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Lu T, Chen X, Zhang Q, Shang K, Yang X, Xiang W. Vitamin D Relieves Epilepsy Symptoms and Neuroinflammation in Juvenile Mice by Activating the mTOR Signaling Pathway via RAF1: Insights from Network Pharmacology and Molecular Docking Studies. Neurochem Res 2024:10.1007/s11064-024-04176-y. [PMID: 38837094 DOI: 10.1007/s11064-024-04176-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Revised: 03/15/2024] [Accepted: 05/22/2024] [Indexed: 06/06/2024]
Abstract
Epilepsy is a common neurological disorder, and the exploration of potential therapeutic drugs for its treatment is still ongoing. Vitamin D has emerged as a promising treatment due to its potential neuroprotective effects and anti-epileptic properties. This study aimed to investigate the effects of vitamin D on epilepsy and neuroinflammation in juvenile mice using network pharmacology and molecular docking, with a focus on the mammalian target of rapamycin (mTOR) signaling pathway. Experimental mouse models of epilepsy were established through intraperitoneal injection of pilocarpine, and in vitro injury models of hippocampal neurons were induced by glutamate (Glu) stimulation. The anti-epileptic effects of vitamin D were evaluated both in vivo and in vitro. Network pharmacology and molecular docking analysis were used to identify potential targets and regulatory pathways of vitamin D in epilepsy. The involvement of the mTOR signaling pathway in the regulation of mouse epilepsy by vitamin D was validated using rapamycin (RAPA). The levels of inflammatory cytokines (TNF-α, IL-1β, and IL-6) were assessed by enzyme-linked immunosorbent assay (ELISA). Gene and protein expressions were detected by quantitative real-time polymerase chain reaction (qRT-PCR) and Western blot, respectively. The terminal deoxynucleotidyl transferase-mediated deoxyuridine triphosphate nick end-labeling (TUNEL) staining was used to analyze the apoptosis of hippocampal neurons. In in vivo experiments, vitamin D reduced the Racine scores of epileptic mice, prolonged the latency of epilepsy, and inhibited the production of TNF-α, IL-1β, and IL-6 in the hippocampus. Furthermore, network pharmacology analysis identified RAF1 as a potential target of vitamin D in epilepsy, which was further confirmed by molecular docking analysis. Additionally, the mTOR signaling pathway was found to be involved in the regulation of mouse epilepsy by vitamin D. In in vitro experiments, Glu stimulation upregulated the expressions of RAF1 and LC3II/LC3I, inhibited mTOR phosphorylation, and induced neuronal apoptosis. Mechanistically, vitamin D activated the mTOR signaling pathway and alleviated mouse epilepsy via RAF1, while the use of the pathway inhibitor RAPA reversed this effect. Vitamin D alleviated epilepsy symptoms and neuroinflammation in juvenile mice by activating the mTOR signaling pathway via RAF1. These findings provided new insights into the molecular mechanisms underlying the anti-epileptic effects of vitamin D and further supported its use as an adjunctive therapy for existing anti-epileptic drugs.
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Affiliation(s)
- Tiantian Lu
- School of Pediatrics, Hainan Medical University, Haikou, 571199, China
- Department of Neonatology, Haikou Maternal and Child Health Hospital, Haikou, 570203, China
| | - Xiuling Chen
- Department of Pediatric Medicine, Affiliated Haikou Hospital of Xiangya Medical School Central South University, Haikou, 570208, China
| | - Qin Zhang
- Department of Neurosurgery, Hainan Women and Children's Medical Center, Haikou, 570312, China
| | - Kun Shang
- Institute of Deep-sea Science and Engineering, Chinese Academy of Science, Sanya, 572000, China
| | - Xiaogui Yang
- Department of Neonatology, Haikou Maternal and Child Health Hospital, Haikou, 570203, China
| | - Wei Xiang
- School of Pediatrics, Hainan Medical University, Haikou, 571199, China.
- Hainan Women and Children's Medical Center, Hainan Medical University, Haikou, 570312, China.
- National Health Commission (NHC) Key Laboratory of Tropical Disease Control, Hainan Medical University, Haikou, 570216, China.
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Li X, Wang T, Liu N, Cai A, Zhang J, Zhang F, Liu Q, Wang J, Wu Y, Gao K, Jiang YW. Focal cortical dysplasia II caused by brain somatic mutation of IRS-1 is associated with ERK signaling pathway activation. Cereb Cortex 2024; 34:bhae227. [PMID: 38836287 DOI: 10.1093/cercor/bhae227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2024] [Revised: 05/05/2024] [Accepted: 05/06/2024] [Indexed: 06/06/2024] Open
Abstract
Somatic mutations have been identified in 10% to 63% of focal cortical dysplasia type II samples, primarily linked to the mTOR pathway. When the causative genetic mutations are not identified, this opens the possibility of discovering new pathogenic genes or pathways that could be contributing to the condition. In our previous study, we identified a novel candidate pathogenic somatic variant of IRS-1 c.1791dupG in the brain tissue of a child with focal cortical dysplasia type II. This study further explored the variant's role in causing type II focal cortical dysplasia through in vitro overexpression in 293T and SH-SY5Y cells and in vivo evaluation via in utero electroporation in fetal brains, assessing effects on neuronal migration, morphology, and network integrity. It was found that the mutant IRS-1 variant led to hyperactivity of p-ERK, increased cell volume, and was predominantly associated with the MAPK signaling pathway. In vivo, the IRS-1 c.1791dupG variant induced abnormal neuron migration, cytomegaly, and network hyperexcitability. Notably, the ERK inhibitor GDC-0994, rather than the mTOR inhibitor rapamycin, effectively rescued the neuronal defects. This study directly highlighted the ERK signaling pathway's role in the pathogenesis of focal cortical dysplasia II and provided a new therapeutic target for cases of focal cortical dysplasia II that are not treatable by rapamycin analogs.
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Affiliation(s)
- Xiao Li
- Department of Pediatrics, Peking University First Hospital, No. 1 Xi'an Men Street, West District, Beijing 100034, China
- Beijing Key Laboratory of Molecular Diagnosis and Study on Pediatric Genetic Diseases, No. 1 Xi'an Men Street, West District, Beijing 100034, China
- Children Epilepsy Center, Peking University First Hospital, No. 1 Xi'an Men Street, West District, Beijing 100034, China
| | - Tianshuang Wang
- Department of Neurology, Children's Hospital of Fudan University, National Children's Medical Center, 399 Wanyuan Road, Minhang District, Shanghai 201102, China
| | - Nana Liu
- Department of Pediatrics, Peking University First Hospital, No. 1 Xi'an Men Street, West District, Beijing 100034, China
- Beijing Key Laboratory of Molecular Diagnosis and Study on Pediatric Genetic Diseases, No. 1 Xi'an Men Street, West District, Beijing 100034, China
- Children Epilepsy Center, Peking University First Hospital, No. 1 Xi'an Men Street, West District, Beijing 100034, China
| | - Aojie Cai
- Department of Pediatrics, Peking University First Hospital, No. 1 Xi'an Men Street, West District, Beijing 100034, China
- Beijing Key Laboratory of Molecular Diagnosis and Study on Pediatric Genetic Diseases, No. 1 Xi'an Men Street, West District, Beijing 100034, China
- Children Epilepsy Center, Peking University First Hospital, No. 1 Xi'an Men Street, West District, Beijing 100034, China
| | - Junjiao Zhang
- Department of Pediatrics, Peking University First Hospital, No. 1 Xi'an Men Street, West District, Beijing 100034, China
- Beijing Key Laboratory of Molecular Diagnosis and Study on Pediatric Genetic Diseases, No. 1 Xi'an Men Street, West District, Beijing 100034, China
- Children Epilepsy Center, Peking University First Hospital, No. 1 Xi'an Men Street, West District, Beijing 100034, China
| | - Fan Zhang
- Department of Pediatrics, Peking University First Hospital, No. 1 Xi'an Men Street, West District, Beijing 100034, China
- Beijing Key Laboratory of Molecular Diagnosis and Study on Pediatric Genetic Diseases, No. 1 Xi'an Men Street, West District, Beijing 100034, China
- Children Epilepsy Center, Peking University First Hospital, No. 1 Xi'an Men Street, West District, Beijing 100034, China
| | - Qingzhu Liu
- Children Epilepsy Center, Peking University First Hospital, No. 1 Xi'an Men Street, West District, Beijing 100034, China
| | - Jingmin Wang
- Department of Pediatrics, Peking University First Hospital, No. 1 Xi'an Men Street, West District, Beijing 100034, China
- Beijing Key Laboratory of Molecular Diagnosis and Study on Pediatric Genetic Diseases, No. 1 Xi'an Men Street, West District, Beijing 100034, China
- Children Epilepsy Center, Peking University First Hospital, No. 1 Xi'an Men Street, West District, Beijing 100034, China
- Key Laboratory for Neuroscience, Ministry of Education/National Health and Family Planning Commission, Peking University, No. 1 Xi'an Men Street, West District, Beijing 100034, China
| | - Ye Wu
- Department of Pediatrics, Peking University First Hospital, No. 1 Xi'an Men Street, West District, Beijing 100034, China
- Beijing Key Laboratory of Molecular Diagnosis and Study on Pediatric Genetic Diseases, No. 1 Xi'an Men Street, West District, Beijing 100034, China
- Children Epilepsy Center, Peking University First Hospital, No. 1 Xi'an Men Street, West District, Beijing 100034, China
| | - Kai Gao
- Department of Pediatrics, Peking University First Hospital, No. 1 Xi'an Men Street, West District, Beijing 100034, China
- Beijing Key Laboratory of Molecular Diagnosis and Study on Pediatric Genetic Diseases, No. 1 Xi'an Men Street, West District, Beijing 100034, China
- Children Epilepsy Center, Peking University First Hospital, No. 1 Xi'an Men Street, West District, Beijing 100034, China
- Key Laboratory for Neuroscience, Ministry of Education/National Health and Family Planning Commission, Peking University, No. 1 Xi'an Men Street, West District, Beijing 100034, China
| | - Yu-Wu Jiang
- Department of Pediatrics, Peking University First Hospital, No. 1 Xi'an Men Street, West District, Beijing 100034, China
- Beijing Key Laboratory of Molecular Diagnosis and Study on Pediatric Genetic Diseases, No. 1 Xi'an Men Street, West District, Beijing 100034, China
- Children Epilepsy Center, Peking University First Hospital, No. 1 Xi'an Men Street, West District, Beijing 100034, China
- Key Laboratory for Neuroscience, Ministry of Education/National Health and Family Planning Commission, Peking University, No. 1 Xi'an Men Street, West District, Beijing 100034, China
- Center of Epilepsy, Beijing Institute for Brain Disorders, No. 1 Xi'an Men Street, West District, Beijing 100034, China
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Medina Lemus A, Boelman C, Myers KA. Epilepsy in Legius syndrome: Coincidence or causation? Am J Med Genet A 2024; 194:e63547. [PMID: 38268057 DOI: 10.1002/ajmg.a.63547] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Revised: 01/10/2024] [Accepted: 01/13/2024] [Indexed: 01/26/2024]
Abstract
Legius syndrome is a rare genetic disorder, caused by heterozygous SPRED1 pathogenic variants, which shares phenotypic features with neurofibromatosis type 1 (NF1). Both conditions typically involve café-au-lait macules, axillary freckling, and macrocephaly; however, patients with NF1 are also at risk for tumors, such as optic nerve gliomas and neurofibromas. Seizure risk is known to be elevated in NF1, but there has been little study of this aspect of Legius syndrome. The reported epilepsy incidence is 3.3%-5%, well above the general population incidence of ~0.5%-1%, but the few reports in the literature have very little data regarding epilepsy phenotype. We identified two unrelated individuals, both with Legius syndrome and epilepsy, and performed thorough phenotyping. One individual's mother also had Legius syndrome and now-resolved childhood epilepsy, as well as reports of more distant relatives who also had multiple café-au-lait macules and seizures. Both probands had experienced childhood-onset focal seizures, with normal brain MRI. In one patient, EEG later showed apparently generalized epileptiform abnormalities. Based on the data from this small case series and literature review, seizure risk is increased in people with Legius syndrome, but the epilepsy prognosis appears to be generally good, with patients having either self-limited or pharmacoresponsive courses.
