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Melis M, Molari A, Floris G, Vascellari S, Balestrino L, Ladogana A, Poleggi A, Parchi P, Cossu G, Melis M, Orrù S, Defazio G. Genetic Creutzfeldt-Jakob disease in Sardinia: a case series linked to the PRNP R208H mutation due to a single founder effect. Neurogenetics 2020; 21:251-257. [PMID: 32458274 DOI: 10.1007/s10048-020-00618-1] [Citation(s) in RCA: 3] [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] [Received: 03/16/2020] [Accepted: 05/19/2020] [Indexed: 01/03/2023]
Abstract
In genetic prion diseases (gPrD), five genetic variants (E200K, V210I, V180I, P102L, and D178N) are responsible for about 85% of cases. The R208H is one of the several additional rare mutations and to date, only 16 cases carrying this mutation have been reported worldwide. To describe the phenotypic features of 5 affected patients belonging to apparently unrelated Sardinian (Italian) families with R208H gPrD, and provide evidence for a possible founder effect are the aims of this study. The R208H PRNP mutation has a much higher relative frequency in Sardinia than elsewhere in Italy (72% vs. 4.4% of gCJD cases). Our cohort shared similar phenotypic features to the previously described patients with R208H-129M haplotype with most patients showing the classical Creutzfeldt-Jakob disease (CJD) phenotype. The analysis of 10 controls and 5 patients by NGS sequencing identified 4 haplotypes, 3 associated with the wild type variant, and one (H1) shared by all patients carrying the 208His variant. This is the first report of a regional cluster for R208H mutation in gPrD and the first report of the presence of a common ancestor for this Sardinian R208H cluster, confirming the probable consequences of genetic isolation process even for rare diseases.
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Affiliation(s)
- Marta Melis
- SC Neurologia AOU Policlinico di Monserrato, Cagliari, Sardinia, Italy.
| | | | - Gianluca Floris
- SC Neurologia AOU Policlinico di Monserrato, Cagliari, Sardinia, Italy
| | - Sarah Vascellari
- Dipartimento di Scienze Biomediche, Sezione di Microbiologia e Virologia, Università degli Studi di Cagliari, Cagliari, Italy
| | - Luisa Balestrino
- Genetica Medica, Dipartimento di Scienze Mediche e Sanità Pubblica, Università di Cagliari, Caligria, Italy
| | - Anna Ladogana
- Department of Neuroscience, Istituto Superiore di Sanità, 00161, Rome, Italy
| | - Anna Poleggi
- Department of Neuroscience, Istituto Superiore di Sanità, 00161, Rome, Italy
| | - Piero Parchi
- IRCCS Istituto delle Scienze Neurologiche di Bologna, 40139, Bologna, Italy.,Department of Experimental Diagnostic and Specialty Medicine (DIMES), Università di Bologna, 40138, Bologna, Italy
| | | | | | - Sandro Orrù
- Genetica Medica, Dipartimento di Scienze Mediche e Sanità Pubblica, Università di Cagliari, Caligria, Italy
| | - Giovanni Defazio
- SC Neurologia AOU Policlinico di Monserrato, Cagliari, Sardinia, Italy
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Bougard D, Bélondrade M, Mayran C, Bruyère-Ostells L, Lehmann S, Fournier-Wirth C, Knight RS, Will RG, Green AJE. Diagnosis of Methionine/Valine Variant Creutzfeldt-Jakob Disease by Protein Misfolding Cyclic Amplification. Emerg Infect Dis 2019; 24:1364-1366. [PMID: 29912702 PMCID: PMC6038758 DOI: 10.3201/eid2407.172105] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
A patient with a heterozygous variant of Creutzfeldt-Jakob disease (CJD) with a methionine/valine genotype at codon 129 of the prion protein gene was recently reported. Using an ultrasensitive and specific protein misfolding cyclic amplification–based assay for detecting variant CJD prions in cerebrospinal fluid, we discriminated this heterozygous case of variant CJD from cases of sporadic CJD.
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Cardone F, Principe S, Schininà ME, Maras B, Capellari S, Parchi P, Notari S, Di Francesco L, Poleggi A, Galeno R, Vinci R, Mellina V, Almonti S, Ladogana A, Pocchiari M. Mutant PrPCJD prevails over wild-type PrPCJD in the brain of V210I and R208H genetic Creutzfeldt-Jakob disease patients. Biochem Biophys Res Commun 2014; 454:289-94. [PMID: 25450391 DOI: 10.1016/j.bbrc.2014.10.051] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2014] [Accepted: 10/12/2014] [Indexed: 11/20/2022]
Abstract
Creutzfeldt-Jakob disease (CJD) is a neurodegenerative disorder characterized by the deposition of the pathological conformer (PrP(CJD)) of the host encoded cellular prion protein (PrP(C)). In genetic CJD associated with V210I or R208H PrP substitutions, the pathogenic role of mutant residues is still poorly understood. To understand how V210I or R208H PrP mutations facilitate the development of the disease, we determined by mass spectrometry the quantitative ratio of mutant/wild-type PrP(CJD) allotypes in brains from affected subjects. We found that the mutant PrP(CJD) allotypes moderately exceeds of 2- or 3-fold the amount of the wild-type counterpart suggesting that these mutations mainly exert their pathogenic effect on the onset of the pathogenic cascade. Different mechanisms can be hypothesized to explain the pathogenic role of mutant residues: V210I and R208H substitutions can increase the concentration of PrP(C) and the probability to form insoluble aggregates, or they may facilitate the formation of pathological intermediates, or, alternatively, they may increase the affinity for ligands that are involved in the initial phases of PrP(CJD) formation and aggregation. Whatever the mechanism, the enrichment found for the mutated PrP(CJD) species indicates that these altered structures are more prone, with respect to the non-mutated ones, to be captured in the polymerization process either at the onset or during the development of the disease.
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