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Ovsepian SV, O'Leary VB, Martinez S. Selective vulnerability of motor neuron types and functional groups to degeneration in amyotrophic lateral sclerosis: review of the neurobiological mechanisms and functional correlates. Brain Struct Funct 2024; 229:1-14. [PMID: 37999738 PMCID: PMC10827929 DOI: 10.1007/s00429-023-02728-6] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Accepted: 10/26/2023] [Indexed: 11/25/2023]
Abstract
Amyotrophic lateral sclerosis (ALS) is a fatal neurodegenerative condition characterised by a progressive loss of motor neurons controlling voluntary muscle activity. The disease manifests through a variety of motor dysfunctions related to the extent of damage and loss of neurons at different anatomical locations. Despite extensive research, it remains unclear why some motor neurons are especially susceptible to the disease, while others are affected less or even spared. In this article, we review the neurobiological mechanisms, neurochemical profiles, and morpho-functional characteristics of various motor neuron groups and types of motor units implicated in their differential exposure to degeneration. We discuss specific cell-autonomous (intrinsic) and extrinsic factors influencing the vulnerability gradient of motor units and motor neuron types to ALS, with their impact on disease manifestation, course, and prognosis, as revealed in preclinical and clinical studies. We consider the outstanding challenges and emerging opportunities for interpreting the phenotypic and mechanistic variability of the disease to identify targets for clinical interventions.
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Affiliation(s)
- Saak V Ovsepian
- Faculty of Engineering and Science, University of Greenwich London, Chatham Maritime, Kent, ME4 4TB, UK.
| | - Valerie B O'Leary
- Department of Medical Genetics, Third Faculty of Medicine, Charles University, Ruská 87, 10000, Prague, Czech Republic
| | - Salvador Martinez
- Instituto de Neurociencias UMH-CSIC, Avda. Ramon y Cajal, 03550, San Juan de Alicante, Spain.
- Center of Biomedical Network Research on Mental Health (CIBERSAM), ISCIII, Madrid, Spain.
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Zapalska E, Wrzesień D, Stępień A. Case report: Flail leg syndrome in familial amyotrophic lateral sclerosis with L144S SOD1 mutation. Front Neurol 2023; 14:1138668. [PMID: 37034065 PMCID: PMC10073428 DOI: 10.3389/fneur.2023.1138668] [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] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Accepted: 02/17/2023] [Indexed: 04/11/2023] Open
Abstract
We observed a Polish family with familial amyotrophic lateral sclerosis with heterozygous L144S SOD1 mutation, which manifested clinically as flail leg syndrome. Flail leg syndrome is a rare phenotype of amyotrophic lateral sclerosis, with slow progression, long survival, and predominance of lower motor neuron signs at onset, as a triad of distal paresis, muscle atrophy, and hyporeflexia/areflexia, confined to the lower limbs for an extended period of time. Although familial amyotrophic lateral sclerosis is usually associated with a worse prognosis than the sporadic form of the disease, the clinical course of the disease in patients with L144S SOD1 mutation is benign, with slow progression and long survival. This unique case report provides an in-depth clinical analysis of all of the symptomatic members of a family, who were diagnosed with amyotrophic lateral sclerosis in our clinic, including three siblings (two brothers and a deceased sister) with flail leg syndrome and their fraternal aunt, who has been previously misdiagnosed with cervical myelopathy and is living with symptoms of the disease for 15 years. Sanger sequencing of the SOD1 gene was performed in all of the living patients, revealing an L144S (c.434T>C, p.Leu145Ser) heterozygous mutation. The aim of this case report is to increase the physician's awareness of the atypical phenotypes of amyotrophic lateral sclerosis and hopefully, to encourage further research on the factors responsible for delayed disease progression in patients with L144S SOD1 mutation.
