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D’Sa K, Evans JR, Virdi GS, Vecchi G, Adam A, Bertolli O, Fleming J, Chang H, Leighton C, Horrocks MH, Athauda D, Choi ML, Gandhi S. Prediction of mechanistic subtypes of Parkinson's using patient-derived stem cell models. NAT MACH INTELL 2023; 5:933-946. [PMID: 37615030 PMCID: PMC10442231 DOI: 10.1038/s42256-023-00702-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2022] [Accepted: 07/06/2023] [Indexed: 08/25/2023]
Abstract
Parkinson's disease is a common, incurable neurodegenerative disorder that is clinically heterogeneous: it is likely that different cellular mechanisms drive the pathology in different individuals. So far it has not been possible to define the cellular mechanism underlying the neurodegenerative disease in life. We generated a machine learning-based model that can simultaneously predict the presence of disease and its primary mechanistic subtype in human neurons. We used stem cell technology to derive control or patient-derived neurons, and generated different disease subtypes through chemical induction or the presence of mutation. Multidimensional fluorescent labelling of organelles was performed in healthy control neurons and in four different disease subtypes, and both the quantitative single-cell fluorescence features and the images were used to independently train a series of classifiers to build deep neural networks. Quantitative cellular profile-based classifiers achieve an accuracy of 82%, whereas image-based deep neural networks predict control and four distinct disease subtypes with an accuracy of 95%. The machine learning-trained classifiers achieve their accuracy across all subtypes, using the organellar features of the mitochondria with the additional contribution of the lysosomes, confirming the biological importance of these pathways in Parkinson's. Altogether, we show that machine learning approaches applied to patient-derived cells are highly accurate at predicting disease subtypes, providing proof of concept that this approach may enable mechanistic stratification and precision medicine approaches in the future.
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Affiliation(s)
- Karishma D’Sa
- Department of Clinical and Movement Neurosciences, UCL Queen Square Institute of Neurology, London, UK
- The Francis Crick Institute, King’s Cross, London, UK
| | - James R. Evans
- Department of Clinical and Movement Neurosciences, UCL Queen Square Institute of Neurology, London, UK
- The Francis Crick Institute, King’s Cross, London, UK
| | - Gurvir S. Virdi
- Department of Clinical and Movement Neurosciences, UCL Queen Square Institute of Neurology, London, UK
- The Francis Crick Institute, King’s Cross, London, UK
| | | | | | | | - James Fleming
- The Francis Crick Institute, King’s Cross, London, UK
| | - Hojong Chang
- Institute for IT Convergence, KAIST, Daejeon, Republic of Korea
| | - Craig Leighton
- EaStCHEM School of Chemistry, The University of Edinburgh, Edinburgh, UK
- IRR Chemistry Hub, Institute for Regeneration and Repair, The University of Edinburgh, Edinburgh, UK
| | - Mathew H. Horrocks
- EaStCHEM School of Chemistry, The University of Edinburgh, Edinburgh, UK
- IRR Chemistry Hub, Institute for Regeneration and Repair, The University of Edinburgh, Edinburgh, UK
| | - Dilan Athauda
- Department of Clinical and Movement Neurosciences, UCL Queen Square Institute of Neurology, London, UK
- The Francis Crick Institute, King’s Cross, London, UK
| | - Minee L. Choi
- Department of Clinical and Movement Neurosciences, UCL Queen Square Institute of Neurology, London, UK
- The Francis Crick Institute, King’s Cross, London, UK
- Department of Brain & Cognitive Sciences, KAIST, Daejeon, Republic of Korea
| | - Sonia Gandhi
- Department of Clinical and Movement Neurosciences, UCL Queen Square Institute of Neurology, London, UK
- The Francis Crick Institute, King’s Cross, London, UK
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Virdi GS, Choi ML, Evans JR, Yao Z, Athauda D, Strohbuecker S, Nirujogi RS, Wernick AI, Pelegrina-Hidalgo N, Leighton C, Saleeb RS, Kopach O, Alrashidi H, Melandri D, Perez-Lloret J, Angelova PR, Sylantyev S, Eaton S, Heales S, Rusakov DA, Alessi DR, Kunath T, Horrocks MH, Abramov AY, Patani R, Gandhi S. Protein aggregation and calcium dysregulation are hallmarks of familial Parkinson's disease in midbrain dopaminergic neurons. NPJ Parkinsons Dis 2022; 8:162. [PMID: 36424392 PMCID: PMC9691718 DOI: 10.1038/s41531-022-00423-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Accepted: 10/27/2022] [Indexed: 11/27/2022] Open
Abstract
Mutations in the SNCA gene cause autosomal dominant Parkinson's disease (PD), with loss of dopaminergic neurons in the substantia nigra, and aggregation of α-synuclein. The sequence of molecular events that proceed from an SNCA mutation during development, to end-stage pathology is unknown. Utilising human-induced pluripotent stem cells (hiPSCs), we resolved the temporal sequence of SNCA-induced pathophysiological events in order to discover early, and likely causative, events. Our small molecule-based protocol generates highly enriched midbrain dopaminergic (mDA) neurons: molecular identity was confirmed using single-cell RNA sequencing and proteomics, and functional identity was established through dopamine synthesis, and measures of electrophysiological activity. At the earliest stage of differentiation, prior to maturation to mDA neurons, we demonstrate the formation of small β-sheet-rich oligomeric aggregates, in SNCA-mutant cultures. Aggregation persists and progresses, ultimately resulting in the accumulation of phosphorylated α-synuclein aggregates. Impaired intracellular calcium signalling, increased basal calcium, and impairments in mitochondrial calcium handling occurred early at day 34-41 post differentiation. Once midbrain identity fully developed, at day 48-62 post differentiation, SNCA-mutant neurons exhibited mitochondrial dysfunction, oxidative stress, lysosomal swelling and increased autophagy. Ultimately these multiple cellular stresses lead to abnormal excitability, altered neuronal activity, and cell death. Our differentiation paradigm generates an efficient model for studying disease mechanisms in PD and highlights that protein misfolding to generate intraneuronal oligomers is one of the earliest critical events driving disease in human neurons, rather than a late-stage hallmark of the disease.
