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Menendez Sepulveda JA, Izquierdo N. Oculopharyngeal Muscular Dystrophy: A Case Report From Puerto Rico. Cureus 2024; 16:e65766. [PMID: 39082045 PMCID: PMC11288381 DOI: 10.7759/cureus.65766] [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] [Accepted: 07/29/2024] [Indexed: 08/02/2024] Open
Abstract
Oculopharyngeal muscular dystrophy (OPMD) is a late-onset inherited skeletal myopathy. The diagnosis is based on a clinical presentation of blepharoptosis, dysphagia, and a positive family history of the disease in patients past 40 years of age. A 57-year-old male patient presented with ptosis without lid crease, adult-onset dysphagia, and bilateral pseudophakia. The patient underwent ptosis repair of upper eyelids via frontalis slings with silicone rods. His mother was subsequently found to have ptosis, dry eyes, and anorexia due to dysphagia, thus suggesting a probable family history. Based on the comprehensive ophthalmic evaluation, and based on his ptosis, dysphagia, and family history, the patient was diagnosed with OPMD.
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Affiliation(s)
| | - Natalio Izquierdo
- Department of Surgery, University of Puerto Rico, Medical Sciences Campus, San Juan, PRI
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2
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Waung MW, Ma F, Wheeler AG, Zai CC, So J. The Diagnostic Landscape of Adult Neurogenetic Disorders. BIOLOGY 2023; 12:1459. [PMID: 38132285 PMCID: PMC10740572 DOI: 10.3390/biology12121459] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/01/2023] [Revised: 11/11/2023] [Accepted: 11/16/2023] [Indexed: 12/23/2023]
Abstract
Neurogenetic diseases affect individuals across the lifespan, but accurate diagnosis remains elusive for many patients. Adults with neurogenetic disorders often undergo a long diagnostic odyssey, with multiple specialist evaluations and countless investigations without a satisfactory diagnostic outcome. Reasons for these diagnostic challenges include: (1) clinical features of neurogenetic syndromes are diverse and under-recognized, particularly those of adult-onset, (2) neurogenetic syndromes may manifest with symptoms that span multiple neurological and medical subspecialties, and (3) a positive family history may not be present or readily apparent. Furthermore, there is a large gap in the understanding of how to apply genetic diagnostic tools in adult patients, as most of the published literature focuses on the pediatric population. Despite these challenges, accurate genetic diagnosis is imperative to provide affected individuals and their families guidance on prognosis, recurrence risk, and, for an increasing number of disorders, offer targeted treatment. Here, we provide a framework for recognizing adult neurogenetic syndromes, describe the current diagnostic approach, and highlight studies using next-generation sequencing in different neurological disease cohorts. We also discuss diagnostic pitfalls, barriers to achieving a definitive diagnosis, and emerging technology that may increase the diagnostic yield of testing.
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Affiliation(s)
- Maggie W. Waung
- Division of General Neurology, Department of Neurology, Weill Institute for Neurosciences, University of California, San Francisco, CA 94158, USA
| | - Fion Ma
- Institute for Human Genetics, University of California San Francisco School of Medicine, San Francisco, CA 94143, USA
| | - Allison G. Wheeler
- Institute for Human Genetics, University of California San Francisco School of Medicine, San Francisco, CA 94143, USA
- Department of Neurology, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA
| | - Clement C. Zai
- Tanenbaum Centre for Pharmacogenetics, Molecular Brain Science, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON M5T 1R8, Canada
- Department of Psychiatry, Institute of Medical Science, Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON M5S 1A8, Canada
| | - Joyce So
- Division of Medical Genetics, Department of Pediatrics, University of California, San Francisco, CA 94158, USA
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3
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Assessment of PABPN1 nuclear inclusions on a large cohort of patients and in a human xenograft model of oculopharyngeal muscular dystrophy. Acta Neuropathol 2022; 144:1157-1170. [PMID: 36197469 PMCID: PMC9637588 DOI: 10.1007/s00401-022-02503-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Revised: 08/26/2022] [Accepted: 09/17/2022] [Indexed: 01/26/2023]
Abstract
Oculopharyngeal muscular dystrophy (OPMD) is a rare muscle disease characterized by an onset of weakness in the pharyngeal and eyelid muscles. The disease is caused by the extension of a polyalanine tract in the Poly(A) Binding Protein Nuclear 1 (PABPN1) protein leading to the formation of intranuclear inclusions or aggregates in the muscle of OPMD patients. Despite numerous studies stressing the deleterious role of nuclear inclusions in cellular and animal OPMD models, their exact contribution to human disease is still unclear. In this study, we used a large and unique collection of human muscle biopsy samples to perform an in-depth analysis of PABPN1 aggregates in relation to age, genotype and muscle status with the final aim to improve our understanding of OPMD physiopathology. Here we demonstrate that age and genotype influence PABPN1 aggregates: the percentage of myonuclei containing PABPN1 aggregates increases with age and the chaperone HSP70 co-localize more frequently with PABPN1 aggregates with a larger polyalanine tract. In addition to the previously described PRMT1 and HSP70 co-factors, we identified new components of PABPN1 aggregates including GRP78/BiP, RPL24 and p62. We also observed that myonuclei containing aggregates are larger than myonuclei without. When comparing two muscles from the same patient, a similar amount of aggregates is observed in different muscles, except for the pharyngeal muscle where fewer aggregates are observed. This could be due to the peculiar nature of this muscle which has a low level of PAPBN1 and contains regenerating fibers. To confirm the fate of PABPN1 aggregates in a regenerating muscle, we generated a xenograft model by transplanting human OPMD muscle biopsy samples into the hindlimb of an immunodeficient mouse. Xenografts from subjects with OPMD displayed regeneration of human myofibers and PABPN1 aggregates were rapidly present-although to a lower extent-after muscle fiber regeneration. Our data obtained on human OPMD samples add support to the dual non-exclusive models in OPMD combining toxic PABPN1 intranuclear inclusions together with PABPN1 loss of function which altogether result in this late-onset and muscle selective disease.
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Zhang Y, Zeuthen C, Zhu C, Wu F, Mezzell AT, Whitlow TJ, Choo HJ, Vest KE. Pharyngeal pathology in a mouse model of oculopharyngeal muscular dystrophy is associated with impaired basal autophagy in myoblasts. Front Cell Dev Biol 2022; 10:986930. [PMID: 36313551 PMCID: PMC9614327 DOI: 10.3389/fcell.2022.986930] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Accepted: 09/26/2022] [Indexed: 11/05/2023] Open
Abstract
Oculopharyngeal muscular dystrophy (OPMD) is a late-onset dominant disease that primarily affects craniofacial muscles. Despite the fact that the genetic cause of OPMD is known to be expansion mutations in the gene encoding the nuclear polyadenosine RNA binding protein PABPN1, the molecular mechanisms of pathology are unknown and no pharmacologic treatments are available. Due to the limited availability of patient tissues, several animal models have been employed to study the pathology of OPMD. However, none of these models have demonstrated functional deficits in the muscles of the pharynx, which are predominantly affected by OPMD. Here, we used a knock-in mouse model of OPMD, Pabpn1 +/A17 , that closely genocopies patients. In Pabpn1 +/A17 mice, we detected impaired pharyngeal muscle function, and impaired pharyngeal satellite cell proliferation and fusion. Molecular studies revealed that basal autophagy, which is required for normal satellite cell function, is higher in pharynx-derived myoblasts than in myoblasts derived from limb muscles. Interestingly, basal autophagy is impaired in cells derived from Pabpn1 +/A17 mice. Pabpn1 knockdown in pharyngeal myoblasts failed to recapitulate the autophagy defect detected in Pabpn1 +/A17 myoblasts suggesting that loss of PABPN1 function does not contribute to the basal autophagy defect. Taken together, these studies provide the first evidence for pharyngeal muscle and satellite cell pathology in a mouse model of OPMD and suggest that aberrant gain of PABPN1 function contributes to the craniofacial pathology in OPMD.
