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Platt N, Shepherd D, Smith DA, Smith C, Wallom KL, Luqmani R, Churchill GC, Galione A, Platt FM. Dysregulation of the NLRP3 Inflammasome and Promotion of Disease by IL-1β in a Murine Model of Sandhoff Disease. Cells 2025; 14:35. [PMID: 39791736 PMCID: PMC11720672 DOI: 10.3390/cells14010035] [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: 11/14/2024] [Revised: 12/12/2024] [Accepted: 12/19/2024] [Indexed: 01/12/2025] Open
Abstract
Sandhoff disease (SD) is a progressive neurodegenerative lysosomal storage disorder characterized by GM2 ganglioside accumulation as a result of mutations in the HEXB gene, which encodes the β-subunit of the enzyme β-hexosaminidase. Lysosomal storage of GM2 triggers inflammation in the CNS and periphery. The NLRP3 inflammasome is an important coordinator of pro-inflammatory responses, and we have investigated its regulation in murine SD. The NLRP3 inflammasome requires two signals, lipopolysaccharide (LPS) and ATP, to prime and activate the complex, respectively, leading to IL-1β secretion. Peritoneal, but not bone-marrow-derived, macrophages from symptomatic SD mice, but not those from pre-symptomatic animals, secrete the cytokine following priming with LPS with no requirement for activation with ATP, suggesting that such NLRP3 deregulation is related to the extent of glycosphingolipid storage. Dysregulated production of IL-1β was dependent upon caspase activity but not cathepsin B. We investigated the role of IL-1β in SD pathology using two approaches: the creation of hexb-/-Il1r1-/- double knockout mice or by treating hexb-/- animals with anakinra, a recombinant form of the IL-1 receptor antagonist, IL-1Ra. Both resulted in modest but significant extensions in lifespan and improvement of neurological function. These data demonstrate that IL-1β actively participates in the disease process and provides proof-of-principle that blockade of the pro-inflammatory cytokine IL-1β may provide benefits to patients.
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Affiliation(s)
- Nick Platt
- Department of Pharmacology, University of Oxford, Mansfield Road, Oxford OX1 3QT, UK; (N.P.); (D.S.); (D.A.S.); (C.S.); (K.-L.W.); (G.C.C.); (A.G.)
| | - Dawn Shepherd
- Department of Pharmacology, University of Oxford, Mansfield Road, Oxford OX1 3QT, UK; (N.P.); (D.S.); (D.A.S.); (C.S.); (K.-L.W.); (G.C.C.); (A.G.)
| | - David A. Smith
- Department of Pharmacology, University of Oxford, Mansfield Road, Oxford OX1 3QT, UK; (N.P.); (D.S.); (D.A.S.); (C.S.); (K.-L.W.); (G.C.C.); (A.G.)
| | - Claire Smith
- Department of Pharmacology, University of Oxford, Mansfield Road, Oxford OX1 3QT, UK; (N.P.); (D.S.); (D.A.S.); (C.S.); (K.-L.W.); (G.C.C.); (A.G.)
| | - Kerri-Lee Wallom
- Department of Pharmacology, University of Oxford, Mansfield Road, Oxford OX1 3QT, UK; (N.P.); (D.S.); (D.A.S.); (C.S.); (K.-L.W.); (G.C.C.); (A.G.)
| | - Raashid Luqmani
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Windmill Road, Oxford OX3 7LD, UK;
| | - Grant C. Churchill
- Department of Pharmacology, University of Oxford, Mansfield Road, Oxford OX1 3QT, UK; (N.P.); (D.S.); (D.A.S.); (C.S.); (K.-L.W.); (G.C.C.); (A.G.)
| | - Antony Galione
- Department of Pharmacology, University of Oxford, Mansfield Road, Oxford OX1 3QT, UK; (N.P.); (D.S.); (D.A.S.); (C.S.); (K.-L.W.); (G.C.C.); (A.G.)
| | - Frances M. Platt
- Department of Pharmacology, University of Oxford, Mansfield Road, Oxford OX1 3QT, UK; (N.P.); (D.S.); (D.A.S.); (C.S.); (K.-L.W.); (G.C.C.); (A.G.)