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Affiliation(s)
- Gurvir S Virdi
- The Francis Crick Institute, 1 Midland Road, London, NW1 1AT, UK
- Department of Clinical and Movement Neurosciences, UCL Queen Square Institute of Neurology, Queen Square, London, WC1N 3BG, UK
- Aligning Science Across Parkinson's (ASAP) Collaborative Research Network, Chevy Chase, MD, 20815, USA
| | - Minee L Choi
- The Francis Crick Institute, 1 Midland Road, London, NW1 1AT, UK
- Department of Clinical and Movement Neurosciences, UCL Queen Square Institute of Neurology, Queen Square, London, WC1N 3BG, UK
- Aligning Science Across Parkinson's (ASAP) Collaborative Research Network, Chevy Chase, MD, 20815, USA
| | - James R Evans
- The Francis Crick Institute, 1 Midland Road, London, NW1 1AT, UK
- Department of Clinical and Movement Neurosciences, UCL Queen Square Institute of Neurology, Queen Square, London, WC1N 3BG, UK
- Aligning Science Across Parkinson's (ASAP) Collaborative Research Network, Chevy Chase, MD, 20815, USA
| | - Zhi Yao
- The Francis Crick Institute, 1 Midland Road, London, NW1 1AT, UK
- Department of Clinical and Movement Neurosciences, UCL Queen Square Institute of Neurology, Queen Square, London, WC1N 3BG, UK
| | - Dilan Athauda
- The Francis Crick Institute, 1 Midland Road, London, NW1 1AT, UK
- Department of Clinical and Movement Neurosciences, UCL Queen Square Institute of Neurology, Queen Square, London, WC1N 3BG, UK
| | | | - Raja S Nirujogi
- Aligning Science Across Parkinson's (ASAP) Collaborative Research Network, Chevy Chase, MD, 20815, USA
- Medical Research Council (MRC) Protein Phosphorylation and Ubiquitylation Unit, School of Life Sciences, University of Dundee, Dow Street, Dundee, DD1 5EH, UK
| | - Anna I Wernick
- The Francis Crick Institute, 1 Midland Road, London, NW1 1AT, UK
- Department of Clinical and Movement Neurosciences, UCL Queen Square Institute of Neurology, Queen Square, London, WC1N 3BG, UK
- Aligning Science Across Parkinson's (ASAP) Collaborative Research Network, Chevy Chase, MD, 20815, USA
| | - Noelia Pelegrina-Hidalgo
- EaStCHEM School of Chemistry, University of Edinburgh, Edinburgh, EH9 3FJ, UK
- Center for Regenerative Medicine, University of Edinburgh, Edinburgh, EH16 4UU, UK
| | - Craig Leighton
- EaStCHEM School of Chemistry, University of Edinburgh, Edinburgh, EH9 3FJ, UK
- Center for Regenerative Medicine, University of Edinburgh, Edinburgh, EH16 4UU, UK
| | - Rebecca S Saleeb
- EaStCHEM School of Chemistry, University of Edinburgh, Edinburgh, EH9 3FJ, UK
| | - Olga Kopach
- Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, London, WC1N 3BG, UK
| | - Haya Alrashidi
- UCL Great Ormond Street Institute of Child Health, London, WC1N 1EH, UK
| | - Daniela Melandri
- Department of Neurodegenerative Diseases, UCL Queen Square Institute of Neurology, Queen Square, London, WC1N 3BG, UK
| | | | - Plamena R Angelova
- Department of Clinical and Movement Neurosciences, UCL Queen Square Institute of Neurology, Queen Square, London, WC1N 3BG, UK
| | - Sergiy Sylantyev
- Rowett Institute, University of Aberdeen, Ashgrove Rd West, Aberdeen, AB25 2ZD, UK
| | - Simon Eaton
- UCL Great Ormond Street Institute of Child Health, London, WC1N 1EH, UK
| | - Simon Heales
- UCL Great Ormond Street Institute of Child Health, London, WC1N 1EH, UK
| | - Dmitri A Rusakov
- Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, London, WC1N 3BG, UK
| | - Dario R Alessi
- Aligning Science Across Parkinson's (ASAP) Collaborative Research Network, Chevy Chase, MD, 20815, USA
- Medical Research Council (MRC) Protein Phosphorylation and Ubiquitylation Unit, School of Life Sciences, University of Dundee, Dow Street, Dundee, DD1 5EH, UK
| | - Tilo Kunath
- Center for Regenerative Medicine, University of Edinburgh, Edinburgh, EH16 4UU, UK
| | - Mathew H Horrocks
- EaStCHEM School of Chemistry, University of Edinburgh, Edinburgh, EH9 3FJ, UK
| | - Andrey Y Abramov
- Department of Clinical and Movement Neurosciences, UCL Queen Square Institute of Neurology, Queen Square, London, WC1N 3BG, UK
| | - Rickie Patani
- The Francis Crick Institute, 1 Midland Road, London, NW1 1AT, UK.
- Department of Neuromuscular Disease, UCL Queen Square Institute of Neurology, Queen Square, London, WC1N 3BG, UK.
| | - Sonia Gandhi
- The Francis Crick Institute, 1 Midland Road, London, NW1 1AT, UK.
- Department of Clinical and Movement Neurosciences, UCL Queen Square Institute of Neurology, Queen Square, London, WC1N 3BG, UK.
- Aligning Science Across Parkinson's (ASAP) Collaborative Research Network, Chevy Chase, MD, 20815, USA.
