. Among dALS cases 11.8% (32/270) were found to have the C9orf72 HRE. Patients of non-Caucasian geoancestry were less likely to test positive for the C9orf72 HRE, but were more likely to test positive on panel testing, compared with those of Caucasian ancestry. Conclusions The ALS GAP program provided a genetic diagnosis to ∼1 in 3 participants and may serve as a model for clinical genetic testing in ALS.
Collapse
Affiliation(s)
- Jennifer Roggenbuck
- Department of Internal Medicine (J.R.) and Department of Neurology (J.R., K.A.R.), The Ohio State University Wexner Medical Center, Columbus; The Ohio State University Wexner Medical Center (L.V.), College of Medicine, Columbus; Department of Biomedical Informatics (M.P.), The Ohio State University, Center for Biostatistics, Columbus; PreventionGenetics, LLC (J.S., C.Z., T.L., L.D.), Marshfield, WI; The Northeast ALS Consortium (NEALS) (T.L.); and Emory ALS Center (J.D.G.), Emory University School of Medicine, Atlanta, GA
| | - Kelly A Rich
- Department of Internal Medicine (J.R.) and Department of Neurology (J.R., K.A.R.), The Ohio State University Wexner Medical Center, Columbus; The Ohio State University Wexner Medical Center (L.V.), College of Medicine, Columbus; Department of Biomedical Informatics (M.P.), The Ohio State University, Center for Biostatistics, Columbus; PreventionGenetics, LLC (J.S., C.Z., T.L., L.D.), Marshfield, WI; The Northeast ALS Consortium (NEALS) (T.L.); and Emory ALS Center (J.D.G.), Emory University School of Medicine, Atlanta, GA
| | - Leah Vicini
- Department of Internal Medicine (J.R.) and Department of Neurology (J.R., K.A.R.), The Ohio State University Wexner Medical Center, Columbus; The Ohio State University Wexner Medical Center (L.V.), College of Medicine, Columbus; Department of Biomedical Informatics (M.P.), The Ohio State University, Center for Biostatistics, Columbus; PreventionGenetics, LLC (J.S., C.Z., T.L., L.D.), Marshfield, WI; The Northeast ALS Consortium (NEALS) (T.L.); and Emory ALS Center (J.D.G.), Emory University School of Medicine, Atlanta, GA
| | - Marilly Palettas
- Department of Internal Medicine (J.R.) and Department of Neurology (J.R., K.A.R.), The Ohio State University Wexner Medical Center, Columbus; The Ohio State University Wexner Medical Center (L.V.), College of Medicine, Columbus; Department of Biomedical Informatics (M.P.), The Ohio State University, Center for Biostatistics, Columbus; PreventionGenetics, LLC (J.S., C.Z., T.L., L.D.), Marshfield, WI; The Northeast ALS Consortium (NEALS) (T.L.); and Emory ALS Center (J.D.G.), Emory University School of Medicine, Atlanta, GA
| | - Joceyln Schroeder
- Department of Internal Medicine (J.R.) and Department of Neurology (J.R., K.A.R.), The Ohio State University Wexner Medical Center, Columbus; The Ohio State University Wexner Medical Center (L.V.), College of Medicine, Columbus; Department of Biomedical Informatics (M.P.), The Ohio State University, Center for Biostatistics, Columbus; PreventionGenetics, LLC (J.S., C.Z., T.L., L.D.), Marshfield, WI; The Northeast ALS Consortium (NEALS) (T.L.); and Emory ALS Center (J.D.G.), Emory University School of Medicine, Atlanta, GA
| | - Christina Zaleski
- Department of Internal Medicine (J.R.) and Department of Neurology (J.R., K.A.R.), The Ohio State University Wexner Medical Center, Columbus; The Ohio State University Wexner Medical Center (L.V.), College of Medicine, Columbus; Department of Biomedical Informatics (M.P.), The Ohio State University, Center for Biostatistics, Columbus; PreventionGenetics, LLC (J.S., C.Z., T.L., L.D.), Marshfield, WI; The Northeast ALS Consortium (NEALS) (T.L.); and Emory ALS Center (J.D.G.), Emory University School of Medicine, Atlanta, GA
| | - Tara Lincoln
- Department of Internal Medicine (J.R.) and Department of Neurology (J.R., K.A.R.), The Ohio State University Wexner Medical Center, Columbus; The Ohio State University Wexner Medical Center (L.V.), College of Medicine, Columbus; Department of Biomedical Informatics (M.P.), The Ohio State University, Center for Biostatistics, Columbus; PreventionGenetics, LLC (J.S., C.Z., T.L., L.D.), Marshfield, WI; The Northeast ALS Consortium (NEALS) (T.L.); and Emory ALS Center (J.D.G.), Emory University School of Medicine, Atlanta, GA
| | - Luke Drury
- Department of Internal Medicine (J.R.) and Department of Neurology (J.R., K.A.R.), The Ohio State University Wexner Medical Center, Columbus; The Ohio State University Wexner Medical Center (L.V.), College of Medicine, Columbus; Department of Biomedical Informatics (M.P.), The Ohio State University, Center for Biostatistics, Columbus; PreventionGenetics, LLC (J.S., C.Z., T.L., L.D.), Marshfield, WI; The Northeast ALS Consortium (NEALS) (T.L.); and Emory ALS Center (J.D.G.), Emory University School of Medicine, Atlanta, GA
| | - Jonathan D Glass
- Department of Internal Medicine (J.R.) and Department of Neurology (J.R., K.A.R.), The Ohio State University Wexner Medical Center, Columbus; The Ohio State University Wexner Medical Center (L.V.), College of Medicine, Columbus; Department of Biomedical Informatics (M.P.), The Ohio State University, Center for Biostatistics, Columbus; PreventionGenetics, LLC (J.S., C.Z., T.L., L.D.), Marshfield, WI; The Northeast ALS Consortium (NEALS) (T.L.); and Emory ALS Center (J.D.G.), Emory University School of Medicine, Atlanta, GA
| |
Collapse
|
28
|
Holdom CJ, Janse van Mantgem MR, van Eijk RPA, Howe SL, van den Berg LH, McCombe PA, Henderson RD, Ngo ST, Steyn FJ. Venous creatinine as a biomarker for loss of fat-free mass and disease progression in patients with amyotrophic lateral sclerosis. Eur J Neurol 2021; 28:3615-3625. [PMID: 34216521 DOI: 10.1111/ene.15003] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Revised: 06/16/2021] [Accepted: 06/30/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND AND PURPOSE To establish the utility of venous creatinine as a biomarker to monitor loss of fat-free mass in patients with amyotrophic lateral sclerosis (ALS). METHODS In this multicenter natural history study, body composition and venous creatinine were assessed in 107 patients with ALS and 52 healthy controls. Longitudinal patterns of venous creatinine and its association with the risk of death during follow-up were determined in a cohort of patients with ALS from Australia (n = 69) and the Netherlands (n = 38). RESULTS The mean levels of venous creatinine were 75.78 ± 11.15 μmol/L for controls, 70.25 ± 12.81 μmol/L for Australian patients, and 59.95 ± 14.62 μmol/L for Dutch patients with ALS. The relationship between measures of venous creatinine and fat-free mass was similar between all groups (r = 0.36, p < 0.001). Within patients, fat-free mass declined by 0.31 (95% confidence interval [CI]: 0.22-0.40) kg/month, and venous creatinine declined by 0.52 (95% CI: 0.38-0.66) μmol/L/month, with a longitudinal correlation of 0.57 (95% CI: 0.35-0.76, p < 0.001). Lower levels of venous creatinine were associated with increased risk for earlier death in patients with ALS (hazard ratio = 0.94, 95% CI: 0.90-0.98, p = 0.007). CONCLUSIONS Venous creatinine is decreased in ALS and declines alongside a decline in fat-free mass over the course of the disease, and may serve as a practical marker to monitor the change of fat-free mass in patients with ALS. This could inform clinical care and provide an alternative endpoint for the evaluation of therapeutic interventions that focus on slowing the loss of fat-free mass and disease progression in ALS.
Collapse
Affiliation(s)
- Cory J Holdom
- Australian Institute for Bioengineering and Nanotechnology, The University of Queensland, Brisbane, QLD, Australia.,Centre for Clinical Research, The University of Queensland, Brisbane, QLD, Australia
| | - Mark R Janse van Mantgem
- Department of Neurology, UMC Utrecht Brain Centre, University Medical Centre Utrecht, Utrecht, the Netherlands
| | - Ruben P A van Eijk
- Department of Neurology, UMC Utrecht Brain Centre, University Medical Centre Utrecht, Utrecht, the Netherlands.,Biostatistics & Research Support, Julius Centre for Health Sciences and Primary Care, University Medical Centre Utrecht, Utrecht, the Netherlands
| | - Stephanie L Howe
- Australian Institute for Bioengineering and Nanotechnology, The University of Queensland, Brisbane, QLD, Australia
| | - Leonard H van den Berg
- Department of Neurology, UMC Utrecht Brain Centre, University Medical Centre Utrecht, Utrecht, the Netherlands
| | - Pamela A McCombe
- Centre for Clinical Research, The University of Queensland, Brisbane, QLD, Australia.,Department of Neurology, Royal Brisbane and Women's Hospital, Brisbane, QLD, Australia
| | - Robert D Henderson
- Centre for Clinical Research, The University of Queensland, Brisbane, QLD, Australia.,Department of Neurology, Royal Brisbane and Women's Hospital, Brisbane, QLD, Australia
| | - Shyuan T Ngo
- Australian Institute for Bioengineering and Nanotechnology, The University of Queensland, Brisbane, QLD, Australia.,Centre for Clinical Research, The University of Queensland, Brisbane, QLD, Australia.,Department of Neurology, Royal Brisbane and Women's Hospital, Brisbane, QLD, Australia
| | - Frederik J Steyn
- Centre for Clinical Research, The University of Queensland, Brisbane, QLD, Australia.,Department of Neurology, Royal Brisbane and Women's Hospital, Brisbane, QLD, Australia.,School of Biomedical Sciences, The University of Queensland, Brisbane, QLD, Australia
| |
Collapse
|
29
|
Tseng YJ, Sandwith SN, Green KM, Chambers AE, Krans A, Raimer HM, Sharlow ME, Reisinger MA, Richardson AE, Routh ED, Smaldino MA, Wang YH, Vaughn JP, Todd PK, Smaldino PJ. The RNA helicase DHX36-G4R1 modulates C9orf72 GGGGCC hexanucleotide repeat-associated translation. J Biol Chem 2021; 297:100914. [PMID: 34174288 PMCID: PMC8326427 DOI: 10.1016/j.jbc.2021.100914] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Revised: 06/02/2021] [Accepted: 06/22/2021] [Indexed: 12/26/2022] Open
Abstract
GGGGCC (G4C2) hexanucleotide repeat expansions in the endosomal trafficking gene C9orf72 are the most common genetic cause of ALS and frontotemporal dementia. Repeat-associated non-AUG (RAN) translation of this expansion through near-cognate initiation codon usage and internal ribosomal entry generates toxic proteins that accumulate in patients' brains and contribute to disease pathogenesis. The helicase protein DEAH-box helicase 36 (DHX36–G4R1) plays active roles in RNA and DNA G-quadruplex (G4) resolution in cells. As G4C2 repeats are known to form G4 structures in vitro, we sought to determine the impact of manipulating DHX36 expression on repeat transcription and RAN translation. Using a series of luciferase reporter assays both in cells and in vitro, we found that DHX36 depletion suppresses RAN translation in a repeat length–dependent manner, whereas overexpression of DHX36 enhances RAN translation from G4C2 reporter RNAs. Moreover, upregulation of RAN translation that is typically triggered by integrated stress response activation is prevented by loss of DHX36. These results suggest that DHX36 is active in regulating G4C2 repeat translation, providing potential implications for therapeutic development in nucleotide repeat expansion disorders.