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Simonaro CM, Yasuda M, Schuchman EH. Endocannabinoid receptor 2 is a potential biomarker and therapeutic target for the lysosomal storage disorders. J Inherit Metab Dis 2025; 48:e12813. [PMID: 39569490 PMCID: PMC11670223 DOI: 10.1002/jimd.12813] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2024] [Revised: 10/24/2024] [Accepted: 10/30/2024] [Indexed: 11/22/2024]
Abstract
Herein, we studied the expression of endocannabinoid receptor 2 (CB2R), a known inflammation mediator, in several lysosomal storage disorder (LSD) animal models and evaluated it as a potential biomarker and therapeutic target for these diseases. CB2R was highly elevated in the plasma of Farber disease and mucopolysaccharidosis (MPS) type IIIA mice, followed by Fabry disease and MPS type I mice. Mice with acid sphingomyelinase-deficient Niemann-Pick disease (ASMD) and rats with MPS type VI exhibited little or no plasma CB2R elevation. High-level expression of CB2R was also observed in tissues of Farber and MPS IIIA mice. Treatment of MPS IIIIA patient cells with CB2R agonists led to a reduction of CB2R and monocyte chemoattractant protein-1 (MCP-1), a chemotactic factor that is elevated in this LSD. Treatment of MPS IIIA mice with one of these agonists (JWH133) led to a reduction of plasma and tissue CB2R and MCP-1, a reduction of glial fibrillary acidic protein (GFAP) in the brain, and an improvement in hanging test performance. JWH133 treatment of Farber disease mice also led to a reduction of MCP-1 in tissues and plasma, and treatment of these mice by enzyme replacement therapy (ERT) led to a reduction of plasma CB2R, indicating its potential to monitor treatment response. Overall, these findings suggest that CB2R should be further examined as a potential therapeutic target for the LSDs and may also be a useful biomarker to monitor the impact of therapies.
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Affiliation(s)
- Calogera M. Simonaro
- Department of Genetics & Genomic SciencesIcahn School of Medicine at Mount SinaiNew YorkNew YorkUSA
| | - Makiko Yasuda
- Department of Genetics & Genomic SciencesIcahn School of Medicine at Mount SinaiNew YorkNew YorkUSA
| | - Edward H. Schuchman
- Department of Genetics & Genomic SciencesIcahn School of Medicine at Mount SinaiNew YorkNew YorkUSA
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Lv Y, Ji L, Dai H, Qiu S, Wang Y, Teng C, Yu B, Mi D, Yao C. Identification of key regulatory genes involved in myelination after spinal cord injury by GSEA analysis. Exp Neurol 2024; 382:114966. [PMID: 39326824 DOI: 10.1016/j.expneurol.2024.114966] [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: 04/15/2024] [Revised: 08/31/2024] [Accepted: 09/21/2024] [Indexed: 09/28/2024]
Abstract
Multilayer dense myelin tissue provides insulating space and nutritional support for axons in healthy spinal cord tissue. Oligodendrocyte precursor cells (OPCs) are the main glial cells that complement myelin loss in the central nervous system and play an important role in the repair of spinal cord injury (SCI). However, the regulation of axonal remyelination after SCI is still insufficient. In this study, we focused on the changes in genes related to myelin repair after rat hemisection SCI by gene set enrichment analysis (GSEA). Key genes proteolipid protein 1 (Plp1), hexosaminidase subunit alpha (Hexa), and hexosaminidase subunit beta (Hexb) during remyelination after SCI were found. Through quantitative real-time polymerase chain reaction (qPCR) experiments, we confirmed that within 28 days after rat hemisection SCI, the mRNA expression of gene Plp1 gradually decreased, while the expressions of gene Hexa and Hexb gradually increased, which was consistent with RNA sequencing results. In vitro, we performed EdU proliferation assays on OPC cell line OLN-93 and primary rat OPCs. We found that interference of Plp1 promoted OPC proliferation, while interference of Hexa and Hexb inhibited OPC proliferation. In addition, we performed in vitro differentiation experiments on primary rat OPCs. By measuring myelin sheath branch outgrowth and the fluorescence intensity of the mature myelin sheath marker myelin basic protein (MBP), we found that interference of Hexa or Hexb promoted OPC differentiation and maturation, but interference of Plp1 inhibited this process. Finally, we injected Hexb siRNA in vivo and found that interfering Hexb could improve motor movements and myelin regeneration after SCI in rats. Our results provide new target genes that can selectively regulate the proliferation and differentiation of endogenous OPCs, providing new ideas for promoting remyelination and functional recovery after SCI.
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Affiliation(s)
- Yehua Lv
- Key Laboratory of Neuroregeneration of Jiangsu and Ministry of Education, Affiliated Traditional Chinese Medicine Hospital and Medical School, Co-Innovation Center of Neuroregeneration, Nantong University, Nantong 226001, Jiangsu, China
| | - Lingyun Ji
- Key Laboratory of Neuroregeneration of Jiangsu and Ministry of Education, Affiliated Traditional Chinese Medicine Hospital and Medical School, Co-Innovation Center of Neuroregeneration, Nantong University, Nantong 226001, Jiangsu, China
| | - Hui Dai
- Key Laboratory of Neuroregeneration of Jiangsu and Ministry of Education, Affiliated Traditional Chinese Medicine Hospital and Medical School, Co-Innovation Center of Neuroregeneration, Nantong University, Nantong 226001, Jiangsu, China
| | - Shanru Qiu
- Key Laboratory of Neuroregeneration of Jiangsu and Ministry of Education, Affiliated Traditional Chinese Medicine Hospital and Medical School, Co-Innovation Center of Neuroregeneration, Nantong University, Nantong 226001, Jiangsu, China
| | - Yu Wang
- Key Laboratory of Neuroregeneration of Jiangsu and Ministry of Education, Affiliated Traditional Chinese Medicine Hospital and Medical School, Co-Innovation Center of Neuroregeneration, Nantong University, Nantong 226001, Jiangsu, China
| | - Cheng Teng
- Key Laboratory of Neuroregeneration of Jiangsu and Ministry of Education, Affiliated Traditional Chinese Medicine Hospital and Medical School, Co-Innovation Center of Neuroregeneration, Nantong University, Nantong 226001, Jiangsu, China
| | - Bin Yu
- Key Laboratory of Neuroregeneration of Jiangsu and Ministry of Education, Affiliated Traditional Chinese Medicine Hospital and Medical School, Co-Innovation Center of Neuroregeneration, Nantong University, Nantong 226001, Jiangsu, China
| | - Daguo Mi
- Key Laboratory of Neuroregeneration of Jiangsu and Ministry of Education, Affiliated Traditional Chinese Medicine Hospital and Medical School, Co-Innovation Center of Neuroregeneration, Nantong University, Nantong 226001, Jiangsu, China.