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Choi ML, Chappard A, Singh BP, Maclachlan C, Rodrigues M, Fedotova EI, Berezhnov AV, De S, Peddie CJ, Athauda D, Virdi GS, Zhang W, Evans JR, Wernick AI, Zanjani ZS, Angelova PR, Esteras N, Vinokurov AY, Morris K, Jeacock K, Tosatto L, Little D, Gissen P, Clarke DJ, Kunath T, Collinson L, Klenerman D, Abramov AY, Horrocks MH, Gandhi S. Author Correction: Pathological structural conversion of α-synuclein at the mitochondria induces neuronal toxicity. Nat Neurosci 2022; 25:1582. [PMID: 36261654 PMCID: PMC9630127 DOI: 10.1038/s41593-022-01206-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Affiliation(s)
- Minee L Choi
- Department of Clinical and Movement Neurosciences, UCL Queen Square Institute of Neurology, London, UK.,The Francis Crick Institute, London, UK.,Aligning Science Across Parkinson's (ASAP) Collaborative Research Network, Chevy Chase, MD, USA
| | | | - Bhanu P Singh
- EaStCHEM School of Chemistry, University of Edinburgh, Edinburgh, UK.,School of Physics, University of Edinburgh, Edinburgh, UK
| | | | - Margarida Rodrigues
- Department of Chemistry, University of Cambridge, Cambridge, UK.,Dementia Research institute at University of Cambridge, Cambridge, UK
| | - Evgeniya I Fedotova
- Institute of Cell Biophysics, Russian Academy of Sciences, Pushchino, Russia.,Cell Physiology and Pathology Laboratory, Orel State University, Orel, Russia
| | - Alexey V Berezhnov
- Institute of Cell Biophysics, Russian Academy of Sciences, Pushchino, Russia.,Cell Physiology and Pathology Laboratory, Orel State University, Orel, Russia
| | - Suman De
- Department of Chemistry, University of Cambridge, Cambridge, UK.,Dementia Research institute at University of Cambridge, Cambridge, UK
| | | | - Dilan Athauda
- Department of Clinical and Movement Neurosciences, UCL Queen Square Institute of Neurology, London, UK.,The Francis Crick Institute, London, UK
| | - Gurvir S Virdi
- Department of Clinical and Movement Neurosciences, UCL Queen Square Institute of Neurology, London, UK.,The Francis Crick Institute, London, UK.,Aligning Science Across Parkinson's (ASAP) Collaborative Research Network, Chevy Chase, MD, USA
| | - Weijia Zhang
- Department of Clinical and Movement Neurosciences, UCL Queen Square Institute of Neurology, London, UK.,The Francis Crick Institute, London, UK
| | - James R Evans
- Department of Clinical and Movement Neurosciences, UCL Queen Square Institute of Neurology, London, UK.,The Francis Crick Institute, London, UK.,Aligning Science Across Parkinson's (ASAP) Collaborative Research Network, Chevy Chase, MD, USA
| | - Anna I Wernick
- Department of Clinical and Movement Neurosciences, UCL Queen Square Institute of Neurology, London, UK.,The Francis Crick Institute, London, UK.,Aligning Science Across Parkinson's (ASAP) Collaborative Research Network, Chevy Chase, MD, USA
| | - Zeinab Shadman Zanjani
- Department of Clinical and Movement Neurosciences, UCL Queen Square Institute of Neurology, London, UK.,The Francis Crick Institute, London, UK.,Aligning Science Across Parkinson's (ASAP) Collaborative Research Network, Chevy Chase, MD, USA
| | - Plamena R Angelova
- Department of Clinical and Movement Neurosciences, UCL Queen Square Institute of Neurology, London, UK
| | - Noemi Esteras
- Department of Clinical and Movement Neurosciences, UCL Queen Square Institute of Neurology, London, UK
| | - Andrey Y Vinokurov
- Cell Physiology and Pathology Laboratory, Orel State University, Orel, Russia
| | - Katie Morris
- EaStCHEM School of Chemistry, University of Edinburgh, Edinburgh, UK
| | - Kiani Jeacock
- EaStCHEM School of Chemistry, University of Edinburgh, Edinburgh, UK
| | - Laura Tosatto
- Department of Chemistry, University of Cambridge, Cambridge, UK.,Istituto di Biofisica, National Council of Research, Trento, Italy
| | - Daniel Little
- MRC Laboratory for Molecular Cell Biology, University College London, London, UK.,NIHR Great Ormond Street Hospital Biomedical Research Centre, London, UK
| | - Paul Gissen
- MRC Laboratory for Molecular Cell Biology, University College London, London, UK.,NIHR Great Ormond Street Hospital Biomedical Research Centre, London, UK
| | - David J Clarke
- EaStCHEM School of Chemistry, University of Edinburgh, Edinburgh, UK
| | - Tilo Kunath
- Centre for Regenerative Medicine, Institute for Stem Cell Research, School of Biological Sciences, University of Edinburgh, Edinburgh, UK
| | | | - David Klenerman
- Department of Chemistry, University of Cambridge, Cambridge, UK.,Dementia Research institute at University of Cambridge, Cambridge, UK
| | - Andrey Y Abramov
- Department of Clinical and Movement Neurosciences, UCL Queen Square Institute of Neurology, London, UK. .,Cell Physiology and Pathology Laboratory, Orel State University, Orel, Russia.
| | - Mathew H Horrocks
- EaStCHEM School of Chemistry, University of Edinburgh, Edinburgh, UK.
| | - Sonia Gandhi
- Department of Clinical and Movement Neurosciences, UCL Queen Square Institute of Neurology, London, UK. .,The Francis Crick Institute, London, UK. .,Aligning Science Across Parkinson's (ASAP) Collaborative Research Network, Chevy Chase, MD, USA.
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4
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Choi ML, Chappard A, Singh BP, Maclachlan C, Rodrigues M, Fedotova EI, Berezhnov AV, De S, Peddie CJ, Athauda D, Virdi GS, Zhang W, Evans JR, Wernick AI, Zanjani ZS, Angelova PR, Esteras N, Vinokurov AY, Morris K, Jeacock K, Tosatto L, Little D, Gissen P, Clarke DJ, Kunath T, Collinson L, Klenerman D, Abramov AY, Horrocks MH, Gandhi S. Pathological structural conversion of α-synuclein at the mitochondria induces neuronal toxicity. Nat Neurosci 2022; 25:1134-1148. [PMID: 36042314 PMCID: PMC9448679 DOI: 10.1038/s41593-022-01140-3] [Citation(s) in RCA: 62] [Impact Index Per Article: 31.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Accepted: 07/12/2022] [Indexed: 11/08/2022]
Abstract
Aggregation of alpha-synuclein (α-Syn) drives Parkinson's disease (PD), although the initial stages of self-assembly and structural conversion have not been directly observed inside neurons. In this study, we tracked the intracellular conformational states of α-Syn using a single-molecule Förster resonance energy transfer (smFRET) biosensor, and we show here that α-Syn converts from a monomeric state into two distinct oligomeric states in neurons in a concentration-dependent and sequence-specific manner. Three-dimensional FRET-correlative light and electron microscopy (FRET-CLEM) revealed that intracellular seeding events occur preferentially on membrane surfaces, especially at mitochondrial membranes. The mitochondrial lipid cardiolipin triggers rapid oligomerization of A53T α-Syn, and cardiolipin is sequestered within aggregating lipid-protein complexes. Mitochondrial aggregates impair complex I activity and increase mitochondrial reactive oxygen species (ROS) generation, which accelerates the oligomerization of A53T α-Syn and causes permeabilization of mitochondrial membranes and cell death. These processes were also observed in induced pluripotent stem cell (iPSC)-derived neurons harboring A53T mutations from patients with PD. Our study highlights a mechanism of de novo α-Syn oligomerization at mitochondrial membranes and subsequent neuronal toxicity.