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Affiliation(s)
- Yu Zhang
- Department of Molecular Genetics, Biochemistry and Microbiology, University of Cincinnati College of Medicine, Cincinnati, OH, United States
| | - Christopher Zeuthen
- Department of Cell Biology, Emory University School of Medicine, Atlanta, GA, United States
| | - Carol Zhu
- Department of Cell Biology, Emory University School of Medicine, Atlanta, GA, United States
| | - Fang Wu
- Department of Cell Biology, Emory University School of Medicine, Atlanta, GA, United States
| | - Allison T. Mezzell
- Department of Molecular Genetics, Biochemistry and Microbiology, University of Cincinnati College of Medicine, Cincinnati, OH, United States
| | - Thomas J. Whitlow
- Department of Molecular Genetics, Biochemistry and Microbiology, University of Cincinnati College of Medicine, Cincinnati, OH, United States
| | - Hyojung J. Choo
- Department of Cell Biology, Emory University School of Medicine, Atlanta, GA, United States
| | - Katherine E. Vest
- Department of Molecular Genetics, Biochemistry and Microbiology, University of Cincinnati College of Medicine, Cincinnati, OH, United States
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Kroon RHMJM, Kalf JG, Meijers RL, de Swart BJM, Cameron IGM, Doorduin J, van Alfen N, van Engelen BGM, Horlings CGC. Muscle ultrasound is a sensitive biomarker in oculopharyngeal muscular dystrophy. Muscle Nerve 2022; 66:453-461. [PMID: 35859342 DOI: 10.1002/mus.27679] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2021] [Revised: 07/15/2022] [Accepted: 07/17/2022] [Indexed: 01/07/2023]
Abstract
INTRODUCTION/AIMS Oculopharyngeal muscular dystrophy (OPMD) is a late-onset, progressive muscle disease. Quantitative muscle ultrasound (QMUS) assesses structural changes in muscles and is a sensitive biomarker in neuromuscular disorders. Our aim of this study was to determine whether QMUS can detect muscle pathology and can be used as longitudinal imaging biomarker in OPMD. METHODS Genetically confirmed OPMD patients, recruited by their treating physicians or from the national neuromuscular database, were examined twice, 20 months apart, using QMUS of orofacial and limb muscles, and measurements of functional capacity and muscle strength. Absolute echo intensity (AEI) and muscle thickness of all muscles were analyzed and correlated with clinical data. RESULTS The tongue, deltoid, iliopsoas, rectus femoris, and soleus muscles showed increased AEI at baseline compared with normal values in 43 OPMD patients, with the rectus femoris being most often affected (51%).The AEI and muscle thickness of 9 of 11 muscles correlated significantly with the motor function measure, 10-step stair test, swallowing capacity, dynamometry, Medical Research Council grade, tongue strength, and bite force (r = 0.302 to -0.711). Between baseline and follow-up, deterioration in AEI was found for the temporalis, tongue, and deltoid muscles, and decreased muscle thickness was detected for the temporalis, masseter, digastric, tongue, deltoid, iliopsoas, and soleus muscles (P < .05). No relation was found between the change in AEI and repeat length or disease duration. DISCUSSION QMUS detected muscle pathology and disease progression in OPMD over 20 months. We conclude that QMUS should be considered as a biomarker in treatment trials.
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Affiliation(s)
- Rosemarie H M J M Kroon
- Radboud university medical center, Donders Institute for Brain, Cognition and Behaviour, Department of Rehabilitation, Nijmegen, The Netherlands
| | - Johanna G Kalf
- Radboud university medical center, Donders Institute for Brain, Cognition and Behaviour, Department of Rehabilitation, Nijmegen, The Netherlands
| | - Rutger L Meijers
- Radboud university medical center, Donders Institute of Brain, Cognition and Behaviour, Department of Neurology, Nijmegen, the Netherlands
| | - Bert J M de Swart
- Radboud university medical center, Donders Institute for Brain, Cognition and Behaviour, Department of Rehabilitation, Nijmegen, The Netherlands
| | - Ian G M Cameron
- Radboud University, Donders Institute for Brain, Cognition and Behaviour, Centre for Neuroscience, Nijmegen, The Netherlands.,University of Twente, Biomedical Signals and Systems, Faculty of Electrical Engineering, Mathematics and Computer, Science, Enschede, The Netherlands
| | - Jonne Doorduin
- Radboud university medical center, Donders Institute of Brain, Cognition and Behaviour, Department of Neurology, Nijmegen, the Netherlands
| | - Nens van Alfen
- Radboud university medical center, Donders Institute of Brain, Cognition and Behaviour, Department of Neurology, Nijmegen, the Netherlands
| | - Baziel G M van Engelen
- Radboud university medical center, Donders Institute of Brain, Cognition and Behaviour, Department of Neurology, Nijmegen, the Netherlands
| | - Corinne G C Horlings
- Radboud university medical center, Donders Institute of Brain, Cognition and Behaviour, Department of Neurology, Nijmegen, the Netherlands.,Medical University of Innsbruck, Department of Neurology, Innsbruck, Austria
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Richard P, Stojkovic T, Metay C, Lacau St Guily J, Trollet C. Distrofia muscolare oculofaringea. Neurologia 2022. [DOI: 10.1016/s1634-7072(22)46725-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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7
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Alonso-Pérez J, de León Hernández JC, Pérez-Pérez H, Mendoza-Grimón MD, Gutierrez-Martinez AJ, Hadjigeorgiou I, Montón-Álvarez F, González-Quereda L, Alonso-Jimenez A, Suárez-Calvet X, Díaz-Manera J. Clinical and genetic features of a large homogeneous cohort of oculopharyngeal muscular dystrophy patients from the Canary Islands. Eur J Neurol 2022; 29:1488-1495. [PMID: 35112761 DOI: 10.1111/ene.15252] [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: 11/25/2021] [Revised: 12/30/2021] [Accepted: 01/10/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND Oculopharyngeal muscular dystrophy (OPMD) is an autosomal dominant, late-onset myopathy characterized by ptosis, dysphagia, and progressive proximal limb muscle weakness. The disease is produced by a short expansion of the (GCN)n triplet in the PABPN1 gene. The size of expansion has been correlated to the disease onset and severity. We report the clinical features of a large cohort of OPMD patients harboring the (GCN)15 allele from the Canary Islands. METHODS A retrospective observational study was performed analyzing the clinical, demographic, and genetic data of 123 OPMD patients. Clinical data from this cohort were compared with clinical data collected in a large European study including 139 OPMD patients. RESULTS A total of 113 patients (94.2%) carried the (GCN)15 expanded PABN1 allele. Age of symptoms' onset was 45.1 years. The most frequent symptom at onset was ptosis (85.2%) followed by dysphagia (12%). The severity of the disease was milder in the Canary cohort compared to European patients as limb weakness (35.1% vs. 50.4%), the proportion of patients that require assistance for walking or use a wheelchair (9.3% vs. 27.4%), and needed of surgery because of severe dysphagia (4.6% vs. 22.8%) was higher in the European cohort. CONCLUSIONS Nearly 95% of patients with OPMD from the Canary Islands harbored the (GCN)15 expanded allele supporting a potential founder effect. Disease progression seemed to be milder in the (GCN)15 OPMD Canary cohort than in other cohorts with shorter expansions suggesting that other factors, apart from the expansion size, could be involved in the progression of the disease.
