1
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Tjeertes J, Bacino CA, Bichell TJ, Bird LM, Bustamante M, Crean R, Jeste S, Komorowski RW, Krishnan ML, Miller MT, Nobbs D, Ochoa-Lubinoff C, Parkerson KA, Rotenberg A, Sadhwani A, Shen MD, Squassante L, Tan WH, Vincenzi B, Wheeler AC, Hipp JF, Berry-Kravis E. Enabling endpoint development for interventional clinical trials in individuals with Angelman syndrome: a prospective, longitudinal, observational clinical study (FREESIAS). J Neurodev Disord 2023; 15:22. [PMID: 37495977 PMCID: PMC10373389 DOI: 10.1186/s11689-023-09494-w] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Accepted: 07/04/2023] [Indexed: 07/28/2023] Open
Abstract
BACKGROUND Angelman syndrome (AS) is a rare neurodevelopmental disorder characterized by the absence of a functional UBE3A gene, which causes developmental, behavioral, and medical challenges. While currently untreatable, comprehensive data could help identify appropriate endpoints assessing meaningful improvements in clinical trials. Herein are reported the results from the FREESIAS study assessing the feasibility and utility of in-clinic and at-home measures of key AS symptoms. METHODS Fifty-five individuals with AS (aged < 5 years: n = 16, 5-12 years: n = 27, ≥ 18 years: n = 12; deletion genotype: n = 40, nondeletion genotype: n = 15) and 20 typically developing children (aged 1-12 years) were enrolled across six USA sites. Several clinical outcome assessments and digital health technologies were tested, together with overnight 19-lead electroencephalography (EEG) and additional polysomnography (PSG) sensors. Participants were assessed at baseline (Clinic Visit 1), 12 months later (Clinic Visit 2), and during intermittent home visits. RESULTS The participants achieved high completion rates for the clinical outcome assessments (adherence: 89-100% [Clinic Visit 1]; 76-91% [Clinic Visit 2]) and varied feasibility of and adherence to digital health technologies. The coronavirus disease 2019 (COVID-19) pandemic impacted participants' uptake of and/or adherence to some measures. It also potentially impacted the at-home PSG/EEG recordings, which were otherwise feasible. Participants achieved Bayley-III results comparable to the available natural history data, showing similar scores between individuals aged ≥ 18 and 5-12 years. Also, participants without a deletion generally scored higher on most clinical outcome assessments than participants with a deletion. Furthermore, the observed AS EEG phenotype of excess delta-band power was consistent with prior reports. CONCLUSIONS Although feasible clinical outcome assessments and digital health technologies are reported herein, further improved assessments of meaningful AS change are needed. Despite the COVID-19 pandemic, remote assessments facilitated high adherence levels and the results suggested that at-home PSG/EEG might be a feasible alternative to the in-clinic EEG assessments. Taken altogether, the combination of in-clinic/at-home clinical outcome assessments, digital health technologies, and PSG/EEG may improve protocol adherence, reduce patient burden, and optimize study outcomes in AS and other rare disease populations.
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Affiliation(s)
- Jorrit Tjeertes
- F. Hoffmann-La Roche Ltd, Grenzacherstrasse 124, 4070, Basel, Switzerland.
| | - Carlos A Bacino
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, TX, USA
- Texas Children's Hospital, Houston, TX, USA
| | | | - Lynne M Bird
- Department of Pediatrics, University of California San Diego, San Diego, CA, USA
- Division of Dysmorphology/Genetics, Rady Children's Hospital, San Diego, CA, USA
| | - Mariana Bustamante
- F. Hoffmann-La Roche Ltd, Grenzacherstrasse 124, 4070, Basel, Switzerland
| | | | - Shafali Jeste
- Children's Hospital Los Angeles, Los Angeles, CA, USA
- Keck School of Medicine of USC, Los Angeles, CA, USA
| | | | | | - Meghan T Miller
- F. Hoffmann-La Roche Ltd, Grenzacherstrasse 124, 4070, Basel, Switzerland
| | - David Nobbs
- F. Hoffmann-La Roche Ltd, Grenzacherstrasse 124, 4070, Basel, Switzerland
| | - Cesar Ochoa-Lubinoff
- Departments of Pediatrics, Division of Developmental-Behavioral Pediatrics, Rush University Medical Center, Chicago, IL, USA
| | | | - Alexander Rotenberg
- Department of Neurology, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
| | - Anjali Sadhwani
- Department of Psychiatry and Behavioral Services, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
| | - Mark D Shen
- Carolina Institute for Developmental Disabilities & UNC Neuroscience Center, University of North Carolina, Chapel Hill, NC, USA
| | - Lisa Squassante
- F. Hoffmann-La Roche Ltd, Grenzacherstrasse 124, 4070, Basel, Switzerland
| | - Wen-Hann Tan
- Division of Genetics and Genomics, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
| | - Brenda Vincenzi
- F. Hoffmann-La Roche Ltd, Grenzacherstrasse 124, 4070, Basel, Switzerland
| | - Anne C Wheeler
- Carolina Institute for Developmental Disabilities, Carrboro, NC, USA
- RTI International, Durham, NC, USA
| | - Joerg F Hipp
- F. Hoffmann-La Roche Ltd, Grenzacherstrasse 124, 4070, Basel, Switzerland
| | - Elizabeth Berry-Kravis
- Departments of Pediatrics, Neurological Sciences, Anatomy and Cell Biology, Rush University Medical Center, 1725 W Harrison St, Suite 718, Chicago, IL, 60612, USA.
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Georgiou-Karistianis N, Corben LA, Reetz K, Adanyeguh IM, Corti M, Deelchand DK, Delatycki MB, Dogan I, Evans R, Farmer J, França MC, Gaetz W, Harding IH, Harris KS, Hersch S, Joules R, Joers JJ, Krishnan ML, Lax M, Lock EF, Lynch D, Mareci T, Muthuhetti Gamage S, Pandolfo M, Papoutsi M, Rezende TJR, Roberts TPL, Rosenberg JT, Romanzetti S, Schulz JB, Schilling T, Schwarz AJ, Subramony S, Yao B, Zicha S, Lenglet C, Henry PG. A natural history study to track brain and spinal cord changes in individuals with Friedreich's ataxia: TRACK-FA study protocol. PLoS One 2022; 17:e0269649. [PMID: 36410013 PMCID: PMC9678384 DOI: 10.1371/journal.pone.0269649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2022] [Accepted: 05/25/2022] [Indexed: 11/23/2022] Open
Abstract
INTRODUCTION Drug development for neurodegenerative diseases such as Friedreich's ataxia (FRDA) is limited by a lack of validated, sensitive biomarkers of pharmacodynamic response in affected tissue and disease progression. Studies employing neuroimaging measures to track FRDA have thus far been limited by their small sample sizes and limited follow up. TRACK-FA, a longitudinal, multi-site, and multi-modal neuroimaging natural history study, aims to address these shortcomings by enabling better understanding of underlying pathology and identifying sensitive, clinical trial ready, neuroimaging biomarkers for FRDA. METHODS 200 individuals with FRDA and 104 control participants will be recruited across seven international study sites. Inclusion criteria for participants with genetically confirmed FRDA involves, age of disease onset ≤ 25 years, Friedreich's Ataxia Rating Scale (FARS) functional staging score of ≤ 5, and a total modified FARS (mFARS) score of ≤ 65 upon enrolment. The control cohort is matched to the FRDA cohort for age, sex, handedness, and years of education. Participants will be evaluated at three study visits over two years. Each visit comprises of a harmonized multimodal Magnetic Resonance Imaging (MRI) and Spectroscopy (MRS) scan of the brain and spinal cord; clinical, cognitive, mood and speech assessments and collection of a blood sample. Primary outcome measures, informed by previous neuroimaging studies, include measures of: spinal cord and brain morphometry, spinal cord and brain microstructure (measured using diffusion MRI), brain iron accumulation (using Quantitative Susceptibility Mapping) and spinal cord biochemistry (using MRS). Secondary and exploratory outcome measures include clinical, cognitive assessments and blood biomarkers. DISCUSSION Prioritising immediate areas of need, TRACK-FA aims to deliver a set of sensitive, clinical trial-ready neuroimaging biomarkers to accelerate drug discovery efforts and better understand disease trajectory. Once validated, these potential pharmacodynamic biomarkers can be used to measure the efficacy of new therapeutics in forestalling disease progression. CLINICAL TRIAL REGISTRATION ClinicalTrails.gov Identifier: NCT04349514.