Collapse
Affiliation(s)
- Yi-Ju Tseng
- Department of Neurology, University of Michigan, Ann Arbor, Michigan, USA; Cellular and Molecular Biology Graduate Program, University of Michigan, Ann Arbor, Michigan, USA
| | - Siara N Sandwith
- Department of Biology, Ball State University, Muncie, Indiana, USA
| | - Katelyn M Green
- Department of Neurology, University of Michigan, Ann Arbor, Michigan, USA
| | | | - Amy Krans
- Department of Neurology, University of Michigan, Ann Arbor, Michigan, USA
| | - Heather M Raimer
- Department of Biochemistry and Molecular Genetics, University of Virginia, Charlottesville, Virginia, USA
| | | | | | | | - Eric D Routh
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | | | - Yuh-Hwa Wang
- Department of Biochemistry and Molecular Genetics, University of Virginia, Charlottesville, Virginia, USA
| | - James P Vaughn
- Division of Cancer Biology, NanoMedica LLC, Winston-Salem, North Carolina, USA
| | - Peter K Todd
- Department of Neurology, University of Michigan, Ann Arbor, Michigan, USA; Department of Neurology, Ann Arbor VA Medical Center, Ann Arbor, Michigan, USA.
| | | |
Collapse
|
30
|
Péladeau C, Sandhu JK. Aberrant NLRP3 Inflammasome Activation Ignites the Fire of Inflammation in Neuromuscular Diseases. Int J Mol Sci 2021; 22:ijms22116068. [PMID: 34199845 PMCID: PMC8200055 DOI: 10.3390/ijms22116068] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Revised: 05/30/2021] [Accepted: 06/01/2021] [Indexed: 12/24/2022] Open
Abstract
Inflammasomes are molecular hubs that are assembled and activated by a host in response to various microbial and non-microbial stimuli and play a pivotal role in maintaining tissue homeostasis. The NLRP3 is a highly promiscuous inflammasome that is activated by a wide variety of sterile triggers, including misfolded protein aggregates, and drives chronic inflammation via caspase-1-mediated proteolytic cleavage and secretion of proinflammatory cytokines, interleukin-1β and interleukin-18. These cytokines further amplify inflammatory responses by activating various signaling cascades, leading to the recruitment of immune cells and overproduction of proinflammatory cytokines and chemokines, resulting in a vicious cycle of chronic inflammation and tissue damage. Neuromuscular diseases are a heterogeneous group of muscle disorders that involve injury or dysfunction of peripheral nerves, neuromuscular junctions and muscles. A growing body of evidence suggests that dysregulation, impairment or aberrant NLRP3 inflammasome signaling leads to the initiation and exacerbation of pathological processes associated with neuromuscular diseases. In this review, we summarize the available knowledge about the NLRP3 inflammasome in neuromuscular diseases that affect the peripheral nervous system and amyotrophic lateral sclerosis, which affects the central nervous system. In addition, we also examine whether therapeutic targeting of the NLRP3 inflammasome components is a viable approach to alleviating the detrimental phenotype of neuromuscular diseases and improving clinical outcomes.
Collapse
Affiliation(s)
- Christine Péladeau
- Human Health Therapeutics Research Centre, National Research Council Canada, 1200 Montreal Road, Ottawa, ON K1A 0R6, Canada;
| | - Jagdeep K. Sandhu
- Human Health Therapeutics Research Centre, National Research Council Canada, 1200 Montreal Road, Ottawa, ON K1A 0R6, Canada;
- Department of Biochemistry, Microbiology and Immunology, University of Ottawa, 451 Smyth Road, Ottawa, ON K1H 8M5, Canada
- Correspondence: ; Tel.: +1-613-993-5304
| |
Collapse
|
31
|
Pinilla G, Kumar A, Floaters MK, Pardo CA, Rothstein J, Ilieva H. Increased synthesis of pro-inflammatory cytokines in C9ORF72 patients. Amyotroph Lateral Scler Frontotemporal Degener 2021; 22:517-527. [PMID: 33929933 DOI: 10.1080/21678421.2021.1912100] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
C9ORF72 hexanucleotide expansion is the most common genetic cause of familial amyotrophic lateral sclerosis (ALS)/fronto-temporal dementia (FTD) disease spectrum. Even though three major mechanisms of disease pathogenesis have been proposed, we lack detailed understanding of the factors that influence disease onset and progression. We sought to characterize cerebrospinal fluid and sera of C9ORF72 patients via a multiplex assay of 41 chemokines and cytokines in comparison to neurological controls and sporadic ALS patients. We found an increase in synthesis of pro-inflammatory chemokines and cytokines in disease samples and particularly in C9ORF72 patients in comparison to controls. We provide evidence that a CSF pro-inflammatory signature is a feature of C9ORF72-mediated disease.
Collapse
Affiliation(s)
- Gabriel Pinilla
- Department of Neurology, Johns Hopkins University, Baltimore, MD, USA.,Fundación Valle del Lili, Cali, Icesi University, Valle del Cauca, Colombia
| | - Anupama Kumar
- Department of Neurology, Johns Hopkins University, Baltimore, MD, USA
| | - Mary Kay Floaters
- National Institutes of Health, National Institute of Neurological Disorders and Stroke, Bethesda, MD, USA
| | - Carlos A Pardo
- Department of Neurology, Johns Hopkins University, Baltimore, MD, USA
| | - Jeffrey Rothstein
- Department of Neurology, Johns Hopkins University, Baltimore, MD, USA
| | - Hristelina Ilieva
- Department of Neurology, Johns Hopkins University, Baltimore, MD, USA.,ALS Weinberg Center, Thomas Jefferson University, Philadelphia, PA, USA, and
| |
Collapse
|
32
|
Tsai YL, Manley JL. Multiple ways to a dead end: diverse mechanisms by which ALS mutant genes induce cell death. Cell Cycle 2021; 20:631-646. [PMID: 33722167 DOI: 10.1080/15384101.2021.1886661] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Abstract
Amyotrophic Lateral Sclerosis (ALS) is a deadly neuromuscular disorder caused by progressive motor neuron loss in the brain and spinal cord. Over the past decades, a number of genetic mutations have been identified that cause or are associated with ALS disease progression. Numerous genes harbor ALS mutations, and they encode proteins displaying a wide range of physiological functions, with limited overlap. Despite the divergent functions, mutations in these genes typically trigger protein aggregation, which can confer gain- and/or loss-of-function to a number of essential cellular processes. Nuclear processes such as mRNA splicing and the response to DNA damage are significantly affected in ALS patients. Cytoplasmic organelles such as mitochondria are damaged by ALS mutant proteins. Processes that maintain cellular homeostasis such as autophagy, nonsense-mediated mRNA decay and nucleocytoplasmic transport, are also impaired by ALS mutations. Here, we review the multiple mechanisms by which mutations in major ALS-associated genes, such as TARDBP, C9ORF72 and FUS, lead to impairment of essential cellular processes.
Collapse
Affiliation(s)
- Yueh-Lin Tsai
- Department of Biological Sciences, Columbia University, New York, NY, United States
| | - James L Manley
- Department of Biological Sciences, Columbia University, New York, NY, United States
| |
Collapse
|
33
|
Glasmacher SA, Wong C, Pearson IE, Pal S. Survival and Prognostic Factors in C9orf72 Repeat Expansion Carriers: A Systematic Review and Meta-analysis. JAMA Neurol 2021; 77:367-376. [PMID: 31738367 DOI: 10.1001/jamaneurol.2019.3924] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Importance The c9orf72 repeat expansion (c9 or c9orf72RE) confers a survival disadvantage in amyotrophic lateral sclerosis (ALS); its effect on prognosis in frontotemporal dementia (FTD) remains uncertain. Data on prognostic factors in c9orf72RE disorders could inform patient care, genetic counseling, and trial design. Objective To examine prognostic factors in c9ALS, c9FTD, c9ALS-FTD, and atypical phenotypes. Data Sources The MEDLINE, Embase, Amed, ProQuest, PsychINFO, CINAHL, and LILACS databases were searched between January 2011 and January 2019. Keywords used were c9orf72 and chromosome 9 open reading frame 72. Reference lists, citations of eligible studies, and review articles were also searched by hand. Study Selection Studies reporting disease duration for patients with a confirmed c9orf72RE and a neurological and/or psychiatric disorder were included. A second author independently reviewed studies classified as irrelevant by the first author. Analysis began in January 2019. Data Extraction and Synthesis Data were extracted by 1 author; a further author independently extracted 10% of data. Data were synthesized in univariate and multivariable Cox regression and are displayed as hazard ratios (HR) and 95% confidence intervals. Main Outcomes and Measures Survival after symptom onset. Results Overall, 206 studies reporting on 1060 patients were included from 2878 publications identified (c9ALS: n = 455; c9FTD: n = 296; c9ALS-FTD: n = 198; atypical phenotypes: n = 111); 197 duplicate cases were excluded. The median (95% CI) survival (in years) differed significantly between patients with c9ALS (2.8 [2.67-3.00]), c9FTD (9.0 [8.09-9.91]), and c9ALS-FTD (3.0 [2.73-3.27]); survival in atypical phenotypes varied substantially. Older age at onset was associated with shorter survival in c9ALS (HR, 1.03; 95% CI, 1.02-1.04; P < .001), c9FTD (HR, 1.04; 95% CI, 1.02-1.06; P < .001), and c9ALS-FTD (HR, 1.02; 95% CI, 1.004-1.04; P = .016). Bulbar onset was associated with shorter survival in c9ALS (HR, 1.64; 95% CI, 1.27-2.08; P < .001). Age at onset and bulbar onset ALS remained significant in multivariable regression including variables indicating potential diagnostic ascertainment bias, selection bias, and reporting bias. Family history, sex, study continent, FTD subtype, or the presence of additional pathogenic sequence variants were not significantly associated with survival. Clinical phenotypes in patients with neuropathologically confirmed frontotemporal lobar degeneration-TDP-43, motor neuron disease-TDP-43 and frontotemporal lobar degeneration-motor neuron disease-TDP-43 were heterogenous and impacted on survival. Conclusions and Relevance Several factors associated with survival in c9orf72RE disorders were identified. The inherent limitations of our methodological approach must be considered; nonetheless, the reported prognostic factors were not significantly associated with the bias indicators examined.