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Kubat Oktem E, Aydin B, Yazar M, Arga KY. Integrative Analysis of Motor Neuron and Microglial Transcriptomes from SOD1 G93A Mice Models Uncover Potential Drug Treatments for ALS. J Mol Neurosci 2022; 72:2360-2376. [PMID: 36178612 DOI: 10.1007/s12031-022-02071-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [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: 05/28/2022] [Accepted: 09/19/2022] [Indexed: 02/07/2023]
Abstract
Amyotrophic lateral sclerosis (ALS) is a fatal disease of motor neurons that mainly affects the motor cortex, brainstem, and spinal cord. Under disease conditions, microglia could possess two distinct profiles, M1 (toxic) and M2 (protective), with the M2 profile observed at disease onset. SOD1 (superoxide dismutase 1) gene mutations account for up to 20% of familial ALS cases. Comparative gene expression differences in M2-protective (early) stage SOD1G93A microglia and age-matched SOD1G93A motor neurons are poorly understood. We evaluated the differential gene expression profiles in SOD1G93A microglia and SOD1G93A motor neurons utilizing publicly available transcriptomics data and bioinformatics analyses, constructed biomolecular networks around them, and identified gene clusters as potential drug targets. Following a drug repositioning strategy, 5 small compounds (belinostat, auranofin, BRD-K78930611, AZD-8055, and COT-10b) were repositioned as potential ALS therapeutic candidates that mimic the protective state of microglia and reverse the toxic state of motor neurons. We anticipate that this study will provide new insights into the ALS pathophysiology linking the M2 state of microglia and drug repositioning.
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Affiliation(s)
- Elif Kubat Oktem
- Department of Molecular Biology and Genetics, Faculty of Engineering and Natural Sciences, Istanbul Medeniyet University, Kuzey Yerleşkesi H Blok, Ünalan Sk. D100 Karayolu Yanyol 34700, Istanbul, Turkey.
| | - Busra Aydin
- Department of Bioengineering, Faculty of Engineering and Architecture, Konya Food and Agriculture University, Konya, Turkey
| | - Metin Yazar
- Department of Genetics and Bioengineering, Faculty of Engineering and Natural Sciences, Istanbul Okan University, Istanbul, Turkey.,Department of Bioengineering, Faculty of Engineering, Marmara University, Istanbul, Turkey
| | - Kazim Yalcin Arga
- Department of Bioengineering, Faculty of Engineering, Marmara University, Istanbul, Turkey.,Genetic and Metabolic Diseases Research and Investigation Center, Marmara University, Istanbul, Turkey
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Kim D, Kim S, Sung A, Patel N, Wong N, Conboy MJ, Conboy IM. Autologous treatment for ALS with implication for broad neuroprotection. Transl Neurodegener 2022; 11:16. [PMID: 35272709 PMCID: PMC8915496 DOI: 10.1186/s40035-022-00290-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [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: 10/22/2021] [Accepted: 02/18/2022] [Indexed: 01/20/2023] Open
Abstract
Background Amyotrophic lateral sclerosis (ALS) is characterized by a progressive loss of motor neurons (MNs), leading to paralysis, respiratory failure and death within 2–5 years of diagnosis. The exact mechanisms of sporadic ALS, which comprises 90% of all cases, remain unknown. In familial ALS, mutations in superoxide dismutase (SOD1) cause 10% of cases. Methods ALS patient-derived human-induced pluripotent stem cells (ALS hiPSCs, harboring the SOD1AV4 mutation), were differentiated to MNs (ALS-MNs). The neuroprotective effects of conditioned medium (CM) of hESCs (H9), wt hiPSCs (WTC-11) and the ALS iPSCs, on MN apoptosis and viability, formation and maintenance of neurites, mitochondrial activity and expression of inflammatory genes, were examined. For in vivo studies, 200 μl of CM from the ALS iPSCs (CS07 and CS053) was injected subcutaneously into the ALS model mice (transgenic for the human SOD1G93A mutation). Animal agility and strength, muscle innervation and mass, neurological score, onset of paralysis and lifespan of the ALS mice were assayed. After observing significant disease-modifying effects, the CM was characterized biochemically by fractionation, comparative proteomics, and epigenetic screens for the dependence on pluripotency. CM of fibroblasts that were differentiated from the wt hiPSCs lacked any neuroprotective activity and was used as a negative control throughout the studies. Results The secretome of PSCs including the ALS patient iPSCs was neuroprotective in the H2O2 model. In the model with pathogenic SOD1 mutation, ALS iPSC-CM attenuated all examined hallmarks of ALS pathology, rescued human ALS-MNs from denervation and death, restored mitochondrial health, and reduced the expression of inflammatory genes. The ALS iPSC-CM also improved neuro-muscular health and function, and delayed paralysis and morbidity in ALS mice. Compared side by side, cyclosporine (CsA), a mitochondrial membrane blocker that prevents the leakage of mitochondrial DNA, failed to avert the death of ALS-MNs, although CsA and ALS iPSC-CM equally stabilized MN mitochondria and attenuated inflammatory genes. Biochemical characterization, comparative proteomics, and epigenetic screen all suggested that it was the interactome of several key proteins from different fractions of PSC-CM that delivered the multifaceted neuroprotection. Conclusions This work introduces and mechanistically characterizes a new biologic for treating ALS and other complex neurodegenerative diseases. Supplementary Information The online version contains supplementary material available at 10.1186/s40035-022-00290-5.