| | - Chun Yao
- Key Laboratory of Neuroregeneration of Jiangsu and Ministry of Education, Affiliated Traditional Chinese Medicine Hospital and Medical School, Co-Innovation Center of Neuroregeneration, Nantong University, Nantong 226001, Jiangsu, China.
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Chen X, Cao Y, Ye K, Liu Y, Chi F, Niu Y, Lu D, Zhao B, Chen L, Zheng X, Feng W. Alkaloids with Their Protective Effects Against A β25-35-Induced PC-12 Cell Injury from the Tubers of Pinellia pedatisecta Schott. Molecules 2024; 29:5059. [PMID: 39519701 PMCID: PMC11547655 DOI: 10.3390/molecules29215059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2024] [Revised: 10/23/2024] [Accepted: 10/24/2024] [Indexed: 11/16/2024] Open
Abstract
Seven new alkaloids [1, (±)-2, (±)-3, 4, and 5] and one new natural product (6), along with eight known analogues, were isolated from the tubers of Pinellia pedatisecta Schott. Their structures were determined by a comprehensive analysis of spectroscopic data, including HRESIMS, and electronic circular dichroism (ECD). In addition, the results of the bioactivity evaluation showed that compounds (±)-3, 6, and 9 exhibited significantly protective effects against Aβ25-35-induced PC-12 cell injury and ameliorated cell viabilities by decreasing the levels of the reactive oxidative species (ROS) and mitochondrial membrane potential (MMP).
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Affiliation(s)
- Xu Chen
- School of Pharmacy, Henan University of Chinese Medicine, Zhengzhou 450046, China; (X.C.); (Y.C.); (K.Y.); (Y.L.); (F.C.); (Y.N.); (D.L.); (B.Z.); (L.C.); (X.Z.)
- The Engineering and Technology Center for Chinese Medicine Development of Henan Province China, Zhengzhou 450046, China
| | - Yangang Cao
- School of Pharmacy, Henan University of Chinese Medicine, Zhengzhou 450046, China; (X.C.); (Y.C.); (K.Y.); (Y.L.); (F.C.); (Y.N.); (D.L.); (B.Z.); (L.C.); (X.Z.)
- The Engineering and Technology Center for Chinese Medicine Development of Henan Province China, Zhengzhou 450046, China
| | - Kaili Ye
- School of Pharmacy, Henan University of Chinese Medicine, Zhengzhou 450046, China; (X.C.); (Y.C.); (K.Y.); (Y.L.); (F.C.); (Y.N.); (D.L.); (B.Z.); (L.C.); (X.Z.)
- The Engineering and Technology Center for Chinese Medicine Development of Henan Province China, Zhengzhou 450046, China
| | - Yanling Liu
- School of Pharmacy, Henan University of Chinese Medicine, Zhengzhou 450046, China; (X.C.); (Y.C.); (K.Y.); (Y.L.); (F.C.); (Y.N.); (D.L.); (B.Z.); (L.C.); (X.Z.)
- The Engineering and Technology Center for Chinese Medicine Development of Henan Province China, Zhengzhou 450046, China
| | - Fangge Chi
- School of Pharmacy, Henan University of Chinese Medicine, Zhengzhou 450046, China; (X.C.); (Y.C.); (K.Y.); (Y.L.); (F.C.); (Y.N.); (D.L.); (B.Z.); (L.C.); (X.Z.)
- The Engineering and Technology Center for Chinese Medicine Development of Henan Province China, Zhengzhou 450046, China
| | - Ying Niu
- School of Pharmacy, Henan University of Chinese Medicine, Zhengzhou 450046, China; (X.C.); (Y.C.); (K.Y.); (Y.L.); (F.C.); (Y.N.); (D.L.); (B.Z.); (L.C.); (X.Z.)
- The Engineering and Technology Center for Chinese Medicine Development of Henan Province China, Zhengzhou 450046, China
| | - Di Lu
- School of Pharmacy, Henan University of Chinese Medicine, Zhengzhou 450046, China; (X.C.); (Y.C.); (K.Y.); (Y.L.); (F.C.); (Y.N.); (D.L.); (B.Z.); (L.C.); (X.Z.)