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Affiliation(s)
- Nellie Georgiou-Karistianis
- School of Psychological Sciences, The Turner Institute for Brain and Mental Health, Monash University, Clayton, Victoria, Australia
- * E-mail:
| | - Louise A. Corben
- Bruce Lefroy Centre for Genetic Health Research, Murdoch Children’s Research Institute, Parkville, Victoria, Australia
- Department of Paediatrics, University of Melbourne, Parkville, Victoria, Australia
| | - Kathrin Reetz
- Department of Neurology, RWTH Aachen University, Aachen, Germany
- JARA-BRAIN Institute Molecular Neuroscience and Neuroimaging, Forschungszentrum Jülich GmbH and RWTH Aachen University, Aachen, Germany
| | - Isaac M. Adanyeguh
- Center for Magnetic Resonance Research and Department of Radiology, University of Minnesota, Minneapolis, Minnesota, United States of America
| | - Manuela Corti
- Powell Gene Therapy Centre, University of Florida, Gainesville, Florida, United States of America
| | - Dinesh K. Deelchand
- Center for Magnetic Resonance Research and Department of Radiology, University of Minnesota, Minneapolis, Minnesota, United States of America
| | - Martin B. Delatycki
- School of Psychological Sciences, The Turner Institute for Brain and Mental Health, Monash University, Clayton, Victoria, Australia
- Bruce Lefroy Centre for Genetic Health Research, Murdoch Children’s Research Institute, Parkville, Victoria, Australia
- Department of Paediatrics, University of Melbourne, Parkville, Victoria, Australia
| | - Imis Dogan
- Department of Neurology, RWTH Aachen University, Aachen, Germany
- JARA-BRAIN Institute Molecular Neuroscience and Neuroimaging, Forschungszentrum Jülich GmbH and RWTH Aachen University, Aachen, Germany
| | - Rebecca Evans
- Takeda Pharmaceutical Company Ltd, Cambridge, Massachusetts, United States of America
| | - Jennifer Farmer
- Friedreich’s Ataxia Research Alliance (FARA), Downingtown, Pennsylvania, United States of America
| | - Marcondes C. França
- Department of Neurology, University of Campinas, Campinas, Sao Paulo, Brazil
| | - William Gaetz
- Department of Radiology, Lurie Family Foundations MEG Imaging Center, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania, United States of America
| | - Ian H. Harding
- Department of Neuroscience, Central Clinical School, Monash University, Melbourne, Australia
| | - Karen S. Harris
- School of Psychological Sciences, The Turner Institute for Brain and Mental Health, Monash University, Clayton, Victoria, Australia
| | - Steven Hersch
- Neurology Business Group, Eisai Inc., Nutley, New Jersey, United States of America
| | | | - James J. Joers
- Center for Magnetic Resonance Research and Department of Radiology, University of Minnesota, Minneapolis, Minnesota, United States of America
| | - Michelle L. Krishnan
- Translational Medicine, Novartis Institutes for Biomedical Research, Cambridge, MA, United States of America
| | | | - Eric F. Lock
- Division of Biostatistics, School of Public Health, University of Minnesota, Minneapolis, MN, United States of America
| | - David Lynch
- Department of Neurology, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania, United States of America
| | - Thomas Mareci
- Department of Biochemistry and Molecular Biology, University of Florida, Gainesville, FL, United States of America
| | - Sahan Muthuhetti Gamage
- School of Psychological Sciences, The Turner Institute for Brain and Mental Health, Monash University, Clayton, Victoria, Australia
| | - Massimo Pandolfo
- Department of Neurology and Neurosurgery, McGill University, Montreal, Canada
| | | | | | - Timothy P. L. Roberts
- Department of Radiology, Lurie Family Foundations MEG Imaging Center, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania, United States of America
| | - Jens T. Rosenberg
- McKnight Brain Institute, Department of Neurology, University of Florida, Gainesville, Florida, United States of America
| | - Sandro Romanzetti
- Department of Neurology, RWTH Aachen University, Aachen, Germany
- JARA-BRAIN Institute Molecular Neuroscience and Neuroimaging, Forschungszentrum Jülich GmbH and RWTH Aachen University, Aachen, Germany
| | - Jörg B. Schulz
- Department of Neurology, RWTH Aachen University, Aachen, Germany
- JARA-BRAIN Institute Molecular Neuroscience and Neuroimaging, Forschungszentrum Jülich GmbH and RWTH Aachen University, Aachen, Germany
| | - Traci Schilling
- PTC Therapeutics, Inc, South Plainfield, New Jersey, United States of America
| | - Adam J. Schwarz
- Takeda Pharmaceutical Company Ltd, Cambridge, Massachusetts, United States of America
| | - Sub Subramony
- McKnight Brain Institute, Department of Neurology, University of Florida, Gainesville, Florida, United States of America
| | - Bert Yao
- PTC Therapeutics, Inc, South Plainfield, New Jersey, United States of America
| | - Stephen Zicha
- Takeda Pharmaceutical Company Ltd, Cambridge, Massachusetts, United States of America
| | - Christophe Lenglet
- Center for Magnetic Resonance Research and Department of Radiology, University of Minnesota, Minneapolis, Minnesota, United States of America
| | - Pierre-Gilles Henry
- Center for Magnetic Resonance Research and Department of Radiology, University of Minnesota, Minneapolis, Minnesota, United States of America
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3
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Mueller A, Paterson E, McIntosh A, Praestgaard J, Bylo M, Hoefling H, Wells M, Lynch DR, Rummey C, Krishnan ML, Schultz M, Malanga CJ. Digital endpoints for self-administered home-based functional assessment in pediatric Friedreich's ataxia. Ann Clin Transl Neurol 2021; 8:1845-1856. [PMID: 34355532 PMCID: PMC8419399 DOI: 10.1002/acn3.51438] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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: 05/14/2021] [Revised: 07/16/2021] [Accepted: 07/17/2021] [Indexed: 01/18/2023] Open
Abstract
Background Friedreich’s ataxia is an inherited, progressive, neurodegenerative disease that typically begins in childhood. Disease severity is commonly assessed with rating scales, such as the modified Friedreich’s Ataxia Rating Scale, which are usually administered in the clinic by a neurology specialist. Objective This study evaluated the utility of home‐based, self‐administered digital endpoints in children with Friedreich’s ataxia and unaffected controls and their relationship to standard clinical rating scales. Methods In a cross‐sectional study with 25 participants (13 with Friedreich’s ataxia and 12 unaffected controls, aged 6–15 years), home‐based digital endpoints that reflect activities of daily living were recorded over 1 week. Domains analyzed were hand motor function with a digitized drawing, automated analysis of speech with a recorded oral diadochokinesis test, and gait and balance with wearable sensors. Results Hand‐drawing and speech tests were easy to conduct and generated high‐quality data. The sensor‐based gait and balance tests suffered from technical limitations in this study setup. Several parameters discriminated between groups or correlated strongly with modified Friedreich’s Ataxia Rating Scale total score and activities of daily living total score in the Friedreich’s ataxia group. Hand‐drawing parameters also strongly correlated with standard 9‐hole peg test scores. Interpretation Deploying digital endpoints in home settings is feasible in this population, results in meaningful and robust data collection, and may allow for frequent sampling over longer periods of time to track disease progression. Care must be taken when training participants, and investigators should consider the complexity of the tasks and equipment used.
