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Crayle JI, Rampersaud E, Myers JR, Wuu J, Taylor JP, Wu G, Benatar M, Bedlack RS. Genetic Associations With an Amyotrophic Lateral Sclerosis Reversal Phenotype. Neurology 2024; 103:e209696. [PMID: 39079071 PMCID: PMC11286288 DOI: 10.1212/wnl.0000000000209696] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2024] [Accepted: 05/29/2024] [Indexed: 08/02/2024] Open
Abstract
BACKGROUND AND OBJECTIVES The term "ALS Reversal" describes patients who initially meet diagnostic criteria for amyotrophic lateral sclerosis (ALS) or had clinical features most consistent with progressive muscular atrophy (PMA) but subsequently demonstrated substantial and sustained clinical improvement. The objective of this genome-wide association study (GWAS) was to identify correlates of this unusual clinical phenotype. METHODS Participants were recruited from a previously created database of individuals with the ALS Reversal phenotype. Whole-genome sequencing (WGS) data were compared with ethnicity-matched patients with typically progressive ALS enrolled through the CReATe Consortium's Phenotype-Genotype-Biomarker (PGB) study. These results were replicated using an independent ethnically matched WGS data set from Target ALS. Significant results were further explored with available databases of genetic regulatory markers and expression quantitative trait loci (eQTL) analysis. RESULTS WGS from 22 participants with documented ALS Reversals was compared with the PGB primary cohort (n = 103) and the Target ALS validation cohort (n = 140). Two genetic loci met predefined criteria for statistical significance (two-sided permutation p ≤ 0.01) and remained plausible after fine-mapping. The lead single nucleotide variant (SNV) from the first locus was rs4242007 (primary cohort GWAS OR = 12.0, 95% CI 4.1 to 34.6), which is in an IGFBP7 intron and is in near-perfect linkage disequilibrium with a SNV in the IGFBP7 promoter region. Both SNVs are associated with decreased frontal cortex IGFBP7 expression in eQTL data sets. Notably, 3 Reversals, but none of the typically progressive individuals (n = 243), were homozygous for rs4242007. The importance of the second locus, located near GRIP1, is uncertain given the absence of an associated effect on nearby gene transcription. DISCUSSION We found a significant association between the Reversal phenotype and an IGFBP7 noncoding SNV that is associated with IGFBP7 expression. This is biologically relevant as IGFBP7 is a reported inhibitor of the insulin growth factor-1 (IGF-1) receptor that activates the possibly neuroprotective IGF-1 signaling pathway. This finding is limited by small sample size but suggests that there may be merit in further exploration of IGF-1 pathway signaling as a therapeutic mechanism for ALS. TRIAL REGISTRATION INFORMATION This study was registered with ClinicalTrials.gov (NCT03464903) on March 14, 2018. The first participant was enrolled on June 22, 2018.
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Affiliation(s)
- Jesse I Crayle
- From the Department of Neurology (J.I.C., R.S.B.), Duke University School of Medicine, Durham, NC; Department of Neurology (J.I.C.), Washington University in Saint Louis, MO; Center for Applied Bioinformatics (E.R., J.R.M., G.W.), St. Jude Children's Research Hospital, Memphis, TN; Department of Neurology (J.W., M.B.), University of Miami Miller School of Medicine, FL; and Department of Cell and Molecular Biology (J.P.T.), St. Jude Children's Research Hospital, Memphis, TN
| | - Evadnie Rampersaud
- From the Department of Neurology (J.I.C., R.S.B.), Duke University School of Medicine, Durham, NC; Department of Neurology (J.I.C.), Washington University in Saint Louis, MO; Center for Applied Bioinformatics (E.R., J.R.M., G.W.), St. Jude Children's Research Hospital, Memphis, TN; Department of Neurology (J.W., M.B.), University of Miami Miller School of Medicine, FL; and Department of Cell and Molecular Biology (J.P.T.), St. Jude Children's Research Hospital, Memphis, TN
| | - Jason R Myers
