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Bainbridge MN, Mazumder A, Ogasawara D, Abou Jamra R, Bernard G, Bertini E, Burglen L, Cope H, Crawford A, Derksen A, Dure L, Gantz E, Koch-Hogrebe M, Hurst ACE, Mahida S, Marshall P, Micalizzi A, Novelli A, Peng H, Rodriguez D, Robbins SL, Rutledge SL, Scalise R, Schließke S, Shashi V, Srivastava S, Thiffault I, Topol S, Qebibo L, Wieczorek D, Cravatt B, Haricharan S, Torkamani A, Friedman J. Endocannabinoid dysfunction in neurological disease: neuro-ocular DAGLA-related syndrome. Brain 2022; 145:3383-3390. [PMID: 35737950 PMCID: PMC9586540 DOI: 10.1093/brain/awac223] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [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: 04/16/2022] [Accepted: 05/30/2022] [Indexed: 11/12/2022] Open
Abstract
The endocannabinoid system is a highly conserved and ubiquitous signalling pathway with broad-ranging effects. Despite critical pathway functions, gene variants have not previously been conclusively linked to human disease. We identified nine children from eight families with heterozygous, de novo truncating variants in the last exon of DAGLA with a neuro-ocular phenotype characterized by developmental delay, ataxia and complex oculomotor abnormality. All children displayed paroxysms of nystagmus or eye deviation accompanied by compensatory head posture and worsened incoordination most frequently after waking. RNA sequencing showed clear expression of the truncated transcript and no differences were found between mutant and wild-type DAGLA activity. Immunofluorescence staining of patient-derived fibroblasts and HEK cells expressing the mutant protein showed distinct perinuclear aggregation not detected in control samples. This report establishes truncating variants in the last DAGLA exon as the cause of a unique paediatric syndrome. Because enzymatic activity was preserved, the observed mislocalization of the truncated protein may account for the observed phenotype. Potential mechanisms include DAGLA haploinsufficiency at the plasma membrane or dominant negative effect. To our knowledge, this is the first report directly linking an endocannabinoid system component with human genetic disease and sets the stage for potential future therapeutic avenues.
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Affiliation(s)
- Matthew N Bainbridge
- Rady Children's Institute for Genomic Medicine (RCIGM), San Diego, CA 92123, USA
| | - Aloran Mazumder
- Sanford Burnham Prebys Medical Discovery Institute, La Jolla, CA 92037, USA
| | - Daisuke Ogasawara
- The Scripps Research Translational Institute, The Scripps Research Institute, La Jolla, CA 92037, USA
| | - Rami Abou Jamra
- Institute of Human Genetics, University Medical Center Leipzig, Leipzig 04103, Germany
| | - Geneviève Bernard
- Department of Neurology and Neurosurgery, McGill University, Montreal, Canada.,Department of Pediatrics and Human Genetics, McGill University, Montreal, Canada.,Department of Human Genetics, McGill University, Montreal, Canada.,Department Specialized Medicine, Division of Medical Genetics, McGill University Health Center, Montreal, Canada.,Child Health and Human Development Program, Research Institute of the McGill University Health Center, Montreal, Canada
| | - Enrico Bertini
- Unit of Neuromuscular and Neurodegenerative Disorders, Department of Neurosciences 'Bambino Gesu' Children's Research Hospital, IRCCS, Rome, Italy
| | - Lydie Burglen
- Centre de Référence Malformations et Maladies Congénitales du Cervelet, Département de génétique, AP-HP Sorbonne Université, Hôpital Trousseau, Paris, France.,Developmental Brain Disorders Laboratory, Imagine Institute, INSERM UMR 1163, Paris, France
| | - Heidi Cope
- Department of Pediatrics, Division Medical Genetics Durham, Duke University Medical Center, North Carolina, USA
| | | | - Alexa Derksen
- Department of Neurology and Neurosurgery, McGill University, Montreal, Canada.,Child Health and Human Development Program, Research Institute of the McGill University Health Center, Montreal, Canada
| | - Leon Dure
- Division of Pediatric Neurology, Department of Pediatrics, University of Alabama at Birmingham, Birmingham, AL 35233, USA
| | - Emily Gantz
- Division of Pediatric Neurology, Department of Pediatrics, University of Alabama at Birmingham, Birmingham, AL 35233, USA
| | | | - Anna C E Hurst
- Department of Genetics, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Sonal Mahida
- Department of Neurology, Boston Children's Hospital, Boston, Massachusetts, USA
| | - Paige Marshall
- Department of Neurology, Boston Children's Hospital, Boston, Massachusetts, USA
| | - Alessia Micalizzi
- Translational Cytogenomics Research Unit, Bambino Gesù Children's Hospital, IRCCS, Roma, Italy
| | - Antonio Novelli
- Translational Cytogenomics Research Unit, Bambino Gesù Children's Hospital, IRCCS, Roma, Italy
| | - Hongfan Peng
- The Scripps Research Translational Institute, The Scripps Research Institute, La Jolla, CA 92037, USA
| | | | - Diana Rodriguez