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Affiliation(s)
- Arne Mueller
- Translational Medicine, Novartis Institutes for BioMedical Research, Basel, Switzerland
| | - Elaine Paterson
- Translational Medicine, Novartis Institutes for BioMedical Research, Cambridge, Massachusetts, USA
| | | | | | - Mary Bylo
- Translational Medicine, Novartis Institutes for BioMedical Research, Cambridge, Massachusetts, USA
| | - Holger Hoefling
- NIBR Informatics, Novartis Institute of Biomedical Research, Basel, Switzerland
| | - McKenzie Wells
- Division of Neurology, Departments of Neurology and Pediatrics, Children's Hospital of Philadelphia, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, USA
| | - David R Lynch
- Division of Neurology, Departments of Neurology and Pediatrics, Children's Hospital of Philadelphia, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, USA
| | | | - Michelle L Krishnan
- Translational Medicine, Novartis Institutes for BioMedical Research, Basel, Switzerland
| | - Meredith Schultz
- Translational Medicine, Novartis Institutes for BioMedical Research, Cambridge, Massachusetts, USA
| | - C J Malanga
- Translational Medicine, Novartis Institutes for BioMedical Research, Cambridge, Massachusetts, USA
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4
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Krishnan ML, Berry-Kravis E, Capal JK, Carpenter R, Gringras P, Hipp JF, Miller MT, Mingorance A, Philpot BD, Pletcher MT, Rotenberg A, Tjeertes J, Wang PP, Willgoss T, de Wit MC, Jeste SS. Clinical trial strategies for rare neurodevelopmental disorders: challenges and opportunities. Nat Rev Drug Discov 2021; 20:653-654. [PMID: 34002058 DOI: 10.1038/d41573-021-00085-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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5
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Keute M, Miller MT, Krishnan ML, Sadhwani A, Chamberlain S, Thibert RL, Tan WH, Bird LM, Hipp JF. Angelman syndrome genotypes manifest varying degrees of clinical severity and developmental impairment. Mol Psychiatry 2021; 26:3625-3633. [PMID: 32792659 PMCID: PMC8505254 DOI: 10.1038/s41380-020-0858-6] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2020] [Revised: 07/24/2020] [Accepted: 07/28/2020] [Indexed: 11/18/2022]
Abstract
Angelman Syndrome (AS) is a severe neurodevelopmental disorder due to impaired expression of UBE3A in neurons. There are several genetic mechanisms that impair UBE3A expression, but they differ in how neighboring genes on chromosome 15 at 15q11-q13 are affected. There is evidence that different genetic subtypes present with different clinical severity, but a systematic quantitative investigation is lacking. Here we analyze natural history data on a large sample of individuals with AS (n = 250, 848 assessments), including clinical scales that quantify development of motor, cognitive, and language skills (Bayley Scales of Infant Development, Third Edition; Preschool Language Scale, Fourth Edition), adaptive behavior (Vineland Adaptive Behavioral Scales, Second Edition), and AS-specific symptoms (AS Clinical Severity Scale). We found that clinical severity, as captured by these scales, differs between genetic subtypes: individuals with UBE3A pathogenic variants and imprinting defects (IPD) are less affected than individuals with uniparental paternal disomy (UPD); of those with UBE3A pathogenic variants, individuals with truncating mutations are more impaired than those with missense mutations. Individuals with a deletion that encompasses UBE3A and other genes are most impaired, but in contrast to previous work, we found little evidence for an influence of deletion length (class I vs. II) on severity of manifestations. The results of this systematic analysis highlight the relevance of genomic regions beyond UBE3A as contributing factors in the AS phenotype, and provide important information for the development of new therapies for AS. More generally, this work exemplifies how increasing genetic irregularities are reflected in clinical severity.
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Affiliation(s)
- Marius Keute
- grid.417570.00000 0004 0374 1269Roche Pharma Research and Early Development, Neuroscience and Rare Diseases, Roche Innovation Center Basel, Basel, Switzerland ,grid.5807.a0000 0001 1018 4307Department of Neurology, Otto-von-Guericke-University, Magdeburg, Germany
| | - Meghan T. Miller
- grid.417570.00000 0004 0374 1269Roche Pharma Research and Early Development, Neuroscience and Rare Diseases, Roche Innovation Center Basel, Basel, Switzerland
| | - Michelle L. Krishnan
- grid.417570.00000 0004 0374 1269Roche Pharma Research and Early Development, Neuroscience and Rare Diseases, Roche Innovation Center Basel, Basel, Switzerland
| | - Anjali Sadhwani
- grid.2515.30000 0004 0378 8438Department of Psychiatry, Boston Children’s Hospital, Boston, MA USA ,grid.38142.3c000000041936754XHarvard Medical School, Boston, MA USA
| | - Stormy Chamberlain
- grid.63054.340000 0001 0860 4915Department of Genetics and Genome Sciences, University of Connecticut, Farmington, CT USA
| | - Ronald L. Thibert
- grid.32224.350000 0004 0386 9924Department of Neurology, Massachusetts General Hospital, Boston, MA USA
| | - Wen-Hann Tan
- grid.38142.3c000000041936754XHarvard Medical School, Boston, MA USA ,grid.2515.30000 0004 0378 8438Division of Genetics and Genomics, Boston Children’s Hospital, Boston, MA USA
| | - Lynne M. Bird
- grid.266100.30000 0001 2107 4242Department of Pediatrics, University of California, San Diego, CA USA ,grid.286440.c0000 0004 0383 2910Department of Genetics/Dysmorphology, Rady Children’s Hospital, San Diego, CA USA
| | - Joerg F. Hipp
- grid.417570.00000 0004 0374 1269Roche Pharma Research and Early Development, Neuroscience and Rare Diseases, Roche Innovation Center Basel, Basel, Switzerland
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6
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Willgoss T, Cassater D, Connor S, Krishnan ML, Miller MT, Dias-Barbosa C, Phillips D, McCormack J, Bird LM, Burdine RD, Claridge S, Bichell TJ. Measuring What Matters to Individuals with Angelman Syndrome and Their Families: Development of a Patient-Centered Disease Concept Model. Child Psychiatry Hum Dev 2021; 52:654-668. [PMID: 32880036 PMCID: PMC8238699 DOI: 10.1007/s10578-020-01051-z] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Angelman syndrome (AS) is a complex, heterogeneous, and life-long neurodevelopmental disorder. Despite the considerable impact on individuals and caregivers, no disease-modifying treatments are available. To support holistic clinical management and the development of AS-specific outcome measures for clinical studies, we conducted primary and secondary research identifying the impact of symptoms on individuals with AS and their unmet need. This qualitative research adopted a rigorous step-wise approach, aggregating information from published literature, then evaluating it via disease concept elicitation interviews with clinical experts and caregivers. We found that the AS-defining concepts most relevant for treatment included: impaired expressive communication, seizures, maladaptive behavior, cognitive impairment, motor function difficulties, sleep disturbance, and limited self-care abilities. We highlight the relevance of age in experiencing these key AS concepts, and the difference between the perceptions of clinicians and caregivers towards the syndrome. Finally, we outline the impact of AS on individuals, caregivers, and families.