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Affiliation(s)
- Adalbeis Medina Lemus
- Division of Neurology, Department of Pediatrics, Montreal Children's Hospital, McGill University Health Centre, Montreal, Quebec, Canada
| | - Cyrus Boelman
- Division of Neurology, Department of Pediatrics, British Columbia Children's Hospital, Vancouver, British Columbia, Canada
| | - Kenneth A Myers
- Division of Neurology, Department of Pediatrics, Montreal Children's Hospital, McGill University Health Centre, Montreal, Quebec, Canada
- Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada
- Department of Neurology and Neurosurgery, Montreal Children's Hospital, McGill University Health Centre, Montreal, Quebec, Canada
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Carton RJ, Doyle MG, Kearney H, Steward CA, Lench NJ, Rogers A, Heinzen EL, McDonald S, Fay J, Lacey A, Beausang A, Cryan J, Brett F, El-Naggar H, Widdess-Walsh P, Costello D, Kilbride R, Doherty CP, Sweeney KJ, O'Brien DF, Henshall DC, Delanty N, Cavalleri GL, Benson KA. Somatic variants as a cause of drug-resistant epilepsy including mesial temporal lobe epilepsy with hippocampal sclerosis. Epilepsia 2024; 65:1451-1461. [PMID: 38491957 DOI: 10.1111/epi.17943] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Revised: 02/14/2024] [Accepted: 02/26/2024] [Indexed: 03/18/2024]
Abstract
OBJECTIVE The contribution of somatic variants to epilepsy has recently been demonstrated, particularly in the etiology of malformations of cortical development. The aim of this study was to determine the diagnostic yield of somatic variants in genes that have been previously associated with a somatic or germline epilepsy model, ascertained from resected brain tissue from patients with multidrug-resistant focal epilepsy. METHODS Forty-two patients were recruited across three categories: (1) malformations of cortical development, (2) mesial temporal lobe epilepsy with hippocampal sclerosis, and (3) nonlesional focal epilepsy. Participants were subdivided based on histopathology of the resected brain. Paired blood- and brain-derived DNA samples were sequenced using high-coverage targeted next generation sequencing to high depth (585× and 1360×, respectively). Variants were identified using Genome Analysis ToolKit (GATK4) MuTect-2 and confirmed using high-coverage Amplicon-EZ sequencing. RESULTS Sequence data on 41 patients passed quality control. Four somatic variants were validated following amplicon sequencing: within CBL, ALG13, MTOR, and FLNA. The diagnostic yield across 41 patients was 10%, 9% in mesial temporal lobe epilepsy with hippocampal sclerosis and 20% in malformations of cortical development. SIGNIFICANCE This study provides novel insights into the etiology of mesial temporal lobe epilepsy with hippocampal sclerosis, highlighting a potential pathogenic role of somatic variants in CBL and ALG13. We also report candidate diagnostic somatic variants in FLNA in focal cortical dysplasia, while providing further insight into the importance of MTOR and related genes in focal cortical dysplasia. This work demonstrates the potential molecular diagnostic value of variants in both germline and somatic epilepsy genes.
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Affiliation(s)
- Robert J Carton
- FutureNeuro Science Foundation Ireland Research Centre, Royal College of Surgeons in Ireland, Dublin, Ireland
- School of Pharmacy and Biomolecular Sciences, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Michael G Doyle
- FutureNeuro Science Foundation Ireland Research Centre, Royal College of Surgeons in Ireland, Dublin, Ireland
- School of Pharmacy and Biomolecular Sciences, Royal College of Surgeons in Ireland, Dublin, Ireland
- Epilepsy Programme, Department of Neurology, Beaumont Hospital, Dublin, Ireland
- Strategic Academic Recruitment Doctor of Medicine Programme, Royal College of Surgeons in Ireland in collaboration with Blackrock Clinic, Dublin, Ireland
| | - Hugh Kearney
- FutureNeuro Science Foundation Ireland Research Centre, Royal College of Surgeons in Ireland, Dublin, Ireland
- Epilepsy Programme, Department of Neurology, Beaumont Hospital, Dublin, Ireland
| | | | | | - Anthony Rogers
- Congenica Limited, BioData Innovation Centre, Cambridge, UK
| | - Erin L Heinzen
- Department of Genetics, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Seamus McDonald
- School of Pharmacy and Biomolecular Sciences, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Joanna Fay
- Royal College of Surgeons in Ireland Biobanking Service, Dublin, Ireland
| | - Austin Lacey
- FutureNeuro Science Foundation Ireland Research Centre, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Alan Beausang
- Department of Neuropathology, Beaumont Hospital, Dublin, Ireland
| | - Jane Cryan
- Department of Neuropathology, Beaumont Hospital, Dublin, Ireland
| | - Francesca Brett
- Department of Neuropathology, Beaumont Hospital, Dublin, Ireland
| | - Hany El-Naggar
- FutureNeuro Science Foundation Ireland Research Centre, Royal College of Surgeons in Ireland, Dublin, Ireland
- Epilepsy Programme, Department of Neurology, Beaumont Hospital, Dublin, Ireland
| | - Peter Widdess-Walsh
- FutureNeuro Science Foundation Ireland Research Centre, Royal College of Surgeons in Ireland, Dublin, Ireland
- Epilepsy Programme, Department of Neurology, Beaumont Hospital, Dublin, Ireland
| | - Daniel Costello
- FutureNeuro Science Foundation Ireland Research Centre, Royal College of Surgeons in Ireland, Dublin, Ireland
- Department of Neurology, Cork University Hospital, Cork, Ireland
| | - Ronan Kilbride
- FutureNeuro Science Foundation Ireland Research Centre, Royal College of Surgeons in Ireland, Dublin, Ireland
- Epilepsy Programme, Department of Neurology, Beaumont Hospital, Dublin, Ireland
| | - Colin P Doherty
- FutureNeuro Science Foundation Ireland Research Centre, Royal College of Surgeons in Ireland, Dublin, Ireland
- Department of Neurology, St. James's Hospital, Dublin, Ireland
| | - Kieron J Sweeney
- FutureNeuro Science Foundation Ireland Research Centre, Royal College of Surgeons in Ireland, Dublin, Ireland
- Epilepsy Programme, Department of Neurology, Beaumont Hospital, Dublin, Ireland
| | - Donncha F O'Brien
- FutureNeuro Science Foundation Ireland Research Centre, Royal College of Surgeons in Ireland, Dublin, Ireland
- Epilepsy Programme, Department of Neurology, Beaumont Hospital, Dublin, Ireland
| | - David C Henshall
- FutureNeuro Science Foundation Ireland Research Centre, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Norman Delanty
- FutureNeuro Science Foundation Ireland Research Centre, Royal College of Surgeons in Ireland, Dublin, Ireland
- School of Pharmacy and Biomolecular Sciences, Royal College of Surgeons in Ireland, Dublin, Ireland
- Epilepsy Programme, Department of Neurology, Beaumont Hospital, Dublin, Ireland
| | - Gianpiero L Cavalleri
- FutureNeuro Science Foundation Ireland Research Centre, Royal College of Surgeons in Ireland, Dublin, Ireland
- School of Pharmacy and Biomolecular Sciences, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Katherine A Benson
- FutureNeuro Science Foundation Ireland Research Centre, Royal College of Surgeons in Ireland, Dublin, Ireland
- School of Pharmacy and Biomolecular Sciences, Royal College of Surgeons in Ireland, Dublin, Ireland
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Pierpont EI, Bennett AM, Schoyer L, Stronach B, Anschutz A, Borrie SC, Briggs B, Burkitt-Wright E, Castel P, Cirstea IC, Draaisma F, Ellis M, Fear VS, Frone MN, Flex E, Gelb BD, Green T, Gripp KW, Khoshkhoo S, Kieran MW, Kleemann K, Klein-Tasman BP, Kontaridis MI, Kruszka P, Leoni C, Liu CZ, Merchant N, Magoulas PL, Moertel C, Prada CE, Rauen KA, Roelofs R, Rossignol R, Sevilla C, Sevilla G, Sheedy R, Stieglitz E, Sun D, Tiemens D, White F, Wingbermühle E, Wolf C, Zenker M, Andelfinger G. The 8th International RASopathies Symposium: Expanding research and care practice through global collaboration and advocacy. Am J Med Genet A 2024; 194:e63477. [PMID: 37969032 PMCID: PMC10939912 DOI: 10.1002/ajmg.a.63477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Accepted: 11/04/2023] [Indexed: 11/17/2023]
Abstract
Germline pathogenic variants in the RAS/mitogen-activated protein kinase (MAPK) signaling pathway are the molecular cause of RASopathies, a group of clinically overlapping genetic syndromes. RASopathies constitute a wide clinical spectrum characterized by distinct facial features, short stature, predisposition to cancer, and variable anomalies in nearly all the major body systems. With increasing global recognition of these conditions, the 8th International RASopathies Symposium spotlighted global perspectives on clinical care and research, including strategies for building international collaborations and developing diverse patient cohorts in anticipation of interventional trials. This biannual meeting, organized by RASopathies Network, was held in a hybrid virtual/in-person format. The agenda featured emerging discoveries and case findings as well as progress in preclinical and therapeutic pipelines. Stakeholders including basic scientists, clinician-scientists, practitioners, industry representatives, patients, and family advocates gathered to discuss cutting edge science, recognize current gaps in knowledge, and hear from people with RASopathies about the experience of daily living. Presentations by RASopathy self-advocates and early-stage investigators were featured throughout the program to encourage a sustainable, diverse, long-term research and advocacy partnership focused on improving health and bringing treatments to people with RASopathies.