- The Engineering and Technology Center for Chinese Medicine Development of Henan Province China, Zhengzhou 450046, China
| | - Bingxian Zhao
- School of Pharmacy, Henan University of Chinese Medicine, Zhengzhou 450046, China; (X.C.); (Y.C.); (K.Y.); (Y.L.); (F.C.); (Y.N.); (D.L.); (B.Z.); (L.C.); (X.Z.)
- The Engineering and Technology Center for Chinese Medicine Development of Henan Province China, Zhengzhou 450046, China
| | - Lan Chen
- School of Pharmacy, Henan University of Chinese Medicine, Zhengzhou 450046, China; (X.C.); (Y.C.); (K.Y.); (Y.L.); (F.C.); (Y.N.); (D.L.); (B.Z.); (L.C.); (X.Z.)
- The Engineering and Technology Center for Chinese Medicine Development of Henan Province China, Zhengzhou 450046, China
| | - Xiaoke Zheng
- School of Pharmacy, Henan University of Chinese Medicine, Zhengzhou 450046, China; (X.C.); (Y.C.); (K.Y.); (Y.L.); (F.C.); (Y.N.); (D.L.); (B.Z.); (L.C.); (X.Z.)
- The Engineering and Technology Center for Chinese Medicine Development of Henan Province China, Zhengzhou 450046, China
- Co-Construction Collaborative Innovation Center for Chinese Medicine and Respiratory Disease by Henan and Education Ministry of P.R. China, Zhengzhou 450046, China
| | - Weisheng Feng
- School of Pharmacy, Henan University of Chinese Medicine, Zhengzhou 450046, China; (X.C.); (Y.C.); (K.Y.); (Y.L.); (F.C.); (Y.N.); (D.L.); (B.Z.); (L.C.); (X.Z.)
- The Engineering and Technology Center for Chinese Medicine Development of Henan Province China, Zhengzhou 450046, China
- Co-Construction Collaborative Innovation Center for Chinese Medicine and Respiratory Disease by Henan and Education Ministry of P.R. China, Zhengzhou 450046, China
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5
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Park J, Bremova-Ertl T, Brands M, Foltan T, Gautschi M, Gissen P, Hahn A, Jones S, Arash-Kaps L, Kolnikova M, Patterson M, Perlman S, Ramaswami U, Reichmannová S, Rohrbach M, Schneider SA, Shaikh A, Sivananthan S, Synofzik M, Walterfarng M, Wibawa P, Martakis K, Manto M. Assessment of the reliability, responsiveness, and meaningfulness of the scale for the assessment and rating of ataxia (SARA) for lysosomal storage disorders. J Neurol 2024; 271:6888-6902. [PMID: 39225743 PMCID: PMC11447074 DOI: 10.1007/s00415-024-12664-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: 07/19/2024] [Revised: 08/18/2024] [Accepted: 08/23/2024] [Indexed: 09/04/2024]
Abstract
OBJECTIVE To evaluate the reliability, responsiveness, and validity of the Scale for the Assessment and Rating of Ataxia (SARA) in patients with lysosomal storage disorders (LSDs) who present with neurological symptoms, and quantify the threshold for a clinically meaningful change. METHODS We analyzed data from three clinical trial cohorts (IB1001-201, IB1001-202, and IB1001-301) of patients with Niemann-Pick disease type C (NPC) and GM2 Gangliosidoses (Tay-Sachs and Sandhoff disease) comprising 122 patients and 703 visits. Reproducibility was described as re-test reliability between repeat baseline visits or baseline and post-treatment washout visits. Responsiveness was determined in relation to the Investigator's, Caregiver's, and Patient's Clinical Global Impression of Improvement (CGI-I). The CGI-I data was also used to quantify a threshold for a clinically meaningful improvement on the SARA scale. Using a qualitative methods approach, patient/caregiver interviews from the IB1001-301 trial were further used to assess a threshold of meaningful change as well as the breadth of neurological signs and symptoms captured and evaluated by the SARA scale. RESULTS The Inter-Class Correlation (ICC) was 0.95 or greater for all three trials, indicating a high internal consistency/reliability. The mean change in SARA between repeat baseline and post-treatment washout visit assessments in all trials was -0.05, SD 1.98, i.e., minimal, indicating no significant differences, learning effects or other systematic biases. For the CGI-I responses and change in SARA scores, Area Under the Curve (AUC) values were 0.82, 0.71, and 0.77 for the Investigator's, Caregiver's, and Patient's CGI-I respectively, indicating strong agreement. Further qualitative analyses of the patient/caregiver interviews demonstrated a 1-point or greater change on SARA to be a clinically meaningful improvement which is directly relevant to the patient's everyday functioning and quality of life. Changes captured by the SARA were also paralleled by improvement in a broad range of neurological signs and symptoms and beyond cerebellar ataxia. CONCLUSION Qualitative and quantitative data demonstrate the reliability and responsiveness of the SARA score as a valid measure of neurological signs and symptoms in LSDs with CNS involvement, such as NPC and GM2 Gangliosidoses. A 1-point change represents a clinically meaningful transition reflecting the gain or loss of complex function.