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Affiliation(s)
- Tom Willgoss
- Roche Products Limited, Hexagon Place, 6 Falcon Way, Shire Park, Welwyn Garden City, AL7 1TW, UK.
| | - Daiana Cassater
- grid.417570.00000 0004 0374 1269Roche Innovation Center Basel, F. Hoffmann-La Roche Ltd, Basel, Switzerland
| | - Siobhan Connor
- grid.419227.bRoche Products Limited, Hexagon Place, 6 Falcon Way, Shire Park, Welwyn Garden City, AL7 1TW UK
| | - Michelle L. Krishnan
- grid.417570.00000 0004 0374 1269Roche Innovation Center Basel, F. Hoffmann-La Roche Ltd, Basel, Switzerland
| | - Meghan T. Miller
- grid.417570.00000 0004 0374 1269Roche Innovation Center Basel, F. Hoffmann-La Roche Ltd, Basel, Switzerland
| | | | - Dawn Phillips
- grid.410711.20000 0001 1034 1720Division of Physical Therapy, School of Medicine, University of North Carolina, Chapel Hill, NC USA
| | - Julie McCormack
- grid.423257.50000 0004 0510 2209Evidera, Patient-Centered Research, Bethesda, MD USA
| | - Lynne M. Bird
- grid.266100.30000 0001 2107 4242Department of Pediatrics, University of California San Diego, San Diego, CA USA
| | - Rebecca D. Burdine
- grid.16750.350000 0001 2097 5006Department of Molecular Biology, Princeton University, Princeton, NJ USA
| | - Sharon Claridge
- Foundation for Angelman Syndrome Research (FAST), Downers Grove, IL USA
| | - Terry Jo Bichell
- Consortium for Outcome Measures and Biomarkers for Neurodevelopmental Disorders, Nashville, TN USA
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7
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Van Steenwinckel J, Schang AL, Krishnan ML, Degos V, Delahaye-Duriez A, Bokobza C, Csaba Z, Verdonk F, Montané A, Sigaut S, Hennebert O, Lebon S, Schwendimann L, Le Charpentier T, Hassan-Abdi R, Ball G, Aljabar P, Saxena A, Holloway RK, Birchmeier W, Baud O, Rowitch D, Miron V, Chretien F, Leconte C, Besson VC, Petretto EG, Edwards AD, Hagberg H, Soussi-Yanicostas N, Fleiss B, Gressens P. Decreased microglial Wnt/β-catenin signalling drives microglial pro-inflammatory activation in the developing brain. Brain 2020; 142:3806-3833. [PMID: 31665242 DOI: 10.1093/brain/awz319] [Citation(s) in RCA: 74] [Impact Index Per Article: 18.5] [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: 10/23/2018] [Revised: 07/24/2019] [Accepted: 08/19/2019] [Indexed: 12/14/2022] Open
Abstract
Microglia of the developing brain have unique functional properties but how their activation states are regulated is poorly understood. Inflammatory activation of microglia in the still-developing brain of preterm-born infants is associated with permanent neurological sequelae in 9 million infants every year. Investigating the regulators of microglial activation in the developing brain across models of neuroinflammation-mediated injury (mouse, zebrafish) and primary human and mouse microglia we found using analysis of genes and proteins that a reduction in Wnt/β-catenin signalling is necessary and sufficient to drive a microglial phenotype causing hypomyelination. We validated in a cohort of preterm-born infants that genomic variation in the Wnt pathway is associated with the levels of connectivity found in their brains. Using a Wnt agonist delivered by a blood-brain barrier penetrant microglia-specific targeting nanocarrier we prevented in our animal model the pro-inflammatory microglial activation, white matter injury and behavioural deficits. Collectively, these data validate that the Wnt pathway regulates microglial activation, is critical in the evolution of an important form of human brain injury and is a viable therapeutic target.
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Affiliation(s)
| | - Anne-Laure Schang
- Université de Paris, NeuroDiderot, Inserm, F-75019 Paris, France.,PremUP, F-75006 Paris, France.,UMR CNRS 8638-Chimie Toxicologie Analytique et Cellulaire, Université Paris Descartes, Sorbonne Paris Cité, Faculté de Pharmacie de Paris, 4 Avenue de l'Observatoire, F-75006 Paris, France
| | - Michelle L Krishnan
- Centre for the Developing Brain, Division of Imaging Sciences and Biomedical Engineering, King's College London, King's Health Partners, St. Thomas' Hospital, London, SE1 7EH, UK
| | - Vincent Degos
- Université de Paris, NeuroDiderot, Inserm, F-75019 Paris, France.,PremUP, F-75006 Paris, France.,Department of Anesthesia and Intensive Care, Pitié Salpétrière Hospital, F-75013 Paris France
| | - Andrée Delahaye-Duriez
- Université de Paris, NeuroDiderot, Inserm, F-75019 Paris, France.,UFR de Santé, Médecine et Biologie Humaine, Université Paris 13, Sorbonne Paris Cité, F-93000 Bobigny, France
| | - Cindy Bokobza
- Université de Paris, NeuroDiderot, Inserm, F-75019 Paris, France.,PremUP, F-75006 Paris, France
| | - Zsolt Csaba
- Université de Paris, NeuroDiderot, Inserm, F-75019 Paris, France.,PremUP, F-75006 Paris, France
| | - Franck Verdonk
- Infection and Epidemiology Department, Human Histopathology and Animal Models Unit, Institut Pasteur, F-75015 Paris, France.,Paris Descartes University, Sorbonne Paris Cité, F-75006 Paris, France
| | - Amélie Montané
- Université de Paris, NeuroDiderot, Inserm, F-75019 Paris, France.,PremUP, F-75006 Paris, France
| | - Stéphanie Sigaut
- Université de Paris, NeuroDiderot, Inserm, F-75019 Paris, France.,PremUP, F-75006 Paris, France
| | - Olivier Hennebert
- Université de Paris, NeuroDiderot, Inserm, F-75019 Paris, France.,PremUP, F-75006 Paris, France.,Conservatoire national des arts et métiers, F-75003 Paris, France
| | - Sophie Lebon
- Université de Paris, NeuroDiderot, Inserm, F-75019 Paris, France.,PremUP, F-75006 Paris, France
| | - Leslie Schwendimann
- Université de Paris, NeuroDiderot, Inserm, F-75019 Paris, France.,PremUP, F-75006 Paris, France
| | - Tifenn Le Charpentier
- Université de Paris, NeuroDiderot, Inserm, F-75019 Paris, France.,PremUP, F-75006 Paris, France
| | - Rahma Hassan-Abdi
- Université de Paris, NeuroDiderot, Inserm, F-75019 Paris, France.,PremUP, F-75006 Paris, France
| | - Gareth Ball
- Centre for the Developing Brain, Division of Imaging Sciences and Biomedical Engineering, King's College London, King's Health Partners, St. Thomas' Hospital, London, SE1 7EH, UK
| | - Paul Aljabar
- Centre for the Developing Brain, Division of Imaging Sciences and Biomedical Engineering, King's College London, King's Health Partners, St. Thomas' Hospital, London, SE1 7EH, UK
| | - Alka Saxena
- Genomics Core Facility, NIHR Biomedical Research Centre, Guy's and St Thomas' NHS Foundation Trust, London, SE1 9RT, UK
| | - Rebecca K Holloway
- MRC Centre for Reproductive Health, The Queen's Medical Research Institute, The University of Edinburgh, Edinburgh, EH16 4TJ, UK
| | - Walter Birchmeier
- Cancer Research Program, Max Delbrueck Center for Molecular Medicine in the Helmholtz Society, Berlin-Buch, Germany
| | - Olivier Baud
- Université de Paris, NeuroDiderot, Inserm, F-75019 Paris, France.,PremUP, F-75006 Paris, France
| | - David Rowitch
- Department of Paediatrics, University of Cambridge, Cambridge, CB2 0QQ, UK
| | - Veronique Miron
- MRC Centre for Reproductive Health, The Queen's Medical Research Institute, The University of Edinburgh, Edinburgh, EH16 4TJ, UK
| | - Fabrice Chretien
- UFR de Santé, Médecine et Biologie Humaine, Université Paris 13, Sorbonne Paris Cité, F-93000 Bobigny, France.,Infection and Epidemiology Department, Human Histopathology and Animal Models Unit, Institut Pasteur, F-75015 Paris, France.,Laboratoire de Neuropathologie, Centre Hospitalier Sainte Anne, F-75014 Paris, France