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Affiliation(s)
- Daehwan Kim
- Department of Bioengineering and QB3 Institute, University of California, Berkeley, CA, 94720, USA
| | - Subin Kim
- Department of Bioengineering and QB3 Institute, University of California, Berkeley, CA, 94720, USA
| | - Ashley Sung
- Department of Bioengineering and QB3 Institute, University of California, Berkeley, CA, 94720, USA
| | - Neetika Patel
- Department of Bioengineering and QB3 Institute, University of California, Berkeley, CA, 94720, USA
| | - Nathan Wong
- Department of Bioengineering and QB3 Institute, University of California, Berkeley, CA, 94720, USA
| | - Michael J Conboy
- Department of Bioengineering and QB3 Institute, University of California, Berkeley, CA, 94720, USA
| | - Irina M Conboy
- Department of Bioengineering and QB3 Institute, University of California, Berkeley, CA, 94720, USA.
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de Souza PVS, Pinto WBVDR, Farias IB, Badia BDML, Pinto IFN, Costa GC, Marin CM, Dos Santos Jorge AC, Souto EC, Serrano PDL, Machado RIL, Chieia MAT, Bertini E, Oliveira ASB. Progressive spastic tetraplegia and axial hypotonia (STAHP) due to SOD1 deficiency: is it really a new entity? Orphanet J Rare Dis 2021; 16:360. [PMID: 34380534 PMCID: PMC8359534 DOI: 10.1186/s13023-021-01993-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 06/20/2021] [Accepted: 08/01/2021] [Indexed: 11/30/2022] Open
Abstract
Background Amyotrophic Lateral Sclerosis (ALS) is a rare, progressive, and fatal neurodegenerative disease due to upper and lower motor neuron involvement with symptoms classically occurring in adulthood with an increasing recognition of juvenile presentations and childhood neurodegenerative disorders caused by genetic variants in genes related to Amyotrophic Lateral Sclerosis. The main objective of this study is detail clinical, radiological, neurophysiological, and genetic findings of a Brazilian cohort of patients with a recent described condition known as Spastic Tetraplegia and Axial Hypotonia (STAHP) due to SOD1 deficiency and compare with other cases described in the literature and discuss whether the clinical picture related to SOD1 protein deficiency is a new entity or may be represent a very early-onset form of Amyotrophic Lateral Sclerosis. Methods We conducted a case series report which included retrospective data from five Brazilian patients with SOD1 protein deficiency of a Brazilian reference center for Neuromuscular Disorders. Clinical data were obtained from a review of the medical records and descriptive statistics and variables were summarized using counts and percentages of the total population. Results All 5 patients presented with a childhood-onset neurodegenerative disorders characterized by spastic tetraplegia with axial hypotonia in all cases, with gestational history showing polyhydramnios in 4/5 and intrauterine growth restriction in 3/5 patients, with most patients initially presenting a normal motor development until the six month of life or during the first year followed by a rapidly progressive motor decline with severe dysphagia and respiratory insufficiency in all patients accompanied by cognitive impairment in 3/5 patients. All patients were homozygous for the c.335dupG (p.Cys112Trpfs*11) mutation in the SOD1 gene with completely decreased enzyme activity. Conclusions This case series is the biggest data collection of the new recent clinical entity described as Spastic Tetraplegia and Axial Hypotonia (STAHP) due to SOD1 deficiency.
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Affiliation(s)
- Paulo Victor Sgobbi de Souza
- Department of Neurology and Neurosurgery, Federal University of São Paulo (UNIFESP), Embaú Street, 67, Vila Clementino, São Paulo, SP, 04039-060, Brazil.