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Affiliation(s)
- Jorge Alonso-Pérez
- Neuromuscular Diseases Unit, Department of Neurology, Department of Medicine, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain.,Department of Neurology, Hospital Universitario Nuestra Señora de la Candelaria, Santa Cruz de Tenerife, Spain
| | | | - Helena Pérez-Pérez
- Department of Neurology, Hospital Universitario de Canarias, Santa Cruz de Tenerife, Spain
| | - María Dolores Mendoza-Grimón
- Department of Neurology, Hospital Universitario de Gran Canaria Doctor Negrín, Las Palmas de Gran Canaria, Spain
| | | | | | - Fernando Montón-Álvarez
- Department of Neurology, Hospital Universitario Nuestra Señora de la Candelaria, Santa Cruz de Tenerife, Spain
| | - Lidia González-Quereda
- Genetics Department, IIB Sant Pau, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain.,Centro de Investigación Biomédica en Red en Enfermedades Raras (CIBERER), Valencia, Spain
| | - Alicia Alonso-Jimenez
- Neuromuscular Reference Center, Department of Neurology, Antwerp University Hospital, Antwerp, Belgium
| | - Xavier Suárez-Calvet
- Neuromuscular Diseases Unit, Department of Neurology, Department of Medicine, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain.,Centro de Investigación Biomédica en Red en Enfermedades Raras (CIBERER), Valencia, Spain
| | - Jordi Díaz-Manera
- Neuromuscular Diseases Unit, Department of Neurology, Department of Medicine, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain.,Centro de Investigación Biomédica en Red en Enfermedades Raras (CIBERER), Valencia, Spain.,John Walton Muscular Dystrophy Research Centre, Newcastle University and Newcastle Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
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Ribot C, Soler C, Chartier A, Al Hayek S, Naït-Saïdi R, Barbezier N, Coux O, Simonelig M. Activation of the ubiquitin-proteasome system contributes to oculopharyngeal muscular dystrophy through muscle atrophy. PLoS Genet 2022; 18:e1010015. [PMID: 35025870 PMCID: PMC8791501 DOI: 10.1371/journal.pgen.1010015] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Revised: 01/26/2022] [Accepted: 01/01/2022] [Indexed: 12/05/2022] Open
Abstract
Oculopharyngeal muscular dystrophy (OPMD) is a late-onset disorder characterized by progressive weakness and degeneration of specific muscles. OPMD is due to extension of a polyalanine tract in poly(A) binding protein nuclear 1 (PABPN1). Aggregation of the mutant protein in muscle nuclei is a hallmark of the disease. Previous transcriptomic analyses revealed the consistent deregulation of the ubiquitin-proteasome system (UPS) in OPMD animal models and patients, suggesting a role of this deregulation in OPMD pathogenesis. Subsequent studies proposed that UPS contribution to OPMD involved PABPN1 aggregation. Here, we use a Drosophila model of OPMD to address the functional importance of UPS deregulation in OPMD. Through genome-wide and targeted genetic screens we identify a large number of UPS components that are involved in OPMD. Half dosage of UPS genes reduces OPMD muscle defects suggesting a pathological increase of UPS activity in the disease. Quantification of proteasome activity confirms stronger activity in OPMD muscles, associated with degradation of myofibrillar proteins. Importantly, improvement of muscle structure and function in the presence of UPS mutants does not correlate with the levels of PABPN1 aggregation, but is linked to decreased degradation of muscle proteins. Oral treatment with the proteasome inhibitor MG132 is beneficial to the OPMD Drosophila model, improving muscle function although PABPN1 aggregation is enhanced. This functional study reveals the importance of increased UPS activity that underlies muscle atrophy in OPMD. It also provides a proof-of-concept that inhibitors of proteasome activity might be an attractive pharmacological approach for OPMD. Oculopharyngeal muscular dystrophy (OPMD) is a genetic disease characterized by progressive weakness of specific muscles, leading to swallowing difficulties (dysphagia), eyelid drooping (ptosis) and walking difficulties at later stages. No drug treatments are currently available. OPMD is due to mutations in a nuclear protein called poly(A) binding protein nuclear 1 (PABPN1) that is involved in processing of different classes of RNAs in the nucleus. We have used an animal model of OPMD that we have developed in the fly Drosophila to investigate the role in OPMD of the ubiquitin-proteasome system, a pathway specialized in protein degradation. We report an increased activity of the ubiquitin-proteasome system that is associated with degradation of muscular proteins in the OPMD Drosophila model. We propose that higher activity of the ubiquitin-proteasome system leads to muscle atrophy in OPMD. Importantly, oral treatment of this OPMD animal model with an inhibitor of proteasome activity reduces muscle defects. A number of proteasome inhibitors are approved drugs used in clinic against cancers, therefore our results provide a proof-of-concept that inhibitors of proteasome might be of interest in future treatments of OPMD.
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Affiliation(s)
- Cécile Ribot
- mRNA Regulation and Development, Institute of Human Genetics, UMR9002 CNRS-Univ Montpellier, Montpellier, France
| | - Cédric Soler
- mRNA Regulation and Development, Institute of Human Genetics, UMR9002 CNRS-Univ Montpellier, Montpellier, France
| | - Aymeric Chartier
- mRNA Regulation and Development, Institute of Human Genetics, UMR9002 CNRS-Univ Montpellier, Montpellier, France
| | - Sandy Al Hayek
- GReD Laboratory, Clermont-Auvergne University, INSERM U1103, CNRS UMR6293, Clermont-Ferrand, France
| | - Rima Naït-Saïdi
- mRNA Regulation and Development, Institute of Human Genetics, UMR9002 CNRS-Univ Montpellier, Montpellier, France
| | - Nicolas Barbezier
- mRNA Regulation and Development, Institute of Human Genetics, UMR9002 CNRS-Univ Montpellier, Montpellier, France
| | - Olivier Coux
- Ubiquitin-proteasome system and cell cycle control, Montpellier Cell Biology Research Center, UMR5237 CNRS-Univ Montpellier, Montpellier, France
| | - Martine Simonelig
- mRNA Regulation and Development, Institute of Human Genetics, UMR9002 CNRS-Univ Montpellier, Montpellier, France
- * E-mail:
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Kroon RHMJM, Kalf JG, de Swart BJM, van der Sluijs BM, Glennon JC, Raz V, van Engelen BG, Horlings CGC. Longitudinal Assessment of Strength, Functional Capacity, Oropharyngeal Function, and Quality of Life in Oculopharyngeal Muscular Dystrophy. Neurology 2021; 97:e1475-e1483. [PMID: 34380753 PMCID: PMC8575133 DOI: 10.1212/wnl.0000000000012640] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Accepted: 07/21/2021] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Oculopharyngeal muscular dystrophy (OPMD) is a late-onset, progressive muscle disease. Disease progression is known to be slow, but details on the natural history remain unknown. We aimed to examine the natural history of OPMD in a large nationwide cohort to determine clinical outcome measures that capture disease progression and can be used in future clinical trials. METHODS Patients invited by their treating physicians or identified from the national neuromuscular database and invited family members were examined twice 20 months apart with fixed dynamometry; Medical Research Council (MRC) grading; maximum bite force and isometric tongue strength; Motor Function Measure (MFM); 10-step stair test; maximum swallowing, chewing, and speech tasks; and quality of life assessments. RESULTS Disease progression was captured by 8 of 18 measures over 20 months in 43 patients with genetically confirmed OPMD. The largest deterioration was seen in deltoid muscle strength (-27% [range -17% to -37%]), followed by the quadriceps (-14% [range -6 to -23%]), iliopsoas (-12.2%), tongue (-9.9%), and MRC sum score (-2.5%). The 10-step stair test (-12.5%), MFM part D1 (-7.1%), and maximum repetition rate of /pa/ (-5.3%) showed a significant decrease as well (all p < 0.05). The Physical Functioning domain of the Short Form-36 Health Survey significantly deteriorated (p = 0.044). No relationship was found between disease progression and genotype or disease duration (p > 0.05). DISCUSSION Despite the slow disease progression of OPMD, this study showed that several outcome measures detected progression within 20 months. Deltoid muscle strength, measured by fixed dynamometry, showed the greatest decline. These longitudinal data provide clinical outcome measures that can be used as biomarkers in future clinical trials.