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Affiliation(s)
| | | | | | | | | | - Sarah C Borrie
- KU Leuven, Laboratory for the Research of Neurodegenerative Diseases
| | - Benjamin Briggs
- School of Medicine, Uniformed Services University of the Health Sciences
| | - Emma Burkitt-Wright
- Manchester Centre for Genomic Medicine, Manchester University NHS Foundation Trust and University of Manchester, Manchester, UK
| | - Pau Castel
- Department of Biochemistry & Molecular Pharmacology, NYU Grossman School of Medicine
| | - Ion C Cirstea
- Institute of Comparative Molecular Endocrinology, Ulm University
- Institute of Applied Physiology, Ulm University
| | - Fieke Draaisma
- Department of Pediatrics, Radboud Institute for Health Sciences, Radboud University Medical Center, Amalia Children’s Hospital
| | | | - Vanessa S. Fear
- Translational Genetics, Precision Health, Telethon Kids Institute, The University of Western Australia
| | - Megan N. Frone
- Clinical Genetics Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH
| | - Elisabetta Flex
- Department of Oncology and Molecular Medicine, Instituo Superiore di Sanità
| | - Bruce D. Gelb
- Mindich Child Health and Development Institute and the Departments of Pediatrics and Genetics and Genomic Sciences, Icahn School of Medicine
| | - Tamar Green
- Division of Interdisciplinary Brain Sciences, Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine
| | - Karen W. Gripp
- Division of Medical Genetics, Department of Pediatrics, Nemours Children’s Hospital
| | - Sattar Khoshkhoo
- Department of Neurology, Brigham and Women’s Hospital, Harvard Medical School
| | | | - Karolin Kleemann
- Clinic for Cardiothoracic and Vascular Surgery, University Medical Center Göttingen
- German Center for Cardiovascular Research (DZHK), partner site Göttingen
| | | | - Maria I Kontaridis
- Department of Biomedical Research and Translational Medicine, Masonic Medical Research Institute, Utica, New York, USA
- Division of Cardiology, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA
- Department of Biological Chemistry and Molecular Pharmacology, Harvard Medical School, Boston, Massachusetts, USA
| | | | - Chiara Leoni
- Center for Rare Diseases and Birth Defects, Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A.Gemelli, IRCCS, Rome, Italy
| | - Clifford Z. Liu
- Mindich Child Health and Development Institute and the Departments of Pediatrics and Genetics and Genomic Sciences, Icahn School of Medicine
| | | | - Pilar L. Magoulas
- Department of Molecular and Human Genetics, Baylor College of Medicine and Texas Children’s Hospital
| | | | - Carlos E. Prada
- Division of Genetics, Genomics, and Metabolism, Ann and Robert H. Lurie Children’s Hospital of Chicago
- Department of Pediatrics, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Katherine A. Rauen
- Department of Pediatrics, Division of Genomic Medicine, University of California Davis
| | - Renée Roelofs
- Centre of Excellence for Neuropsychiatry, Vincent van Gogh Institute for Psychiatry, Venray, The Netherlands
| | | | | | | | | | - Elliot Stieglitz
- Department of Pediatrics, Benioff Children’s Hospital, University of California
| | - Daochun Sun
- Cancer Biology & Genetics Program, Memorial Sloan Kettering Cancer Center
| | - Dagmar Tiemens
- Department of Pediatrics, Radboud Institute for Health Sciences, Radboud University Medical Center, Amalia Children’s Hospital
| | - Forest White
- Department of Biological Engineering, Massachusetts Institute of Technology
| | - Ellen Wingbermühle
- Centre of Excellence for Neuropsychiatry, Vincent van Gogh Institute for Psychiatry, Venray, The Netherlands
| | - Cordula Wolf
- Department of Pediatric Cardiology and Congenital Heart Disease, German Heart Center Munich, Technical University Munich
| | - Martin Zenker
- Institute of Human Genetics, University Hospital Magdeburg
| | - Gregor Andelfinger
- Department of Anatomy and Cell Biology, McGill School of Biomedical Sciences
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6
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Gooley S, Perucca P, Tubb C, Hildebrand MS, Berkovic SF. Somatic mosaicism in focal epilepsies. Curr Opin Neurol 2024; 37:105-114. [PMID: 38235675 DOI: 10.1097/wco.0000000000001244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2024]
Abstract
PURPOSE OF REVIEW Over the past decade, it has become clear that brain somatic mosaicism is an important contributor to many focal epilepsies. The number of cases and the range of underlying pathologies with somatic mosaicism are rapidly increasing. This growth in somatic variant discovery is revealing dysfunction in distinct molecular pathways in different focal epilepsies. RECENT FINDINGS We briefly summarize the current diagnostic yield of pathogenic somatic variants across all types of focal epilepsy where somatic mosaicism has been implicated and outline the specific molecular pathways affected by these variants. We will highlight the recent findings that have increased diagnostic yields such as the discovery of pathogenic somatic variants in novel genes, and new techniques that allow the discovery of somatic variants at much lower variant allele fractions. SUMMARY A major focus will be on the emerging evidence that somatic mosaicism may contribute to some of the more common focal epilepsies such as temporal lobe epilepsy with hippocampal sclerosis, which could lead to it being re-conceptualized as a genetic disorder.
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Affiliation(s)
- Samuel Gooley
- Epilepsy Research Centre, Department of Medicine, University of Melbourne
- Bladin-Berkovic Comprehensive Epilepsy Program, Department of Neurology, Austin Health, Heidelberg
| | - Piero Perucca
- Epilepsy Research Centre, Department of Medicine, University of Melbourne
- Bladin-Berkovic Comprehensive Epilepsy Program, Department of Neurology, Austin Health, Heidelberg
- Department of Neuroscience, Central Clinical School, Monash University
- Department of Neurology, Alfred Health, Melbourne
- Department of Neurology, The Royal Melbourne Hospital
| | - Caitlin Tubb
- Epilepsy Research Centre, Department of Medicine, University of Melbourne
| | - Michael S Hildebrand
- Epilepsy Research Centre, Department of Medicine, University of Melbourne
- Neuroscience Group, Murdoch Children's Research Institute, Royal Children's Hospital, Parkville, Victoria, Australia
| | - Samuel F Berkovic
- Epilepsy Research Centre, Department of Medicine, University of Melbourne
- Bladin-Berkovic Comprehensive Epilepsy Program, Department of Neurology, Austin Health, Heidelberg
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7
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Ma M, Cheng Y, Hou X, Li Z, Wang M, Ma B, Cheng Q, Ding Z, Feng H. Serum biomarkers in patients with drug-resistant epilepsy: a proteomics-based analysis. Front Neurol 2024; 15:1383023. [PMID: 38585359 PMCID: PMC10995353 DOI: 10.3389/fneur.2024.1383023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2024] [Accepted: 03/08/2024] [Indexed: 04/09/2024] Open
Abstract
Objective To investigate the serum biomarkers in patients with drug-resistant epilepsy (DRE). Methods A total of 9 DRE patients and 9 controls were enrolled. Serum from DRE patients was prospectively collected and analyzed for potential serum biomarkers using TMT18-labeled proteomics. After fine quality control, bioinformatics analysis was conducted to find differentially expressed proteins. Pathway enrichment analysis identified some biological features shared by differential proteins. Protein-protein interaction (PPI) network analysis was further performed to discover the core proteins. Results A total of 117 serum differential proteins were found in our study, of which 44 were revised upwards and 73 downwards. The up-regulated proteins mainly include UGGT2, PDIA4, SEMG1, KIAA1191, CCT7 etc. and the down-regulated proteins mainly include ROR1, NIF3L1, ITIH4, CFP, COL11A2 etc. Pathway enrichment analysis identified that the upregulated proteins were mainly enriched in processes such as immune response, extracellular exosome, serine-type endopeptidase activity and complement and coagulation cascades, and the down-regulated proteins were enriched in signal transduction, extracellular exosome, zinc/calcium ion binding and metabolic pathways. PPI network analysis revealed that the core proteins nodes include PRDX6, CAT, PRDX2, SOD1, PARK7, GSR, TXN, ANXA1, HINT1, and S100A8 etc. Conclusion The discovery of these differential proteins enriched our understanding of serum biomarkers in patients with DRE and potentially provides guidance for future targeted therapy.