| | - Wladimir Bocca Vieira de Rezende Pinto
- Department of Neurology and Neurosurgery, Federal University of São Paulo (UNIFESP), Embaú Street, 67, Vila Clementino, São Paulo, SP, 04039-060, Brazil
| | - Igor Braga Farias
- Department of Neurology and Neurosurgery, Federal University of São Paulo (UNIFESP), Embaú Street, 67, Vila Clementino, São Paulo, SP, 04039-060, Brazil
| | - Bruno de Mattos Lombardi Badia
- Department of Neurology and Neurosurgery, Federal University of São Paulo (UNIFESP), Embaú Street, 67, Vila Clementino, São Paulo, SP, 04039-060, Brazil
| | - Icaro França Navarro Pinto
- Department of Neurology and Neurosurgery, Federal University of São Paulo (UNIFESP), Embaú Street, 67, Vila Clementino, São Paulo, SP, 04039-060, Brazil
| | - Gustavo Carvalho Costa
- Department of Neurology and Neurosurgery, Federal University of São Paulo (UNIFESP), Embaú Street, 67, Vila Clementino, São Paulo, SP, 04039-060, Brazil
| | - Carolina Maria Marin
- Department of Neurology and Neurosurgery, Federal University of São Paulo (UNIFESP), Embaú Street, 67, Vila Clementino, São Paulo, SP, 04039-060, Brazil
| | - Ana Carolina Dos Santos Jorge
- Department of Neurology and Neurosurgery, Federal University of São Paulo (UNIFESP), Embaú Street, 67, Vila Clementino, São Paulo, SP, 04039-060, Brazil
| | - Emília Correia Souto
- Department of Neurology and Neurosurgery, Federal University of São Paulo (UNIFESP), Embaú Street, 67, Vila Clementino, São Paulo, SP, 04039-060, Brazil
| | - Paulo de Lima Serrano
- Department of Neurology and Neurosurgery, Federal University of São Paulo (UNIFESP), Embaú Street, 67, Vila Clementino, São Paulo, SP, 04039-060, Brazil
| | - Roberta Ismael Lacerda Machado
- Department of Neurology and Neurosurgery, Federal University of São Paulo (UNIFESP), Embaú Street, 67, Vila Clementino, São Paulo, SP, 04039-060, Brazil
| | - Marco Antônio Troccoli Chieia
- Department of Neurology and Neurosurgery, Federal University of São Paulo (UNIFESP), Embaú Street, 67, Vila Clementino, São Paulo, SP, 04039-060, Brazil
| | - Enrico Bertini
- Unit of Neuromuscular and Neurodegenerative Disorders, Bambino Gesù Children's Research Hospital, IRCCS, Rome, Italy
| | - Acary Souza Bulle Oliveira
- Department of Neurology and Neurosurgery, Federal University of São Paulo (UNIFESP), Embaú Street, 67, Vila Clementino, São Paulo, SP, 04039-060, Brazil
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Meszlényi V, Patai R, Polgár TF, Nógrádi B, Körmöczy L, Kristóf R, Spisák K, Tripolszki K, Széll M, Obál I, Engelhardt JI, Siklós L. Passive Transfer of Sera from ALS Patients with Identified Mutations Evokes an Increased Synaptic Vesicle Number and Elevation of Calcium Levels in Motor Axon Terminals, Similar to Sera from Sporadic Patients. Int J Mol Sci 2020; 21:ijms21155566. [PMID: 32756522 PMCID: PMC7432249 DOI: 10.3390/ijms21155566] [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] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Accepted: 07/31/2020] [Indexed: 12/28/2022] Open
Abstract
Previously, we demonstrated increased calcium levels and synaptic vesicle densities in the motor axon terminals (MATs) of sporadic amyotrophic lateral sclerosis (ALS) patients. Such alterations could be conferred to mice with an intraperitoneal injection of sera from these patients or with purified immunoglobulin G. Later, we confirmed the presence of similar alterations in the superoxide dismutase 1 G93A transgenic mouse strain model of familial ALS. These consistent observations suggested that calcium plays a central role in the pathomechanism of ALS. This may be further reinforced by completing a similar analytical study of the MATs of ALS patients with identified mutations. However, due to the low yield of muscle biopsy samples containing MATs, and the low incidence of ALS patients with the identified mutations, these examinations are not technically feasible. Alternatively, a passive transfer of sera from ALS patients with known mutations was used, and the MATs of the inoculated mice were tested for alterations in their calcium homeostasis and synaptic activity. Patients with 11 different ALS-related mutations participated in the study. Intraperitoneal injection of sera from these patients on two consecutive days resulted in elevated intracellular calcium levels and increased vesicle densities in the MATs of mice, which is comparable to the effect of the passive transfer from sporadic patients. Our results support the idea that the pathomechanism underlying the identical manifestation of the disease with or without identified mutations is based on a common final pathway, in which increasing calcium levels play a central role.
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Affiliation(s)
- Valéria Meszlényi
- Biological Research Centre, Institute of Biophysics, 62 Temesvári krt., H-6726 Szeged, Hungary; (V.M.); (R.P.); (T.F.P.); (B.N.); (L.K.); (R.K.); (K.S.)