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Affiliation(s)
- Rosemarie H M J M Kroon
- From the Departments of Rehabilitation (R.H.M.J.M.K., J.G.K., B.J.M.d.S.) and Neurology (B.G.v.E., C.G.C.H.), Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen; Department of Neurology (B.M.v.d.S.), Gelre Hospital Zutphen, the Netherlands; Conway Institute of Biomolecular and Biomedical Research (J.C.G.), School of Medicine, University College Dublin, Ireland; Department of Human Genetics (V.R.), Leiden University Medical Centre; and Department of Neurology (C.G.C.H., Maastricht University Medical Center, Maastricht, the Netherlands
| | - Johanna G Kalf
- From the Departments of Rehabilitation (R.H.M.J.M.K., J.G.K., B.J.M.d.S.) and Neurology (B.G.v.E., C.G.C.H.), Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen; Department of Neurology (B.M.v.d.S.), Gelre Hospital Zutphen, the Netherlands; Conway Institute of Biomolecular and Biomedical Research (J.C.G.), School of Medicine, University College Dublin, Ireland; Department of Human Genetics (V.R.), Leiden University Medical Centre; and Department of Neurology (C.G.C.H., Maastricht University Medical Center, Maastricht, the Netherlands
| | - Bert J M de Swart
- From the Departments of Rehabilitation (R.H.M.J.M.K., J.G.K., B.J.M.d.S.) and Neurology (B.G.v.E., C.G.C.H.), Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen; Department of Neurology (B.M.v.d.S.), Gelre Hospital Zutphen, the Netherlands; Conway Institute of Biomolecular and Biomedical Research (J.C.G.), School of Medicine, University College Dublin, Ireland; Department of Human Genetics (V.R.), Leiden University Medical Centre; and Department of Neurology (C.G.C.H., Maastricht University Medical Center, Maastricht, the Netherlands
| | - Barbara M van der Sluijs
- From the Departments of Rehabilitation (R.H.M.J.M.K., J.G.K., B.J.M.d.S.) and Neurology (B.G.v.E., C.G.C.H.), Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen; Department of Neurology (B.M.v.d.S.), Gelre Hospital Zutphen, the Netherlands; Conway Institute of Biomolecular and Biomedical Research (J.C.G.), School of Medicine, University College Dublin, Ireland; Department of Human Genetics (V.R.), Leiden University Medical Centre; and Department of Neurology (C.G.C.H., Maastricht University Medical Center, Maastricht, the Netherlands
| | - Jeffrey C Glennon
- From the Departments of Rehabilitation (R.H.M.J.M.K., J.G.K., B.J.M.d.S.) and Neurology (B.G.v.E., C.G.C.H.), Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen; Department of Neurology (B.M.v.d.S.), Gelre Hospital Zutphen, the Netherlands; Conway Institute of Biomolecular and Biomedical Research (J.C.G.), School of Medicine, University College Dublin, Ireland; Department of Human Genetics (V.R.), Leiden University Medical Centre; and Department of Neurology (C.G.C.H., Maastricht University Medical Center, Maastricht, the Netherlands
| | - Vered Raz
- From the Departments of Rehabilitation (R.H.M.J.M.K., J.G.K., B.J.M.d.S.) and Neurology (B.G.v.E., C.G.C.H.), Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen; Department of Neurology (B.M.v.d.S.), Gelre Hospital Zutphen, the Netherlands; Conway Institute of Biomolecular and Biomedical Research (J.C.G.), School of Medicine, University College Dublin, Ireland; Department of Human Genetics (V.R.), Leiden University Medical Centre; and Department of Neurology (C.G.C.H., Maastricht University Medical Center, Maastricht, the Netherlands
| | - Baziel G van Engelen
- From the Departments of Rehabilitation (R.H.M.J.M.K., J.G.K., B.J.M.d.S.) and Neurology (B.G.v.E., C.G.C.H.), Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen; Department of Neurology (B.M.v.d.S.), Gelre Hospital Zutphen, the Netherlands; Conway Institute of Biomolecular and Biomedical Research (J.C.G.), School of Medicine, University College Dublin, Ireland; Department of Human Genetics (V.R.), Leiden University Medical Centre; and Department of Neurology (C.G.C.H., Maastricht University Medical Center, Maastricht, the Netherlands
| | - Corinne G C Horlings
- From the Departments of Rehabilitation (R.H.M.J.M.K., J.G.K., B.J.M.d.S.) and Neurology (B.G.v.E., C.G.C.H.), Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen; Department of Neurology (B.M.v.d.S.), Gelre Hospital Zutphen, the Netherlands; Conway Institute of Biomolecular and Biomedical Research (J.C.G.), School of Medicine, University College Dublin, Ireland; Department of Human Genetics (V.R.), Leiden University Medical Centre; and Department of Neurology (C.G.C.H., Maastricht University Medical Center, Maastricht, the Netherlands
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10
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Mohanan NK, Shaji F, Koshre GR, Laishram RS. Alternative polyadenylation: An enigma of transcript length variation in health and disease. WILEY INTERDISCIPLINARY REVIEWS-RNA 2021; 13:e1692. [PMID: 34581021 DOI: 10.1002/wrna.1692] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Revised: 06/16/2021] [Accepted: 08/24/2021] [Indexed: 12/19/2022]
Abstract
Alternative polyadenylation (APA) is a molecular mechanism during a pre-mRNA processing that involves usage of more than one polyadenylation site (PA-site) generating transcripts of varying length from a single gene. The location of a PA-site affects transcript length and coding potential of an mRNA contributing to both mRNA and protein diversification. This variation in the transcript length affects mRNA stability and translation, mRNA subcellular and tissue localization, and protein function. APA is now considered as an important regulatory mechanism in the pathophysiology of human diseases. An important consequence of the changes in the length of 3'-untranslated region (UTR) from disease-induced APA is altered protein expression. Yet, the relationship between 3'-UTR length and protein expression remains a paradox in a majority of diseases. Here, we review occurrence of APA, mechanism of PA-site selection, and consequences of transcript length variation in different diseases. Emerging evidence reveals coordinated involvement of core RNA processing factors including poly(A) polymerases in the PA-site selection in diseases-associated APAs. Targeting such APA regulators will be therapeutically significant in combating drug resistance in cancer and other complex diseases. This article is categorized under: RNA Processing > 3' End Processing RNA in Disease and Development > RNA in Disease Translation > Regulation.