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Affiliation(s)
- Julien Park
- Department of General Paediatrics, University of Münster, 48149, Münster, Germany.
| | - Tatiana Bremova-Ertl
- Department of Neurology, University Hospital Bern (Inselspital), Bern, Switzerland
| | - Marion Brands
- Department of Paediatric Metabolic Disease, Amsterdam University Medical Center, Amsterdam, Netherlands
| | - Tomas Foltan
- Department of Pediatric Neurology, National Institute of Children's Diseases, Comenius University in Bratislava, Bratislava, Slovak Republic
| | - Matthias Gautschi
- Division of Paediatric Endocrinology, Diabetology and Metabolism, Department of Paediatrics, and Institute of Clinical Chemistry, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Paul Gissen
- NIHR Great Ormond Street Hospital Biomedical Research Centre, University College London, London, UK
| | - Andreas Hahn
- Department of Child Neurology, Justus Liebig University, Giessen, Germany
| | - Simon Jones
- Willink Unit, Manchester Centre for Genomic Medicine, Royal Manchester Children's Hospital, University of Manchester, Manchester, UK
| | - Laila Arash-Kaps
- SphinCS-Institute of Clinical Science in Lysosomal Storage Disorders, Hochheim, Germany
| | - Miriam Kolnikova
- Department of Pediatric Neurology, National Institute of Children's Diseases, Comenius University in Bratislava, Bratislava, Slovak Republic
| | - Marc Patterson
- Departments of Neurology, Pediatrics and Clinical Genomics, Mayo Clinic Children's Center, Rochester, MN, USA
| | - Susan Perlman
- Department of Neurology, University of California, Los Angeles, CA, USA
| | - Uma Ramaswami
- Lysosomal Storage Disorder Unit, Royal Free London NHS Foundation Trust, London, UK
| | - Stella Reichmannová
- Department of Paediatrics and Inherited Metabolic Disorders, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic
| | - Marianne Rohrbach
- Division of Metabolism, University Children's Hospital and Children's Research Centre, Zurich, Switzerland
| | | | - Aasef Shaikh
- Department of Neurology, Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - Siyamini Sivananthan
- NIHR Great Ormond Street Hospital Biomedical Research Centre, University College London, London, UK
| | - Matthis Synofzik
- Department of Neurodegenerative Diseases, Hertie-Institute for Clinical Brain Research and Center of Neurology, University of Tübingen, Tübingen, Germany
| | - Mark Walterfarng
- Department of Neuropsychiatry, The Royal Melbourne Hospital, Melbourne, VIC, Australia
| | - Pierre Wibawa
- Department of Neuropsychiatry, The Royal Melbourne Hospital, Melbourne, VIC, Australia
| | - Kyriakos Martakis
- Department of Child Neurology, Justus Liebig University, Giessen, Germany
- Department of Pediatrics, Medical Faculty and University Hospital, University of Cologne, Cologne, Germany
| | - Mario Manto
- Unité Des Ataxies Cérébelleuses, Service de Neurologie, Médiathèque Jean Jacquy, CHU-Charleroi, 6000, Charleroi, Belgium
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6
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Cai X, Dai J, Xie Y, Xu S, Liu M. Multi-omics study unravels gut microbiota and metabolites alteration in patients with Wilson's disease. Sci Rep 2024; 14:21025. [PMID: 39251728 PMCID: PMC11384772 DOI: 10.1038/s41598-024-71740-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2023] [Accepted: 08/30/2024] [Indexed: 09/11/2024] Open
Abstract
Hepatolenticular degeneration (HLD), also known as Wilson's disease (WD), is a rare autosomal recessive disorder regarding copper metabolism. Whether gut microbiota imbalance is involved in developing HLD remains unknown. A comprehensive 16S rRNA amplicon sequencing, metagenomic sequencing, and metabonomic analysis were undertaken in patients with WD to analyze the composition and function profiles of gut microbiota in patients with WD. The data demonstrated differences in gut microbiota and metabolic pathways between WD patients and normal individuals, significantly decreasing bacterial richness and diversity. The levels of Selenomonaceae and Megamonas in WD patients are significantly higher than those in healthy individuals. The relative abundances of Roseburia inulinivorans in patients with WD are lower than in healthy individuals. Compared with healthy people, the level of metabolites in patients with WD is abnormal. Leucylproline, 5-Phenylvaleric Acid and N-Desmethylclobazam, which have nutritional and protective effects, are significantly reduced fecal metabolites in patients with WD. D-Gluconic acid, which can chelate metal ions, may be a potential treatment for WD. The positive correlation it demonstrates with Alistipes indistinctus and Prevotella stercora indicates potential bacteria able to treat WD. These metabolites are mainly related to the biosynthesis of antibiotics, alpha-linolenic acid metabolism, one carbon pool by folate, nicotinate and nicotinamide metabolism. In conclusion, the data from this study elucidate novel mechanisms describing how abnormal gut miccrobiota contribute to the pathogenesis of WD and outlines new molecules for the treatment of WD.