- Foundation for the Future of Biomedical Sciences in Szeged, Szeged Scientists Academy, 15 Lechner tér, H-6721 Szeged, Hungary
| | - Roland Patai
- Biological Research Centre, Institute of Biophysics, 62 Temesvári krt., H-6726 Szeged, Hungary; (V.M.); (R.P.); (T.F.P.); (B.N.); (L.K.); (R.K.); (K.S.)
| | - Tamás F. Polgár
- Biological Research Centre, Institute of Biophysics, 62 Temesvári krt., H-6726 Szeged, Hungary; (V.M.); (R.P.); (T.F.P.); (B.N.); (L.K.); (R.K.); (K.S.)
| | - Bernát Nógrádi
- Biological Research Centre, Institute of Biophysics, 62 Temesvári krt., H-6726 Szeged, Hungary; (V.M.); (R.P.); (T.F.P.); (B.N.); (L.K.); (R.K.); (K.S.)
- Foundation for the Future of Biomedical Sciences in Szeged, Szeged Scientists Academy, 15 Lechner tér, H-6721 Szeged, Hungary
| | - Laura Körmöczy
- Biological Research Centre, Institute of Biophysics, 62 Temesvári krt., H-6726 Szeged, Hungary; (V.M.); (R.P.); (T.F.P.); (B.N.); (L.K.); (R.K.); (K.S.)
| | - Rebeka Kristóf
- Biological Research Centre, Institute of Biophysics, 62 Temesvári krt., H-6726 Szeged, Hungary; (V.M.); (R.P.); (T.F.P.); (B.N.); (L.K.); (R.K.); (K.S.)
| | - Krisztina Spisák
- Biological Research Centre, Institute of Biophysics, 62 Temesvári krt., H-6726 Szeged, Hungary; (V.M.); (R.P.); (T.F.P.); (B.N.); (L.K.); (R.K.); (K.S.)
| | - Kornélia Tripolszki
- Department of Medical Genetics, University of Szeged, 4/B Szőkefalvi-Nagy Béla u., H-6720 Szeged, Hungary; (K.T.); (M.S.)
| | - Márta Széll
- Department of Medical Genetics, University of Szeged, 4/B Szőkefalvi-Nagy Béla u., H-6720 Szeged, Hungary; (K.T.); (M.S.)
- Dermatological Research Group, University of Szeged, Hungarian Academy of Sciences, 4/B Szőkefalvi-Nagy Béla u., H-6720 Szeged, Hungary
| | - Izabella Obál
- Department of Neurology, Aalborg University Hospital, 15 Skovvej Sdr., DK-9000 Aalborg, Denmark;
- Department of Neurology, University of Szeged, 6 Semmelweis u., H-6725 Szeged, Hungary;
| | - József I. Engelhardt
- Department of Neurology, University of Szeged, 6 Semmelweis u., H-6725 Szeged, Hungary;
| | - László Siklós
- Biological Research Centre, Institute of Biophysics, 62 Temesvári krt., H-6726 Szeged, Hungary; (V.M.); (R.P.); (T.F.P.); (B.N.); (L.K.); (R.K.); (K.S.)
- Correspondence: ; Tel.: +36-62-599-611
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Abstract
Lou Gehrig's disease, a synonym of amyotrophic lateral sclerosis, is an adult-onset lethal neurodegenerative disorder. Irrespective of extensive efforts to elucidate the pathogenesis of the disease and searches for therapies, no favorable pharmacotherapeutic strategies have yet to be proposed. In a popular rodent model of ALS, G93A SOD1 strain of mouse, intracellular copper conditions were geared toward copper accumulation inside cells, resulting in an acceleration of oxidative stress and apoptotic process. Disruption of intracellular copper homeostasis was common to transgenic mice expressing human mutant SOD1s. In this review, the novel hypothesis that disruption of intracellular copper homeostasis could be involved in the development of the disease was introduced. Based upon the hypothesis, therapeutic outcomes of agents that are capable of correcting and/or modifying intracellular copper homeostasis are described. Administration of ammonium tetrathiomolybdate, a selective intracellular copper chelator, delayed onset, slowed progression, and prolonged survival of a rodent model of the disease (G93A SOD1 mice). Metallothionein is a low molecular weight, cysteine-rich, metal-binding cytoplasmic protein that has beneficial properties in detoxification of toxic heavy metals, homeostatic regulation of intracellular essential trace elements, including copper, antioxidant, and antiapoptotic roles. In animal experiments of the G93A SOD1 mice, an increase of metallothionein proteins by means of induction by exercise or dexamethasone, genetic overexpression, or intraperitoneal administration, all resulted in a preferable outcome. The therapeutic effects were not inferior to those of approved drugs for ALS in humans. These observations suggest that metallothionein could be worth investigating the therapeutic potential in clinical use.