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Affiliation(s)
- Neeraja K Mohanan
- Cardiovascular and Diabetes Biology Group, Rajiv Gandhi Centre for Biotechnology, Trivandrum, India
- Manipal Academy of Higher Education, Manipal, India
| | - Feba Shaji
- Cardiovascular and Diabetes Biology Group, Rajiv Gandhi Centre for Biotechnology, Trivandrum, India
- Regional Centre for Biotechnology, Faridabad, India
| | - Ganesh R Koshre
- Cardiovascular and Diabetes Biology Group, Rajiv Gandhi Centre for Biotechnology, Trivandrum, India
- Manipal Academy of Higher Education, Manipal, India
| | - Rakesh S Laishram
- Cardiovascular and Diabetes Biology Group, Rajiv Gandhi Centre for Biotechnology, Trivandrum, India
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11
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Nicolau S, Milone M, Liewluck T. Guidelines for genetic testing of muscle and neuromuscular junction disorders. Muscle Nerve 2021; 64:255-269. [PMID: 34133031 DOI: 10.1002/mus.27337] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Accepted: 05/28/2021] [Indexed: 12/24/2022]
Abstract
Despite recent advances in the understanding of inherited muscle and neuromuscular junction diseases, as well as the advent of a wide range of genetic tests, patients continue to face delays in diagnosis of sometimes treatable disorders. These guidelines outline an approach to genetic testing in such disorders. Initially, a patient's phenotype is evaluated to identify myopathies requiring directed testing, including myotonic dystrophies, facioscapulohumeral muscular dystrophy, oculopharyngeal muscular dystrophy, mitochondrial myopathies, dystrophinopathies, and oculopharyngodistal myopathy. Initial investigation in the remaining patients is generally a comprehensive gene panel by next-generation sequencing. Broad panels have a higher diagnostic yield and can be cost-effective. Due to extensive phenotypic overlap and treatment implications, genes responsible for congenital myasthenic syndromes should be included when evaluating myopathy patients. For patients whose initial genetic testing is negative or inconclusive, phenotypic re-evaluation is warranted, along with consideration of genes and variants not included initially, as well as their acquired mimickers.
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Affiliation(s)
- Stefan Nicolau
- Department of Neurology, Mayo Clinic, Rochester, Minnesota, USA
| | | | - Teerin Liewluck
- Department of Neurology, Mayo Clinic, Rochester, Minnesota, USA
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12
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Bamia A, Sinane M, Naït-Saïdi R, Dhiab J, Keruzoré M, Nguyen PH, Bertho A, Soubigou F, Halliez S, Blondel M, Trollet C, Simonelig M, Friocourt G, Béringue V, Bihel F, Voisset C. Anti-prion Drugs Targeting the Protein Folding Activity of the Ribosome Reduce PABPN1 Aggregation. Neurotherapeutics 2021; 18:1137-1150. [PMID: 33533011 PMCID: PMC8423950 DOI: 10.1007/s13311-020-00992-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/13/2020] [Indexed: 01/10/2023] Open
Abstract
Prion diseases are caused by the propagation of PrPSc, the pathological conformation of the PrPC prion protein. The molecular mechanisms underlying PrPSc propagation are still unsolved and no therapeutic solution is currently available. We thus sought to identify new anti-prion molecules and found that flunarizine inhibited PrPSc propagation in cell culture and significantly prolonged survival of prion-infected mice. Using an in silico therapeutic repositioning approach based on similarities with flunarizine chemical structure, we tested azelastine, duloxetine, ebastine, loperamide and metixene and showed that they all have an anti-prion activity. Like flunarizine, these marketed drugs reduced PrPSc propagation in cell culture and in mouse cerebellum organotypic slice culture, and inhibited the protein folding activity of the ribosome (PFAR). Strikingly, some of these drugs were also able to alleviate phenotypes due to PABPN1 nuclear aggregation in cell and Drosophila models of oculopharyngeal muscular dystrophy (OPMD). These data emphasize the therapeutic potential of anti-PFAR drugs for neurodegenerative and neuromuscular proteinopathies.
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Affiliation(s)
- Aline Bamia
- Inserm, Univ Brest, EFS, UMR 1078, GGB, F-29200, Brest, France
| | - Maha Sinane
- Inserm, Univ Brest, EFS, UMR 1078, GGB, F-29200, Brest, France
| | - Rima Naït-Saïdi
- Institute of Human Genetics, UMR9002 CNRS-Univ Montpellier, mRNA Regulation and Development, Montpellier, France
| | - Jamila Dhiab
- Sorbanne Université, Inserm, Institut de Myologie, Centre de Recherche en Myologie, F75013, Paris, France
| | - Marc Keruzoré
- Inserm, Univ Brest, EFS, UMR 1078, GGB, F-29200, Brest, France
| | - Phu Hai Nguyen
- Inserm, Univ Brest, EFS, UMR 1078, GGB, F-29200, Brest, France
- Host Parasite Interactions Section, Laboratory of Intracellular Parasites, NIAID, NIH, Rocky Mountain Laboratories, Hamilton, MT, USA
| | - Agathe Bertho
- Inserm, Univ Brest, EFS, UMR 1078, GGB, F-29200, Brest, France
| | - Flavie Soubigou
- Inserm, Univ Brest, EFS, UMR 1078, GGB, F-29200, Brest, France
- Centre for Gene Regulation and Expression, Sir James Black Centre, School of Life Sciences, University of Dundee, Dundee, DD1 5EH, UK
| | - Sophie Halliez
- INRAE, UVSQ, VIM, Université Paris-Saclay, Jouy-en-Josas, France
- Inserm, CHU Lille, U1172 - LilNCog - Lille Neuroscience & Cognition, Univ. Lille, F-59000, Lille, France
| | - Marc Blondel
- Inserm, Univ Brest, EFS, UMR 1078, GGB, F-29200, Brest, France
| | - Capucine Trollet
- Sorbanne Université, Inserm, Institut de Myologie, Centre de Recherche en Myologie, F75013, Paris, France
| | - Martine Simonelig
- Institute of Human Genetics, UMR9002 CNRS-Univ Montpellier, mRNA Regulation and Development, Montpellier, France
| | | | - Vincent Béringue
- INRAE, UVSQ, VIM, Université Paris-Saclay, Jouy-en-Josas, France
| | - Frédéric Bihel
- Laboratoire d'Innovation Thérapeutique, LIT, UMR7200, IMS MEDALIS, Faculty of Pharmacy, CNRS, Université de Strasbourg, Illkirch, F-67400, France.
| | - Cécile Voisset
- Inserm, Univ Brest, EFS, UMR 1078, GGB, F-29200, Brest, France.