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Affiliation(s)
- Xiangsheng Cai
- Clinical Laboratory, Guangzhou Eleventh People's Hospital, Guangzhou Cadre and Talent Health Management Center, Guangzhou, China
| | - Jincheng Dai
- Shenzhen Hospital, University of Chinese Academy of Science, Shenzhen, China
| | - Yingjun Xie
- Department of Obstetrics and Gynecology, Guangdong Provincial Key Laboratory of Major Obstetric Diseases, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Shu Xu
- Shenzhen Hospital, University of Chinese Academy of Science, Shenzhen, China
| | - Minqi Liu
- Shenzhen Hospital, University of Chinese Academy of Science, Shenzhen, China.
- Assisted Reproductive Technology Unit, Department of Obstetrics and Gynaecology, Faculty of Medicine, The Chinese University of Hong Kong, Hongkong, China.
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7
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Oertel WH, Janzen A, Henrich MT, Geibl FF, Sittig E, Meles SK, Carli G, Leenders K, Booij J, Surmeier DJ, Timmermann L, Strupp M. Acetyl-DL-leucine in two individuals with REM sleep behavior disorder improves symptoms, reverses loss of striatal dopamine-transporter binding and stabilizes pathological metabolic brain pattern-case reports. Nat Commun 2024; 15:7619. [PMID: 39223119 PMCID: PMC11369233 DOI: 10.1038/s41467-024-51502-7] [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: 02/28/2024] [Accepted: 08/08/2024] [Indexed: 09/04/2024] Open
Abstract
Isolated REM Sleep Behavior Disorder (iRBD) is considered a prodrome of Parkinson's disease (PD). We investigate whether the potentially disease-modifying compound acetyl-DL-leucine (ADLL; 5 g/d) has an effect on prodromal PD progression in 2 iRBD-patients. Outcome parameters are RBD-severity sum-score (RBD-SS-3), dopamine-transporter single-photon emission computerized tomography (DAT-SPECT) and metabolic "Parkinson-Disease-related-Pattern (PDRP)"-z-score in 18F-fluorodeoxyglucose positron emission tomography (FDG-PET). After 3 weeks ADLL-treatment, the RBD-SS-3 drops markedly in both patients and remains reduced for >18 months of ADLL-treatment. In patient 1 (female), the DAT-SPECT putaminal binding ratio (PBR) decreases in the 5 years pretreatment from normal (1.88) to pathological (1.22) and the patient's FDG-PET-PDRP-z-score rises from 1.72 to 3.28 (pathological). After 22 months of ADLL-treatment, the DAT-SPECT-PBR increases to 1.67 and the FDG-PET-PDRP-z-score stabilizes at 3.18. Similar results are seen in patient 2 (male): his DAT-SPECT-PBR rises from a pretreatment value of 1.42 to 1.72 (close to normal) and the FDG-PET-PDRP-z-score decreases from 1.02 to 0.30 after 18 months of ADLL-treatment. These results support exploration of whether ADLL may have disease-modifying properties in prodromal PD.
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Affiliation(s)
- Wolfgang H Oertel
- Department of Neurology, Philipps University of Marburg, Marburg, Germany.
- Institute of Neurogenomics, Helmholtz Center for Medicine and Environment, Munich, Germany.
| | - Annette Janzen
- Department of Neurology, Philipps University of Marburg, Marburg, Germany
| | - Martin T Henrich
- Department of Neurology, Philipps University of Marburg, Marburg, Germany
- Department of Psychiatry and Psychotherapy, Philipps University of Marburg, Marburg, Germany
- Department of Neuroscience, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Fanni F Geibl
- Department of Neurology, Philipps University of Marburg, Marburg, Germany
- Department of Psychiatry and Psychotherapy, Philipps University of Marburg, Marburg, Germany
- Department of Neuroscience, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Elisabeth Sittig
- Department of Neurology, Philipps University of Marburg, Marburg, Germany
| | - Sanne K Meles
- Department of Neurology, University Medical Center Groningen, Groningen, The Netherlands
| | - Giulia Carli
- Department of Nuclear Medicine and Molecular Imaging, University Medical Center Groningen, Groningen, The Netherlands
| | - Klaus Leenders
- Department of Nuclear Medicine and Molecular Imaging, University Medical Center Groningen, Groningen, The Netherlands
| | - Jan Booij
- Department of Radiology and Nuclear Medicine, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, The Netherlands
| | - D James Surmeier
- Department of Neuroscience, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Lars Timmermann
- Department of Neurology, Philipps University of Marburg, Marburg, Germany
| | - Michael Strupp
- Department of Neurology, LMU University Hospital, LMU, Munich, Germany.