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Affiliation(s)
- Minee L Choi
- Department of Clinical and Movement Neurosciences, UCL Queen Square Institute of Neurology, London, UK
- The Francis Crick Institute, London, UK
- Aligning Science Across Parkinson's (ASAP) Collaborative Research Network, Chevy Chase, MD, USA
| | | | - Bhanu P Singh
- EaStCHEM School of Chemistry, University of Edinburgh, Edinburgh, UK
- School of Physics, University of Edinburgh, Edinburgh, UK
| | | | - Margarida Rodrigues
- Department of Chemistry, University of Cambridge, Cambridge, UK
- Dementia Research institute at University of Cambridge, Cambridge, UK
| | - Evgeniya I Fedotova
- Institute of Cell Biophysics, Russian Academy of Sciences, Pushchino, Russia
- Cell Physiology and Pathology Laboratory, Orel State University, Orel, Russia
| | - Alexey V Berezhnov
- Institute of Cell Biophysics, Russian Academy of Sciences, Pushchino, Russia
- Cell Physiology and Pathology Laboratory, Orel State University, Orel, Russia
| | - Suman De
- Department of Chemistry, University of Cambridge, Cambridge, UK
- Dementia Research institute at University of Cambridge, Cambridge, UK
| | | | - Dilan Athauda
- Department of Clinical and Movement Neurosciences, UCL Queen Square Institute of Neurology, London, UK
- The Francis Crick Institute, London, UK
| | - Gurvir S Virdi
- Department of Clinical and Movement Neurosciences, UCL Queen Square Institute of Neurology, London, UK
- The Francis Crick Institute, London, UK
- Aligning Science Across Parkinson's (ASAP) Collaborative Research Network, Chevy Chase, MD, USA
| | - Weijia Zhang
- Department of Clinical and Movement Neurosciences, UCL Queen Square Institute of Neurology, London, UK
- The Francis Crick Institute, London, UK
| | - James R Evans
- Department of Clinical and Movement Neurosciences, UCL Queen Square Institute of Neurology, London, UK
- The Francis Crick Institute, London, UK
- Aligning Science Across Parkinson's (ASAP) Collaborative Research Network, Chevy Chase, MD, USA
| | - Anna I Wernick
- Department of Clinical and Movement Neurosciences, UCL Queen Square Institute of Neurology, London, UK
- The Francis Crick Institute, London, UK
- Aligning Science Across Parkinson's (ASAP) Collaborative Research Network, Chevy Chase, MD, USA
| | - Zeinab Shadman Zanjani
- Department of Clinical and Movement Neurosciences, UCL Queen Square Institute of Neurology, London, UK
- The Francis Crick Institute, London, UK
- Aligning Science Across Parkinson's (ASAP) Collaborative Research Network, Chevy Chase, MD, USA
| | - Plamena R Angelova
- Department of Clinical and Movement Neurosciences, UCL Queen Square Institute of Neurology, London, UK
| | - Noemi Esteras
- Department of Clinical and Movement Neurosciences, UCL Queen Square Institute of Neurology, London, UK
| | - Andrey Y Vinokurov
- Cell Physiology and Pathology Laboratory, Orel State University, Orel, Russia
| | - Katie Morris
- EaStCHEM School of Chemistry, University of Edinburgh, Edinburgh, UK
| | - Kiani Jeacock
- EaStCHEM School of Chemistry, University of Edinburgh, Edinburgh, UK
| | - Laura Tosatto
- Department of Chemistry, University of Cambridge, Cambridge, UK
- Istituto di Biofisica, National Council of Research, Trento, Italy
| | - Daniel Little
- MRC Laboratory for Molecular Cell Biology, University College London, London, UK
- NIHR Great Ormond Street Hospital Biomedical Research Centre, London, UK
| | - Paul Gissen
- MRC Laboratory for Molecular Cell Biology, University College London, London, UK
- NIHR Great Ormond Street Hospital Biomedical Research Centre, London, UK
| | - David J Clarke
- EaStCHEM School of Chemistry, University of Edinburgh, Edinburgh, UK
| | - Tilo Kunath
- Centre for Regenerative Medicine, Institute for Stem Cell Research, School of Biological Sciences, University of Edinburgh, Edinburgh, UK
| | | | - David Klenerman
- Department of Chemistry, University of Cambridge, Cambridge, UK
- Dementia Research institute at University of Cambridge, Cambridge, UK
| | - Andrey Y Abramov
- Department of Clinical and Movement Neurosciences, UCL Queen Square Institute of Neurology, London, UK.
- Cell Physiology and Pathology Laboratory, Orel State University, Orel, Russia.
| | - Mathew H Horrocks
- EaStCHEM School of Chemistry, University of Edinburgh, Edinburgh, UK.
| | - Sonia Gandhi
- Department of Clinical and Movement Neurosciences, UCL Queen Square Institute of Neurology, London, UK.
- The Francis Crick Institute, London, UK.
- Aligning Science Across Parkinson's (ASAP) Collaborative Research Network, Chevy Chase, MD, USA.