| | - Claire Leconte
- EA4475 - Pharmacologie de la Circulation Cérébrale, Faculté de Pharmacie de Paris, Université Paris Descartes, Sorbonne Paris Cité, F-75006 Paris, France
| | - Valérie C Besson
- EA4475 - Pharmacologie de la Circulation Cérébrale, Faculté de Pharmacie de Paris, Université Paris Descartes, Sorbonne Paris Cité, F-75006 Paris, France
| | | | - A David Edwards
- Centre for the Developing Brain, Division of Imaging Sciences and Biomedical Engineering, King's College London, King's Health Partners, St. Thomas' Hospital, London, SE1 7EH, UK
| | - Henrik Hagberg
- Centre for the Developing Brain, Division of Imaging Sciences and Biomedical Engineering, King's College London, King's Health Partners, St. Thomas' Hospital, London, SE1 7EH, UK.,Perinatal Center, Institute of Clinical Sciences and Institute of Neuroscience and Physiology, Sahlgrenska Academy, Gothenburg University, 41390 Gothenburg, Sweden
| | - Nadia Soussi-Yanicostas
- Université de Paris, NeuroDiderot, Inserm, F-75019 Paris, France.,PremUP, F-75006 Paris, France
| | - Bobbi Fleiss
- Université de Paris, NeuroDiderot, Inserm, F-75019 Paris, France.,PremUP, F-75006 Paris, France.,Centre for the Developing Brain, Division of Imaging Sciences and Biomedical Engineering, King's College London, King's Health Partners, St. Thomas' Hospital, London, SE1 7EH, UK.,School of Health and Biomedical Sciences, RMIT University, Bundoora, 3083, VIC, Australia
| | - Pierre Gressens
- Université de Paris, NeuroDiderot, Inserm, F-75019 Paris, France.,PremUP, F-75006 Paris, France.,Centre for the Developing Brain, Division of Imaging Sciences and Biomedical Engineering, King's College London, King's Health Partners, St. Thomas' Hospital, London, SE1 7EH, UK
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8
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Krishnan ML, Van Steenwinckel J, Schang AL, Yan J, Arnadottir J, Le Charpentier T, Csaba Z, Dournaud P, Cipriani S, Auvynet C, Titomanlio L, Pansiot J, Ball G, Boardman JP, Walley AJ, Saxena A, Mirza G, Fleiss B, Edwards AD, Petretto E, Gressens P. Integrative genomics of microglia implicates DLG4 (PSD95) in the white matter development of preterm infants. Nat Commun 2017; 8:428. [PMID: 28874660 PMCID: PMC5585205 DOI: 10.1038/s41467-017-00422-w] [Citation(s) in RCA: 58] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2016] [Accepted: 06/28/2017] [Indexed: 12/12/2022] Open
Abstract
Preterm birth places infants in an adverse environment that leads to abnormal brain development and cerebral injury through a poorly understood mechanism known to involve neuroinflammation. In this study, we integrate human and mouse molecular and neuroimaging data to investigate the role of microglia in preterm white matter damage. Using a mouse model where encephalopathy of prematurity is induced by systemic interleukin-1β administration, we undertake gene network analysis of the microglial transcriptomic response to injury, extend this by analysis of protein-protein interactions, transcription factors and human brain gene expression, and translate findings to living infants using imaging genomics. We show that DLG4 (PSD95) protein is synthesised by microglia in immature mouse and human, developmentally regulated, and modulated by inflammation; DLG4 is a hub protein in the microglial inflammatory response; and genetic variation in DLG4 is associated with structural differences in the preterm infant brain. DLG4 is thus apparently involved in brain development and impacts inter-individual susceptibility to injury after preterm birth.Inflammation mediated by microglia plays a key role in brain injury associated with preterm birth, but little is known about the microglial response in preterm infants. Here, the authors integrate molecular and imaging data from animal models and preterm infants, and find that microglial expression of DLG4 plays a role.
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Affiliation(s)
- Michelle L Krishnan
- Centre for the Developing Brain, Department of Perinatal Imaging and Health, Division of Imaging Sciences and Biomedical Engineering, King's College London, King's Health Partners, St. Thomas' Hospital, London, SE1 7EH, UK
| | - Juliette Van Steenwinckel
- PROTECT, INSERM, Université Paris Diderot, Sorbonne Paris Cité, Paris, 75014, France
- PremUP, F-75006, Paris, France
| | - Anne-Laure Schang
- PROTECT, INSERM, Université Paris Diderot, Sorbonne Paris Cité, Paris, 75014, France
- PremUP, F-75006, Paris, France
| | - Jun Yan
- PROTECT, INSERM, Université Paris Diderot, Sorbonne Paris Cité, Paris, 75014, France
- PremUP, F-75006, Paris, France
| | - Johanna Arnadottir
- PROTECT, INSERM, Université Paris Diderot, Sorbonne Paris Cité, Paris, 75014, France
- PremUP, F-75006, Paris, France
| | - Tifenn Le Charpentier
- PROTECT, INSERM, Université Paris Diderot, Sorbonne Paris Cité, Paris, 75014, France
- PremUP, F-75006, Paris, France
| | - Zsolt Csaba
- PROTECT, INSERM, Université Paris Diderot, Sorbonne Paris Cité, Paris, 75014, France
- PremUP, F-75006, Paris, France
| | - Pascal Dournaud
- PROTECT, INSERM, Université Paris Diderot, Sorbonne Paris Cité, Paris, 75014, France
- PremUP, F-75006, Paris, France
| | - Sara Cipriani
- PROTECT, INSERM, Université Paris Diderot, Sorbonne Paris Cité, Paris, 75014, France
- PremUP, F-75006, Paris, France
| | - Constance Auvynet
- Pierre and Marie Curie University, UMRS-1135, Sorbonne Paris Cité, F-75006, Paris, France
| | - Luigi Titomanlio
- PROTECT, INSERM, Université Paris Diderot, Sorbonne Paris Cité, Paris, 75014, France
| | - Julien Pansiot
- PROTECT, INSERM, Université Paris Diderot, Sorbonne Paris Cité, Paris, 75014, France
- PremUP, F-75006, Paris, France
| | - Gareth Ball
- Centre for the Developing Brain, Department of Perinatal Imaging and Health, Division of Imaging Sciences and Biomedical Engineering, King's College London, King's Health Partners, St. Thomas' Hospital, London, SE1 7EH, UK
| | - James P Boardman
- Medical Research Council/University of Edinburgh Centre for Reproductive Health, Edinburgh, EH16 4TJ, UK
| | - Andrew J Walley
- Cell Biology and Genetics Research Centre, St. George's University of London, London, SW17 0RE, UK
| | - Alka Saxena
- Genomics Core Facility, NIHR Biomedical Research Centre, Guy's and St. Thomas' NHS Foundation Trust, London, SE1 9RT, UK
| | - Ghazala Mirza
- Department of Clinical and Experimental Epilepsy, UCL Institute of Neurology, London, WC1N 3BG, UK
- Epilepsy Society, Chalfont-St-Peter, Bucks, SL9 0RJ, UK
| | - Bobbi Fleiss
- Centre for the Developing Brain, Department of Perinatal Imaging and Health, Division of Imaging Sciences and Biomedical Engineering, King's College London, King's Health Partners, St. Thomas' Hospital, London, SE1 7EH, UK
- PROTECT, INSERM, Université Paris Diderot, Sorbonne Paris Cité, Paris, 75014, France
- PremUP, F-75006, Paris, France
| | - A David Edwards
- Centre for the Developing Brain, Department of Perinatal Imaging and Health, Division of Imaging Sciences and Biomedical Engineering, King's College London, King's Health Partners, St. Thomas' Hospital, London, SE1 7EH, UK.
| | - Enrico Petretto
- Duke-NUS Medical School, 8 College Road, Singapore, 169857, Singapore.
| | - Pierre Gressens
- Centre for the Developing Brain, Department of Perinatal Imaging and Health, Division of Imaging Sciences and Biomedical Engineering, King's College London, King's Health Partners, St. Thomas' Hospital, London, SE1 7EH, UK.