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Affiliation(s)
- Mian Ma
- Department of Neurosurgery, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Suzhou, Jiangsu, China
| | - Ying Cheng
- Suzhou Jinchang Street Bailian Community Health Service Center, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Suzhou, Jiangsu, China
| | - Xiaoxia Hou
- Department of Neurology, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Suzhou, Jiangsu, China
| | - Zhisen Li
- Department of Radiology, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Suzhou, Jiangsu, China
| | - Meixia Wang
- Department of Neurology, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Suzhou, Jiangsu, China
| | - Bodun Ma
- Department of Neurology, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Suzhou, Jiangsu, China
| | - Qingzhang Cheng
- Department of Neurology, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Suzhou, Jiangsu, China
| | - Zhiliang Ding
- Department of Neurosurgery, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Suzhou, Jiangsu, China
| | - Hongxuan Feng
- Department of Neurology, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Suzhou, Jiangsu, China
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Phillips HW, D'Gama AM, Wang Y, Chahine Y, Chiu M, Swanson AC, Ahtam B, Bolton JB, Madsen JR, Lee EA, Prabhu SP, Lidov HG, Papadakis J, Huang AY, Poduri A, Stone SS, Walsh CA. Somatic Mosaicism in PIK3CA Variant Correlates With Stereoelectroencephalography-Derived Electrophysiology. Neurol Genet 2024; 10:e200117. [PMID: 38149038 PMCID: PMC10751024 DOI: 10.1212/nxg.0000000000200117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Accepted: 10/20/2023] [Indexed: 12/28/2023]
Abstract
Objectives Brain-limited pathogenic somatic variants are associated with focal pediatric epilepsy, but reliance on resected brain tissue samples has limited our ability to correlate epileptiform activity with abnormal molecular pathology. We aimed to identify the pathogenic variant and map variant allele fractions (VAFs) across an abnormal region of epileptogenic brain in a patient who underwent stereoelectroencephalography (sEEG) and subsequent motor-sparing left frontal disconnection. Methods We extracted genomic DNA from peripheral blood, brain tissue resected from peri-sEEG electrode regions, and microbulk brain tissue adherent to sEEG electrodes. Samples were mapped based on an anatomic relationship with the presumed seizure onset zone (SOZ). We performed deep panel sequencing of amplified and unamplified DNA to identify pathogenic variants with subsequent orthogonal validation. Results We detect a pathogenic somatic PIK3CA variant, c.1624G>A (p.E542K), in the brain tissue samples, with VAF inversely correlated with distance from the SOZ. In addition, we identify this variant in amplified electrode-derived samples, albeit with lower VAFs. Discussion We demonstrate regional mosaicism across epileptogenic tissue, suggesting a correlation between variant burden and SOZ. We also validate a pathogenic variant from individual amplified sEEG electrode-derived brain specimens, although further optimization of techniques is required.
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Affiliation(s)
- H Westley Phillips
- From the Department of Neurosurgery (H.W.P.), Stanford School of Medicine, Palo Alto, CA; Department of Neurosurgery (H.W.P., J.R.M., J.P., S.S.S.), Boston Children's Hospital, Harvard Medical School; Broad Institute of MIT and Harvard (H.W.P., Y.W., Y.C., E.A.L., A.Y.H., C.A.W.), Cambridge; Division of Genetics and Genomics (H.W.P., Y.W., E.A.L., A.Y.H., C.A.W.), Manton Center for Orphan Disease Research; Division of Newborn Medicine (A.M.D.G., B.A.), Department of Pediatrics; Epilepsy Genetics Program (A.M.D.G., J.B.B., A.P.), Department of Neurology; Department of Pediatrics (A.M.D.G., J.B.B., E.A.L., A.Y.H., C.A.W.), Harvard Medical School, Boston Children's Hospital; Program in Biological and Biomedical Sciences (Y.W.); Department of Neurology (M.C., J.B.B., A.P., C.A.W.), Boston Children's Hospital, Harvard Medical School; Translational Neuroscience Center (A.C.S.), Boston Children's Hospital; Department of Radiology (S.P.P.), Division of Neuroradiology; Department of Pathology (H.G.L.), Division of Neuropathology, Boston Children's Hospital, Harvard Medical School; and Howard Hughes Medical Institute (C.A.W.), Boston, MA
| | - Alissa M D'Gama
- From the Department of Neurosurgery (H.W.P.), Stanford School of Medicine, Palo Alto, CA; Department of Neurosurgery (H.W.P., J.R.M., J.P., S.S.S.), Boston Children's Hospital, Harvard Medical School; Broad Institute of MIT and Harvard (H.W.P., Y.W., Y.C., E.A.L., A.Y.H., C.A.W.), Cambridge; Division of Genetics and Genomics (H.W.P., Y.W., E.A.L., A.Y.H., C.A.W.), Manton Center for Orphan Disease Research; Division of Newborn Medicine (A.M.D.G., B.A.), Department of Pediatrics; Epilepsy Genetics Program (A.M.D.G., J.B.B., A.P.), Department of Neurology; Department of Pediatrics (A.M.D.G., J.B.B., E.A.L., A.Y.H., C.A.W.), Harvard Medical School, Boston Children's Hospital; Program in Biological and Biomedical Sciences (Y.W.); Department of Neurology (M.C., J.B.B., A.P., C.A.W.), Boston Children's Hospital, Harvard Medical School; Translational Neuroscience Center (A.C.S.), Boston Children's Hospital; Department of Radiology (S.P.P.), Division of Neuroradiology; Department of Pathology (H.G.L.), Division of Neuropathology, Boston Children's Hospital, Harvard Medical School; and Howard Hughes Medical Institute (C.A.W.), Boston, MA
| | - Yilan Wang
- From the Department of Neurosurgery (H.W.P.), Stanford School of Medicine, Palo Alto, CA; Department of Neurosurgery (H.W.P., J.R.M., J.P., S.S.S.), Boston Children's Hospital, Harvard Medical School; Broad Institute of MIT and Harvard (H.W.P., Y.W., Y.C., E.A.L., A.Y.H., C.A.W.), Cambridge; Division of Genetics and Genomics (H.W.P., Y.W., E.A.L., A.Y.H., C.A.W.), Manton Center for Orphan Disease Research; Division of Newborn Medicine (A.M.D.G., B.A.), Department of Pediatrics; Epilepsy Genetics Program (A.M.D.G., J.B.B., A.P.), Department of Neurology; Department of Pediatrics (A.M.D.G., J.B.B., E.A.L., A.Y.H., C.A.W.), Harvard Medical School, Boston Children's Hospital; Program in Biological and Biomedical Sciences (Y.W.); Department of Neurology (M.C., J.B.B., A.P., C.A.W.), Boston Children's Hospital, Harvard Medical School; Translational Neuroscience Center (A.C.S.), Boston Children's Hospital; Department of Radiology (S.P.P.), Division of Neuroradiology; Department of Pathology (H.G.L.), Division of Neuropathology, Boston Children's Hospital, Harvard Medical School; and Howard Hughes Medical Institute (C.A.W.), Boston, MA
| | - Yasmine Chahine
- From the Department of Neurosurgery (H.W.P.), Stanford School of Medicine, Palo Alto, CA; Department of Neurosurgery (H.W.P., J.R.M., J.P., S.S.S.), Boston Children's Hospital, Harvard Medical School; Broad Institute of MIT and Harvard (H.W.P., Y.W., Y.C., E.A.L., A.Y.H., C.A.W.), Cambridge; Division of Genetics and Genomics (H.W.P., Y.W., E.A.L., A.Y.H., C.A.W.), Manton Center for Orphan Disease Research; Division of Newborn Medicine (A.M.D.G., B.A.), Department of Pediatrics; Epilepsy Genetics Program (A.M.D.G., J.B.B., A.P.), Department of Neurology; Department of Pediatrics (A.M.D.G., J.B.B., E.A.L., A.Y.H., C.A.W.), Harvard Medical School, Boston Children's Hospital; Program in Biological and Biomedical Sciences (Y.W.); Department of Neurology (M.C., J.B.B., A.P., C.A.W.), Boston Children's Hospital, Harvard Medical School; Translational Neuroscience Center (A.C.S.), Boston Children's Hospital; Department of Radiology (S.P.P.), Division of Neuroradiology; Department of Pathology (H.G.L.), Division of Neuropathology, Boston Children's Hospital, Harvard Medical School; and Howard Hughes Medical Institute (C.A.W.), Boston, MA
| | - Michelle Chiu
- From the Department of Neurosurgery (H.W.P.), Stanford School of Medicine, Palo Alto, CA; Department of Neurosurgery (H.W.P., J.R.M., J.P., S.S.S.), Boston Children's Hospital, Harvard Medical School; Broad Institute of MIT and Harvard (H.W.P., Y.W., Y.C., E.A.L., A.Y.H., C.A.W.), Cambridge; Division of Genetics and Genomics (H.W.P., Y.W., E.A.L., A.Y.H., C.A.W.), Manton Center for Orphan Disease Research; Division of Newborn Medicine (A.M.D.G., B.A.), Department of Pediatrics; Epilepsy Genetics Program (A.M.D.G., J.B.B., A.P.), Department of Neurology; Department of Pediatrics (A.M.D.G., J.B.B., E.A.L., A.Y.H., C.A.W.), Harvard Medical School, Boston Children's Hospital; Program in Biological and Biomedical Sciences (Y.W.); Department of Neurology (M.C., J.B.B., A.P., C.A.W.), Boston Children's Hospital, Harvard Medical School; Translational Neuroscience Center (A.C.S.), Boston Children's Hospital; Department of Radiology (S.P.P.), Division of Neuroradiology; Department of Pathology (H.G.L.), Division of Neuropathology, Boston Children's Hospital, Harvard Medical School; and Howard Hughes Medical Institute (C.A.W.), Boston, MA
| | - Amanda C Swanson