- Sorbonne Université, INSERM UMR 1141, AP-HP.SU, Centre de Référence Maladies Rares Malformations et Maladies Congénitales du Cervelet & Service de Neuropédiatrie, Hôpital Trousseau, Paris, France
| | - Shira L Robbins
- Ratner Children's Eye Center at the Shiley Eye Institute; Viterbi Family Department of Ophthalmology, University of California San Diego, La Jolla, CA 92093, USA
| | - S Lane Rutledge
- Division of Pediatric Neurology, Department of Pediatrics, University of Alabama at Birmingham, Birmingham, AL 35233, USA.,Department of Genetics, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Roberta Scalise
- Department of Developmental Neuroscience, IRCCS Stella Maris Foundation, Pisa, Italy.,Tuscan PhD Program of Neuroscience, University of Florence, Pisa and Siena, Florence, Italy
| | - Sophia Schließke
- Institute of Human Genetics, University Medical Center Leipzig, Leipzig 04103, Germany
| | - Vandana Shashi
- Department of Pediatrics, Division Medical Genetics Durham, Duke University Medical Center, North Carolina, USA
| | | | - Isabella Thiffault
- Genomic Medicine Center, Children's Mercy Hospital, Kansas City, Missouri, USA.,Faculty of Medicine, University of Missouri Kansas City, Kansas City, Missouri, USA.,Department of Pathology, Children's Mercy Hospital, Kansas City, Missouri, USA
| | - Sarah Topol
- The Scripps Research Translational Institute, The Scripps Research Institute, La Jolla, CA 92037, USA
| | | | - Leila Qebibo
- Centre de Référence Malformations et Maladies Congénitales du Cervelet, Département de génétique, AP-HP Sorbonne Université, Hôpital Trousseau, Paris, France
| | - Dagmar Wieczorek
- Institute of Human Genetics, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, 40225, Düsseldorf, Germany
| | - Benjamin Cravatt
- The Scripps Research Translational Institute, The Scripps Research Institute, La Jolla, CA 92037, USA
| | - Svasti Haricharan
- Sanford Burnham Prebys Medical Discovery Institute, La Jolla, CA 92037, USA
| | - Ali Torkamani
- The Scripps Research Translational Institute, The Scripps Research Institute, La Jolla, CA 92037, USA
| | - Jennifer Friedman
- Rady Children's Institute for Genomic Medicine (RCIGM), San Diego, CA 92123, USA.,Division of Neurology, Rady Children's Hospital San Diego, CA 92123, USA.,Department of Neurosciences, University of California La Jolla, CA 92037, USA.,Department of Pediatrics, University of California La Jolla, CA 92037, USA
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Webb BD, Evans A, Naidich TP, M Bird L, Parikh S, Fernandez Garcia M, Henderson LB, Millan F, Si Y, Brennand KJ, Hung P, Rucker JC, Wheeler PG, Schadt EE. Haploinsufficiency of POU4F1 causes an ataxia syndrome with hypotonia and intention tremor. Hum Mutat 2021; 42:685-693. [PMID: 33783914 DOI: 10.1002/humu.24201] [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] [Received: 12/05/2020] [Revised: 03/25/2021] [Accepted: 03/26/2021] [Indexed: 11/06/2022]
Abstract
De novo, heterozygous, loss-of-function variants were identified in Pou domain, class 4, transcription factor 1 (POU4F1) via whole-exome sequencing in four independent probands presenting with ataxia, intention tremor, and hypotonia. POU4F1 is expressed in the developing nervous system, and mice homozygous for null alleles of Pou4f1 exhibit uncoordinated movements with newborns being unable to successfully right themselves to feed. Head magnetic resonance imaging of the four probands was reviewed and multiple abnormalities were noted, including significant cerebellar vermian atrophy and hypertrophic olivary degeneration in one proband. Transcriptional activation of the POU4F1 p.Gln306Arg protein was noted to be decreased when compared with wild type. These findings suggest that heterozygous, loss-of-function variants in POU4F1 are causative of a novel ataxia syndrome.
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Affiliation(s)
- Bryn D Webb
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Anthony Evans
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Thomas P Naidich
- Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Lynne M Bird
- Department of Pediatrics, University of California San Diego, Rady Children's Hospital, San Diego, California, USA
| | - Sumit Parikh
- Neurometabolism & Neurogenetics, Cleveland Clinic, Cleveland, Ohio, USA
| | - Meilin Fernandez Garcia
- Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | | | | | - Yue Si
- GeneDx, Gaithersburg, Maryland, USA
| | - Kristen J Brennand
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, New York, USA.,Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Peter Hung
- Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Janet C Rucker
- Department of Neurology, New York University Grossman School of Medicine, New York, New York, USA.,Department of Ophthalmology, New York University Grossman School of Medicine, New York, New York, USA
| | | | - Eric E Schadt
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, New York, USA
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