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5
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Athauda D, Evans J, Wernick A, Virdi G, Choi ML, Lawton M, Vijiaratnam N, Girges C, Ben‐Shlomo Y, Ismail K, Morris H, Grosset D, Foltynie T, Gandhi S. The Impact of Type 2 Diabetes in Parkinson's Disease. Mov Disord 2022; 37:1612-1623. [PMID: 35699244 PMCID: PMC9543753 DOI: 10.1002/mds.29122] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Revised: 05/16/2022] [Accepted: 05/19/2022] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND Type 2 diabetes (T2DM) is an established risk factor for developing Parkinson's disease (PD), but its effect on disease progression is not well understood. OBJECTIVE The aim of this study was to investigate the influence of T2DM on aspects of disease progression in PD. METHODS We analyzed data from the Tracking Parkinson's study to examine the effects of comorbid T2DM on PD progression and quality of life by comparing symptom severity scores assessing a range of motor and nonmotor symptoms. RESULTS We identified 167 (8.7%) patients with PD and T2DM (PD + T2DM) and 1763 (91.3%) patients with PD without T2DM (PD). After controlling for confounders, patients with T2DM had more severe motor symptoms, as assessed by Movement Disorder Society Unified Parkinson's Disease Rating Scale, Part III (25.8 [0.9] vs. 22.5 [0.3] P = 0.002), and nonmotor symptoms, as assessed by Non-Motor Symptoms Scale total (38.4 [2.5] vs. 31.8 [0.7] P < 0.001), and were significantly more likely to report loss of independence (odds ratio, 2.08; 95% confidence interval [CI]: 1.34-3.25; P = 0.001) and depression (odds ratio, 1.62; CI: 1.10-2.39; P = 0.015). Furthermore, over time, patients with T2DM had significantly faster motor symptom progression (P = 0.012), developed worse mood symptoms (P = 0.041), and were more likely to develop substantial gait impairment (hazard ratio, 1.55; CI: 1.07-2.23; P = 0.020) and mild cognitive impairment (hazard ratio, 1.7; CI: 1.24-2.51; P = 0.002) compared with the PD group. CONCLUSIONS In the largest study to date, T2DM is associated with faster disease progression in Parkinson's, highlighting an interaction between these two diseases. Because it is a potentially modifiable metabolic state, with multiple peripheral and central targets for intervention, it may represent a target for alleviating parkinsonian symptoms and slowing progression to disability and dementia. © 2022 The Authors. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Dilan Athauda
- Neurodegeneration Biology LaboratoryFrancis Crick InstituteLondonUnited Kingdom,UCL Queen Square Institute of NeurologyLondonUnited Kingdom,Department of Clinical and Movement NeurosciencesUCL Queen Square Institute of NeurologyLondonUnited Kingdom
| | - James Evans
- Neurodegeneration Biology LaboratoryFrancis Crick InstituteLondonUnited Kingdom,UCL Queen Square Institute of NeurologyLondonUnited Kingdom
| | - Anna Wernick
- Neurodegeneration Biology LaboratoryFrancis Crick InstituteLondonUnited Kingdom,UCL Queen Square Institute of NeurologyLondonUnited Kingdom
| | - Gurvir Virdi
- Neurodegeneration Biology LaboratoryFrancis Crick InstituteLondonUnited Kingdom,UCL Queen Square Institute of NeurologyLondonUnited Kingdom
| | - Minee L. Choi
- Neurodegeneration Biology LaboratoryFrancis Crick InstituteLondonUnited Kingdom,UCL Queen Square Institute of NeurologyLondonUnited Kingdom
| | - Michael Lawton
- School of Social and Community MedicineUniversity of BristolBristolUnited Kingdom
| | - Nirosen Vijiaratnam
- Department of Clinical and Movement NeurosciencesUCL Queen Square Institute of NeurologyLondonUnited Kingdom
| | - Christine Girges
- Department of Clinical and Movement NeurosciencesUCL Queen Square Institute of NeurologyLondonUnited Kingdom
| | - Yoav Ben‐Shlomo
- School of Social and Community MedicineUniversity of BristolBristolUnited Kingdom
| | - Khalida Ismail
- Department of Psychological MedicineKing's College LondonUnited Kingdom
| | - Huw Morris
- Department of Clinical and Movement NeurosciencesUCL Queen Square Institute of NeurologyLondonUnited Kingdom
| | - Donald Grosset
- Institute of Neurological SciencesQueen Elizabeth University HospitalGlasgowUnited Kingdom
| | - Thomas Foltynie
- Department of Clinical and Movement NeurosciencesUCL Queen Square Institute of NeurologyLondonUnited Kingdom
| | - Sonia Gandhi
- Neurodegeneration Biology LaboratoryFrancis Crick InstituteLondonUnited Kingdom,UCL Queen Square Institute of NeurologyLondonUnited Kingdom,Department of Clinical and Movement NeurosciencesUCL Queen Square Institute of NeurologyLondonUnited Kingdom
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6
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Angelova PR, Choi ML, Berezhnov AV, Horrocks MH, Hughes CD, De S, Rodrigues M, Yapom R, Little D, Dolt KS, Kunath T, Devine MJ, Gissen P, Shchepinov MS, Sylantyev S, Pavlov EV, Klenerman D, Abramov AY, Gandhi S. Correction: Alpha synuclein aggregation drives ferroptosis: an interplay of iron, calcium and lipid peroxidation. Cell Death Differ 2020; 27:2747. [PMID: 32409771 DOI: 10.1038/s41418-020-0552-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
An amendment to this paper has been published and can be accessed via a link at the top of the paper.
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Affiliation(s)
- Plamena R Angelova
- UCL Queen Square Institute of Neurology, Queen Square, London, WC1N 3BG, UK
| | - Minee L Choi
- UCL Queen Square Institute of Neurology, Queen Square, London, WC1N 3BG, UK.,The Francis Crick Institute, London, UK
| | - Alexey V Berezhnov
- Institute of Cell Biophysics, Russian Academy of Sciences, Pushchino, Russia, 142290.,Orel State University, Orel, Russia
| | - Mathew H Horrocks
- EaStCHEM School of Chemistry, University of Edinburgh, Edinburgh, UK.,Department of Chemistry, University of Cambridge, Cambridge, UK
| | - Craig D Hughes
- Department of Chemistry, University of Cambridge, Cambridge, UK
| | - Suman De
- Department of Chemistry, University of Cambridge, Cambridge, UK.,Dementia Research institute at University of Cambridge, Cambridge, UK
| | - Margarida Rodrigues
- Department of Chemistry, University of Cambridge, Cambridge, UK.,Dementia Research institute at University of Cambridge, Cambridge, UK
| | - Ratsuda Yapom
- RC Centre for Regenerative Medicine, The University of Edinburgh, Edinburgh, UK
| | - Daniel Little
- MRC Laboratory for Molecular Cell Biology, University College London, Gower Street, London, UK.,NIHR Great Ormond Street Hospital Biomedical Research Centre, London, UK
| | - Karamjit S Dolt
- RC Centre for Regenerative Medicine, The University of Edinburgh, Edinburgh, UK
| | - Tilo Kunath
- RC Centre for Regenerative Medicine, The University of Edinburgh, Edinburgh, UK
| | - Michael J Devine
- MRC Laboratory for Molecular Cell Biology, University College London, Gower Street, London, UK
| | - Paul Gissen
- MRC Laboratory for Molecular Cell Biology, University College London, Gower Street, London, UK.,NIHR Great Ormond Street Hospital Biomedical Research Centre, London, UK
| | | | - Sergiy Sylantyev
- UCL Queen Square Institute of Neurology, Queen Square, London, WC1N 3BG, UK.,Rowett Institute, University of Aberdeen, Ashgrove Rd West, Aberdeen, AB25 2ZD, UK
| | - Evgeny V Pavlov
- College of Dentistry, New York University, New York, NY, USA
| | - David Klenerman
- Department of Chemistry, University of Cambridge, Cambridge, UK.,Dementia Research institute at University of Cambridge, Cambridge, UK
| | - Andrey Y Abramov
- UCL Queen Square Institute of Neurology, Queen Square, London, WC1N 3BG, UK. .,Orel State University, Orel, Russia.
| | - Sonia Gandhi
- UCL Queen Square Institute of Neurology, Queen Square, London, WC1N 3BG, UK. .,The Francis Crick Institute, London, UK.