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Affiliation(s)
- Shin-Ichi Ono
- Laboratory of Clinical Medicine, School of Pharmacy, Nihon University, 7-1, 7-chome, Narashinodai, Funabashi, Chiba 274-8555. Japan
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Taieb G, Polge A, Juntas-Morales R, Pageot N, Lumbroso S, Mouzat K, Camu W. Slowly progressive motor neuron disease with multi-system involvement related to p.E121G SOD1 mutation. Amyotroph Lateral Scler Frontotemporal Degener 2016; 18:296-297. [PMID: 27892702 DOI: 10.1080/21678421.2016.1255756] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
We report the third case of amyotrophic lateral sclerosis related to p.E121G Superoxide dismutase-1 (SOD1) mutation. Besides a sporadic presentation and a slow progressive course, as described in the 2 previously cases, our patient presented with prominent sensory and cerebellar signs. This case report strengthens that p.E121G should be considered as a causal mutation. Slowly upper and lower motor neuron degeneration, even with non-motor clinical features, should prompt a sequencing of SOD1.
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Affiliation(s)
- Guillaume Taieb
- a Department of Neurology , CHU Montpellier, Hopital Guy de Chauliac , 80 avenue Augustin Fliche , 34295 Montpellier Cedex 5 , France and
| | - Anne Polge
- b Department of Biochemistry and Molecular Biology , CHU Nîmes, Hôpital Caremeau , Place du Pr Debré , 30029 Nîmes Cedex 4 , France
| | - Raul Juntas-Morales
- a Department of Neurology , CHU Montpellier, Hopital Guy de Chauliac , 80 avenue Augustin Fliche , 34295 Montpellier Cedex 5 , France and
| | - Nicolas Pageot
- a Department of Neurology , CHU Montpellier, Hopital Guy de Chauliac , 80 avenue Augustin Fliche , 34295 Montpellier Cedex 5 , France and
| | - Serge Lumbroso
- b Department of Biochemistry and Molecular Biology , CHU Nîmes, Hôpital Caremeau , Place du Pr Debré , 30029 Nîmes Cedex 4 , France
| | - Kevin Mouzat
- b Department of Biochemistry and Molecular Biology , CHU Nîmes, Hôpital Caremeau , Place du Pr Debré , 30029 Nîmes Cedex 4 , France
| | - William Camu
- a Department of Neurology , CHU Montpellier, Hopital Guy de Chauliac , 80 avenue Augustin Fliche , 34295 Montpellier Cedex 5 , France and
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Zou ZY, Liu MS, Li XG, Cui LY. H46R SOD1 mutation is consistently associated with a relatively benign form of amyotrophic lateral sclerosis with slow progression. Amyotroph Lateral Scler Frontotemporal Degener 2016; 17:610-613. [PMID: 27348463 DOI: 10.1080/21678421.2016.1199698] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Amyotrophic lateral sclerosis (ALS) is a fatal neurodegenerative disease caused by progressive loss of motor neurons in the motor cortex, brainstem, and spinal cord. Over 60% of patients die from respiratory failure within three years of presentation. We report two ALS patients carrying the p.H46R missense mutation in the SOD1 gene presented with a characteristic clinical phenotype of very slow progression. We also reviewed the 13 pedigrees harbouring the p.H46R mutation reported previously. SOD1 p.H46R mutation is consistently associated with a specific phenotype, i.e. lower limb onset with rare bulbar involvement, and a slow progression with longer survival. It is important to recognize the typical clinical picture of the SOD1 p.H46R mutation, and SOD1 sequencing may be necessary to give the patient correct diagnosis and prognosis.
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Affiliation(s)
- Zhang-Yu Zou
- a Department of Neurology , Fujian Medical University Union Hospital , Fuzhou , and.,b Department of Neurology , Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College , Beijing , China
| | - Ming-Sheng Liu
- b Department of Neurology , Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College , Beijing , China
| | - Xiao-Guang Li
- b Department of Neurology , Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College , Beijing , China
| | - Li-Ying Cui
- b Department of Neurology , Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College , Beijing , China
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