- PROTECT, INSERM, Université Paris Diderot, Sorbonne Paris Cité, Paris, 75014, France.
- PremUP, F-75006, Paris, France.
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9
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Kuncheva Z, Krishnan ML, Montana G. EXPLORING BRAIN TRANSCRIPTOMIC PATTERNS: A TOPOLOGICAL ANALYSIS USING SPATIAL EXPRESSION NETWORKS. Pac Symp Biocomput 2017; 22:70-81. [PMID: 27896963 DOI: 10.1142/9789813207813_0008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Characterizing the transcriptome architecture of the human brain is fundamental in gaining an understanding of brain function and disease. A number of recent studies have investigated patterns of brain gene expression obtained from an extensive anatomical coverage across the entire human brain using experimental data generated by the Allen Human Brain Atlas (AHBA) project. In this paper, we propose a new representation of a gene's transcription activity that explicitly captures the pattern of spatial co-expression across different anatomical brain regions. For each gene, we define a Spatial Expression Network (SEN), a network quantifying co-expression patterns amongst several anatomical locations. Network similarity measures are then employed to quantify the topological resemblance between pairs of SENs and identify naturally occurring clusters. Using network-theoretical measures, three large clusters have been detected featuring distinct topological properties. We then evaluate whether topological diversity of the SENs reects significant differences in biological function through a gene ontology analysis. We report on evidence suggesting that one of the three SEN clusters consists of genes specifically involved in the nervous system, including genes related to brain disorders, while the remaining two clusters are representative of immunity, transcription and translation. These findings are consistent with previous studies showing that brain gene clusters are generally associated with one of these three major biological processes.
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10
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Krishnan ML, Wang Z, Silver M, Boardman JP, Ball G, Counsell SJ, Walley AJ, Montana G, Edwards AD. Possible relationship between common genetic variation and white matter development in a pilot study of preterm infants. Brain Behav 2016; 6:e00434. [PMID: 27110435 PMCID: PMC4821839 DOI: 10.1002/brb3.434] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2015] [Revised: 12/16/2015] [Accepted: 12/19/2015] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND The consequences of preterm birth are a major public health concern with high rates of ensuing multisystem morbidity, and uncertain biological mechanisms. Common genetic variation may mediate vulnerability to the insult of prematurity and provide opportunities to predict and modify risk. OBJECTIVE To gain novel biological and therapeutic insights from the integrated analysis of magnetic resonance imaging and genetic data, informed by prior knowledge. METHODS We apply our previously validated pathway-based statistical method and a novel network-based method to discover sources of common genetic variation associated with imaging features indicative of structural brain damage. RESULTS Lipid pathways were highly ranked by Pathways Sparse Reduced Rank Regression in a model examining the effect of prematurity, and PPAR (peroxisome proliferator-activated receptor) signaling was the highest ranked pathway once degree of prematurity was accounted for. Within the PPAR pathway, five genes were found by Graph Guided Group Lasso to be highly associated with the phenotype: aquaporin 7 (AQP7), malic enzyme 1, NADP(+)-dependent, cytosolic (ME1), perilipin 1 (PLIN1), solute carrier family 27 (fatty acid transporter), member 1 (SLC27A1), and acetyl-CoA acyltransferase 1 (ACAA1). Expression of four of these (ACAA1, AQP7, ME1, and SLC27A1) is controlled by a common transcription factor, early growth response 4 (EGR-4). CONCLUSIONS This suggests an important role for lipid pathways in influencing development of white matter in preterm infants, and in particular a significant role for interindividual genetic variation in PPAR signaling.
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Affiliation(s)
- Michelle L Krishnan
- Centre for the Developing Brain King's College London St Thomas' Hospital London SE1 7EH UK
| | - Zi Wang
- Department of Biomedical Engineering King's College London St Thomas' Hospital London SE1 7EH UK
| | - Matt Silver
- Department of Population Health London School of Hygiene and Tropical Medicine London WC1E 7HT UK
| | - James P Boardman
- MRC Centre for Reproductive Health University of Edinburgh Edinburgh EH16 4TJ UK
| | - Gareth Ball
- Centre for the Developing Brain King's College London St Thomas' Hospital London SE1 7EH UK
| | - Serena J Counsell
- Centre for the Developing Brain King's College London St Thomas' Hospital London SE1 7EH UK
| | - Andrew J Walley
- School of Public Health Faculty of Medicine Imperial College London Norfolk Place London W2 1PG UK
| | - Giovanni Montana
- Department of Biomedical Engineering King's College London St Thomas' Hospital London SE1 7EH UK
| | - Anthony David Edwards
- Centre for the Developing Brain King's College London St Thomas' Hospital London SE1 7EH UK
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11
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Johnson MR, Behmoaras J, Bottolo L, Krishnan ML, Pernhorst K, Santoscoy PLM, Rossetti T, Speed D, Srivastava PK, Chadeau-Hyam M, Hajji N, Dabrowska A, Rotival M, Razzaghi B, Kovac S, Wanisch K, Grillo FW, Slaviero A, Langley SR, Shkura K, Roncon P, De T, Mattheisen M, Niehusmann P, O'Brien TJ, Petrovski S, von Lehe M, Hoffmann P, Eriksson J, Coffey AJ, Cichon S, Walker M, Simonato M, Danis B, Mazzuferi M, Foerch P, Schoch S, De Paola V, Kaminski RM, Cunliffe VT, Becker AJ, Petretto E. Systems genetics identifies Sestrin 3 as a regulator of a proconvulsant gene network in human epileptic hippocampus. Nat Commun 2015; 6:6031. [PMID: 25615886 DOI: 10.1038/ncomms7031] [Citation(s) in RCA: 133] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2014] [Accepted: 12/04/2014] [Indexed: 01/20/2023] Open
Abstract
Gene-regulatory network analysis is a powerful approach to elucidate the molecular processes and pathways underlying complex disease. Here we employ systems genetics approaches to characterize the genetic regulation of pathophysiological pathways in human temporal lobe epilepsy (TLE). Using surgically acquired hippocampi from 129 TLE patients, we identify a gene-regulatory network genetically associated with epilepsy that contains a specialized, highly expressed transcriptional module encoding proconvulsive cytokines and Toll-like receptor signalling genes. RNA sequencing analysis in a mouse model of TLE using 100 epileptic and 100 control hippocampi shows the proconvulsive module is preserved across-species, specific to the epileptic hippocampus and upregulated in chronic epilepsy. In the TLE patients, we map the trans-acting genetic control of this proconvulsive module to Sestrin 3 (SESN3), and demonstrate that SESN3 positively regulates the module in macrophages, microglia and neurons. Morpholino-mediated Sesn3 knockdown in zebrafish confirms the regulation of the transcriptional module, and attenuates chemically induced behavioural seizures in vivo.