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7
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Choi ML, Horrocks MH, Rodrigues M, De S, Tosatto L, Zhang W, Virdi G, Klenerman D, Abramov AY, Gandhi S. Tracking Oligomerization of Alpha-Synuclein Demonstrates Pivotal Role of Mitochondria in Seeding. Biophys J 2020. [DOI: 10.1016/j.bpj.2019.11.1289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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8
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Hughes CD, Choi ML, Ryten M, Hopkins L, Drews A, Botía JA, Iljina M, Rodrigues M, Gagliano SA, Gandhi S, Bryant C, Klenerman D. Correction to: Picomolar concentrations of oligomeric alpha-synuclein sensitizes TLR4 to play an initiating role in Parkinson's disease pathogenesis. Acta Neuropathol 2019; 137:121. [PMID: 30328509 DOI: 10.1007/s00401-018-1919-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
In the original publication of this article, the author Magarida Rodrigues was written incorrectly.
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9
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Choi ML, Gandhi S. Crucial role of protein oligomerization in the pathogenesis of Alzheimer's and Parkinson's diseases. FEBS J 2018; 285:3631-3644. [PMID: 29924502 DOI: 10.1111/febs.14587] [Citation(s) in RCA: 82] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2018] [Revised: 05/11/2018] [Accepted: 06/14/2018] [Indexed: 12/16/2022]
Abstract
Misfolding and aggregation of the proteins amyloid-β, tau and alpha-synuclein is the predominant pathology underlying the neurodegenerative disorders, Alzheimer's and Parkinson's disease. While end stage insoluble products of aggregation have been well characterised in human and animal models of disease, accumulating evidence from biophysical, cellular and in vivo studies has shown that soluble intermediates of aggregation, or oligomers, may be the key species that mediate toxicity and underlie seeding and spreading in disease. Here, we review the process of protein misfolding, and the intrinsic and extrinsic processes that cause the native states of the key aggregating proteins to undergo conformational change to form oligomers and ultimately fibrils. We discuss the structural features of the key toxic intermediate, and describe the putative mechanisms by which oligomers may cause cell toxicity. Finally, we explore the potential therapeutic approaches raised by the oligomer hypothesis in neurodegenerative disease.
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Affiliation(s)
- Minee L Choi
- Sobell Department of Motor Neuroscience and Movement Disorders, UCL Institute of Neurology, London, UK.,The Francis Crick Institute, London, UK
| | - Sonia Gandhi
- Sobell Department of Motor Neuroscience and Movement Disorders, UCL Institute of Neurology, London, UK.,The Francis Crick Institute, London, UK
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10
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Iljina M, Hong L, Horrocks MH, Ludtmann MH, Choi ML, Hughes CD, Ruggeri FS, Guilliams T, Buell AK, Lee JE, Gandhi S, Lee SF, Bryant CE, Vendruscolo M, Knowles TPJ, Dobson CM, De Genst E, Klenerman D. Nanobodies raised against monomeric ɑ-synuclein inhibit fibril formation and destabilize toxic oligomeric species. BMC Biol 2017; 15:57. [PMID: 28673288 PMCID: PMC5496350 DOI: 10.1186/s12915-017-0390-6] [Citation(s) in RCA: 53] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2017] [Accepted: 06/06/2017] [Indexed: 11/16/2022] Open
Abstract
Background The aggregation of the protein ɑ-synuclein (ɑS) underlies a range of increasingly common neurodegenerative disorders including Parkinson’s disease. One widely explored therapeutic strategy for these conditions is the use of antibodies to target aggregated ɑS, although a detailed molecular-level mechanism of the action of such species remains elusive. Here, we characterize ɑS aggregation in vitro in the presence of two ɑS-specific single-domain antibodies (nanobodies), NbSyn2 and NbSyn87, which bind to the highly accessible C-terminal region of ɑS. Results We show that both nanobodies inhibit the formation of ɑS fibrils. Furthermore, using single-molecule fluorescence techniques, we demonstrate that nanobody binding promotes a rapid conformational conversion from more stable oligomers to less stable oligomers of ɑS, leading to a dramatic reduction in oligomer-induced cellular toxicity. Conclusions The results indicate a novel mechanism by which diseases associated with protein aggregation can be inhibited, and suggest that NbSyn2 and NbSyn87 could have significant therapeutic potential. Electronic supplementary material The online version of this article (doi:10.1186/s12915-017-0390-6) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Marija Iljina
- Department of Chemistry, University of Cambridge, Lensfield Road, Cambridge, CB2 1EW, UK
| | - Liu Hong
- Department of Chemistry, University of Cambridge, Lensfield Road, Cambridge, CB2 1EW, UK.,Zhou Pei-Yuan Center for Applied Mathematics, Tsinghua University, Beijing, 100084, China
| | - Mathew H Horrocks
- Department of Chemistry, University of Cambridge, Lensfield Road, Cambridge, CB2 1EW, UK.,Wellcome Trust-Medical Research Council Cambridge Stem Cell Institute, University of Cambridge, Cambridge, CB2 1QR, UK
| | - Marthe H Ludtmann
- Department of Molecular Neuroscience, University College London, Institute of Neurology, Queen Square, London, WC1N 3BG, UK
| | - Minee L Choi
- Department of Molecular Neuroscience, University College London, Institute of Neurology, Queen Square, London, WC1N 3BG, UK
| | - Craig D Hughes
- Department of Veterinary Medicine, University of Cambridge, Madingley Road, Cambridge, CB3 0ES, UK
| | - Francesco S Ruggeri
- Department of Chemistry, University of Cambridge, Lensfield Road, Cambridge, CB2 1EW, UK
| | - Tim Guilliams
- Department of Chemistry, University of Cambridge, Lensfield Road, Cambridge, CB2 1EW, UK.,Present address: Healx Ltd., St John's Innovation Centre, Cowley Road, Cambridge, CB4 0WS, UK
| | - Alexander K Buell
- Department of Chemistry, University of Cambridge, Lensfield Road, Cambridge, CB2 1EW, UK.,Present address: Institute of Physical Biology, University of Düsseldorf, Universitätsstr. 1, 40225, Düsseldorf, Germany
| | - Ji-Eun Lee
- Department of Chemistry, University of Cambridge, Lensfield Road, Cambridge, CB2 1EW, UK
| | - Sonia Gandhi
- Department of Molecular Neuroscience, University College London, Institute of Neurology, Queen Square, London, WC1N 3BG, UK
| | - Steven F Lee
- Department of Chemistry, University of Cambridge, Lensfield Road, Cambridge, CB2 1EW, UK
| | - Clare E Bryant
- Department of Veterinary Medicine, University of Cambridge, Madingley Road, Cambridge, CB3 0ES, UK
| | - Michele Vendruscolo
- Department of Chemistry, University of Cambridge, Lensfield Road, Cambridge, CB2 1EW, UK
| | - Tuomas P J Knowles
- Department of Chemistry, University of Cambridge, Lensfield Road, Cambridge, CB2 1EW, UK
| | - Christopher M Dobson
- Department of Chemistry, University of Cambridge, Lensfield Road, Cambridge, CB2 1EW, UK.