Collapse
Affiliation(s)
- Stella A Glasmacher
- College of Medicine and Veterinary Medicine, University of Edinburgh, Edinburgh, United Kingdom
| | - Charis Wong
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, United Kingdom.,Anne Rowling Regenerative Neurology Clinic, University of Edinburgh, Edinburgh, United Kingdom.,Euan MacDonald Centre for Motor Neurone Disease Research, University of Edinburgh, Edinburgh, United Kingdom
| | - Iona E Pearson
- College of Medicine and Veterinary Medicine, University of Edinburgh, Edinburgh, United Kingdom
| | - Suvankar Pal
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, United Kingdom.,Anne Rowling Regenerative Neurology Clinic, University of Edinburgh, Edinburgh, United Kingdom.,Euan MacDonald Centre for Motor Neurone Disease Research, University of Edinburgh, Edinburgh, United Kingdom
| |
Collapse
|
34
|
Placek K, Benatar M, Wuu J, Rampersaud E, Hennessy L, Van Deerlin VM, Grossman M, Irwin DJ, Elman L, McCluskey L, Quinn C, Granit V, Statland JM, Burns TM, Ravits J, Swenson A, Katz J, Pioro EP, Jackson C, Caress J, So Y, Maiser S, Walk D, Lee EB, Trojanowski JQ, Cook P, Gee J, Sha J, Naj AC, Rademakers R, Chen W, Wu G, Paul Taylor J, McMillan CT. Machine learning suggests polygenic risk for cognitive dysfunction in amyotrophic lateral sclerosis. EMBO Mol Med 2021; 13:e12595. [PMID: 33270986 PMCID: PMC7799365 DOI: 10.15252/emmm.202012595] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Revised: 10/27/2020] [Accepted: 10/30/2020] [Indexed: 11/09/2022] Open
Abstract
Amyotrophic lateral sclerosis (ALS) is a multi-system disease characterized primarily by progressive muscle weakness. Cognitive dysfunction is commonly observed in patients; however, factors influencing risk for cognitive dysfunction remain elusive. Using sparse canonical correlation analysis (sCCA), an unsupervised machine-learning technique, we observed that single nucleotide polymorphisms collectively associate with baseline cognitive performance in a large ALS patient cohort (N = 327) from the multicenter Clinical Research in ALS and Related Disorders for Therapeutic Development (CReATe) Consortium. We demonstrate that a polygenic risk score derived using sCCA relates to longitudinal cognitive decline in the same cohort and also to in vivo cortical thinning in the orbital frontal cortex, anterior cingulate cortex, lateral temporal cortex, premotor cortex, and hippocampus (N = 90) as well as post-mortem motor cortical neuronal loss (N = 87) in independent ALS cohorts from the University of Pennsylvania Integrated Neurodegenerative Disease Biobank. Our findings suggest that common genetic polymorphisms may exert a polygenic contribution to the risk of cortical disease vulnerability and cognitive dysfunction in ALS.
Collapse
|
35
|
Placek K, Benatar M, Wuu J, Rampersaud E, Hennessy L, Van Deerlin VM, Grossman M, Irwin DJ, Elman L, McCluskey L, Quinn C, Granit V, Statland JM, Burns TM, Ravits J, Swenson A, Katz J, Pioro EP, Jackson C, Caress J, So Y, Maiser S, Walk D, Lee EB, Trojanowski JQ, Cook P, Gee J, Sha J, Naj AC, Rademakers R, Chen W, Wu G, Paul Taylor J, McMillan CT. Machine learning suggests polygenic risk for cognitive dysfunction in amyotrophic lateral sclerosis. EMBO Mol Med 2021. [PMID: 33270986 PMCID: PMC7799365 DOI: 10.15252/emmm.202012595|] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Abstract
Amyotrophic lateral sclerosis (ALS) is a multi-system disease characterized primarily by progressive muscle weakness. Cognitive dysfunction is commonly observed in patients; however, factors influencing risk for cognitive dysfunction remain elusive. Using sparse canonical correlation analysis (sCCA), an unsupervised machine-learning technique, we observed that single nucleotide polymorphisms collectively associate with baseline cognitive performance in a large ALS patient cohort (N = 327) from the multicenter Clinical Research in ALS and Related Disorders for Therapeutic Development (CReATe) Consortium. We demonstrate that a polygenic risk score derived using sCCA relates to longitudinal cognitive decline in the same cohort and also to in vivo cortical thinning in the orbital frontal cortex, anterior cingulate cortex, lateral temporal cortex, premotor cortex, and hippocampus (N = 90) as well as post-mortem motor cortical neuronal loss (N = 87) in independent ALS cohorts from the University of Pennsylvania Integrated Neurodegenerative Disease Biobank. Our findings suggest that common genetic polymorphisms may exert a polygenic contribution to the risk of cortical disease vulnerability and cognitive dysfunction in ALS.
Collapse
Affiliation(s)
- Katerina Placek
- Department of NeurologyUniversity of Pennsylvania Perelman School of MedicinePhiladelphiaPAUSA
| | - Michael Benatar
- Department of NeurologyLeonard M. Miller School of MedicineUniversity of MiamiMiamiFLUSA
| | - Joanne Wuu
- Department of NeurologyLeonard M. Miller School of MedicineUniversity of MiamiMiamiFLUSA
| | - Evadnie Rampersaud
- Center for Applied BioinformaticsSt. Jude Children’s Research HospitalMemphisTNUSA
| | - Laura Hennessy
- Department of NeurologyUniversity of Pennsylvania Perelman School of MedicinePhiladelphiaPAUSA
| | - Vivianna M Van Deerlin
- Department of Pathology & Laboratory MedicineUniversity of Pennsylvania Perelman School of MedicinePhiladelphiaPAUSA
| | - Murray Grossman
- Department of NeurologyUniversity of Pennsylvania Perelman School of MedicinePhiladelphiaPAUSA
| | - David J Irwin
- Department of NeurologyUniversity of Pennsylvania Perelman School of MedicinePhiladelphiaPAUSA
| | - Lauren Elman
- Department of NeurologyUniversity of Pennsylvania Perelman School of MedicinePhiladelphiaPAUSA
| | - Leo McCluskey
- Department of NeurologyUniversity of Pennsylvania Perelman School of MedicinePhiladelphiaPAUSA
| | - Colin Quinn
- Department of NeurologyUniversity of Pennsylvania Perelman School of MedicinePhiladelphiaPAUSA
| | - Volkan Granit
- Department of NeurologyLeonard M. Miller School of MedicineUniversity of MiamiMiamiFLUSA
| | - Jeffrey M Statland
- Department of NeurologyUniversity of Kansas Medical CenterKansas CityKSUSA
| | - Ted M Burns
- Department of NeurologyUniversity of Virginia Health SystemCharlottesvilleVAUSA
| | - John Ravits
- Department of NeurosciencesUniversity of California San DiegoSan DiegoCAUSA
| | | | - Jon Katz
- Forbes Norris ALS CenterCalifornia Pacific Medical CenterSan FranciscoCAUSA
| | - Erik P Pioro
- Department of NeurologyCleveland ClinicClevelandOHUSA
| | - Carlayne Jackson
- Department of NeurologyUniversity of Texas Health Science CenterSan AntonioTXUSA
| | - James Caress
- Department of NeurologyWake Forest University School of MedicineWinston‐SalemNCUSA
| | - Yuen So
- Department of NeurologyStanford University Medical CenterSan JoseCAUSA
| | - Samuel Maiser
- Department of NeurologyUniversity of Minnesota Medical CenterMinneapolisMNUSA
| | - David Walk
- Department of NeurologyUniversity of Minnesota Medical CenterMinneapolisMNUSA
| | - Edward B Lee
- Department of Pathology & Laboratory MedicineUniversity of Pennsylvania Perelman School of MedicinePhiladelphiaPAUSA
| | - John Q Trojanowski
- Department of Pathology & Laboratory MedicineUniversity of Pennsylvania Perelman School of MedicinePhiladelphiaPAUSA
| | - Philip Cook
- Penn Image Computing Science Laboratory (PICSL)Department of RadiologyUniversity of Pennsylvania Perelman School of MedicinePhiladelphiaPAUSA
| | - James Gee
- Penn Image Computing Science Laboratory (PICSL)Department of RadiologyUniversity of Pennsylvania Perelman School of MedicinePhiladelphiaPAUSA
| | - Jin Sha
- Department of Biostatistics, Epidemiology, and InformaticsUniversity of Pennsylvania Perelman School of MedicinePhiladelphiaPAUSA,Penn Neurodegeneration Genomics CenterDepartment of Pathology and Laboratory MedicineUniversity of Pennsylvania Perelman School of MedicinePhiladelphiaPAUSA
| | - Adam C Naj
- Department of Pathology & Laboratory MedicineUniversity of Pennsylvania Perelman School of MedicinePhiladelphiaPAUSA,Department of Biostatistics, Epidemiology, and InformaticsUniversity of Pennsylvania Perelman School of MedicinePhiladelphiaPAUSA,Penn Neurodegeneration Genomics CenterDepartment of Pathology and Laboratory MedicineUniversity of Pennsylvania Perelman School of MedicinePhiladelphiaPAUSA
| | | | | | - Wenan Chen
- Center for Applied BioinformaticsSt. Jude Children’s Research HospitalMemphisTNUSA
| | - Gang Wu
- Center for Applied BioinformaticsSt. Jude Children’s Research HospitalMemphisTNUSA
| | - J Paul Taylor
- Center for Applied BioinformaticsSt. Jude Children’s Research HospitalMemphisTNUSA,The Howard Hughes Medical InstituteChevy ChaseMSUSA
| | - Corey T McMillan
- Department of NeurologyUniversity of Pennsylvania Perelman School of MedicinePhiladelphiaPAUSA
| |
Collapse
|
36
|
Brand D, Polak M, Glass JD, Fournier CN. Comparison of Phenotypic Characteristics and Prognosis Between Black and White Patients in a Tertiary ALS Clinic. Neurology 2020; 96:e840-e844. [PMID: 33372030 DOI: 10.1212/wnl.0000000000011396] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Accepted: 09/28/2020] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To compare characteristics between Black and White patients with amyotrophic lateral sclerosis (ALS) in order to identify disparities and phenotypic variability. METHODS We performed database review for patients seen between 1997 and 2020 at the Emory ALS Center in Atlanta, Georgia. Patients with ALS were included for analyses if race was self-reported as Black or White and symptom onset was prior to January 1, 2017. Variables examined include race, age at onset, diagnostic delay, site of onset, median income, C9orf72 mutation status, feeding tube and tracheostomy status, vital capacity, Amyotrophic Lateral Sclerosis Functional Rating Scale-revised(ALSFRS-R) score, and survival time. RESULTS A total of 2,363 patient records were queried, and 1,298 were included in analysis; 203 self-identified as Black and 1,095 as White. Black patients had younger age at symptom onset, lower frequency of C9orf72 mutations, lower median income, longer diagnostic delay, and lower baseline ALSFRS-R and vital capacity compared to White patients. Black patients had a longer median survival than White patients; however, race was not an independent predictor of survival time when controlling for age at symptom onset, bulbar onset, and C9orf72 positivity. CONCLUSIONS Black patients with ALS had longer median survival compared to White patients, but race was not independently associated with survival after controlling for age, site of onset, and C9orf72 status, factors known to predict prognosis. Black patients with ALS had longer diagnostic delay and lower baseline ventilatory and functional status at first clinic visit compared to White patients, which could be suggestive of barriers to tertiary care. Further studies are needed to identify the underlying causes of ALS racial differences.