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13
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Vest KE, Phillips BL, Banerjee A, Apponi LH, Dammer EB, Xu W, Zheng D, Yu J, Tian B, Pavlath GK, Corbett AH. Novel mouse models of oculopharyngeal muscular dystrophy (OPMD) reveal early onset mitochondrial defects and suggest loss of PABPN1 may contribute to pathology. Hum Mol Genet 2017; 26:3235-3252. [PMID: 28575395 PMCID: PMC5886286 DOI: 10.1093/hmg/ddx206] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2017] [Revised: 05/14/2017] [Accepted: 05/23/2017] [Indexed: 01/09/2023] Open
Abstract
Oculopharyngeal muscular dystrophy (OPMD) is a late onset disease caused by polyalanine expansion in the poly(A) binding protein nuclear 1 (PABPN1). Several mouse models have been generated to study OPMD; however, most of these models have employed transgenic overexpression of alanine-expanded PABPN1. These models do not recapitulate the OPMD patient genotype and PABPN1 overexpression could confound molecular phenotypes. We have developed a knock-in mouse model of OPMD (Pabpn1+/A17) that contains one alanine-expanded Pabpn1 allele under the control of the native promoter and one wild-type Pabpn1 allele. This mouse is the closest available genocopy of OPMD patients. We show that Pabpn1+/A17 mice have a mild myopathic phenotype in adult and aged animals. We examined early molecular and biochemical phenotypes associated with expressing native levels of A17-PABPN1 and detected shorter poly(A) tails, modest changes in poly(A) signal (PAS) usage, and evidence of mitochondrial damage in these mice. Recent studies have suggested that a loss of PABPN1 function could contribute to muscle pathology in OPMD. To investigate a loss of function model of pathology, we generated a heterozygous Pabpn1 knock-out mouse model (Pabpn1+/Δ). Like the Pabpn1+/A17 mice, Pabpn1+/Δ mice have mild histologic defects, shorter poly(A) tails, and evidence of mitochondrial damage. However, the phenotypes detected in Pabpn1+/Δ mice only partially overlap with those detected in Pabpn1+/A17 mice. These results suggest that loss of PABPN1 function could contribute to but may not completely explain the pathology detected in Pabpn1+/A17 mice.
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Affiliation(s)
- Katherine E. Vest
- Department of Pharmacology, Emory University School of Medicine, Atlanta, GA, USA
- Department of Biology, Emory University, Atlanta, GA, USA
| | - Brittany L. Phillips
- Department of Pharmacology, Emory University School of Medicine, Atlanta, GA, USA
- Department of Biology, Emory University, Atlanta, GA, USA
| | - Ayan Banerjee
- Department of Biology, Emory University, Atlanta, GA, USA
| | - Luciano H. Apponi
- Department of Pharmacology, Emory University School of Medicine, Atlanta, GA, USA
| | - Eric B. Dammer
- Department of Biochemistry, Emory University School of Medicine, Atlanta, GA, USA
| | - Weiting Xu
- Department of Microbiology, Biochemistry, and Molecular Genetics, Rutgers New Jersey Medical School, Newark, NJ, USA
| | - Dinghai Zheng
- Department of Microbiology, Biochemistry, and Molecular Genetics, Rutgers New Jersey Medical School, Newark, NJ, USA
| | - Julia Yu
- Department of Biology, Emory University, Atlanta, GA, USA
| | - Bin Tian
- Department of Microbiology, Biochemistry, and Molecular Genetics, Rutgers New Jersey Medical School, Newark, NJ, USA
| | - Grace K. Pavlath
- Department of Pharmacology, Emory University School of Medicine, Atlanta, GA, USA
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14
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Malerba A, Klein P, Bachtarzi H, Jarmin SA, Cordova G, Ferry A, Strings V, Espinoza MP, Mamchaoui K, Blumen SC, St Guily JL, Mouly V, Graham M, Butler-Browne G, Suhy DA, Trollet C, Dickson G. PABPN1 gene therapy for oculopharyngeal muscular dystrophy. Nat Commun 2017; 8:14848. [PMID: 28361972 PMCID: PMC5380963 DOI: 10.1038/ncomms14848] [Citation(s) in RCA: 47] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2016] [Accepted: 02/07/2017] [Indexed: 01/14/2023] Open
Abstract
Oculopharyngeal muscular dystrophy (OPMD) is an autosomal dominant, late-onset muscle disorder characterized by ptosis, swallowing difficulties, proximal limb weakness and nuclear aggregates in skeletal muscles. OPMD is caused by a trinucleotide repeat expansion in the PABPN1 gene that results in an N-terminal expanded polyalanine tract in polyA-binding protein nuclear 1 (PABPN1). Here we show that the treatment of a mouse model of OPMD with an adeno-associated virus-based gene therapy combining complete knockdown of endogenous PABPN1 and its replacement by a wild-type PABPN1 substantially reduces the amount of insoluble aggregates, decreases muscle fibrosis, reverts muscle strength to the level of healthy muscles and normalizes the muscle transcriptome. The efficacy of the combined treatment is further confirmed in cells derived from OPMD patients. These results pave the way towards a gene replacement approach for OPMD treatment. Oculopharyngeal muscular dystrophy is caused by trinucleotide repeat expansions in the PABPN1 gene. Here the authors use AAV-based gene therapy to knockdown the mutant gene and replace it with a wild-type allele, and show effectiveness in mice and in patient cells.
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Affiliation(s)
- A Malerba
- School of Biological Sciences, Royal Holloway, University of London, Egham Hill, Egham, TW20 0EX Surrey, UK
| | - P Klein
- Sorbonne Universités, UPMC Univ Paris 06, UM76, INSERM U974, Institut de Myologie, CNRS FRE3617, 47 bd de l'Hôpital, 75013 Paris, France
| | - H Bachtarzi
- School of Biological Sciences, Royal Holloway, University of London, Egham Hill, Egham, TW20 0EX Surrey, UK
| | - S A Jarmin
- School of Biological Sciences, Royal Holloway, University of London, Egham Hill, Egham, TW20 0EX Surrey, UK
| | - G Cordova
- Sorbonne Universités, UPMC Univ Paris 06, UM76, INSERM U974, Institut de Myologie, CNRS FRE3617, 47 bd de l'Hôpital, 75013 Paris, France
| | - A Ferry
- Sorbonne Universités, UPMC Univ Paris 06, UM76, INSERM U974, Institut de Myologie, CNRS FRE3617, 47 bd de l'Hôpital, 75013 Paris, France.,Sorbonne Paris Cité, Université Paris Descartes, 75006 Paris, France
| | - V Strings
- Benitec Biopharma, 3940 Trust Way, Hayward, California 94545, USA
| | - M Polay Espinoza
- Sorbonne Universités, UPMC Univ Paris 06, UM76, INSERM U974, Institut de Myologie, CNRS FRE3617, 47 bd de l'Hôpital, 75013 Paris, France
| | - K Mamchaoui
- Sorbonne Universités, UPMC Univ Paris 06, UM76, INSERM U974, Institut de Myologie, CNRS FRE3617, 47 bd de l'Hôpital, 75013 Paris, France
| | - S C Blumen