| | - Erwin De Genst
- Department of Chemistry, University of Cambridge, Lensfield Road, Cambridge, CB2 1EW, UK. .,Present address: Astra Zeneca, Innovative Medicines Discovery Sciences Unit 310, Darwin Building, Cambridge Science Park, Milton Road, Cambridge, CB4 0WG, UK.
| | - David Klenerman
- Department of Chemistry, University of Cambridge, Lensfield Road, Cambridge, CB2 1EW, UK.
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11
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Iljina M, Tosatto L, Choi ML, Sang JC, Ye Y, Hughes CD, Bryant CE, Gandhi S, Klenerman D. Arachidonic acid mediates the formation of abundant alpha-helical multimers of alpha-synuclein. Sci Rep 2016; 6:33928. [PMID: 27671749 PMCID: PMC5037366 DOI: 10.1038/srep33928] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2016] [Accepted: 08/31/2016] [Indexed: 12/12/2022] Open
Abstract
The protein alpha-synuclein (αS) self-assembles into toxic beta-sheet aggregates in Parkinson’s disease, while it is proposed that αS forms soluble alpha-helical multimers in healthy neurons. Here, we have made αS multimers in vitro using arachidonic acid (ARA), one of the most abundant fatty acids in the brain, and characterized them by a combination of bulk experiments and single-molecule Fӧrster resonance energy transfer (sm-FRET) measurements. The data suggest that ARA-induced oligomers are alpha-helical, resistant to fibril formation, more prone to disaggregation, enzymatic digestion and degradation by the 26S proteasome, and lead to lower neuronal damage and reduced activation of microglia compared to the oligomers formed in the absence of ARA. These multimers can be formed at physiologically-relevant concentrations, and pathological mutants of αS form less multimers than wild-type αS. Our work provides strong biophysical evidence for the formation of alpha-helical multimers of αS in the presence of a biologically relevant fatty acid, which may have a protective role with respect to the generation of beta-sheet toxic structures during αS fibrillation.
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Affiliation(s)
- Marija Iljina
- Department of Chemistry, University of Cambridge, Lensfield Road, Cambridge CB2 1EW, UK
| | - Laura Tosatto
- Department of Chemistry, University of Cambridge, Lensfield Road, Cambridge CB2 1EW, UK
| | - Minee L Choi
- Department of Molecular Neuroscience, University College London, Institute of Neurology, Queen Square, London WC1N 3BG, UK
| | - Jason C Sang
- Department of Chemistry, University of Cambridge, Lensfield Road, Cambridge CB2 1EW, UK
| | - Yu Ye
- Department of Chemistry, University of Cambridge, Lensfield Road, Cambridge CB2 1EW, UK.,Department of Cell Biology, Harvard Medical School, Boston, 02115, USA
| | - Craig D Hughes
- Department of Veterinary Medicine, University Of Cambridge, Madingley Road, Cambridge, CB3 0ES, United Kingdom
| | - Clare E Bryant
- Department of Veterinary Medicine, University Of Cambridge, Madingley Road, Cambridge, CB3 0ES, United Kingdom
| | - Sonia Gandhi
- Department of Molecular Neuroscience, University College London, Institute of Neurology, Queen Square, London WC1N 3BG, UK
| | - David Klenerman
- Department of Chemistry, University of Cambridge, Lensfield Road, Cambridge CB2 1EW, UK
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12
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Choi ML, Begeti F, Barker RA, Kim N. A simple assessment model to quantifying the dynamic hippocampal neurogenic process in the adult mammalian brain. Hippocampus 2016; 26:517-29. [PMID: 26443687 DOI: 10.1002/hipo.22541] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/28/2015] [Indexed: 09/17/2023]
Abstract
Adult hippocampal neurogenesis is a highly dynamic process in which new cells are born, but only some of which survive. Of late it has become clear that these surviving newborn neurons have functional roles, most notably in certain forms of memory. Conventional methods to look at adult neurogenesis are based on the quantification of the number of newly born neurons using a simple cell counting methodology. However, this type of approach fails to capture the dynamic aspects of the neurogenic process, where neural proliferation, death and differentiation take place continuously and simultaneously. In this paper, we propose a simple mathematical approach to better understand the adult neurogenic process in the hippocampus which in turn will allow for a better analysis of this process in disease states and following drug therapies.
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Affiliation(s)
- Minee L Choi
- Department of Clinical Neurosciences, John Van Geest Centre for Brain Repair, University of Cambridge, Cambridge, CB2 0PY, United Kingdom
| | - Faye Begeti
- Department of Clinical Neurosciences, John Van Geest Centre for Brain Repair, University of Cambridge, Cambridge, CB2 0PY, United Kingdom
- School of Clinical Medicine, University of Cambridge, Addenbrooke's Hospital, Cambridge, CB2 0SP, United Kingdom
| | - Roger A Barker
- Department of Clinical Neurosciences, John Van Geest Centre for Brain Repair, University of Cambridge, Cambridge, CB2 0PY, United Kingdom
- Department of Neurology, Addenbrooke's Hospital, Cambridge, CB2 0QQ, United Kingdom
| | - Namho Kim
- Department of Engineering, University of Cambridge, Cambridge, CB2 1PZ, United Kingdom
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13
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Choi ML, Yao Z, Tosatto L, Klenerman D, Abramov AY, Gandhi S. Strain Dependent Effects of Alpha-Synuclein Mutations on Mitochondrial Dysfunction. Biophys J 2016. [DOI: 10.1016/j.bpj.2015.11.2522] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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14
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Choi ML, Begeti F, Oh JH, Lee SY, O'Keeffe GC, Clelland CD, Tyers P, Cho ZH, Kim YB, Barker RA. Dopaminergic manipulations and its effects on neurogenesis and motor function in a transgenic mouse model of Huntington's disease. Neurobiol Dis 2014; 66:19-27. [PMID: 24561069 DOI: 10.1016/j.nbd.2014.02.004] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2013] [Revised: 01/29/2014] [Accepted: 02/10/2014] [Indexed: 11/28/2022] Open
Abstract
Huntington's disease (HD) is an inherited neurodegenerative disorder that is classically defined by a triad of movement and cognitive and psychiatric abnormalities with a well-established pathology that affects the dopaminergic systems of the brain. This has classically been described in terms of an early loss of dopamine D2 receptors (D2R), although interestingly the treatments most effectively used to treat patients with HD block these same receptors. We therefore sought to examine the dopaminergic system in HD not only in terms of striatal function but also at extrastriatal sites especially the hippocampus, given that transgenic (Tg) mice also exhibit deficits in hippocampal-dependent cognitive tests and a reduction in adult hippocampal neurogenesis. We showed that there was an early reduction of D2R in both the striatum and dentate gyrus (DG) of the hippocampus in the R6/1 transgenic HD mouse ahead of any overt motor signs and before striatal neuronal loss. Despite downregulation of D2Rs in these sites, further reduction of the dopaminergic input to these sites by either medial forebrain bundle lesions or receptor blockade using sulpiride was able to improve both deficits in motor performance and adult hippocampal neurogenesis. In contrast, a reduction in dopaminergic innervation of the neurogenic niches resulted in impaired neurogenesis in healthy WT mice. This study therefore provides evidence that D2R blockade improves hippocampal and striatal deficits in HD mice although the underlying mechanism for this is unclear, and suggests that agents working within this network may have greater effects than previously thought.