Collapse
Affiliation(s)
- David Brand
- From the Department of Neurology (M.P., J.D.G., C.N.F.), Emory University School of Medicine (D.B.), Atlanta, GA
| | - Meraida Polak
- From the Department of Neurology (M.P., J.D.G., C.N.F.), Emory University School of Medicine (D.B.), Atlanta, GA
| | - Jonathan D Glass
- From the Department of Neurology (M.P., J.D.G., C.N.F.), Emory University School of Medicine (D.B.), Atlanta, GA.
| | - Christina N Fournier
- From the Department of Neurology (M.P., J.D.G., C.N.F.), Emory University School of Medicine (D.B.), Atlanta, GA.
| |
Collapse
|
37
|
Roggenbuck J. C9orf72 and the Care of the Patient With ALS or FTD: Progress and Recommendations After 10 Years. NEUROLOGY-GENETICS 2020; 7:e542. [PMID: 33575483 PMCID: PMC7862089 DOI: 10.1212/nxg.0000000000000542] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/25/2020] [Accepted: 10/19/2020] [Indexed: 12/12/2022]
Abstract
The 2011 discovery of the pathogenic hexanucleotide repeat expansion (HRE) in C9orf72, the leading genetic cause of both amyotrophic lateral sclerosis (ALS) and frontotemporal dementia (FTD), marked a breakthrough in the effort to unravel the etiology of these conditions. Ten years later, clinicians are still working to integrate the implications of this discovery into the care of individuals with ALS and/or FTD. Consensus management guidelines for ALS do not comprehensively address the issue of genetic testing, and questions remain about whom to test, what counseling should be provided before and after testing, laboratory methods, and test interpretation. These challenges have contributed to inconsistent clinical practices and present barriers to patients wishing to access testing. This review summarizes the clinical impact of the discovery of the C9orf72 HRE, outlines ongoing challenges, and provides recommendations for C9orf72 testing, counseling, and research.
Collapse
Affiliation(s)
- Jennifer Roggenbuck
- Departments of Neurology and Internal Medicine, The Ohio State University Wexner Medical Center, Columbus
| |
Collapse
|
38
|
Iazzolino B, Peotta L, Zucchetti JP, Canosa A, Manera U, Vasta R, Grassano M, Palumbo F, Brunetti M, Barberis M, Sbaiz L, Moglia C, Calvo A, Chiò A. Differential Neuropsychological Profile of Patients With Amyotrophic Lateral Sclerosis With and Without C9orf72 Mutation. Neurology 2020; 96:e141-e152. [PMID: 33106391 DOI: 10.1212/wnl.0000000000011093] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2020] [Accepted: 08/21/2020] [Indexed: 01/28/2023] Open
Abstract
OBJECTIVE To determine whether the neuropsychological profiles of patients with amyotrophic lateral sclerosis (ALS) with (ALSC9+) and without (ALSC9-) C9orf72 expansion are different, we administered a battery of neuropsychological tests to 741 patients with ALS (68 ALSC9+ and 673 ALSC9-) and 129 controls. METHODS The study population includes 741 patients with ALS who were consecutively diagnosed at the Turin ALS expert center in the 2010-2018 period and who underwent both cognitive/behavioral and genetic testing. Patients' neuropsychological patterns were compared (1) at the same degree of cognitive and behavioral deficit according to the revised ALS-Frontotemporal Dementia Consensus Criteria and (2) at the same level of motor impairment according to the King staging system. RESULTS Despite being about 7 years younger, ALSC9+ patients had significantly lower scores in tests exploring executive function and verbal memory both when classified as cognitively normal and when diagnosed in the intermediate cognitive categories. Considering the clinical perspective, ALSC9+ patients showed significantly lower scores compared to ALSC9- patients at King stage 1 and 3 in almost all the examined neuropsychological domains; at King stage 2, ALSC9+ patients were more severely affected only in the verbal memory domain. Behavioral function was comparably impaired in the 2 cohorts. CONCLUSIONS ALSC9+ patients show a different neuropsychological profile compared to ALSC9- patients, being more impaired in executive functions and verbal memory domains at all King stages. Verbal memory emerged as a particularly vulnerable function in ALSC9+, with worse performances even when patients were still classified as cognitively normal.
Collapse
Affiliation(s)
- Barbara Iazzolino
- From the ALS Center, 'Rita Levi Montalcini' Department of Neuroscience (B.I., L.P., J.P.Z., A. Canosa, U.M., R.V., M.G., F.P., M. Brunetti, C.M., A. Calvo, A. Chiò), University of Torino; Medical Genetic Unit (M. Barberis, L.S.) and Neurology 1 (A. Canosa, M. Brunetti, C.M., A. Calvo, A. Chiò), Azienda Ospedaliero-Universitaria Città della Salute e della Scienza of Torino, Turin; and Institute of Cognitive Sciences and Technologies (A. Chiò), National Research Council, Rome, Italy
| | - Laura Peotta
- From the ALS Center, 'Rita Levi Montalcini' Department of Neuroscience (B.I., L.P., J.P.Z., A. Canosa, U.M., R.V., M.G., F.P., M. Brunetti, C.M., A. Calvo, A. Chiò), University of Torino; Medical Genetic Unit (M. Barberis, L.S.) and Neurology 1 (A. Canosa, M. Brunetti, C.M., A. Calvo, A. Chiò), Azienda Ospedaliero-Universitaria Città della Salute e della Scienza of Torino, Turin; and Institute of Cognitive Sciences and Technologies (A. Chiò), National Research Council, Rome, Italy
| | - Jean Pierre Zucchetti
- From the ALS Center, 'Rita Levi Montalcini' Department of Neuroscience (B.I., L.P., J.P.Z., A. Canosa, U.M., R.V., M.G., F.P., M. Brunetti, C.M., A. Calvo, A. Chiò), University of Torino; Medical Genetic Unit (M. Barberis, L.S.) and Neurology 1 (A. Canosa, M. Brunetti, C.M., A. Calvo, A. Chiò), Azienda Ospedaliero-Universitaria Città della Salute e della Scienza of Torino, Turin; and Institute of Cognitive Sciences and Technologies (A. Chiò), National Research Council, Rome, Italy
| | - Antonio Canosa
- From the ALS Center, 'Rita Levi Montalcini' Department of Neuroscience (B.I., L.P., J.P.Z., A. Canosa, U.M., R.V., M.G., F.P., M. Brunetti, C.M., A. Calvo, A. Chiò), University of Torino; Medical Genetic Unit (M. Barberis, L.S.) and Neurology 1 (A. Canosa, M. Brunetti, C.M., A. Calvo, A. Chiò), Azienda Ospedaliero-Universitaria Città della Salute e della Scienza of Torino, Turin; and Institute of Cognitive Sciences and Technologies (A. Chiò), National Research Council, Rome, Italy
| | - Umberto Manera
- From the ALS Center, 'Rita Levi Montalcini' Department of Neuroscience (B.I., L.P., J.P.Z., A. Canosa, U.M., R.V., M.G., F.P., M. Brunetti, C.M., A. Calvo, A. Chiò), University of Torino; Medical Genetic Unit (M. Barberis, L.S.) and Neurology 1 (A. Canosa, M. Brunetti, C.M., A. Calvo, A. Chiò), Azienda Ospedaliero-Universitaria Città della Salute e della Scienza of Torino, Turin; and Institute of Cognitive Sciences and Technologies (A. Chiò), National Research Council, Rome, Italy
| | - Rosario Vasta
- From the ALS Center, 'Rita Levi Montalcini' Department of Neuroscience (B.I., L.P., J.P.Z., A. Canosa, U.M., R.V., M.G., F.P., M. Brunetti, C.M., A. Calvo, A. Chiò), University of Torino; Medical Genetic Unit (M. Barberis, L.S.) and Neurology 1 (A. Canosa, M. Brunetti, C.M., A. Calvo, A. Chiò), Azienda Ospedaliero-Universitaria Città della Salute e della Scienza of Torino, Turin; and Institute of Cognitive Sciences and Technologies (A. Chiò), National Research Council, Rome, Italy
| | - Maurizio Grassano
- From the ALS Center, 'Rita Levi Montalcini' Department of Neuroscience (B.I., L.P., J.P.Z., A. Canosa, U.M., R.V., M.G., F.P., M. Brunetti, C.M., A. Calvo, A. Chiò), University of Torino; Medical Genetic Unit (M. Barberis, L.S.) and Neurology 1 (A. Canosa, M. Brunetti, C.M., A. Calvo, A. Chiò), Azienda Ospedaliero-Universitaria Città della Salute e della Scienza of Torino, Turin; and Institute of Cognitive Sciences and Technologies (A. Chiò), National Research Council, Rome, Italy
| | - Francesca Palumbo
- From the ALS Center, 'Rita Levi Montalcini' Department of Neuroscience (B.I., L.P., J.P.Z., A. Canosa, U.M., R.V., M.G., F.P., M. Brunetti, C.M., A. Calvo, A. Chiò), University of Torino; Medical Genetic Unit (M. Barberis, L.S.) and Neurology 1 (A. Canosa, M. Brunetti, C.M., A. Calvo, A. Chiò), Azienda Ospedaliero-Universitaria Città della Salute e della Scienza of Torino, Turin; and Institute of Cognitive Sciences and Technologies (A. Chiò), National Research Council, Rome, Italy