- From the Department of Neurology (J.I.C., R.S.B.), Duke University School of Medicine, Durham, NC; Department of Neurology (J.I.C.), Washington University in Saint Louis, MO; Center for Applied Bioinformatics (E.R., J.R.M., G.W.), St. Jude Children's Research Hospital, Memphis, TN; Department of Neurology (J.W., M.B.), University of Miami Miller School of Medicine, FL; and Department of Cell and Molecular Biology (J.P.T.), St. Jude Children's Research Hospital, Memphis, TN
| | - Joanne Wuu
- From the Department of Neurology (J.I.C., R.S.B.), Duke University School of Medicine, Durham, NC; Department of Neurology (J.I.C.), Washington University in Saint Louis, MO; Center for Applied Bioinformatics (E.R., J.R.M., G.W.), St. Jude Children's Research Hospital, Memphis, TN; Department of Neurology (J.W., M.B.), University of Miami Miller School of Medicine, FL; and Department of Cell and Molecular Biology (J.P.T.), St. Jude Children's Research Hospital, Memphis, TN
| | - J Paul Taylor
- From the Department of Neurology (J.I.C., R.S.B.), Duke University School of Medicine, Durham, NC; Department of Neurology (J.I.C.), Washington University in Saint Louis, MO; Center for Applied Bioinformatics (E.R., J.R.M., G.W.), St. Jude Children's Research Hospital, Memphis, TN; Department of Neurology (J.W., M.B.), University of Miami Miller School of Medicine, FL; and Department of Cell and Molecular Biology (J.P.T.), St. Jude Children's Research Hospital, Memphis, TN
| | - Gang Wu
- From the Department of Neurology (J.I.C., R.S.B.), Duke University School of Medicine, Durham, NC; Department of Neurology (J.I.C.), Washington University in Saint Louis, MO; Center for Applied Bioinformatics (E.R., J.R.M., G.W.), St. Jude Children's Research Hospital, Memphis, TN; Department of Neurology (J.W., M.B.), University of Miami Miller School of Medicine, FL; and Department of Cell and Molecular Biology (J.P.T.), St. Jude Children's Research Hospital, Memphis, TN
| | - Michael Benatar
- From the Department of Neurology (J.I.C., R.S.B.), Duke University School of Medicine, Durham, NC; Department of Neurology (J.I.C.), Washington University in Saint Louis, MO; Center for Applied Bioinformatics (E.R., J.R.M., G.W.), St. Jude Children's Research Hospital, Memphis, TN; Department of Neurology (J.W., M.B.), University of Miami Miller School of Medicine, FL; and Department of Cell and Molecular Biology (J.P.T.), St. Jude Children's Research Hospital, Memphis, TN
| | - Richard S Bedlack
- From the Department of Neurology (J.I.C., R.S.B.), Duke University School of Medicine, Durham, NC; Department of Neurology (J.I.C.), Washington University in Saint Louis, MO; Center for Applied Bioinformatics (E.R., J.R.M., G.W.), St. Jude Children's Research Hospital, Memphis, TN; Department of Neurology (J.W., M.B.), University of Miami Miller School of Medicine, FL; and Department of Cell and Molecular Biology (J.P.T.), St. Jude Children's Research Hospital, Memphis, TN
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Jhooty S, Barkhaus P, Brown A, Mascias Cadavid J, Carter GT, Crayle J, Heiman-Patterson T, Li X, Mallon E, Mcdermott C, Mushannen T, Pattee G, Ratner D, Wicks P, Wiedau M, Bedlack R. ALSUntangled #74: Withania Somnifera (Ashwagandha). Amyotroph Lateral Scler Frontotemporal Degener 2024:1-4. [PMID: 38318860 DOI: 10.1080/21678421.2024.2311721] [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: 12/21/2023] [Accepted: 01/23/2024] [Indexed: 02/07/2024]
Abstract
ALSUntangled reviews alternative and off-label treatments on behalf of people with ALS (PALS) who ask about them. Here, we review withania somnifera (WS) commonly known as ashwagandha or winter cherry. WS has plausible mechanisms for slowing ALS progression because of its effects on inflammation, oxidative stress, autophagy, mitochondrial function, and apoptosis. Preclinical trials demonstrate that WS slows disease progression in multiple different animal models of ALS. Of the five individuals we found who described using WS for their ALS, two individuals reported moderate benefit while none reported experiencing any significant side effects. There is currently one clinical trial using WS to treat PALS; the results are not yet published. There are no serious side effects associated with WS and the associated cost of this treatment is low. Based on the above information, WS appears to us to be a good candidate for future ALS trials.