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Affiliation(s)
- M L Choi
- Department of Clinical Neurosciences, John van Geest Centre for Brain Repair, University of Cambridge, Cambridge CB2 0PY, UK
| | - F Begeti
- Department of Clinical Neurosciences, John van Geest Centre for Brain Repair, University of Cambridge, Cambridge CB2 0PY, UK; School of Clinical Medicine, University of Cambridge, Addenbrooke's Hospital, Cambridge CB2 0SP, UK
| | - J H Oh
- Neuroscience Research Institute, Gachon University, Incheon 405-760, Republic of Korea
| | - S Y Lee
- Neuroscience Research Institute, Gachon University, Incheon 405-760, Republic of Korea
| | - G C O'Keeffe
- Department of Clinical Neurosciences, John van Geest Centre for Brain Repair, University of Cambridge, Cambridge CB2 0PY, UK
| | - C D Clelland
- Department of Clinical Neurosciences, John van Geest Centre for Brain Repair, University of Cambridge, Cambridge CB2 0PY, UK
| | - P Tyers
- Department of Clinical Neurosciences, John van Geest Centre for Brain Repair, University of Cambridge, Cambridge CB2 0PY, UK
| | - Z H Cho
- Department of Clinical Neurosciences, John van Geest Centre for Brain Repair, University of Cambridge, Cambridge CB2 0PY, UK
| | - Y B Kim
- Department of Clinical Neurosciences, John van Geest Centre for Brain Repair, University of Cambridge, Cambridge CB2 0PY, UK
| | - R A Barker
- Department of Clinical Neurosciences, John van Geest Centre for Brain Repair, University of Cambridge, Cambridge CB2 0PY, UK; Department of Neurology, Addenbrooke's Hospital, Cambridge CB2 0QQ, UK.
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15
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Abstract
Primary nodal drainage basins in melanoma of the head and neck are often unpredictable. The ear is a notorious example of an anatomic site with ambiguous patterns of lymphatic drainage. Preoperative lymphoscintigraphy has recently emerged as one modality to assist in identifying clinically relevant nodes. We propose that the addition of intraoperative lymph node mapping techniques that utilize radioactive tracers ("intraoperative lymphoscintigraphy") can increase the accuracy of identifying sentinel nodes and help to determine which patients may benefit from a complete neck dissection. This report demonstrates the ambiguity in identifying drainage patterns in melanoma of the ear and offers a reliable method of sentinel lymph node mapping. This report also addresses current issues regarding treatment protocols of patients with micrometastatic disease in the periauricular region.
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Affiliation(s)
- P D Wey
- Department of Surgery, UMDNJ-Robert Wood Johnson Medical School, New Brunswick, NJ 08901-0019, USA
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16
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Abstract
Proteus syndrome is a rare congenital disorder comprised of subcutaneous and internal hamartomas, pigmented skin nevi, skull exostoses, hemihypertrophy, and macrodactyly of the hands and feet. A 5-year-old girl diagnosed with Proteus syndrome presented with distal median compression neuropathy with the primary complaint of severe pain involving the left hand. Surgical exploration of the hand revealed a lipofibromatous hamartoma of the median nerve. The transverse carpal ligament was released and epineurectomy of the median nerve was performed. The patient remains symptom free at the 9-month follow-up. This report is the first description of a hamartoma directly involving a peripheral nerve in Proteus syndrome. Decompression of the nerve with the removal of the fibrofatty neural sheath resulted in the resolution of the symptoms in this patient. The surgeon should consider this approach as a potential first line of treatment before a more radical resection of the nerve is contemplated.
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Affiliation(s)
- M L Choi
- Department of Surgery, UMDNJ-Robert Wood Johnson Medical School, New Brunswick, NJ 08903, USA
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17
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Choi ML, Hirigoyen MB, Zhang WX, Weinberg H, Silver L, Chun JK. Increased patency of artificial microvascular grafts using arteriovenous fistula loops: a two-stage procedure for lengthening the pedicle of free-tissue transfer. J Reconstr Microsurg 1996; 12:283-90. [PMID: 8835826 DOI: 10.1055/s-2007-1006487] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
The effect of a high-flow system on the patency of artificial microvascular grafts (AMG) was investigated using arteriovenous (A-V) fistula loops made of polytetrafluoroethylene (PTFE) in a clinically useful longer length. At a second stage, the A-V loops, matured for 7 days, were used as recipient conduits for free-tissue transfer. The patency rates of 5-cm long PTFE A-V fistula loops were compared with 5-cm and 1-cm long interpositional micrografts in a rat model. The patency rate of the loops at 7 days was 80 percent, compared to 0 percent for both the 5-cm and 1-cm interpositional grafts. A-V fistula loops matured for 7 days in vivo were divided in their midsections and used as arterial and venous conduits (each 2.5 cm long) for free epigastric flaps (3 x 6 cm) raised from the contralateral groin. Sixty-seven percent (8/12) of the free flaps were viable at 7 days. The A-V fistula loop in a high-flow system has a beneficial effect in maintaining patency of AMGs. PTFE fistula loops matured for 7 days can be used as arterial and venous conduits for microsurgical tissue transfer in rats.
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Affiliation(s)
- M L Choi
- Department of Surgery, Mount Sinai Medical Center, New York, New York, USA
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