- From the Department of Neurosurgery (H.W.P.), Stanford School of Medicine, Palo Alto, CA; Department of Neurosurgery (H.W.P., J.R.M., J.P., S.S.S.), Boston Children's Hospital, Harvard Medical School; Broad Institute of MIT and Harvard (H.W.P., Y.W., Y.C., E.A.L., A.Y.H., C.A.W.), Cambridge; Division of Genetics and Genomics (H.W.P., Y.W., E.A.L., A.Y.H., C.A.W.), Manton Center for Orphan Disease Research; Division of Newborn Medicine (A.M.D.G., B.A.), Department of Pediatrics; Epilepsy Genetics Program (A.M.D.G., J.B.B., A.P.), Department of Neurology; Department of Pediatrics (A.M.D.G., J.B.B., E.A.L., A.Y.H., C.A.W.), Harvard Medical School, Boston Children's Hospital; Program in Biological and Biomedical Sciences (Y.W.); Department of Neurology (M.C., J.B.B., A.P., C.A.W.), Boston Children's Hospital, Harvard Medical School; Translational Neuroscience Center (A.C.S.), Boston Children's Hospital; Department of Radiology (S.P.P.), Division of Neuroradiology; Department of Pathology (H.G.L.), Division of Neuropathology, Boston Children's Hospital, Harvard Medical School; and Howard Hughes Medical Institute (C.A.W.), Boston, MA
| | - Banu Ahtam
- From the Department of Neurosurgery (H.W.P.), Stanford School of Medicine, Palo Alto, CA; Department of Neurosurgery (H.W.P., J.R.M., J.P., S.S.S.), Boston Children's Hospital, Harvard Medical School; Broad Institute of MIT and Harvard (H.W.P., Y.W., Y.C., E.A.L., A.Y.H., C.A.W.), Cambridge; Division of Genetics and Genomics (H.W.P., Y.W., E.A.L., A.Y.H., C.A.W.), Manton Center for Orphan Disease Research; Division of Newborn Medicine (A.M.D.G., B.A.), Department of Pediatrics; Epilepsy Genetics Program (A.M.D.G., J.B.B., A.P.), Department of Neurology; Department of Pediatrics (A.M.D.G., J.B.B., E.A.L., A.Y.H., C.A.W.), Harvard Medical School, Boston Children's Hospital; Program in Biological and Biomedical Sciences (Y.W.); Department of Neurology (M.C., J.B.B., A.P., C.A.W.), Boston Children's Hospital, Harvard Medical School; Translational Neuroscience Center (A.C.S.), Boston Children's Hospital; Department of Radiology (S.P.P.), Division of Neuroradiology; Department of Pathology (H.G.L.), Division of Neuropathology, Boston Children's Hospital, Harvard Medical School; and Howard Hughes Medical Institute (C.A.W.), Boston, MA
| | - Jeffrey B Bolton
- From the Department of Neurosurgery (H.W.P.), Stanford School of Medicine, Palo Alto, CA; Department of Neurosurgery (H.W.P., J.R.M., J.P., S.S.S.), Boston Children's Hospital, Harvard Medical School; Broad Institute of MIT and Harvard (H.W.P., Y.W., Y.C., E.A.L., A.Y.H., C.A.W.), Cambridge; Division of Genetics and Genomics (H.W.P., Y.W., E.A.L., A.Y.H., C.A.W.), Manton Center for Orphan Disease Research; Division of Newborn Medicine (A.M.D.G., B.A.), Department of Pediatrics; Epilepsy Genetics Program (A.M.D.G., J.B.B., A.P.), Department of Neurology; Department of Pediatrics (A.M.D.G., J.B.B., E.A.L., A.Y.H., C.A.W.), Harvard Medical School, Boston Children's Hospital; Program in Biological and Biomedical Sciences (Y.W.); Department of Neurology (M.C., J.B.B., A.P., C.A.W.), Boston Children's Hospital, Harvard Medical School; Translational Neuroscience Center (A.C.S.), Boston Children's Hospital; Department of Radiology (S.P.P.), Division of Neuroradiology; Department of Pathology (H.G.L.), Division of Neuropathology, Boston Children's Hospital, Harvard Medical School; and Howard Hughes Medical Institute (C.A.W.), Boston, MA
| | - Joseph R Madsen
- From the Department of Neurosurgery (H.W.P.), Stanford School of Medicine, Palo Alto, CA; Department of Neurosurgery (H.W.P., J.R.M., J.P., S.S.S.), Boston Children's Hospital, Harvard Medical School; Broad Institute of MIT and Harvard (H.W.P., Y.W., Y.C., E.A.L., A.Y.H., C.A.W.), Cambridge; Division of Genetics and Genomics (H.W.P., Y.W., E.A.L., A.Y.H., C.A.W.), Manton Center for Orphan Disease Research; Division of Newborn Medicine (A.M.D.G., B.A.), Department of Pediatrics; Epilepsy Genetics Program (A.M.D.G., J.B.B., A.P.), Department of Neurology; Department of Pediatrics (A.M.D.G., J.B.B., E.A.L., A.Y.H., C.A.W.), Harvard Medical School, Boston Children's Hospital; Program in Biological and Biomedical Sciences (Y.W.); Department of Neurology (M.C., J.B.B., A.P., C.A.W.), Boston Children's Hospital, Harvard Medical School; Translational Neuroscience Center (A.C.S.), Boston Children's Hospital; Department of Radiology (S.P.P.), Division of Neuroradiology; Department of Pathology (H.G.L.), Division of Neuropathology, Boston Children's Hospital, Harvard Medical School; and Howard Hughes Medical Institute (C.A.W.), Boston, MA
| | - Eunjung A Lee
- From the Department of Neurosurgery (H.W.P.), Stanford School of Medicine, Palo Alto, CA; Department of Neurosurgery (H.W.P., J.R.M., J.P., S.S.S.), Boston Children's Hospital, Harvard Medical School; Broad Institute of MIT and Harvard (H.W.P., Y.W., Y.C., E.A.L., A.Y.H., C.A.W.), Cambridge; Division of Genetics and Genomics (H.W.P., Y.W., E.A.L., A.Y.H., C.A.W.), Manton Center for Orphan Disease Research; Division of Newborn Medicine (A.M.D.G., B.A.), Department of Pediatrics; Epilepsy Genetics Program (A.M.D.G., J.B.B., A.P.), Department of Neurology; Department of Pediatrics (A.M.D.G., J.B.B., E.A.L., A.Y.H., C.A.W.), Harvard Medical School, Boston Children's Hospital; Program in Biological and Biomedical Sciences (Y.W.); Department of Neurology (M.C., J.B.B., A.P., C.A.W.), Boston Children's Hospital, Harvard Medical School; Translational Neuroscience Center (A.C.S.), Boston Children's Hospital; Department of Radiology (S.P.P.), Division of Neuroradiology; Department of Pathology (H.G.L.), Division of Neuropathology, Boston Children's Hospital, Harvard Medical School; and Howard Hughes Medical Institute (C.A.W.), Boston, MA
| | - Sanjay P Prabhu
- From the Department of Neurosurgery (H.W.P.), Stanford School of Medicine, Palo Alto, CA; Department of Neurosurgery (H.W.P., J.R.M., J.P., S.S.S.), Boston Children's Hospital, Harvard Medical School; Broad Institute of MIT and Harvard (H.W.P., Y.W., Y.C., E.A.L., A.Y.H., C.A.W.), Cambridge; Division of Genetics and Genomics (H.W.P., Y.W., E.A.L., A.Y.H., C.A.W.), Manton Center for Orphan Disease Research; Division of Newborn Medicine (A.M.D.G., B.A.), Department of Pediatrics; Epilepsy Genetics Program (A.M.D.G., J.B.B., A.P.), Department of Neurology; Department of Pediatrics (A.M.D.G., J.B.B., E.A.L., A.Y.H., C.A.W.), Harvard Medical School, Boston Children's Hospital; Program in Biological and Biomedical Sciences (Y.W.); Department of Neurology (M.C., J.B.B., A.P., C.A.W.), Boston Children's Hospital, Harvard Medical School; Translational Neuroscience Center (A.C.S.), Boston Children's Hospital; Department of Radiology (S.P.P.), Division of Neuroradiology; Department of Pathology (H.G.L.), Division of Neuropathology, Boston Children's Hospital, Harvard Medical School; and Howard Hughes Medical Institute (C.A.W.), Boston, MA
| | - Hart G Lidov
- From the Department of Neurosurgery (H.W.P.), Stanford School of Medicine, Palo Alto, CA; Department of Neurosurgery (H.W.P., J.R.M., J.P., S.S.S.), Boston Children's Hospital, Harvard Medical School; Broad Institute of MIT and Harvard (H.W.P., Y.W., Y.C., E.A.L., A.Y.H., C.A.W.), Cambridge; Division of Genetics and Genomics (H.W.P., Y.W., E.A.L., A.Y.H., C.A.W.), Manton Center for Orphan Disease Research; Division of Newborn Medicine (A.M.D.G., B.A.), Department of Pediatrics; Epilepsy Genetics Program (A.M.D.G., J.B.B., A.P.), Department of Neurology; Department of Pediatrics (A.M.D.G., J.B.B., E.A.L., A.Y.H., C.A.W.), Harvard Medical School, Boston Children's Hospital; Program in Biological and Biomedical Sciences (Y.W.); Department of Neurology (M.C., J.B.B., A.P., C.A.W.), Boston Children's Hospital, Harvard Medical School; Translational Neuroscience Center (A.C.S.), Boston Children's Hospital; Department of Radiology (S.P.P.), Division of Neuroradiology; Department of Pathology (H.G.L.), Division of Neuropathology, Boston Children's Hospital, Harvard Medical School; and Howard Hughes Medical Institute (C.A.W.), Boston, MA
| | - Joanna Papadakis
- From the Department of Neurosurgery (H.W.P.), Stanford School of Medicine, Palo Alto, CA; Department of Neurosurgery (H.W.P., J.R.M., J.P., S.S.S.), Boston Children's Hospital, Harvard Medical School; Broad Institute of MIT and Harvard (H.W.P., Y.W., Y.C., E.A.L., A.Y.H., C.A.W.), Cambridge; Division of Genetics and Genomics (H.W.P., Y.W., E.A.L., A.Y.H., C.A.W.), Manton Center for Orphan Disease Research; Division of Newborn Medicine (A.M.D.G., B.A.), Department of Pediatrics; Epilepsy Genetics Program (A.M.D.G., J.B.B., A.P.), Department of Neurology; Department of Pediatrics (A.M.D.G., J.B.B., E.A.L., A.Y.H., C.A.W.), Harvard Medical School, Boston Children's Hospital; Program in Biological and Biomedical Sciences (Y.W.); Department of Neurology (M.C., J.B.B., A.P., C.A.W.), Boston Children's Hospital, Harvard Medical School; Translational Neuroscience Center (A.C.S.), Boston Children's Hospital; Department of Radiology (S.P.P.), Division of Neuroradiology; Department of Pathology (H.G.L.), Division of Neuropathology, Boston Children's Hospital, Harvard Medical School; and Howard Hughes Medical Institute (C.A.W.), Boston, MA