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Affiliation(s)
- Sartaj Jhooty
- Department of Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Paul Barkhaus
- Department of Neurology, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Andrew Brown
- Department of Neurology, University of Miami, Miami, FL, USA
| | | | - Gregory T Carter
- Department of Rehabilitation, Elson S. Floyd College of Medicine, Washington State University, Spokane, WA, USA
| | - Jesse Crayle
- Department of Neurology, Washington University, St. Louis, MO, USA
| | | | - Xiaoyan Li
- Department of Neurology, Duke University, Durham, NC, USA
| | | | | | | | - Gary Pattee
- Department of Neurology, University of Nebraska Medical Center, Omaha, NE, USA
| | | | - Paul Wicks
- Independent Consultant, Lichfield, UK, and
| | - Martina Wiedau
- Department of Neurology, University of California, Los Angeles, CA, USA
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Duran-Ortiz S, List EO, Basu R, Kopchick JJ. Extending lifespan by modulating the growth hormone/insulin-like growth factor-1 axis: coming of age. Pituitary 2021; 24:438-456. [PMID: 33459974 PMCID: PMC8122064 DOI: 10.1007/s11102-020-01117-0] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/10/2020] [Indexed: 02/06/2023]
Abstract
Progress made in the years of aging research have allowed the opportunity to explore potential interventions to slow aging and extend healthy lifespan. Studies performed in yeast, worms, flies and mice subjected to genetic and pharmacological interventions have given insight into the cellular and molecular mechanisms associated with longevity. Furthermore, it is now possible to effectively modulate pathways that slow aging at different stages of life (early life or at an adult age). Interestingly, interventions that extend longevity in adult mice have had sex-specific success, suggesting a potential link between particular pathways that modulate aging and sex. For example, reduction of the growth hormone (GH)/insulin-like growth factor-1 (IGF-1) axis at an adult age extends lifespan preferentially in females. Moreover, several postnatal dietary interventions tested by the 'Intervention Testing Program (ITP)' from the National Institute of Aging (NIA) have shown that while pharmacological interventions like rapamycin affect the IGF-1/insulin pathway and preferentially extend lifespan in females; dietary compounds that target other cellular pathways are effective only in male mice-indicating mutually exclusive sex-specific pathways. Therefore, a combination of interventions that target non-overlapping aging-related pathways appears to be an effective approach to further extend healthy lifespan in both sexes. Here, we review the germline and postnatal mouse lines that target the GH/IGF-1 axis as a mechanism to extend longevity as well as the dietary compounds that tested positive in the NIA program to increase lifespan. We believe that the interventions reviewed in this paper could constitute feasible combinations for an extended healthy lifespan in both male and female mice.
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Affiliation(s)
- Silvana Duran-Ortiz
- Edison Biotechnology Institute, Ohio University, Athens, USA
- Department of Biological Sciences, College of Arts and Sciences, Ohio University, Athens, USA
- Molecular and Cellular Biology Program, Ohio University, Athens, USA
| | - Edward O List
- Edison Biotechnology Institute, Ohio University, Athens, USA
| | - Reetobrata Basu
- Edison Biotechnology Institute, Ohio University, Athens, USA
| | - John J Kopchick
- Edison Biotechnology Institute, Ohio University, Athens, USA.
- Molecular and Cellular Biology Program, Ohio University, Athens, USA.
- Department of Biomedical Sciences, Heritage College of Osteopathic Medicine, Ohio University, Athens, OH, 45701, USA.
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Hoang TT, Johnson DA, Raines RT, Johnson JA. Angiogenin activates the astrocytic Nrf2/antioxidant-response element pathway and thereby protects murine neurons from oxidative stress. J Biol Chem 2019; 294:15095-15103. [PMID: 31431502 DOI: 10.1074/jbc.ra119.008491] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2019] [Revised: 08/15/2019] [Indexed: 12/30/2022] Open
Abstract
The angiogenin (ANG) gene is mutated frequently in individuals with amyotrophic lateral sclerosis (ALS), a fatal neurodegenerative disease characterized by the progressive loss of motor neurons. Delivering human ANG to mice that display ALS-like symptoms extends their lifespan and improves motor function. ANG is a secretory vertebrate RNase that enters neuronal cells and cleaves a subset of tRNAs, leading to the inhibition of translation initiation and the assembly of stress granules. Here, using murine neuronal and astrocytic cell lines, we find that ANG triggers the activation of the Nrf2 (nuclear factor erythroid 2-related factor 2) pathway, which provides a critical cellular defense against oxidative stress. This activation, which occurred in astrocytes but not in neurons, promoted the survival of proximal neurons that had oxidative injury. These findings extend the role of ANG as a neuroprotective agent and underscore its potential utility in ALS management.
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Affiliation(s)
- Trish T Hoang
- Department of Biochemistry, University of Wisconsin-Madison, Madison, Wisconsin 53706
| | - Delinda A Johnson
- School of Pharmacy, University of Wisconsin-Madison, Madison, Wisconsin 53705
| | - Ronald T Raines
- Department of Biochemistry, University of Wisconsin-Madison, Madison, Wisconsin 53706 .,Department of Chemistry, University of Wisconsin-Madison, Madison, Wisconsin 53706.,Department of Chemistry, Massachusetts Institute of Technology, Cambridge, Massachusetts 02139
| | - Jeffrey A Johnson
- School of Pharmacy, University of Wisconsin-Madison, Madison, Wisconsin 53705
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