| | - Maura Brunetti
- From the ALS Center, 'Rita Levi Montalcini' Department of Neuroscience (B.I., L.P., J.P.Z., A. Canosa, U.M., R.V., M.G., F.P., M. Brunetti, C.M., A. Calvo, A. Chiò), University of Torino; Medical Genetic Unit (M. Barberis, L.S.) and Neurology 1 (A. Canosa, M. Brunetti, C.M., A. Calvo, A. Chiò), Azienda Ospedaliero-Universitaria Città della Salute e della Scienza of Torino, Turin; and Institute of Cognitive Sciences and Technologies (A. Chiò), National Research Council, Rome, Italy
| | - Marco Barberis
- From the ALS Center, 'Rita Levi Montalcini' Department of Neuroscience (B.I., L.P., J.P.Z., A. Canosa, U.M., R.V., M.G., F.P., M. Brunetti, C.M., A. Calvo, A. Chiò), University of Torino; Medical Genetic Unit (M. Barberis, L.S.) and Neurology 1 (A. Canosa, M. Brunetti, C.M., A. Calvo, A. Chiò), Azienda Ospedaliero-Universitaria Città della Salute e della Scienza of Torino, Turin; and Institute of Cognitive Sciences and Technologies (A. Chiò), National Research Council, Rome, Italy
| | - Luca Sbaiz
- From the ALS Center, 'Rita Levi Montalcini' Department of Neuroscience (B.I., L.P., J.P.Z., A. Canosa, U.M., R.V., M.G., F.P., M. Brunetti, C.M., A. Calvo, A. Chiò), University of Torino; Medical Genetic Unit (M. Barberis, L.S.) and Neurology 1 (A. Canosa, M. Brunetti, C.M., A. Calvo, A. Chiò), Azienda Ospedaliero-Universitaria Città della Salute e della Scienza of Torino, Turin; and Institute of Cognitive Sciences and Technologies (A. Chiò), National Research Council, Rome, Italy
| | - Cristina Moglia
- From the ALS Center, 'Rita Levi Montalcini' Department of Neuroscience (B.I., L.P., J.P.Z., A. Canosa, U.M., R.V., M.G., F.P., M. Brunetti, C.M., A. Calvo, A. Chiò), University of Torino; Medical Genetic Unit (M. Barberis, L.S.) and Neurology 1 (A. Canosa, M. Brunetti, C.M., A. Calvo, A. Chiò), Azienda Ospedaliero-Universitaria Città della Salute e della Scienza of Torino, Turin; and Institute of Cognitive Sciences and Technologies (A. Chiò), National Research Council, Rome, Italy
| | - Andrea Calvo
- From the ALS Center, 'Rita Levi Montalcini' Department of Neuroscience (B.I., L.P., J.P.Z., A. Canosa, U.M., R.V., M.G., F.P., M. Brunetti, C.M., A. Calvo, A. Chiò), University of Torino; Medical Genetic Unit (M. Barberis, L.S.) and Neurology 1 (A. Canosa, M. Brunetti, C.M., A. Calvo, A. Chiò), Azienda Ospedaliero-Universitaria Città della Salute e della Scienza of Torino, Turin; and Institute of Cognitive Sciences and Technologies (A. Chiò), National Research Council, Rome, Italy
| | - Adriano Chiò
- From the ALS Center, 'Rita Levi Montalcini' Department of Neuroscience (B.I., L.P., J.P.Z., A. Canosa, U.M., R.V., M.G., F.P., M. Brunetti, C.M., A. Calvo, A. Chiò), University of Torino; Medical Genetic Unit (M. Barberis, L.S.) and Neurology 1 (A. Canosa, M. Brunetti, C.M., A. Calvo, A. Chiò), Azienda Ospedaliero-Universitaria Città della Salute e della Scienza of Torino, Turin; and Institute of Cognitive Sciences and Technologies (A. Chiò), National Research Council, Rome, Italy.
| |
Collapse
|
39
|
Martier R, Konstantinova P. Gene Therapy for Neurodegenerative Diseases: Slowing Down the Ticking Clock. Front Neurosci 2020; 14:580179. [PMID: 33071748 PMCID: PMC7530328 DOI: 10.3389/fnins.2020.580179] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2020] [Accepted: 08/31/2020] [Indexed: 12/13/2022] Open
Abstract
Gene therapy is an emerging and powerful therapeutic tool to deliver functional genetic material to cells in order to correct a defective gene. During the past decades, several studies have demonstrated the potential of AAV-based gene therapies for the treatment of neurodegenerative diseases. While some clinical studies have failed to demonstrate therapeutic efficacy, the use of AAV as a delivery tool has demonstrated to be safe. Here, we discuss the past, current and future perspectives of gene therapies for neurodegenerative diseases. We also discuss the current advances on the newly emerging RNAi-based gene therapies which has been widely studied in preclinical model and recently also made it to the clinic.
Collapse
Affiliation(s)
- Raygene Martier
- Department of Research and Development, uniQure Biopharma B.V., Amsterdam, Netherlands
| | - Pavlina Konstantinova
- Department of Research and Development, uniQure Biopharma B.V., Amsterdam, Netherlands
| |
Collapse
|
40
|
Johansen M, Svenstrup K, Mortensen Ó, Andorsdóttir G, Á Steig B, Joensen P, Hansen T, Petersen MS. Amyotrophic lateral sclerosis in the Faroe Islands - a genealogical study. Amyotroph Lateral Scler Frontotemporal Degener 2020; 22:571-575. [PMID: 32885668 DOI: 10.1080/21678421.2020.1813311] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
In the Faroe Islands, a clustering of amyotrophic lateral sclerosis (ALS) was observed on the geographically isolated island, Suðuroy. This study aims to estimate the frequency of familial ALS (fALS) in the Faroes including 43 patients diagnosed with ALS. Patients with fALS were identified through medical records and the Faroese Multi Generation Register. Firstly, fALS was recognized when occurring between first- or second-degree relatives. Secondly, families and individuals with fALS were recognized through pedigrees (≥3 cases within 3 generations). The prevalence of ALS was 3 times higher in Suðuroy compared to the nationwide prevalence. The frequency of fALS was at least 14% (n = 6) and mean survival time was 1.7 years shorter for fALS compared to sporatic ALS (p = 0.01. SD = 0.5, range 1.0-2.2). This study is suggestive of familial clustering in excess of expected for ALS and supports a genetic contribution to ALS in the Faroe Islands albeit environmental exposure within families cannot be excluded.
Collapse
Affiliation(s)
- Malan Johansen
- Department of Occupational Medicine and Public Health, the Faroese Hospital System, Tórshavn, Faroe Islands
| | - Kirsten Svenstrup
- Neurological Department, University Hospital Copenhagen, Rigshospitalet and Bispebjerg Hospital, Copenhagen, Denmark
| | - Ólavur Mortensen
- The Genetic Biobank of the Faroe Islands, Torshavn, Faroe Islands
| | | | - Bjarni Á Steig
- General Medical Department, National Hospital of the Faroe Islands, Tórshavn, Faroe Islands
| | - Poul Joensen
- Department of Medicine and Neurophysiological Laboratory, National Hospital of the Faroe Islands, Tórshavn, Faroe Islands
| | - Torben Hansen
- The Novo Nordisk Foundation Center for Basic Metabolic Research, Section of Metabolic Genetics, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Maria Skaalum Petersen
- Department of Occupational Medicine and Public Health, the Faroese Hospital System, Tórshavn, Faroe Islands
| |
Collapse
|
41
|
Hao Z, Wang R, Ren H, Wang G. Role of the C9ORF72 Gene in the Pathogenesis of Amyotrophic Lateral Sclerosis and Frontotemporal Dementia. Neurosci Bull 2020; 36:1057-1070. [PMID: 32860626 DOI: 10.1007/s12264-020-00567-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2020] [Accepted: 04/30/2020] [Indexed: 12/12/2022] Open
Abstract
Since the discovery of the C9ORF72 gene in 2011, great advances have been achieved in its genetics and in identifying its role in disease models and pathological mechanisms; it is the most common genetic cause of amyotrophic lateral sclerosis (ALS) and frontotemporal dementia (FTD). ALS patients with C9ORF72 expansion show heterogeneous symptoms. Those who are C9ORF72 expansion carriers have shorter survival after disease onset than non-C9ORF72 expansion patients. Pathological and clinical features of C9ORF72 patients have been well mimicked via several models, including induced pluripotent stem cell-derived neurons and transgenic mice that were embedded with bacterial artificial chromosome construct and that overexpressing dipeptide repeat proteins. The mechanisms implicated in C9ORF72 pathology include DNA damage, changes of RNA metabolism, alteration of phase separation, and impairment of nucleocytoplasmic transport, which may underlie C9ORF72 expansion-related ALS/FTD and provide insight into non-C9ORF72 expansion-related ALS, FTD, and other neurodegenerative diseases.