- Department of Neurology, Hillel Yaffe Medical Center, Hadera and Rappaport Faculty of Medicine, The Technion, 1 Efron Street, Haifa 31096, Israel
| | - J Lacau St Guily
- Sorbonne Universités, UPMC Univ Paris 06, UM76, INSERM U974, Institut de Myologie, CNRS FRE3617, 47 bd de l'Hôpital, 75013 Paris, France.,Department of Otolaryngology-Head and Neck Surgery, Faculty of Medicine and University Pierre-et-Marie-Curie, Paris VI, Tenon Hospital, Assistance Publique des Hopitaux de Paris, 75252 Paris, France
| | - V Mouly
- Sorbonne Universités, UPMC Univ Paris 06, UM76, INSERM U974, Institut de Myologie, CNRS FRE3617, 47 bd de l'Hôpital, 75013 Paris, France
| | - M Graham
- Benitec Biopharma, 3940 Trust Way, Hayward, California 94545, USA
| | - G Butler-Browne
- Sorbonne Universités, UPMC Univ Paris 06, UM76, INSERM U974, Institut de Myologie, CNRS FRE3617, 47 bd de l'Hôpital, 75013 Paris, France
| | - D A Suhy
- Benitec Biopharma, 3940 Trust Way, Hayward, California 94545, USA
| | - C Trollet
- Sorbonne Universités, UPMC Univ Paris 06, UM76, INSERM U974, Institut de Myologie, CNRS FRE3617, 47 bd de l'Hôpital, 75013 Paris, France
| | - G Dickson
- School of Biological Sciences, Royal Holloway, University of London, Egham Hill, Egham, TW20 0EX Surrey, UK
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15
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Richard P, Roth F, Stojkovic T, Trollet C. Distrofia muscolare oculofaringea. Neurologia 2017. [DOI: 10.1016/s1634-7072(16)81777-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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16
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Richard P, Trollet C, Stojkovic T, de Becdelievre A, Perie S, Pouget J, Eymard B. Correlation between PABPN1 genotype and disease severity in oculopharyngeal muscular dystrophy. Neurology 2016; 88:359-365. [PMID: 28011929 PMCID: PMC5272966 DOI: 10.1212/wnl.0000000000003554] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2016] [Accepted: 10/19/2016] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE Oculopharyngeal muscular dystrophy (OPMD) is an autosomal dominant adult-onset disease characterized by progressive ptosis, dysphagia, and proximal limb weakness. The genetic cause is an expanded (GCN)n mutation in the PABPN1 gene encoding for the polyadenylate-binding protein nuclear 1. We hypothesized a potential correlation between the size of the (GCN)n expansion and the severity of the phenotype. To do this, we characterized the distribution of the genotypes as well as their correlation with age at diagnosis and phenotypical features in a large cohort of heterozygous and homozygous patients with OPMD in France with a confirmed molecular diagnosis of PABPN1. METHODS We explored 354 unrelated index cases recruited between 1999 and 2014 in several neuromuscular centers in France. RESULTS This cohort allowed us to characterize the frequency of mutated alleles in the French population and to demonstrate a statistical correlation between the size of the expansion and the mean age at diagnosis. We also confirmed that homozygous patients present with a more severe disease. CONCLUSIONS It has been difficult to establish phenotype-genotype correlations because of the rare nature of this disease. Our work demonstrates that patients with OPMD with longer PABPN1 expansion are on average diagnosed at an earlier age than patients with a shorter expansion, confirming that polyalanine expansion size plays a role in OPMD, with an effect on disease severity and progression.
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Affiliation(s)
- Pascale Richard
- From APHP (P.R., A.d.B.), Unité Fonctionnelle de Cardiogénétique et Myogénétique Moléculaire, Hôpitaux Universitaires Pitié Salpêtrière-Charles Foix, Paris Cedex 13, INSERM UMRS1166, UPMC Paris 6; Sorbonne Universités (C.T.), UPMC Univ Paris 6, UM76, INSERM U974, Institut de Myologie, CNRS FRE3617; APHP (T.S., B.E.), Centre de Référence des Maladies Neuromusculaire, Institut de Myologie, Hôpitaux Universitaires Pitié Salpêtrière-Charles Foix, Paris; APHP (S.P.), Service d'ORL et Chirurgie Cervicofaciale, Hôpital Tenon, UPMC Paris 6; and APHM (J.P.), Aix Marseille Université, Centre de Référence des Maladies Neuromusculaires, Hôpital de La Timone, Marseille, France.
| | - Capucine Trollet
- From APHP (P.R., A.d.B.), Unité Fonctionnelle de Cardiogénétique et Myogénétique Moléculaire, Hôpitaux Universitaires Pitié Salpêtrière-Charles Foix, Paris Cedex 13, INSERM UMRS1166, UPMC Paris 6; Sorbonne Universités (C.T.), UPMC Univ Paris 6, UM76, INSERM U974, Institut de Myologie, CNRS FRE3617; APHP (T.S., B.E.), Centre de Référence des Maladies Neuromusculaire, Institut de Myologie, Hôpitaux Universitaires Pitié Salpêtrière-Charles Foix, Paris; APHP (S.P.), Service d'ORL et Chirurgie Cervicofaciale, Hôpital Tenon, UPMC Paris 6; and APHM (J.P.), Aix Marseille Université, Centre de Référence des Maladies Neuromusculaires, Hôpital de La Timone, Marseille, France
| | - Tanya Stojkovic
- From APHP (P.R., A.d.B.), Unité Fonctionnelle de Cardiogénétique et Myogénétique Moléculaire, Hôpitaux Universitaires Pitié Salpêtrière-Charles Foix, Paris Cedex 13, INSERM UMRS1166, UPMC Paris 6; Sorbonne Universités (C.T.), UPMC Univ Paris 6, UM76, INSERM U974, Institut de Myologie, CNRS FRE3617; APHP (T.S., B.E.), Centre de Référence des Maladies Neuromusculaire, Institut de Myologie, Hôpitaux Universitaires Pitié Salpêtrière-Charles Foix, Paris; APHP (S.P.), Service d'ORL et Chirurgie Cervicofaciale, Hôpital Tenon, UPMC Paris 6; and APHM (J.P.), Aix Marseille Université, Centre de Référence des Maladies Neuromusculaires, Hôpital de La Timone, Marseille, France
| | - Alix de Becdelievre
- From APHP (P.R., A.d.B.), Unité Fonctionnelle de Cardiogénétique et Myogénétique Moléculaire, Hôpitaux Universitaires Pitié Salpêtrière-Charles Foix, Paris Cedex 13, INSERM UMRS1166, UPMC Paris 6; Sorbonne Universités (C.T.), UPMC Univ Paris 6, UM76, INSERM U974, Institut de Myologie, CNRS FRE3617; APHP (T.S., B.E.), Centre de Référence des Maladies Neuromusculaire, Institut de Myologie, Hôpitaux Universitaires Pitié Salpêtrière-Charles Foix, Paris; APHP (S.P.), Service d'ORL et Chirurgie Cervicofaciale, Hôpital Tenon, UPMC Paris 6; and APHM (J.P.), Aix Marseille Université, Centre de Référence des Maladies Neuromusculaires, Hôpital de La Timone, Marseille, France
| | - Sophie Perie
- From APHP (P.R., A.d.B.), Unité Fonctionnelle de Cardiogénétique et Myogénétique Moléculaire, Hôpitaux Universitaires Pitié Salpêtrière-Charles Foix, Paris Cedex 13, INSERM UMRS1166, UPMC Paris 6; Sorbonne Universités (C.T.), UPMC Univ Paris 6, UM76, INSERM U974, Institut de Myologie, CNRS FRE3617; APHP (T.S., B.E.), Centre de Référence des Maladies Neuromusculaire, Institut de Myologie, Hôpitaux Universitaires Pitié Salpêtrière-Charles Foix, Paris; APHP (S.P.), Service d'ORL et Chirurgie Cervicofaciale, Hôpital Tenon, UPMC Paris 6; and APHM (J.P.), Aix Marseille Université, Centre de Référence des Maladies Neuromusculaires, Hôpital de La Timone, Marseille, France