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Beaudin M, Dupre N, Manto M. The importance of synthetic pharmacotherapy for recessive cerebellar ataxias. Expert Rev Neurother 2024; 24:897-912. [PMID: 38980086 DOI: 10.1080/14737175.2024.2376840] [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: 04/19/2024] [Accepted: 07/02/2024] [Indexed: 07/10/2024]
Abstract
INTRODUCTION The last decade has witnessed major breakthroughs in identifying novel genetic causes of hereditary ataxias, deepening our understanding of disease mechanisms, and developing therapies for these debilitating disorders. AREAS COVERED This article reviews the currently approved and most promising candidate pharmacotherapies in relation to the known disease mechanisms of the most prevalent autosomal recessive ataxias. Omaveloxolone is an Nrf2 activator that increases antioxidant defense and was recently approved for treatment of Friedreich ataxia. Its therapeutic effect is modest, and further research is needed to find synergistic treatments that would halt or reverse disease progression. Promising approaches include upregulation of frataxin expression by epigenetic mechanisms, direct protein replacement, and gene replacement therapy. For ataxia-telangiectasia, promising approaches include splice-switching antisense oligonucleotides and small molecules targeting oxidative stress, inflammation, and mitochondrial function. Rare recessive ataxias for which disease-modifying therapies exist are also reviewed, emphasizing recently approved therapies. Evidence supporting the use of riluzole and acetyl-leucine in recessive ataxias is discussed. EXPERT OPINION Advances in genetic therapies for other neurogenetic conditions have paved the way to implement feasible approaches with potential dramatic benefits. Particularly, as we develop effective treatments for these conditions, we may need to combine therapies, consider newborn testing for pre-symptomatic treatment, and optimize non-pharmacological approaches.
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Affiliation(s)
- Marie Beaudin
- Department of Neurology and Neurological Sciences, Stanford School of Medicine, Stanford, CA, USA
| | - Nicolas Dupre
- Neuroscience axis, CHU de Québec-Université Laval, Québec, QC, Canada
- Department of Medicine, Faculty of Medicine, Université Laval, Quebec, QC, Canada
| | - Mario Manto
- Service des Neurosciences, Université de Mons, Mons, Belgique
- Unité des Ataxies Cérébelleuses, Service de Neurologie, CHU-Charleroi, Charleroi, Belgique
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9
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Hou Y, Xiao Z, Zhu Y, Li Y, Liu Q, Wang Z. Blood metabolites and chronic kidney disease: a Mendelian randomization study. BMC Med Genomics 2024; 17:147. [PMID: 38807172 PMCID: PMC11131213 DOI: 10.1186/s12920-024-01918-3] [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: 01/19/2024] [Accepted: 05/20/2024] [Indexed: 05/30/2024] Open
Abstract
BACKGROUND Human blood metabolites have demonstrated close associations with chronic kidney disease (CKD) in observational studies. Nonetheless, the causal relationship between metabolites and CKD is still unclear. This study aimed to assess the associations between metabolites and CKD risk. METHODS We applied a two-sample Mendelian randomization (MR) analysis to evaluate relationships between 1400 blood metabolites and eight phenotypes (outcomes) (CKD, estimated glomerular filtration rate(eGFR), urine albumin to creatinine ratio, rapid progress to CKD, rapid decline of eGFR, membranous nephropathy, immunoglobulin A nephropathy, and diabetic nephropathy). The inverse variance weighted (IVW), MR-Egger, and weighted median were used to investigate the causal relationship. Sensitivity analyses were performed with Cochran's Q, MR-Egger intercept, MR-PRESSO Global test, and leave-one-out analysis. Bonferroni correction was used to test the strength of the causal relationship. RESULTS Through the MR analysis of 1400 metabolites and eight clinical phenotypes, a total of 48 metabolites were found to be associated with various outcomes. Among them, N-acetylleucine (OR = 0.923, 95%CI: 0.89-0.957, PIVW = 1.450 × 10-5) has a strong causal relationship with lower risk of CKD after the Bonferroni-corrected test, whereas Glycine to alanine ratio has a strong causal relationship with higher risk of CKD (OR = 1.106, 95%CI: 1.063-1.151, PIVW = 5.850 × 10-7). No horizontal pleiotropy and heterogeneity were detected. CONCLUSION Our study offers groundbreaking insights into the integration of metabolomics and genomics to reveal the pathogenesis of and therapeutic strategies for CKD. It underscores 48 metabolites as potential causal candidates, meriting further investigation.
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Affiliation(s)
- Yawei Hou
- Institute of Chinese Medical Literature and Culture, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Zhenwei Xiao
- Department of Nephrology, Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Yushuo Zhu
- Department of Emergency and Critical Care Medicine, Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Yameng Li
- The First Clinical Medical College, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Qinglin Liu
- College of Traditional Chinese Medicine, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Zhenguo Wang
- Institute of Chinese Medical Literature and Culture, Shandong University of Traditional Chinese Medicine, Jinan, China.