Collapse
Affiliation(s)
- Zongbing Hao
- Laboratory of Molecular Neuropathology, Jiangsu Key Laboratory of Neuropsychiatric Diseases and Department of Pharmacology, College of Pharmaceutical Sciences, Soochow University, Suzhou, 215123, China
| | - Rui Wang
- Laboratory of Molecular Neuropathology, Jiangsu Key Laboratory of Neuropsychiatric Diseases and Department of Pharmacology, College of Pharmaceutical Sciences, Soochow University, Suzhou, 215123, China
| | - Haigang Ren
- Laboratory of Molecular Neuropathology, Jiangsu Key Laboratory of Neuropsychiatric Diseases and Department of Pharmacology, College of Pharmaceutical Sciences, Soochow University, Suzhou, 215123, China
| | - Guanghui Wang
- Laboratory of Molecular Neuropathology, Jiangsu Key Laboratory of Neuropsychiatric Diseases and Department of Pharmacology, College of Pharmaceutical Sciences, Soochow University, Suzhou, 215123, China.
| |
Collapse
|
42
|
Ungaro C, Sprovieri T, Morello G, Perrone B, Spampinato AG, Simone IL, Trojsi F, Monsurrò MR, Spataro R, La Bella V, Andò S, Cavallaro S, Conforti FL. Genetic investigation of amyotrophic lateral sclerosis patients in south Italy: a two-decade analysis. Neurobiol Aging 2020; 99:99.e7-99.e14. [PMID: 32951934 DOI: 10.1016/j.neurobiolaging.2020.08.017] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Revised: 07/21/2020] [Accepted: 08/22/2020] [Indexed: 10/23/2022]
Abstract
Amyotrophic lateral sclerosis (ALS) is a multifactorial disease characterized by the interplay of genetic and environmental factors. In the majority of cases, ALS is sporadic, whereas familial forms occur in less than 10% of patients. Herein, we present the results of molecular analyses performed in a large cohort of Italian ALS patients, focusing on novel and already described variations in ALS-linked genes. Our analysis revealed that more than 10% of tested patients carried a mutation in one of the major ALS genes, with C9orf72 hexanucleotide expansion being the most common mutation. In addition, our study confirmed a significant association between ALS patients carrying the ATNX-1 intermediate repeat and the pathological C9orf72 expansion, supporting the involvement of this risk factor in neuronal degeneration. Overall, our study broadens the known mutational spectrum in ALS and provides new insights for a more accurate view of the genetic pattern of the disease.
Collapse
Affiliation(s)
- Carmine Ungaro
- Department of Earth and Environment, Institute of Atmospheric Pollution (IIA), National Research Council (CNR), Rende (CS), Italy
| | - Teresa Sprovieri
- Department of Earth and Environment, Institute of Atmospheric Pollution (IIA), National Research Council (CNR), Rende (CS), Italy
| | - Giovanna Morello
- Department of Biomedical Science, Institute for Research and Biomedical Innovation (IRIB), National Research Council (CNR), Catania, Italy
| | - Benedetta Perrone
- Department of Pharmacy and Health and Nutritional Sciences, University of Calabria, Rende (CS), Italy
| | - Antonio Gianmaria Spampinato
- Department of Biomedical Science, Institute for Research and Biomedical Innovation (IRIB), National Research Council (CNR), Catania, Italy
| | - Isabella Laura Simone
- Department of Basic Medical Sciences, Neurosciences and Sense Organs, University of Bari, Bari, Italy
| | - Francesca Trojsi
- Department of Advanced Medical and Surgical Sciences, MRI Research Center SUN-FISM, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Maria Rosaria Monsurrò
- Department of Advanced Medical and Surgical Sciences, MRI Research Center SUN-FISM, University of Campania "Luigi Vanvitelli", Naples, Italy
| | | | - Vincenzo La Bella
- Department of Experimental Biomedicine and Clinical Neurosciences, ALS Clinical Research Center and Laboratory of Neurochemistry, University of Palermo, Palermo, Italy
| | - Sebastiano Andò
- Department of Pharmacy and Health and Nutritional Sciences, University of Calabria, Rende (CS), Italy; Centro Sanitario, Università della Calabria, Rende (CS), Italy
| | - Sebastiano Cavallaro
- Department of Biomedical Science, Institute for Research and Biomedical Innovation (IRIB), National Research Council (CNR), Catania, Italy
| | - Francesca Luisa Conforti
- Department of Pharmacy and Health and Nutritional Sciences, University of Calabria, Rende (CS), Italy.
| |
Collapse
|
43
|
Le Gall L, Anakor E, Connolly O, Vijayakumar UG, Duddy WJ, Duguez S. Molecular and Cellular Mechanisms Affected in ALS. J Pers Med 2020; 10:E101. [PMID: 32854276 PMCID: PMC7564998 DOI: 10.3390/jpm10030101] [Citation(s) in RCA: 69] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Revised: 08/17/2020] [Accepted: 08/22/2020] [Indexed: 12/11/2022] Open
Abstract
Amyotrophic lateral sclerosis (ALS) is a terminal late-onset condition characterized by the loss of upper and lower motor neurons. Mutations in more than 30 genes are associated to the disease, but these explain only ~20% of cases. The molecular functions of these genes implicate a wide range of cellular processes in ALS pathology, a cohesive understanding of which may provide clues to common molecular mechanisms across both familial (inherited) and sporadic cases and could be key to the development of effective therapeutic approaches. Here, the different pathways that have been investigated in ALS are summarized, discussing in detail: mitochondrial dysfunction, oxidative stress, axonal transport dysregulation, glutamate excitotoxicity, endosomal and vesicular transport impairment, impaired protein homeostasis, and aberrant RNA metabolism. This review considers the mechanistic roles of ALS-associated genes in pathology, viewed through the prism of shared molecular pathways.
Collapse
Affiliation(s)
- Laura Le Gall
- Northern Ireland Center for Stratified/Personalised Medicine, Biomedical Sciences Research Institute, Ulster University, Derry-Londonderry BT47, UK; (L.L.G.); (E.A.); (O.C.); (U.G.V.); (W.J.D.)
- NIHR Biomedical Research Centre, University College London, Great Ormond Street Institute of Child Health and Great Ormond Street Hospital NHS Trust, London WC1N 1EH, UK
| | - Ekene Anakor
- Northern Ireland Center for Stratified/Personalised Medicine, Biomedical Sciences Research Institute, Ulster University, Derry-Londonderry BT47, UK; (L.L.G.); (E.A.); (O.C.); (U.G.V.); (W.J.D.)
| | - Owen Connolly
- Northern Ireland Center for Stratified/Personalised Medicine, Biomedical Sciences Research Institute, Ulster University, Derry-Londonderry BT47, UK; (L.L.G.); (E.A.); (O.C.); (U.G.V.); (W.J.D.)
| | - Udaya Geetha Vijayakumar
- Northern Ireland Center for Stratified/Personalised Medicine, Biomedical Sciences Research Institute, Ulster University, Derry-Londonderry BT47, UK; (L.L.G.); (E.A.); (O.C.); (U.G.V.); (W.J.D.)
| | - William J. Duddy
- Northern Ireland Center for Stratified/Personalised Medicine, Biomedical Sciences Research Institute, Ulster University, Derry-Londonderry BT47, UK; (L.L.G.); (E.A.); (O.C.); (U.G.V.); (W.J.D.)
| | - Stephanie Duguez
- Northern Ireland Center for Stratified/Personalised Medicine, Biomedical Sciences Research Institute, Ulster University, Derry-Londonderry BT47, UK; (L.L.G.); (E.A.); (O.C.); (U.G.V.); (W.J.D.)
| |
Collapse
|
44
|
Roggenbuck J, Fong JC. Genetic Testing for Amyotrophic Lateral Sclerosis and Frontotemporal Dementia: Impact on Clinical Management. Clin Lab Med 2020; 40:271-287. [PMID: 32718499 DOI: 10.1016/j.cll.2020.05.002] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Amyotrophic lateral sclerosis (ALS) and frontotemporal dementia (FTD) are devastating neurodegenerative disorders that share clinical, pathologic, and genetic features. Persons and families affected by these conditions frequently question why they developed the disease, the expected disease course, treatment options, and the likelihood that family members will be affected. Genetic testing has the potential to answers these important questions. Despite the progress in gene discovery, the offer of genetic testing is not yet "standard of care" in ALS and FTD clinics. The authors review the current genetic landscape and present recommendations for the laboratory genetic evaluation of persons with these conditions.
Collapse
Affiliation(s)
- Jennifer Roggenbuck
- Division of Human Genetics, Department of Neurology, The Ohio State University, 2012 Kenny Road, Columbus, OH 43221, USA.
| | - Jamie C Fong
- Department of Molecular and Human Genetics, Baylor College of Medicine, One Baylor Plaza, MS: BCM115, Houston, TX 77030, USA
| |
Collapse
|
45
|
A Systematic Review of Genotype-Phenotype Correlation across Cohorts Having Causal Mutations of Different Genes in ALS. J Pers Med 2020; 10:jpm10030058. [PMID: 32610599 PMCID: PMC7564886 DOI: 10.3390/jpm10030058] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2020] [Revised: 06/09/2020] [Accepted: 06/15/2020] [Indexed: 12/13/2022] Open
Abstract
Amyotrophic lateral sclerosis is a rare and fatal neurodegenerative disease characterised by progressive deterioration of upper and lower motor neurons that eventually culminates in severe muscle atrophy, respiratory failure and death. There is a concerning lack of understanding regarding the mechanisms that lead to the onset of ALS and as a result there are no reliable biomarkers that aid in the early detection of the disease nor is there an effective treatment. This review first considers the clinical phenotypes associated with ALS, and discusses the broad categorisation of ALS and ALS-mimic diseases into upper and lower motor neuron diseases, before focusing on the genetic aetiology of ALS and considering the potential relationship of mutations of different genes to variations in phenotype. For this purpose, a systematic review is conducted collating data from 107 original published clinical studies on monogenic forms of the disease, surveying the age and site of onset, disease duration and motor neuron involvement. The collected data highlight the complexity of the disease's genotype-phenotype relationship, and thus the need for a nuanced approach to the development of clinical assays and therapeutics.