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Affiliation(s)
- Michael R Johnson
- Division of Brain Sciences, Imperial College London, Hammersmith Hospital Campus, Burlington Danes Building, London W12 0NN, UK
| | - Jacques Behmoaras
- Centre for Complement and Inflammation Research, Imperial College London, Hammersmith Hospital, Du Cane Road, London W12 0NN, UK
| | - Leonardo Bottolo
- Department of Mathematics, Imperial College London, 180 Queen's Gate, London SW7 2AZ, UK
| | - Michelle L Krishnan
- Centre for the Developing Brain, Department of Perinatal Imaging and Health, St Thomas' Hospital, King's College London, London SE1 7EH, UK
| | - Katharina Pernhorst
- Section of Translational Epileptology, Department of Neuropathology, University of Bonn, Sigmund Freud Street 25, Bonn D-53127, Germany
| | - Paola L Meza Santoscoy
- Department of Biomedical Science, Bateson Centre, University of Sheffield, Firth Court, Western Bank, Sheffield S10 2TN, UK
| | - Tiziana Rossetti
- Medical Research Council (MRC) Clinical Sciences Centre, Imperial College London, Hammersmith Hospital, Du Cane Road, London W12 0NN, UK
| | - Doug Speed
- UCL Genetics Institute, University College London, Gower Street, London WC1E 6BT, UK
| | - Prashant K Srivastava
- Division of Brain Sciences, Imperial College London, Hammersmith Hospital Campus, Burlington Danes Building, London W12 0NN, UK.,Medical Research Council (MRC) Clinical Sciences Centre, Imperial College London, Hammersmith Hospital, Du Cane Road, London W12 0NN, UK
| | - Marc Chadeau-Hyam
- Department of Epidemiology and Biostatistics, School of Public Health, MRC/PHE Centre for Environment and Health, Imperial College London, St Mary's Hospital, Norfolk Place, W21PG London, UK
| | - Nabil Hajji
- Department of Medicine, Centre for Pharmacology and Therapeutics, Imperial College London, Du Cane Road, London W12 0NN, UK
| | - Aleksandra Dabrowska
- Department of Medicine, Centre for Pharmacology and Therapeutics, Imperial College London, Du Cane Road, London W12 0NN, UK
| | - Maxime Rotival
- Medical Research Council (MRC) Clinical Sciences Centre, Imperial College London, Hammersmith Hospital, Du Cane Road, London W12 0NN, UK
| | - Banafsheh Razzaghi
- Medical Research Council (MRC) Clinical Sciences Centre, Imperial College London, Hammersmith Hospital, Du Cane Road, London W12 0NN, UK
| | - Stjepana Kovac
- Institute of Neurology, University College London, London WC1N 3BG, UK
| | - Klaus Wanisch
- Institute of Neurology, University College London, London WC1N 3BG, UK
| | - Federico W Grillo
- Medical Research Council (MRC) Clinical Sciences Centre, Imperial College London, Hammersmith Hospital, Du Cane Road, London W12 0NN, UK
| | - Anna Slaviero
- Medical Research Council (MRC) Clinical Sciences Centre, Imperial College London, Hammersmith Hospital, Du Cane Road, London W12 0NN, UK
| | - Sarah R Langley
- Division of Brain Sciences, Imperial College London, Hammersmith Hospital Campus, Burlington Danes Building, London W12 0NN, UK.,Medical Research Council (MRC) Clinical Sciences Centre, Imperial College London, Hammersmith Hospital, Du Cane Road, London W12 0NN, UK
| | - Kirill Shkura
- Division of Brain Sciences, Imperial College London, Hammersmith Hospital Campus, Burlington Danes Building, London W12 0NN, UK.,Medical Research Council (MRC) Clinical Sciences Centre, Imperial College London, Hammersmith Hospital, Du Cane Road, London W12 0NN, UK
| | - Paolo Roncon
- Department of Medical Sciences, Section of Pharmacology and Neuroscience Center, University of Ferrara, 44121 Ferrara, Italy.,National Institute of Neuroscience, 44121 Ferrara, Italy
| | - Tisham De
- Medical Research Council (MRC) Clinical Sciences Centre, Imperial College London, Hammersmith Hospital, Du Cane Road, London W12 0NN, UK
| | - Manuel Mattheisen
- Department of Genomics, Life and Brain Center, University of Bonn, D-53127 Bonn, Germany.,Institute of Human Genetics, University of Bonn, D-53127 Bonn, Germany.,Institute for Genomic Mathematics, University of Bonn, D-53127 Bonn, Germany
| | - Pitt Niehusmann
- Section of Translational Epileptology, Department of Neuropathology, University of Bonn, Sigmund Freud Street 25, Bonn D-53127, Germany
| | - Terence J O'Brien
- Department of Medicine, RMH, University of Melbourne, Royal Melbourne Hospital, Royal Parade, Parkville, Victoria 3050, Australia
| | - Slave Petrovski
- Department of Neurology, Royal Melbourne Hospital, Melbourne, Parkville, Victoria 3050, Australia
| | - Marec von Lehe
- Department of Neurosurgery, University of Bonn Medical Center, Sigmund-Freud-Strasse 25, 53105 Bonn, Germany
| | - Per Hoffmann
- Institute of Human Genetics, University of Bonn, Sigmund-Freud-Strasse 25, 53127 Bonn, Germany.,Department of Biomedicine, University of Basel, Hebelstrasse 20, 4056 Basel, Switzerland
| | - Johan Eriksson
- Folkhälsan Research Centre, Topeliusgatan 20, 00250 Helsinki, Finland.,Helsinki University Central Hospital, Unit of General Practice, Haartmaninkatu 4, Helsinki 00290, Finland.,Department of General Practice and Primary Health Care, University of Helsinki, 407, PO Box 20, Tukholmankatu 8 B, Helsinki 00014, Finland
| | - Alison J Coffey
- Wellcome Trust Sanger Institute, Wellcome Trust Genome Campus, Hinxton CB10 1SA, UK
| | - Sven Cichon
- Institute of Human Genetics, University of Bonn, Sigmund-Freud-Strasse 25, 53127 Bonn, Germany.,Department of Biomedicine, University of Basel, Hebelstrasse 20, 4056 Basel, Switzerland
| | - Matthew Walker
- Institute of Neurology, University College London, London WC1N 3BG, UK
| | - Michele Simonato
- Department of Medical Sciences, Section of Pharmacology and Neuroscience Center, University of Ferrara, 44121 Ferrara, Italy.,National Institute of Neuroscience, 44121 Ferrara, Italy.,Laboratory for Technologies of Advanced Therapies (LTTA), University of Ferrara, 44121 Ferrara, Italy
| | - Bénédicte Danis
- Neuroscience TA, UCB Biopharma SPRL, Avenue de l'industrie, R9, B-1420 Braine l'Alleud, Belgium
| | - Manuela Mazzuferi
- Neuroscience TA, UCB Biopharma SPRL, Avenue de l'industrie, R9, B-1420 Braine l'Alleud, Belgium
| | - Patrik Foerch
- Neuroscience TA, UCB Biopharma SPRL, Avenue de l'industrie, R9, B-1420 Braine l'Alleud, Belgium
| | - Susanne Schoch
- Section of Translational Epileptology, Department of Neuropathology, University of Bonn, Sigmund Freud Street 25, Bonn D-53127, Germany.,Department of Epileptology, University of Bonn Medical Center, Sigmund-Freud-Strasse 25, Bonn D-53127, Germany
| | - Vincenzo De Paola
- Medical Research Council (MRC) Clinical Sciences Centre, Imperial College London, Hammersmith Hospital, Du Cane Road, London W12 0NN, UK
| | - Rafal M Kaminski
- Neuroscience TA, UCB Biopharma SPRL, Avenue de l'industrie, R9, B-1420 Braine l'Alleud, Belgium
| | - Vincent T Cunliffe
- Department of Biomedical Science, Bateson Centre, University of Sheffield, Firth Court, Western Bank, Sheffield S10 2TN, UK
| | - Albert J Becker
- Section of Translational Epileptology, Department of Neuropathology, University of Bonn, Sigmund Freud Street 25, Bonn D-53127, Germany
| | - Enrico Petretto
- Medical Research Council (MRC) Clinical Sciences Centre, Imperial College London, Hammersmith Hospital, Du Cane Road, London W12 0NN, UK.,Duke-NUS Graduate Medical School, 8 College Road, Singapore 169857, Singapore
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12
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Boardman JP, Walley A, Ball G, Takousis P, Krishnan ML, Hughes-Carre L, Aljabar P, Serag A, King C, Merchant N, Srinivasan L, Froguel P, Hajnal J, Rueckert D, Counsell S, Edwards AD. Common genetic variants and risk of brain injury after preterm birth. Pediatrics 2014; 133:e1655-63. [PMID: 24819575 DOI: 10.1542/peds.2013-3011] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND The role of heritable factors in determining the common neurologic deficits seen after preterm birth is unknown, but the characteristic phenotype of neurocognitive, neuroanatomical, and growth abnormalities allows principled selection of candidate genes to test the hypothesis that common genetic variation modulates the risk for brain injury. METHODS We collected an MRI-linked genomic DNA library from 83 preterm infants and genotyped tag single nucleotide polymorphisms in 13 relevant candidate genes. We used tract-based spatial statistics and deformation-based morphometry to examine the risks conferred by carriage of particular alleles at tag single nucleotide polymorphisms in a restricted number of genes and related these to the preterm cerebral endophenotype. RESULTS Carriage of the minor allele at rs2518824 in the armadillo repeat gene deleted in velocardiofacial syndrome (ARVCF) gene, which has been linked to neuronal migration and schizophrenia, and rs174576 in the fatty acid desaturase 2 gene, which encodes a rate-limiting enzyme for endogenous long chain polyunsaturated fatty acid synthesis and has been linked to intelligence, was associated with white matter abnormality measured in vivo using diffusion tensor imaging (P = .0009 and P = .0019, respectively). CONCLUSIONS These results suggest that genetic variants modulate white matter injury after preterm birth, and known susceptibilities to neurologic status in later life may be exposed by the stress of premature exposure to the extrauterine environment.