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10
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Tifft CJ. N-Acetyl-l-Leucine and Neurodegenerative Disease. N Engl J Med 2024; 390:467-470. [PMID: 38294981 DOI: 10.1056/nejme2313791] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2024]
Affiliation(s)
- Cynthia J Tifft
- From the Medical Genetics Branch, National Human Genome Research Institute, National Institutes of Health, Bethesda, MD
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11
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Bremova-Ertl T, Hofmann J, Stucki J, Vossenkaul A, Gautschi M. Inborn Errors of Metabolism with Ataxia: Current and Future Treatment Options. Cells 2023; 12:2314. [PMID: 37759536 PMCID: PMC10527548 DOI: 10.3390/cells12182314] [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: 08/15/2023] [Revised: 09/09/2023] [Accepted: 09/15/2023] [Indexed: 09/29/2023] Open
Abstract
A number of hereditary ataxias are caused by inborn errors of metabolism (IEM), most of which are highly heterogeneous in their clinical presentation. Prompt diagnosis is important because disease-specific therapies may be available. In this review, we offer a comprehensive overview of metabolic ataxias summarized by disease, highlighting novel clinical trials and emerging therapies with a particular emphasis on first-in-human gene therapies. We present disease-specific treatments if they exist and review the current evidence for symptomatic treatments of these highly heterogeneous diseases (where cerebellar ataxia is part of their phenotype) that aim to improve the disease burden and enhance quality of life. In general, a multimodal and holistic approach to the treatment of cerebellar ataxia, irrespective of etiology, is necessary to offer the best medical care. Physical therapy and speech and occupational therapy are obligatory. Genetic counseling is essential for making informed decisions about family planning.
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Affiliation(s)
- Tatiana Bremova-Ertl
- Department of Neurology, University Hospital Bern (Inselspital) and University of Bern, 3010 Bern, Switzerland; (J.H.); (J.S.)
- Center for Rare Diseases, University Hospital Bern (Inselspital) and University of Bern, 3010 Bern, Switzerland
| | - Jan Hofmann
- Department of Neurology, University Hospital Bern (Inselspital) and University of Bern, 3010 Bern, Switzerland; (J.H.); (J.S.)
| | - Janine Stucki
- Department of Neurology, University Hospital Bern (Inselspital) and University of Bern, 3010 Bern, Switzerland; (J.H.); (J.S.)
| | - Anja Vossenkaul
- Division of Pediatric Endocrinology, Diabetes and Metabolism, Department of Paediatrics, Inselspital, Bern University Hospital, University of Bern, 3010 Bern, Switzerland; (A.V.); (M.G.)
| | - Matthias Gautschi
- Division of Pediatric Endocrinology, Diabetes and Metabolism, Department of Paediatrics, Inselspital, Bern University Hospital, University of Bern, 3010 Bern, Switzerland; (A.V.); (M.G.)
- Institute of Clinical Chemistry, Inselspital, Bern University Hospital, University of Bern, 3010 Bern, Switzerland
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Manto M, Cendelin J, Strupp M, Mitoma H. Advances in cerebellar disorders: pre-clinical models, therapeutic targets, and challenges. Expert Opin Ther Targets 2023; 27:965-987. [PMID: 37768297 DOI: 10.1080/14728222.2023.2263911] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Accepted: 09/24/2023] [Indexed: 09/29/2023]
Abstract
INTRODUCTION Cerebellar ataxias (CAs) represent neurological disorders with multiple etiologies and a high phenotypic variability. Despite progress in the understanding of pathogenesis, few therapies are available so far. Closing the loop between preclinical studies and therapeutic trials is important, given the impact of CAs upon patients' health and the roles of the cerebellum in multiple domains. Because of a rapid advance in research on CAs, it is necessary to summarize the main findings and discuss future directions. AREAS COVERED We focus our discussion on preclinical models, cerebellar reserve, the therapeutic management of CAs, and suitable surrogate markers. We searched Web of Science and PubMed using keywords relevant to cerebellar diseases, therapy, and preclinical models. EXPERT OPINION There are many symptomatic and/or disease-modifying therapeutic approaches under investigation. For therapy development, preclinical studies, standardization of disease evaluation, safety assessment, and demonstration of clinical improvements are essential. Stage of the disease and the level of the cerebellar reserve determine the goals of the therapy. Deficits in multiple categories and heterogeneity of CAs may require disease-, stage-, and symptom-specific therapies. More research is needed to clarify how therapies targeting the cerebellum influence both basal ganglia and the cerebral cortex, poorly explored domains in CAs.
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Affiliation(s)
- Mario Manto
- Service des Neurosciences, University of Mons, Mons, Belgium
| | - Jan Cendelin
- Department of Pathophysiology, Faculty of Medicine in Pilsen, Charles University, Pilsen, Czech Republic
| | - Michael Strupp
- Department of Neurology and German Center for Vertigo and Balance Disorders, Ludwig Maximilians University, Munich, Germany
| | - Hiroshi Mitoma
- Department of Medical Education, Tokyo medical University, Tokyo, Japan
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