Collapse
|
46
|
Trojsi F, D’Alvano G, Bonavita S, Tedeschi G. Genetics and Sex in the Pathogenesis of Amyotrophic Lateral Sclerosis (ALS): Is There a Link? Int J Mol Sci 2020; 21:ijms21103647. [PMID: 32455692 PMCID: PMC7279172 DOI: 10.3390/ijms21103647] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Revised: 05/17/2020] [Accepted: 05/18/2020] [Indexed: 12/11/2022] Open
Abstract
Amyotrophic lateral sclerosis (ALS) is a fatal neurodegenerative disease with no known cure. Approximately 90% of ALS cases are sporadic, although multiple genetic risk factors have been recently revealed also in sporadic ALS (SALS). The pathological expansion of a hexanucleotide repeat in chromosome 9 open reading frame 72 (C9orf72) is the most common genetic mutation identified in familial ALS, detected also in 5–10% of SALS patients. C9orf72-related ALS phenotype appears to be dependent on several modifiers, including demographic factors. Sex has been reported as an independent factor influencing ALS development, with men found to be more susceptible than women. Exposure to both female and male sex hormones have been shown to influence disease risk or progression. Moreover, interplay between genetics and sex has been widely investigated in ALS preclinical models and in large populations of ALS patients carrying C9orf72 repeat expansion. In light of the current need for reclassifying ALS patients into pathologically homogenous subgroups potentially responsive to targeted personalized therapies, we aimed to review the recent literature on the role of genetics and sex as both independent and synergic factors, in the pathophysiology, clinical presentation, and prognosis of ALS. Sex-dependent outcomes may lead to optimizing clinical trials for developing patient-specific therapies for ALS.
Collapse
|
47
|
Esselin F, Mouzat K, Polge A, Juntas-Morales R, Pageot N, De la Cruz E, Bernard E, Lagrange E, Danel V, Alphandery S, Labar L, Nogué E, Picot MC, Lumbroso S, Camu W. Clinical Phenotype and Inheritance in Patients With C9ORF72 Hexanucleotide Repeat Expansion: Results From a Large French Cohort. Front Neurosci 2020; 14:316. [PMID: 32410933 PMCID: PMC7199526 DOI: 10.3389/fnins.2020.00316] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2020] [Accepted: 03/17/2020] [Indexed: 12/12/2022] Open
Abstract
Background In familial amyotrophic lateral sclerosis (ALS) cases, the presence of an abnormal C9ORF72 repeat expansion (C9RE) is the most frequent genetic cause identified. Various clinical phenotypes have been described in relation to the presence of C9RE, including psychiatric disorders or Huntington-like symptoms. In a subset of sporadic ALS, C9RE has also been described. In the present study, all index cases with ALS and C9RE identified in our center and their clinical profile, as well as neurological and psychiatric characteristics of identified family members, were described. Clinical characteristics of ALS patients were compared to 999 patients with sporadic ALS (SALS) from our database. Results From the 70 index cases with ALS identified, a total of 200 individuals were studied, 118 with ALS, 32 with fronto-temporal lobe degeneration (FTD), 37 with ALS/FTD, and 13 with psychiatric disorders. A familial history was present in 57 of the index cases (81%). In ALS and ALS/FTD cases with C9RE, the age of onset (AoO) was earlier than that in SALS cases, p < 0.0001 and p = 0.008, respectively. Sporadic cases with C9REALS (n = 13) had an earlier AoO compared to familial C9REALS ones, p < 0.0001. Within families, there was an earlier AoO in index cases and their siblings compared to their parental generation (p < 0.01). There was also a significant intrafamilial correlation for bulbar onset of ALS. The parental generation had significant female predominance compared to index cases and their siblings (sex ratio 0.47 vs. 1.4, p = 0.004), and this predominance was also present when considering parent–child pairs. In the group with psychiatric disorders, suicide was prominent (n = 9) and mean age was 54 years. Conclusion Although our sample size is rather limited, the earlier AoO in index cases and their siblings compared to the parental generation may suggest an anticipation. Reasons for predominance of female transmission are unclear, but the hypothesis that gender influences transmission of the genetic trait or C9RE size variation may be taken into account. Intrafamilial correlation suggests that genetic aspects underlie the occurrence of bulbar onset in ALS patients. Studies on larger samples are warranted to confirm those results.
Collapse
Affiliation(s)
- Florence Esselin
- Centre de référence SLA, CHU Gui de Chauliac, Montpellier, France
| | - Kevin Mouzat
- Laboratoire de Biochimie et Biologie Moléculaire, CHU Nimes, Univ. Montpellier, Nimes, France
| | - Anne Polge
- Laboratoire de Biochimie et Biologie Moléculaire, CHU Nimes, Univ. Montpellier, Nimes, France
| | | | - Nicolas Pageot
- Centre de référence SLA, CHU Gui de Chauliac, Montpellier, France
| | - Elisa De la Cruz
- Centre de référence SLA, CHU Gui de Chauliac, Montpellier, France
| | - Emilien Bernard
- Département de Neurologie, Centre SLA, CHU Wertheimer, Lyon, France
| | | | | | | | - Laura Labar
- Centre de référence SLA, CHU Gui de Chauliac, Montpellier, France
| | - Erika Nogué
- CHU Montpellier, Unité de Recherche Clinique et Epidémiologie (Département Information Médicale), INSERM, Montpellier, France
| | - Marie-Christine Picot
- CHU Montpellier, Unité de Recherche Clinique et Epidémiologie (Département Information Médicale), INSERM, Centre d'Investigation Clinique 1411, Univ Montpellier, Montpellier, France
| | - Serge Lumbroso
- Laboratoire de Biochimie et Biologie Moléculaire, CHU Nimes, Univ. Montpellier, Nimes, France
| | - William Camu
- Centre de référence SLA, CHU Gui de Chauliac, Montpellier, France
| |
Collapse
|
48
|
Falzone YM, Domi T, Agosta F, Pozzi L, Schito P, Fazio R, Del Carro U, Barbieri A, Comola M, Leocani L, Comi G, Carrera P, Filippi M, Quattrini A, Riva N. Serum phosphorylated neurofilament heavy-chain levels reflect phenotypic heterogeneity and are an independent predictor of survival in motor neuron disease. J Neurol 2020; 267:2272-2280. [PMID: 32306171 PMCID: PMC7166001 DOI: 10.1007/s00415-020-09838-9] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2020] [Revised: 04/10/2020] [Accepted: 04/13/2020] [Indexed: 12/11/2022]
Abstract
To investigate the prognostic role and the major determinants of serum phosphorylated neurofilament heavy -chain (pNfH) concentration across a large cohort of motor neuron disease (MND) phenotypes. Enzyme-linked immunosorbent assay (ELISA) was used to measure serum pNfH concentration in 219 MND patients consecutively enrolled in our tertiary MND clinic. A multifactorial analysis was carried out to investigate the major clinical determinants of serum pNfH. Kaplan–Meier survival curves and Cox regression analysis were performed to explore the prognostic value of serum pNfH. Serum pNfH levels were not homogenous among MND phenotypes; higher concentrations in pyramidal, bulbar, and classic phenotypes were observed. C9orf72-MND exhibited higher pNfH concentrations compared to non-C9orf72 MND. Multiple linear regression analysis revealed mean MEP/cMAP and disease progression rate as the two major predictors of serum pNfH levels (R2 = 0.188; p ≤ 0.001). Kaplan–Meier curves showed a significant difference of survival among MND subgroups when divided into quartiles based on pNfH concentrations, log-rank X2 = 53.0, p ≤ 0.0001. Our study evidenced that higher serum pNfH concentration is a negative independent prognostic factor for survival. In Cox multivariate model, pNfH concentration showed the highest hazard ratio compared to the other factors influencing survival included in the analysis. pNfH differs among the MND phenotypes and is an independent prognostic factor for survival. This study provides supporting evidence of the role of pNfH as useful prognostic biomarker for MND patients. Neurofilament measurements should be considered in the future prognostic models and in clinical trials for biomarker-based stratification, and to evaluate treatment response.
Collapse
Affiliation(s)
- Yuri Matteo Falzone
- Division of Neuroscience, Neuropathology Unit, San Raffaele Scientific Institute, via Olgettina 48, 20132, Milan, Italy
- Institute of Experimental Neurology (INSPE), San Raffaele Scientific Institute, Milan, Italy
| | - Teuta Domi
- Division of Neuroscience, Neuropathology Unit, San Raffaele Scientific Institute, via Olgettina 48, 20132, Milan, Italy
- Institute of Experimental Neurology (INSPE), San Raffaele Scientific Institute, Milan, Italy
| | - Federica Agosta
- Vita-Salute San Raffaele University, Milan, Italy
- Division of Neuroscience, Neuroimaging Research Unit, San Raffaele Scientific Institute, Milan, Italy
| | - Laura Pozzi
- Division of Neuroscience, Neuropathology Unit, San Raffaele Scientific Institute, via Olgettina 48, 20132, Milan, Italy
- Institute of Experimental Neurology (INSPE), San Raffaele Scientific Institute, Milan, Italy
| | - Paride Schito
- Division of Neuroscience, Neuropathology Unit, San Raffaele Scientific Institute, via Olgettina 48, 20132, Milan, Italy
- Institute of Experimental Neurology (INSPE), San Raffaele Scientific Institute, Milan, Italy
| | - Raffaella Fazio
- Neurology Unit, San Raffaele Scientific Institute, Milan, Italy
| | - Ubaldo Del Carro
- Neurophysiology Unit, San Raffaele Scientific Institute, Milan, Italy
| | - Alessandra Barbieri
- Neurology Unit, San Raffaele Scientific Institute, Milan, Italy
- Neurorehabilitation Unit, San Raffaele Scientific Institute, Milan, Italy
| | - Mauro Comola
- Neurorehabilitation Unit, San Raffaele Scientific Institute, Milan, Italy
| | - Letizia Leocani
- Vita-Salute San Raffaele University, Milan, Italy
- Neurorehabilitation Unit, San Raffaele Scientific Institute, Milan, Italy
| | - Giancarlo Comi
- Institute of Experimental Neurology (INSPE), San Raffaele Scientific Institute, Milan, Italy
| | - Paola Carrera
- Division of Genetics and Cell Biology, Unit of Genomics for Human Disease Diagnosis, San Raffaele Scientific Institute, Milan, Italy
| | - Massimo Filippi
- Institute of Experimental Neurology (INSPE), San Raffaele Scientific Institute, Milan, Italy
- Vita-Salute San Raffaele University, Milan, Italy
- Division of Neuroscience, Neuroimaging Research Unit, San Raffaele Scientific Institute, Milan, Italy
- Neurology Unit, San Raffaele Scientific Institute, Milan, Italy
- Neurophysiology Unit, San Raffaele Scientific Institute, Milan, Italy
| | - Angelo Quattrini
- Division of Neuroscience, Neuropathology Unit, San Raffaele Scientific Institute, via Olgettina 48, 20132, Milan, Italy
- Institute of Experimental Neurology (INSPE), San Raffaele Scientific Institute, Milan, Italy
| | - Nilo Riva
- Division of Neuroscience, Neuropathology Unit, San Raffaele Scientific Institute, via Olgettina 48, 20132, Milan, Italy.