| | - August Y Huang
- From the Department of Neurosurgery (H.W.P.), Stanford School of Medicine, Palo Alto, CA; Department of Neurosurgery (H.W.P., J.R.M., J.P., S.S.S.), Boston Children's Hospital, Harvard Medical School; Broad Institute of MIT and Harvard (H.W.P., Y.W., Y.C., E.A.L., A.Y.H., C.A.W.), Cambridge; Division of Genetics and Genomics (H.W.P., Y.W., E.A.L., A.Y.H., C.A.W.), Manton Center for Orphan Disease Research; Division of Newborn Medicine (A.M.D.G., B.A.), Department of Pediatrics; Epilepsy Genetics Program (A.M.D.G., J.B.B., A.P.), Department of Neurology; Department of Pediatrics (A.M.D.G., J.B.B., E.A.L., A.Y.H., C.A.W.), Harvard Medical School, Boston Children's Hospital; Program in Biological and Biomedical Sciences (Y.W.); Department of Neurology (M.C., J.B.B., A.P., C.A.W.), Boston Children's Hospital, Harvard Medical School; Translational Neuroscience Center (A.C.S.), Boston Children's Hospital; Department of Radiology (S.P.P.), Division of Neuroradiology; Department of Pathology (H.G.L.), Division of Neuropathology, Boston Children's Hospital, Harvard Medical School; and Howard Hughes Medical Institute (C.A.W.), Boston, MA
| | - Annapurna Poduri
- From the Department of Neurosurgery (H.W.P.), Stanford School of Medicine, Palo Alto, CA; Department of Neurosurgery (H.W.P., J.R.M., J.P., S.S.S.), Boston Children's Hospital, Harvard Medical School; Broad Institute of MIT and Harvard (H.W.P., Y.W., Y.C., E.A.L., A.Y.H., C.A.W.), Cambridge; Division of Genetics and Genomics (H.W.P., Y.W., E.A.L., A.Y.H., C.A.W.), Manton Center for Orphan Disease Research; Division of Newborn Medicine (A.M.D.G., B.A.), Department of Pediatrics; Epilepsy Genetics Program (A.M.D.G., J.B.B., A.P.), Department of Neurology; Department of Pediatrics (A.M.D.G., J.B.B., E.A.L., A.Y.H., C.A.W.), Harvard Medical School, Boston Children's Hospital; Program in Biological and Biomedical Sciences (Y.W.); Department of Neurology (M.C., J.B.B., A.P., C.A.W.), Boston Children's Hospital, Harvard Medical School; Translational Neuroscience Center (A.C.S.), Boston Children's Hospital; Department of Radiology (S.P.P.), Division of Neuroradiology; Department of Pathology (H.G.L.), Division of Neuropathology, Boston Children's Hospital, Harvard Medical School; and Howard Hughes Medical Institute (C.A.W.), Boston, MA
| | - Scellig S Stone
- From the Department of Neurosurgery (H.W.P.), Stanford School of Medicine, Palo Alto, CA; Department of Neurosurgery (H.W.P., J.R.M., J.P., S.S.S.), Boston Children's Hospital, Harvard Medical School; Broad Institute of MIT and Harvard (H.W.P., Y.W., Y.C., E.A.L., A.Y.H., C.A.W.), Cambridge; Division of Genetics and Genomics (H.W.P., Y.W., E.A.L., A.Y.H., C.A.W.), Manton Center for Orphan Disease Research; Division of Newborn Medicine (A.M.D.G., B.A.), Department of Pediatrics; Epilepsy Genetics Program (A.M.D.G., J.B.B., A.P.), Department of Neurology; Department of Pediatrics (A.M.D.G., J.B.B., E.A.L., A.Y.H., C.A.W.), Harvard Medical School, Boston Children's Hospital; Program in Biological and Biomedical Sciences (Y.W.); Department of Neurology (M.C., J.B.B., A.P., C.A.W.), Boston Children's Hospital, Harvard Medical School; Translational Neuroscience Center (A.C.S.), Boston Children's Hospital; Department of Radiology (S.P.P.), Division of Neuroradiology; Department of Pathology (H.G.L.), Division of Neuropathology, Boston Children's Hospital, Harvard Medical School; and Howard Hughes Medical Institute (C.A.W.), Boston, MA
| | - Christopher A Walsh
- From the Department of Neurosurgery (H.W.P.), Stanford School of Medicine, Palo Alto, CA; Department of Neurosurgery (H.W.P., J.R.M., J.P., S.S.S.), Boston Children's Hospital, Harvard Medical School; Broad Institute of MIT and Harvard (H.W.P., Y.W., Y.C., E.A.L., A.Y.H., C.A.W.), Cambridge; Division of Genetics and Genomics (H.W.P., Y.W., E.A.L., A.Y.H., C.A.W.), Manton Center for Orphan Disease Research; Division of Newborn Medicine (A.M.D.G., B.A.), Department of Pediatrics; Epilepsy Genetics Program (A.M.D.G., J.B.B., A.P.), Department of Neurology; Department of Pediatrics (A.M.D.G., J.B.B., E.A.L., A.Y.H., C.A.W.), Harvard Medical School, Boston Children's Hospital; Program in Biological and Biomedical Sciences (Y.W.); Department of Neurology (M.C., J.B.B., A.P., C.A.W.), Boston Children's Hospital, Harvard Medical School; Translational Neuroscience Center (A.C.S.), Boston Children's Hospital; Department of Radiology (S.P.P.), Division of Neuroradiology; Department of Pathology (H.G.L.), Division of Neuropathology, Boston Children's Hospital, Harvard Medical School; and Howard Hughes Medical Institute (C.A.W.), Boston, MA
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Kenney-Jung DL, Collazo-Lopez JE, Rogers DJ, Shanley R, Zatkalik AL, Whitmarsh AE, Roberts AE, Zenker M, Pierpont EI. Epilepsy in cardiofaciocutaneous syndrome: Clinical burden and response to anti-seizure medication. Am J Med Genet A 2024; 194:301-310. [PMID: 37827855 PMCID: PMC10843452 DOI: 10.1002/ajmg.a.63428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2023] [Accepted: 09/20/2023] [Indexed: 10/14/2023]
Abstract
Treatment-resistant epilepsy is among the most serious complications of cardiofaciocutaneous syndrome (CFCS), a rare disorder caused by germline variants in the RAS-MAPK signaling pathway. This study analyzed the clinical characteristics of epilepsy and response to anti-seizure medications (ASMs) in a multinational CFCS cohort. A caregiver survey provided data regarding seizure history, use of ASMs and other treatment approaches, adverse effects, caregiver perception of treatment response, and neurological disease burden impact among individuals with CFCS. Results from 138 survey responses were quantitatively analyzed in conjunction with molecular genetic results and neurological records. The disease burden impact of CFCS was higher among individuals with epilepsy (n = 74/138), especially those with more severe seizure presentation. Oxcarbazepine, a sodium-channel blocker, had the best seizure control profile with relatively infrequent adverse effects. The most commonly prescribed ASM, levetiracetam, demonstrated comparatively poor seizure control. ASM efficacy was generally similar for individuals with BRAF and MAP2K1 gene variants. The high proportion of patients with CFCS who experienced poor seizure control despite use of multiple ASMs highlights a substantial unmet treatment need. Prospective study of ASM efficacy and clinical trials of therapies to attenuate RAS-MAPK signaling may improve avenues for clinical management.
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Affiliation(s)
| | - Josue E. Collazo-Lopez
- Department of Pediatrics, University of Minnesota Medical School
- Ponce Health Sciences University
| | - Dante J. Rogers
- Department of Pediatrics, University of Minnesota Medical School
| | - Ryan Shanley
- Biostatistical Design and Analysis Center, Clinical and Translational Science Institute, University of Minnesota Medical School
| | | | | | - Amy E. Roberts
- Department of Cardiology and Department of Pediatrics, Division of Genetics and Genomics, Boston Childrens Hospital
| | - Martin Zenker
- Institute of Human Genetics, University Hospital, Otto-von-Guericke University Magdeburg
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10
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Vicario R, Fragkogianni S, Weber L, Lazarov T, Hu Y, Hayashi SY, Craddock BP, Socci ND, Alberdi A, Baako A, Ay O, Ogishi M, Lopez-Rodrigo E, Kappagantula R, Viale A, Iacobuzio-Donahue CA, Zhou T, Ransohoff RM, Chesworth R, Bank NB, Abdel-Wahab O, Boisson B, Elemento O, Casanova JL, Miller WT, Geissmann F. A microglia clonal inflammatory disorder in Alzheimer's Disease. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2024:2024.01.25.577216. [PMID: 38328106 PMCID: PMC10849735 DOI: 10.1101/2024.01.25.577216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/09/2024]
Abstract
Somatic genetic heterogeneity resulting from post-zygotic DNA mutations is widespread in human tissues and can cause diseases, however few studies have investigated its role in neurodegenerative processes such as Alzheimer's Disease (AD). Here we report the selective enrichment of microglia clones carrying pathogenic variants, that are not present in neuronal, glia/stromal cells, or blood, from patients with AD in comparison to age-matched controls. Notably, microglia-specific AD-associated variants preferentially target the MAPK pathway, including recurrent CBL ring-domain mutations. These variants activate ERK and drive a microglia transcriptional program characterized by a strong neuro-inflammatory response, both in vitro and in patients. Although the natural history of AD-associated microglial clones is difficult to establish in human, microglial expression of a MAPK pathway activating variant was previously shown to cause neurodegeneration in mice, suggesting that AD-associated neuroinflammatory microglial clones may contribute to the neurodegenerative process in patients.