| | - Jean Pouget
- From APHP (P.R., A.d.B.), Unité Fonctionnelle de Cardiogénétique et Myogénétique Moléculaire, Hôpitaux Universitaires Pitié Salpêtrière-Charles Foix, Paris Cedex 13, INSERM UMRS1166, UPMC Paris 6; Sorbonne Universités (C.T.), UPMC Univ Paris 6, UM76, INSERM U974, Institut de Myologie, CNRS FRE3617; APHP (T.S., B.E.), Centre de Référence des Maladies Neuromusculaire, Institut de Myologie, Hôpitaux Universitaires Pitié Salpêtrière-Charles Foix, Paris; APHP (S.P.), Service d'ORL et Chirurgie Cervicofaciale, Hôpital Tenon, UPMC Paris 6; and APHM (J.P.), Aix Marseille Université, Centre de Référence des Maladies Neuromusculaires, Hôpital de La Timone, Marseille, France
| | - Bruno Eymard
- From APHP (P.R., A.d.B.), Unité Fonctionnelle de Cardiogénétique et Myogénétique Moléculaire, Hôpitaux Universitaires Pitié Salpêtrière-Charles Foix, Paris Cedex 13, INSERM UMRS1166, UPMC Paris 6; Sorbonne Universités (C.T.), UPMC Univ Paris 6, UM76, INSERM U974, Institut de Myologie, CNRS FRE3617; APHP (T.S., B.E.), Centre de Référence des Maladies Neuromusculaire, Institut de Myologie, Hôpitaux Universitaires Pitié Salpêtrière-Charles Foix, Paris; APHP (S.P.), Service d'ORL et Chirurgie Cervicofaciale, Hôpital Tenon, UPMC Paris 6; and APHM (J.P.), Aix Marseille Université, Centre de Référence des Maladies Neuromusculaires, Hôpital de La Timone, Marseille, France
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17
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Klein P, Oloko M, Roth F, Montel V, Malerba A, Jarmin S, Gidaro T, Popplewell L, Perie S, Lacau St Guily J, de la Grange P, Antoniou MN, Dickson G, Butler-Browne G, Bastide B, Mouly V, Trollet C. Nuclear poly(A)-binding protein aggregates misplace a pre-mRNA outside of SC35 speckle causing its abnormal splicing. Nucleic Acids Res 2016; 44:10929-10945. [PMID: 27507886 PMCID: PMC5159528 DOI: 10.1093/nar/gkw703] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2015] [Revised: 07/25/2016] [Accepted: 07/29/2016] [Indexed: 11/21/2022] Open
Abstract
A short abnormal polyalanine expansion in the polyadenylate-binding protein nuclear-1 (PABPN1) protein causes oculopharyngeal muscular dystrophy (OPMD). Mutated PABPN1 proteins accumulate as insoluble intranuclear aggregates in muscles of OPMD patients. While the roles of PABPN1 in nuclear polyadenylation and regulation of alternative poly(A) site choice have been established, the molecular mechanisms which trigger pathological defects in OPMD and the role of aggregates remain to be determined. Using exon array, for the first time we have identified several splicing defects in OPMD. In particular, we have demonstrated a defect in the splicing regulation of the muscle-specific Troponin T3 (TNNT3) mutually exclusive exons 16 and 17 in OPMD samples compared to controls. This splicing defect is directly linked to the SC35 (SRSF2) splicing factor and to the presence of nuclear aggregates. As reported here, PABPN1 aggregates are able to trap TNNT3 pre-mRNA, driving it outside nuclear speckles, leading to an altered SC35-mediated splicing. This results in a decreased calcium sensitivity of muscle fibers, which could in turn plays a role in muscle pathology. We thus report a novel mechanism of alternative splicing deregulation that may play a role in various other diseases with nuclear inclusions or foci containing an RNA binding protein.
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Affiliation(s)
- Pierre Klein
- Sorbonne Universités, UPMC Univ Paris 06, Centre de Recherche en Myologie, INSERM UMRS974, CNRS FRE3617, Institut de Myologie, 47 bd de l'Hôpital, 75013 Paris, France
| | - Martine Oloko
- Sorbonne Universités, UPMC Univ Paris 06, Centre de Recherche en Myologie, INSERM UMRS974, CNRS FRE3617, Institut de Myologie, 47 bd de l'Hôpital, 75013 Paris, France
| | - Fanny Roth
- Sorbonne Universités, UPMC Univ Paris 06, Centre de Recherche en Myologie, INSERM UMRS974, CNRS FRE3617, Institut de Myologie, 47 bd de l'Hôpital, 75013 Paris, France
| | - Valérie Montel
- Univ. Lille - URePSSS - Unité de Recherche Pluridisciplinaire Sport Santé Société, équipe APMS, F-59000 Lille, France
| | - Alberto Malerba
- School of Biological Sciences, Royal Holloway - University of London, Egham, Surrey TW20 0EX, UK
| | - Susan Jarmin
- School of Biological Sciences, Royal Holloway - University of London, Egham, Surrey TW20 0EX, UK
| | - Teresa Gidaro
- Sorbonne Universités, UPMC Univ Paris 06, Centre de Recherche en Myologie, INSERM UMRS974, CNRS FRE3617, Institut de Myologie, 47 bd de l'Hôpital, 75013 Paris, France
| | - Linda Popplewell
- School of Biological Sciences, Royal Holloway - University of London, Egham, Surrey TW20 0EX, UK
| | - Sophie Perie
- Sorbonne Universités, UPMC Univ Paris 06, Centre de Recherche en Myologie, INSERM UMRS974, CNRS FRE3617, Institut de Myologie, 47 bd de l'Hôpital, 75013 Paris, France.,Department of Otolaryngology-Head and Neck Surgery, University Pierre-et-Marie-Curie, Paris VI, Tenon Hospital, Assistance Publique des Hopitaux de Paris, Paris, France
| | - Jean Lacau St Guily
- Sorbonne Universités, UPMC Univ Paris 06, Centre de Recherche en Myologie, INSERM UMRS974, CNRS FRE3617, Institut de Myologie, 47 bd de l'Hôpital, 75013 Paris, France.,Department of Otolaryngology-Head and Neck Surgery, University Pierre-et-Marie-Curie, Paris VI, Tenon Hospital, Assistance Publique des Hopitaux de Paris, Paris, France
| | | | - Michael N Antoniou
- King's College London School of Medicine, Gene Expression and Therapy Group, Department of Medical and Molecular Genetics, Guy's Hospital, London, UK
| | - George Dickson
- School of Biological Sciences, Royal Holloway - University of London, Egham, Surrey TW20 0EX, UK
| | - Gillian Butler-Browne
- Sorbonne Universités, UPMC Univ Paris 06, Centre de Recherche en Myologie, INSERM UMRS974, CNRS FRE3617, Institut de Myologie, 47 bd de l'Hôpital, 75013 Paris, France
| | - Bruno Bastide
- Univ. Lille - URePSSS - Unité de Recherche Pluridisciplinaire Sport Santé Société, équipe APMS, F-59000 Lille, France
| | - Vincent Mouly
- Sorbonne Universités, UPMC Univ Paris 06, Centre de Recherche en Myologie, INSERM UMRS974, CNRS FRE3617, Institut de Myologie, 47 bd de l'Hôpital, 75013 Paris, France
| | - Capucine Trollet
- Sorbonne Universités, UPMC Univ Paris 06, Centre de Recherche en Myologie, INSERM UMRS974, CNRS FRE3617, Institut de Myologie, 47 bd de l'Hôpital, 75013 Paris, France
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