- Institute of Experimental Neurology (INSPE), San Raffaele Scientific Institute, Milan, Italy.
- Neurology Unit, San Raffaele Scientific Institute, Milan, Italy.
- Neurorehabilitation Unit, San Raffaele Scientific Institute, Milan, Italy.
| |
Collapse
|
49
|
Manera U, Calvo A, Daviddi M, Canosa A, Vasta R, Torrieri MC, Grassano M, Brunetti M, D'Alfonso S, Corrado L, De Marchi F, Moglia C, D'Ovidio F, Mora G, Mazzini L, Chiò A. Regional spreading of symptoms at diagnosis as a prognostic marker in amyotrophic lateral sclerosis: a population-based study. J Neurol Neurosurg Psychiatry 2020; 91:291-297. [PMID: 31871138 DOI: 10.1136/jnnp-2019-321153] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2019] [Revised: 10/03/2019] [Accepted: 12/04/2019] [Indexed: 12/22/2022]
Abstract
OBJECTIVE The lack of prognostic biomarkers in patients with amyotrophic lateral sclerosis (ALS) induced researchers to develop clinical evaluation tools for stratification and survival prediction. We assessed the correlation between patterns of functional involvement, considered as a cumulative number of body regions involved, and overall survival in a population-based series of patients with ALS (PARALS). METHODS We derived the functional involvement of four body regions at diagnosis using ALSFRS-R subscores for bulbar, upper limbs, lower limbs and respiratory/thoracic regions. We analysed the effect of number of body regions involved (NBRI) at diagnosis on overall survival, adjusting for age at onset, sex, site of onset, diagnostic delay, forced vital capacity, body mass index, mutational status, cognition and comparing it with King's staging system. RESULTS The NBRI was strongly related to survival, with a progressive increase of death/tracheostomy risk among groups (two body regions HR=1.24, 95% CI 1.06 to 1.45, p=0007; three body regions HR=1.65, 95% CI 1.38 to 1.98, p<0.001; four body regions HR=2.68, 95% CI 2.11 to 3.39, p<0.001). Using ALSFRS-R score, the consistency between the number of regions involved and King's clinical stage at diagnosis was very high (81%). The evaluation of respiratory/thoracic region and cognition allowed to subdivide patients into different prognostic categories. Regional spreading of the disease is associated with survival, independently from the initial region involved. CONCLUSIONS The evaluation of NBRI, with the inclusion of initial respiratory/thoracic involvement and cognition, can be useful in many research fields, improving the stratification of patients. Our findings highlight the importance of the spatial spreading of functional impairment in the prediction of ALS outcome.
Collapse
Affiliation(s)
- Umberto Manera
- Department of Neuroscience 'Rita Levi Montalcini', ALS Centre, University of Turin, Torino, Piemonte, Italy
| | - Andrea Calvo
- Department of Neuroscience 'Rita Levi Montalcini', ALS Centre, University of Turin, Torino, Piemonte, Italy
| | - Margherita Daviddi
- Department of Neuroscience 'Rita Levi Montalcini', ALS Centre, University of Turin, Torino, Piemonte, Italy
| | - Antonio Canosa
- Department of Neuroscience 'Rita Levi Montalcini', ALS Centre, University of Turin, Torino, Piemonte, Italy
| | - Rosario Vasta
- Department of Neuroscience 'Rita Levi Montalcini', ALS Centre, University of Turin, Torino, Piemonte, Italy
| | - Maria Claudia Torrieri
- Department of Neuroscience 'Rita Levi Montalcini', ALS Centre, University of Turin, Torino, Piemonte, Italy
| | - Maurizio Grassano
- Department of Neuroscience 'Rita Levi Montalcini', ALS Centre, University of Turin, Torino, Piemonte, Italy
| | - Maura Brunetti
- Department of Neuroscience 'Rita Levi Montalcini', ALS Centre, University of Turin, Torino, Piemonte, Italy
| | - Sandra D'Alfonso
- Department of Health Sciences, Interdisciplinary Research Center of Autoimmune Diseases, University of Eastern Piedmont Amedeo Avogadro School of Medicine, Novara, Piemonte, Italy
| | - Lucia Corrado
- Department of Health Sciences, Interdisciplinary Research Center of Autoimmune Diseases, University of Eastern Piedmont Amedeo Avogadro School of Medicine, Novara, Piemonte, Italy
| | - Fabiola De Marchi
- Department of Neurology, ALS Centre, Azienda Ospedaliero-Universitaria Maggiore della Carita, Novara, Piemonte, Italy
| | - Cristina Moglia
- Department of Neuroscience 'Rita Levi Montalcini', ALS Centre, University of Turin, Torino, Piemonte, Italy
| | - Fabrizio D'Ovidio
- Department of Neuroscience 'Rita Levi Montalcini', ALS Centre, University of Turin, Torino, Piemonte, Italy
| | - Gabriele Mora
- ALS Centre, Fondazione Salvatore Maugeri Istituto di Ricovero e Cura a Carattere Scientifico, Milano, Lombardia, Italy
| | - Letizia Mazzini
- Department of Neurology, ALS Centre, Azienda Ospedaliero-Universitaria Maggiore della Carita, Novara, Piemonte, Italy
| | - Adriano Chiò
- Department of Neuroscience 'Rita Levi Montalcini', ALS Centre, University of Turin, Torino, Piemonte, Italy.,Neuroscience Institute of Torino (NIT), University of Torino, Torino, Piemonte, Italy
| |
Collapse
|
50
|
Roggenbuck J, Palettas M, Vicini L, Patel R, Quick A, Kolb SJ. Incidence of pathogenic, likely pathogenic, and uncertain ALS variants in a clinic cohort. NEUROLOGY-GENETICS 2020; 6:e390. [PMID: 32042918 PMCID: PMC6984133 DOI: 10.1212/nxg.0000000000000390] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/16/2019] [Accepted: 12/02/2019] [Indexed: 12/12/2022]
Abstract
Objective To determine the incidence of amyotrophic lateral sclerosis (ALS) genetic variants in a clinic-based population. Methods A prospective cohort of patients with definite or probable ALS was offered genetic testing using a testing algorithm based on family history and age at onset. Results The incidence of pathogenic (P) or likely pathogenic (LP) variants was 56.0% in familial ALS (fALS); 11.8% in patients with ALS with a family history of dementia, and 6.8% in sporadic ALS (p < 0.001). C9orf72 expansions accounted for the majority (79%) of P or LP variants in fALS cases. Variants of uncertain significance were identified in 20.0% of fALS cases overall and in 35.7% of C9orf72-negative cases. P or LP variants were detected in 18.5% of early-onset cases (onset age <50 years); the incidence of P or LP variants was not significantly different between family history types in this group. Conclusions Our data suggest that the incidence of P and LP variants in genes other than C9orf72 is lower than expected in Midwestern fALS cases compared with research cohorts and highlights the challenge of variant interpretation in ALS. An accurate understanding of the incidence of pathogenic variants in clinic-based ALS populations is necessary to prioritize targets for therapeutic intervention and inform clinical trial design.
Collapse
Affiliation(s)
- Jennifer Roggenbuck
- Department of Internal Medicine (J.R.) and Department of Neurology (J.R., A.Q., S.J.K.), The Ohio State University Wexner Medical Center; Department of Biomedical Informatics (M.P.), Center for Biostatistics, The Ohio State University Wexner Medical Center; College of Medicine (L.V., R.P.), The Ohio State University Wexner Medical Center; and Department of Biological Chemistry & Pharmacology (S.J.K.), The Ohio State University Wexner Medical Center, Columbus
| | - Marilly Palettas
- Department of Internal Medicine (J.R.) and Department of Neurology (J.R., A.Q., S.J.K.), The Ohio State University Wexner Medical Center; Department of Biomedical Informatics (M.P.), Center for Biostatistics, The Ohio State University Wexner Medical Center; College of Medicine (L.V., R.P.), The Ohio State University Wexner Medical Center; and Department of Biological Chemistry & Pharmacology (S.J.K.), The Ohio State University Wexner Medical Center, Columbus
| | - Leah Vicini
- Department of Internal Medicine (J.R.) and Department of Neurology (J.R., A.Q., S.J.K.), The Ohio State University Wexner Medical Center; Department of Biomedical Informatics (M.P.), Center for Biostatistics, The Ohio State University Wexner Medical Center; College of Medicine (L.V., R.P.), The Ohio State University Wexner Medical Center; and Department of Biological Chemistry & Pharmacology (S.J.K.), The Ohio State University Wexner Medical Center, Columbus
| | - Radha Patel
- Department of Internal Medicine (J.R.) and Department of Neurology (J.R., A.Q., S.J.K.), The Ohio State University Wexner Medical Center; Department of Biomedical Informatics (M.P.), Center for Biostatistics, The Ohio State University Wexner Medical Center; College of Medicine (L.V., R.P.), The Ohio State University Wexner Medical Center; and Department of Biological Chemistry & Pharmacology (S.J.K.), The Ohio State University Wexner Medical Center, Columbus
| | - Adam Quick
- Department of Internal Medicine (J.R.) and Department of Neurology (J.R., A.Q., S.J.K.), The Ohio State University Wexner Medical Center; Department of Biomedical Informatics (M.P.), Center for Biostatistics, The Ohio State University Wexner Medical Center; College of Medicine (L.V., R.P.), The Ohio State University Wexner Medical Center; and Department of Biological Chemistry & Pharmacology (S.J.K.), The Ohio State University Wexner Medical Center, Columbus
| | - Stephen J Kolb
- Department of Internal Medicine (J.R.) and Department of Neurology (J.R., A.Q., S.J.K.), The Ohio State University Wexner Medical Center; Department of Biomedical Informatics (M.P.), Center for Biostatistics, The Ohio State University Wexner Medical Center; College of Medicine (L.V., R.P.), The Ohio State University Wexner Medical Center; and Department of Biological Chemistry & Pharmacology (S.J.K.), The Ohio State University Wexner Medical Center, Columbus
| |
Collapse
|