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Affiliation(s)
- Rocio Vicario
- Immunology Program, Sloan Kettering Institute, Memorial Sloan Kettering Cancer Center, New York, New York 10065, USA
| | - Stamatina Fragkogianni
- Immunology Program, Sloan Kettering Institute, Memorial Sloan Kettering Cancer Center, New York, New York 10065, USA
| | - Leslie Weber
- Immunology Program, Sloan Kettering Institute, Memorial Sloan Kettering Cancer Center, New York, New York 10065, USA
| | - Tomi Lazarov
- Immunology Program, Sloan Kettering Institute, Memorial Sloan Kettering Cancer Center, New York, New York 10065, USA
| | - Yang Hu
- Department of Physiology and Biophysics, Institute for Compxutational Biomedicine,Weill Cornell New York, NY 10021, USA
| | - Samantha Y. Hayashi
- Department of Physiology and Biophysics, Stony Brook University School of Medicine, Stony Brook, NY, 11794-8661
| | - Barbara P. Craddock
- Department of Physiology and Biophysics, Stony Brook University School of Medicine, Stony Brook, NY, 11794-8661
| | - Nicholas D. Socci
- Marie-Josée & Henry R. Kravis Center for Molecular Oncology, Memorial Sloan Kettering Cancer Center, New York, New York 10065, USA
| | - Araitz Alberdi
- Immunology Program, Sloan Kettering Institute, Memorial Sloan Kettering Cancer Center, New York, New York 10065, USA
| | - Ann Baako
- Immunology Program, Sloan Kettering Institute, Memorial Sloan Kettering Cancer Center, New York, New York 10065, USA
| | - Oyku Ay
- Immunology Program, Sloan Kettering Institute, Memorial Sloan Kettering Cancer Center, New York, New York 10065, USA
| | - Masato Ogishi
- St. Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, The Rockefeller University, New York, 10065 NY, USA
| | - Estibaliz Lopez-Rodrigo
- Immunology Program, Sloan Kettering Institute, Memorial Sloan Kettering Cancer Center, New York, New York 10065, USA
| | - Rajya Kappagantula
- Human Oncology & Pathogenesis Program, Memorial Sloan Kettering Cancer Center, New York, New York 10065, USA
| | - Agnes Viale
- Marie-Josée & Henry R. Kravis Center for Molecular Oncology, Memorial Sloan Kettering Cancer Center, New York, New York 10065, USA
| | - Christine A. Iacobuzio-Donahue
- Human Oncology & Pathogenesis Program, Memorial Sloan Kettering Cancer Center, New York, New York 10065, USA
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, New York 10065, USA
| | - Ting Zhou
- SKI Stem Cell Research Core, Memorial Sloan Kettering Cancer Center, New York, New York 10065, USA
| | | | | | | | - Omar Abdel-Wahab
- Human Oncology & Pathogenesis Program, Memorial Sloan Kettering Cancer Center, New York, New York 10065, USA
| | - Bertrand Boisson
- St. Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, The Rockefeller University, New York, 10065 NY, USA
| | - Olivier Elemento
- Department of Physiology and Biophysics, Institute for Compxutational Biomedicine,Weill Cornell New York, NY 10021, USA
| | - Jean-Laurent Casanova
- St. Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, The Rockefeller University, New York, 10065 NY, USA
| | - W. Todd Miller
- Department of Physiology and Biophysics, Stony Brook University School of Medicine, Stony Brook, NY, 11794-8661
| | - Frederic Geissmann
- Immunology Program, Sloan Kettering Institute, Memorial Sloan Kettering Cancer Center, New York, New York 10065, USA
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McClellan JM, Zoghbi AW, Buxbaum JD, Cappi C, Crowley JJ, Flint J, Grice DE, Gulsuner S, Iyegbe C, Jain S, Kuo PH, Lattig MC, Passos-Bueno MR, Purushottam M, Stein DJ, Sunshine AB, Susser ES, Walsh CA, Wootton O, King MC. An evolutionary perspective on complex neuropsychiatric disease. Neuron 2024; 112:7-24. [PMID: 38016473 PMCID: PMC10842497 DOI: 10.1016/j.neuron.2023.10.037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Revised: 08/09/2023] [Accepted: 10/26/2023] [Indexed: 11/30/2023]
Abstract
The forces of evolution-mutation, selection, migration, and genetic drift-shape the genetic architecture of human traits, including the genetic architecture of complex neuropsychiatric illnesses. Studying these illnesses in populations that are diverse in genetic ancestry, historical demography, and cultural history can reveal how evolutionary forces have guided adaptation over time and place. A fundamental truth of shared human biology is that an allele responsible for a disease in anyone, anywhere, reveals a gene critical to the normal biology underlying that condition in everyone, everywhere. Understanding the genetic causes of neuropsychiatric disease in the widest possible range of human populations thus yields the greatest possible range of insight into genes critical to human brain development. In this perspective, we explore some of the relationships between genes, adaptation, and history that can be illuminated by an evolutionary perspective on studies of complex neuropsychiatric disease in diverse populations.
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Affiliation(s)
- Jon M McClellan
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA 98195, USA
| | - Anthony W Zoghbi
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX 77030, USA
| | - Joseph D Buxbaum
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Carolina Cappi
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - James J Crowley
- Department of Genetics, University of North Carolina, Chapel Hill, NC 27599, USA
| | - Jonathan Flint
- Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, CA 90095, USA
| | - Dorothy E Grice
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Suleyman Gulsuner
- Department of Medicine and Department of Genome Sciences, University of Washington, Seattle, WA 98195, USA
| | - Conrad Iyegbe
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Sanjeev Jain
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bengaluru 560029, India
| | - Po-Hsiu Kuo
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei 100, Taiwan
| | | | | | - Meera Purushottam
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bengaluru 560029, India
| | - Dan J Stein
- SAMRC Unit on Risk and Resilience in Mental Disorders, Department of Psychiatry, University of Cape Town, Cape Town, South Africa
| | - Anna B Sunshine
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA 98195, USA; Department of Medicine and Department of Genome Sciences, University of Washington, Seattle, WA 98195, USA
| | - Ezra S Susser
- Department of Epidemiology, Mailman School of Public Health, and New York State Psychiatric Institute, Columbia University, New York, NY 10032, USA
| | - Christopher A Walsh
- Broad Institute of MIT and Harvard, Cambridge, MA 02142, USA; Division of Genetics and Genomics and Howard Hughes Medical Institute, Boston Children's Hospital, Boston, MA 02115, USA; Departments of Pediatrics and Neurology, Harvard Medical School, Boston, MA 02115, USA
| | - Olivia Wootton
- SAMRC Unit on Risk and Resilience in Mental Disorders, Department of Psychiatry, University of Cape Town, Cape Town, South Africa
| | - Mary-Claire King
- Department of Medicine and Department of Genome Sciences, University of Washington, Seattle, WA 98195, USA.
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Blümcke I. Neuropathology and epilepsy surgery - 2024 update. FREE NEUROPATHOLOGY 2024; 5:5-8. [PMID: 38532826 PMCID: PMC10964794 DOI: 10.17879/freeneuropathology-2024-5347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 02/05/2024] [Accepted: 03/11/2024] [Indexed: 03/28/2024]
Abstract
Neuropathology-based studies in neurosurgically resected brain tissue obtained from carefully examined patients with focal epilepsies remain a treasure box for excellent insights into human neuroscience, including avenues to better understand the neurobiology of human brain organization and neuronal hyperexcitability at the cellular level including glio-neuronal interaction. It also allows to translate results from animal models in order to develop personalized treatment strategies in the near future. A nice example of this is the discovery of a new disease entity in 2017, termed mild malformation of cortical development with oligodendroglial hyperplasia in epilepsy or MOGHE, in the frontal lobe of young children with intractable seizures. In 2021, a brain somatic missense mutation of the galactose transporter SLC35A2 leading to altered glycosylation of lipoproteins in the Golgi apparatus was detected in 50 % of MOGHE samples. In 2023, the first clinical trial evaluated galactose supplementation in patients with histopathologically confirmed MOGHE carrying brain somatic SLC35A2 mutations that were not seizure free after surgery. The promising results of this pilot trial are an example of personalized medicine in the arena of epileptology. Besides this, neuropathological studies of epilepsy samples have revealed many other fascinating results for the main disease categories in focal epilepsies, such as the first deep-learning based classifier for Focal Cortical Dysplasia, or the genomic landscape of cortical malformations showing new candidate genes such as PTPN11, which is associated with ganglioglioma and adverse clinical outcome. This update will also ask why common pathogenic variants accumulate in certain brain regions, e.g., MTOR in the frontal lobe, and BRAF in the temporal lobe. Finally, I will highlight the ongoing discussion addressing commonalities between temporal lobe epilepsy and Alzheimer's disease, the impact of adult neurogenesis and gliogenesis for the initiation and progression of temporal lobe seizures in the human brain as well as the immunopathogenesis of glutamic acid decarboxylase antibody associated temporal lobe epilepsy as a meaningful disease entity. This review will update the reader on some of these fascinating publications from 2022 and 2023 which were selected carefully, yet subjectively, by the author.
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Affiliation(s)
- Ingmar Blümcke
- Department of Neuropathology, University Hospital Erlangen, Germany
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13
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Maury EA, Walsh CA, Kahle KT. Neurosurgery elucidates somatic mutations. Science 2023; 382:1360-1362. [PMID: 38127765 DOI: 10.1126/science.adj2244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2023]
Abstract
Surgical innovation is helping to identify roles for somatic mutations in brain disorders.
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Affiliation(s)
- Eduardo A Maury
- Division of Genetics and Genomics, Manton Center for Orphan Disease, Boston Children's Hospital, Boston, MA, USA
- Harvard/MIT MD-PhD Program, Harvard Medical School, Boston, MA, USA
- Program in Medical and Population Genetics, Broad Institute of MIT and Harvard, Cambridge, MA, USA
| | - Christopher A Walsh
- Division of Genetics and Genomics, Manton Center for Orphan Disease, Boston Children's Hospital, Boston, MA, USA
- Program in Medical and Population Genetics, Broad Institute of MIT and Harvard, Cambridge, MA, USA
- Howard Hughes Medical Institute, Boston Children's Hospital, Boston, MA, USA
| | - Kristopher T Kahle
- Division of Genetics and Genomics, Manton Center for Orphan Disease, Boston Children's Hospital, Boston, MA, USA
- Program in Neuroscience, Broad Institute of MIT and Harvard, Cambridge, MA, USA
- Department of Neurosurgery, Boston Children's Hospital, Boston, MA, USA
- Department of Neurosurgery, Massachusetts General Hospital, Boston, MA, USA
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14
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Mentis AFA, Papavassiliou KA, Piperi C, Papavassiliou AG. How can cancer research be illuminated by brain research (and vice versa)? Int J Cancer 2023; 153:1967-1970. [PMID: 37534858 DOI: 10.1002/ijc.34682] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2023] [Revised: 07/27/2023] [Accepted: 07/28/2023] [Indexed: 08/04/2023]
Abstract
Cancer and brain research have historically followed concrete pathways and converged mostly to studying brain cancer. Nowadays, the fields of neuro-oncology and neuroendocrine regulation of tumorigenesis are both emerging fields of intense research and promising applications. An increasing body of evidence suggests that somatic mutations in cancer-related genes are prevalent in several noncancerous brain disorders. These findings highlighting that certain aspects of cancer development/progression and pathologies of the nervous system share molecular alterations, could assist in elucidating the unique hallmarks of cancer and in cancer drugs repurposing for brain disorders. In so doing, identifying the commonalities in these conditions could be crucial not only for better understanding the basis of these pathologies but also for considering the previously underappreciated and/or neglected possibility of using drugs known to be effective in one type of pathology for the other type.