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MESH Headings
- Alleles
- Armadillo Domain Proteins/genetics
- Brain/pathology
- Brain Damage, Chronic/diagnosis
- Brain Damage, Chronic/genetics
- Catechol O-Methyltransferase/genetics
- Cell Adhesion Molecules/genetics
- Chromosomes, Human, Pair 11/genetics
- Chromosomes, Human, Pair 22/genetics
- Cohort Studies
- Diffusion Magnetic Resonance Imaging
- Endophenotypes
- Fatty Acid Desaturases/genetics
- Gene Library
- Genetic Association Studies
- Genetic Carrier Screening
- Genetic Predisposition to Disease/genetics
- Genetic Variation/genetics
- Genotype
- Humans
- Image Interpretation, Computer-Assisted
- Infant, Newborn
- Infant, Premature, Diseases/diagnosis
- Infant, Premature, Diseases/genetics
- Intelligence/genetics
- Magnetic Resonance Imaging
- Phosphoproteins/genetics
- Polymorphism, Single Nucleotide/genetics
- Schizophrenia/genetics
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Affiliation(s)
- James P Boardman
- Medical Research Council/University of Edinburgh Centre for Reproductive Health, Edinburgh, United Kingdom;
| | - Andrew Walley
- Departments of Genomics of Common Disease, School of Public Health,Molecular Genetics and Genomics, National Heart and Lung Institute
| | - Gareth Ball
- Centre for the Developing Brain, King's College London, London, England, United Kingdom
| | - Petros Takousis
- Departments of Genomics of Common Disease, School of Public Health
| | - Michelle L Krishnan
- Centre for the Developing Brain, King's College London, London, England, United Kingdom
| | | | - Paul Aljabar
- Centre for the Developing Brain, King's College London, London, England, United Kingdom
| | - Ahmed Serag
- The Advanced Pediatric Brain Imaging Research Laboratory, Children's National Medical Center, Washington, District of Columbia; and
| | | | - Nazakat Merchant
- Centre for the Developing Brain, King's College London, London, England, United Kingdom
| | | | - Philippe Froguel
- Departments of Genomics of Common Disease, School of Public Health,Centre National de la Recherche Scientifique-CNRS 8199, Lille 2 University, Paris, France
| | - Jo Hajnal
- Centre for the Developing Brain, King's College London, London, England, United Kingdom
| | - Daniel Rueckert
- Computing, Imperial College London, London, England, United Kingdom
| | - Serena Counsell
- Centre for the Developing Brain, King's College London, London, England, United Kingdom
| | - A David Edwards
- Centre for the Developing Brain, King's College London, London, England, United Kingdom
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Krishnan ML, Commowick O, Jeste SS, Weisenfeld N, Hans A, Gregas MC, Sahin M, Warfield SK. Diffusion features of white matter in tuberous sclerosis with tractography. Pediatr Neurol 2010; 42:101-6. [PMID: 20117745 PMCID: PMC2831465 DOI: 10.1016/j.pediatrneurol.2009.08.001] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2009] [Revised: 07/02/2009] [Accepted: 08/06/2009] [Indexed: 11/19/2022]
Abstract
Normal-appearing white matter has been shown via diffusion tensor imaging to be affected in tuberous sclerosis complex. Under the hypothesis that some systems might be differentially affected, including the visual pathways and systems of social cognition, diffusion properties of various regions of white matter were compared. For 10 patients and 6 age-matched control subjects, 3 T magnetic resonance imaging was assessed using diffusion tensor imaging obtained in 35 directions. Three-dimensional volumes corresponding to the geniculocalcarine tracts were extracted via tractography, and two-dimensional regions of interest were used to sample other regions. Regression analysis indicated lower fractional anisotropy in the splenium of corpus callosum and geniculocalcarine tracts in tuberous sclerosis complex group, as well as lower axial diffusivity in the internal capsule, superior temporal gyrus, and geniculocalcarine tracts. Mean and radial diffusivity of the splenium of corpus callosum were higher in the tuberous sclerosis complex group. The differences in diffusion properties of white matter between tuberous sclerosis complex patients and control subjects suggest disorganized and structurally compromised axons with poor myelination. The visual and social cognition systems appear to be differentially involved, which might in part explain the behavioral and cognitive characteristics of the tuberous sclerosis complex population.
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Affiliation(s)
- Michelle L Krishnan
- Computational Radiology Laboratory, Department of Radiology, Children's Hospital Boston, Harvard Medical School, Boston, Massachusetts
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Krishnan ML, Dyet LE, Boardman JP, Kapellou O, Allsop JM, Cowan F, Edwards AD, Rutherford MA, Counsell SJ. Relationship between white matter apparent diffusion coefficients in preterm infants at term-equivalent age and developmental outcome at 2 years. Pediatrics 2007; 120:e604-9. [PMID: 17698966 DOI: 10.1542/peds.2006-3054] [Citation(s) in RCA: 124] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE The aim of this study was to develop a simple reproducible method for the measurement of apparent diffusion coefficient values in the white matter of preterm infants using diffusion-weighted imaging to test the hypothesis that elevated mean apparent diffusion coefficient values are associated with lower developmental quotient scores at 2 years' corrected age. METHODS We obtained diffusion-weighted imaging in 38 preterm infants at term-equivalent age who had no evidence of overt cerebral pathology on conventional MRI. Mean apparent diffusion coefficient values at the level of the centrum semiovale were determined. The children were assessed using a standardized neurologic examination, and the Griffiths Mental Development Scales were administered to obtain a developmental quotient at 2 years' corrected age. The relationship between mean apparent diffusion coefficient values and developmental quotient was examined. Clinical data relating to postnatal sepsis, antenatal steroid exposure, supplemental oxygen, gender, patent ductus arteriosus, and inotrope requirement were collected, and the mean apparent diffusion coefficient values for each group were compared. RESULTS The mean (+/-SD) apparent diffusion coefficient value in the white matter was 1.385 +/- 0.07 x 10(-3) mm2/second, and the mean developmental quotient was 108.9 +/- 11.5. None of the children had a significant neurologic problem. There was a significant negative correlation between mean apparent diffusion coefficient and developmental quotient. CONCLUSION These findings suggest that higher white matter apparent diffusion coefficient values at term-equivalent age in preterm infants without overt lesions are associated with poorer developmental performance in later childhood. Consequently, apparent diffusion coefficient values at term may be of prognostic value for neurodevelopmental outcome in infants who are born preterm and who have no other imaging indicators of abnormality.
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Affiliation(s)
- Michelle L Krishnan
- Robert Steiner Magnetic Resonance Unit, Medical Research Council Clinical Sciences Centre, Imperial College London, London, United Kingdom
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