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Affiliation(s)
| | - Kostas A Papavassiliou
- First University Department of Respiratory Medicine, 'Sotiria' Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Christina Piperi
- Department of Biological Chemistry, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Athanasios G Papavassiliou
- Department of Biological Chemistry, Medical School, National and Kapodistrian University of Athens, Athens, Greece
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15
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Hallermayr A, Keßler T, Steinke-Lange V, Heitzer E, Holinski-Feder E, Speicher M. The utility of liquid biopsy in clinical genetic diagnosis of cancer and monogenic mosaic disorders. MED GENET-BERLIN 2023; 35:275-284. [PMID: 38835734 PMCID: PMC11006364 DOI: 10.1515/medgen-2023-2066] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2024]
Abstract
Liquid biopsy for minimally invasive diagnosis and monitoring of cancer patients is progressing toward routine clinical practice. With the implementation of highly sensitive next-generation sequencing (NGS) based assays for the analysis of cfDNA, however, consideration of the utility of liquid biopsy for clinical genetic testing is critical. While the focus of liquid biopsy for cancer diagnosis is the detection of circulating tumor DNA (ctDNA) as a fraction of total cell-free DNA (cfDNA), cfDNA analysis reveals both somatic mosaic tumor and germline variants and clonal hematopoiesis. Here we outline advantages and limitations of mosaic and germline variant detection as well as the impact of clonal hematopoiesis on liquid biopsy in cancer diagnosis. We also evaluate the potential of cfDNA analysis for the molecular diagnosis of monogenic mosaic disorders.
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Affiliation(s)
| | - Thomas Keßler
- MGZ - Medizinisch Genetisches Zentrum München Germany
| | | | - Ellen Heitzer
- Medical University of Graz Institute of Human Genetics, Diagnostic and Research Center for Molecular Biomedicine (Austria) Graz Austria
| | | | - Michael Speicher
- Medical University of Graz Institute of Human Genetics, Diagnostic and Research Center for Molecular Biomedicine (Austria), Neue Stiftingtalstraße 2 Graz Austria
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Kadam SD. Open Sesame: Door to Enriched Somatic Variants Underlying Sporadic mTLE. Epilepsy Curr 2023; 23:383-385. [PMID: 38269352 PMCID: PMC10805092 DOI: 10.1177/15357597231201127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2024] Open
Abstract
Contribution of Somatic Ras/Raf/Mitogen-Activated Protein Kinase Variants in the Hippocampus in Drug-Resistant Mesial Temporal Lobe Epilepsy Khoshkhoo S, Wang Y, Chahine Y, Erson-Omay EZ, Robert SM, Kiziltug E, Damisah EC, Nelson-Williams C, Zhu G, Kong W, Huang AY, Stronge E, Phillips HW, Chhouk BH, Bizzotto S, Chen MH, Adikari TN, Ye Z, Witkowski T, Lai D, Lee N, Lokan J, Scheffer IE, Berkovic SF, Haider S, Hildebrand MS, Yang E, Gunel M, Lifton RP, Richardson RM, Blümcke I, Alexandrescu S, Huttner A, Heinzen EL, Zhu J, Poduri A, DeLanerolle N, Spencer DD, Lee EA, Walsh CA, Kahle KT. JAMA Neurol . 2023;80(6):578-587. doi:10.1001/jamaneurol.2023.0473 Importance: Mesial temporal lobe epilepsy (MTLE) is the most common focal epilepsy subtype and is often refractory to antiseizure medications. While most patients with MTLE do not have pathogenic germline genetic variants, the contribution of postzygotic (i.e., somatic) variants in the brain is unknown. Objective: To test the association between pathogenic somatic variants in the hippocampus and MTLE. Design, Setting, and Participants: This case-control genetic association study analyzed the DNA derived from hippocampal tissue of neurosurgically treated patients with MTLE and age-matched and sex-matched neurotypical controls. Participants treated at level 4 epilepsy centers were enrolled from 1988 through 2019, and clinical data were collected retrospectively. Whole-exome and gene-panel sequencing (each genomic region sequenced more than 500 times on average) were used to identify candidate pathogenic somatic variants. A subset of novel variants was functionally evaluated using cellular and molecular assays. Patients with nonlesional and lesional (mesial temporal sclerosis, focal cortical dysplasia, and low-grade epilepsy–associated tumors) drug-resistant MTLE who underwent anterior medial temporal lobectomy were eligible. All patients with available frozen tissue and appropriate consent were included. Control brain tissue was obtained from neurotypical donors at brain banks. Data were analyzed from June 2020 to August 2022. Exposures: Drug-resistant MTLE. Main Outcomes and Measures: Presence and abundance of pathogenic somatic variants in the hippocampus vs the unaffected temporal neocortex. Results: Of 105 included patients with MTLE, 53 (50.5%) were female, and the median (IQR) age was 32 (26-44) years; of 30 neurotypical controls, 11 (36.7%) were female, and the median (IQR) age was 37 (18-53) years. Eleven pathogenic somatic variants enriched in the hippocampus relative to the unaffected temporal neocortex (median [IQR] variant allele frequency, 1.92 [1.5-2.7] vs 0.3 [0-0.9]; P = .01) were detected in patients with MTLE but not in controls. Ten of these variants were in PTPN11, SOS1, KRAS, BRAF, and NF1, all predicted to constitutively activate Ras/Raf/mitogen-activated protein kinase (MAPK) signaling. Immunohistochemical studies of variant-positive hippocampal tissue demonstrated increased Erk1/2 phosphorylation, indicative of Ras/Raf/MAPK activation, predominantly in glial cells. Molecular assays showed abnormal liquid-liquid phase separation for the PTPN11 variants as a possible dominant gain-of-function mechanism. Conclusions and Relevance: Hippocampal somatic variants, particularly those activating Ras/Raf/MAPK signaling, may contribute to the pathogenesis of sporadic, drug-resistant MTLE. These findings may provide a novel genetic mechanism and highlight new therapeutic targets for this common indication for epilepsy surgery.
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Lerond J, Mathon B, Scopin M, Nichelli L, Guégan J, Bertholle C, Izac B, Andrieu M, Gareau T, Donneger F, Mohand Oumoussa B, Letourneur F, Tran S, Bertrand M, Le Roux I, Touat M, Dupont S, Poncer JC, Navarro V, Bielle F. Hippocampal and neocortical BRAF mutant non-expansive lesions in focal epilepsies. Neuropathol Appl Neurobiol 2023; 49:e12937. [PMID: 37740653 DOI: 10.1111/nan.12937] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Revised: 08/31/2023] [Accepted: 09/18/2023] [Indexed: 09/24/2023]
Abstract
OBJECTIVE Mesial Temporal Lobe Epilepsy-associated Hippocampal Sclerosis (MTLE-HS) is a syndrome associated with various aetiologies. We previously identified CD34-positive extravascular stellate cells (CD34+ cells) possibly related to BRAFV600E oncogenic variant in a subset of MTLE-HS. We aimed to identify the BRAFV600E oncogenic variants and characterise the CD34+ cells. METHODS We analysed BRAFV600E oncogenic variant by digital droplet Polymerase Chain Reaction in 53 MTLE-HS samples (25 with CD34+ cells) and nine non-expansive neocortical lesions resected during epilepsy surgery (five with CD34+ cells). Ex vivo multi-electrode array recording, immunolabelling, methylation microarray and single nuclei RNAseq were performed on BRAFwildtype MTLE-HS and BRAFV600E mutant non-expansive lesion of hippocampus and/or neocortex. RESULTS We identified a BRAFV600E oncogenic variant in five MTLE-HS samples with CD34+ cells (19%) and in five neocortical samples with CD34+ cells (100%). Single nuclei RNAseq of resected samples revealed two unique clusters of abnormal cells (including CD34+ cells) associated with senescence and oligodendrocyte development in both hippocampal and neocortical BRAFV600E mutant samples. The co-expression of the oncogene-induced senescence marker p16INK4A and the outer subventricular zone radial glia progenitor marker HOPX in CD34+ cells was confirmed by multiplex immunostaining. Pseudotime analysis showed that abnormal cells share a common lineage from progenitors to myelinating oligodendrocytes. Epilepsy surgery led to seizure freedom in eight of the 10 patients with BRAF mutant lesions. INTERPRETATION BRAFV600E underlies a subset of MTLE-HS and epileptogenic non-expansive neocortical focal lesions. Detection of the oncogenic variant may help diagnosis and open perspectives for targeted therapies.
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Affiliation(s)
- Julie Lerond
- Institut du Cerveau-Paris Brain Institute-ICM, Inserm, CNRS, Sorbonne Université, Paris, France
| | - Bertrand Mathon
- AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière-Charles Foix, Department of Neurosurgery, Sorbonne Université, Paris, France
| | - Mélina Scopin
- Institut du Fer à Moulin, Inserm, Sorbonne Université, Paris, France
| | - Lucia Nichelli
- AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière-Charles Foix, Department of Neuroradiology, Sorbonne Université, Paris, France
| | - Justine Guégan
- Institut du Cerveau-Paris Brain Institute-ICM-Data Analysis Core platform, Inserm, CNRS, APHP, Hôpital de la Pitié Salpêtrière, Sorbonne Université, Paris, France
| | - Céline Bertholle
- CNRS, INSERM, Institut Cochin, Université Paris Cité, Paris, France
| | - Brigitte Izac
- CNRS, INSERM, Institut Cochin, Université Paris Cité, Paris, France
| | - Muriel Andrieu
- CNRS, INSERM, Institut Cochin, Université Paris Cité, Paris, France
| | - Thomas Gareau
- Institut du Cerveau-Paris Brain Institute-ICM-Data Analysis Core platform, Inserm, CNRS, APHP, Hôpital de la Pitié Salpêtrière, Sorbonne Université, Paris, France
| | - Florian Donneger
- Institut du Fer à Moulin, Inserm, Sorbonne Université, Paris, France
| | - Badreddine Mohand Oumoussa
- Inserm, UMS Production et Analyse des données en Sciences de la vie et en Santé, PASS, Plateforme Post-génomique de la Pitié-Salpêtrière, Sorbonne Université, Paris, France
| | | | - Suzanne Tran
- AP-HP, Institut du Cerveau-Paris Brain Institute-ICM, Inserm, CNRS, Hôpitaux Universitaires La Pitié Salpêtrière-Charles Foix, Department of Neuropathology, Sorbonne Université, Paris, France
| | - Mathilde Bertrand
- Institut du Cerveau-Paris Brain Institute-ICM-Data Analysis Core platform, Inserm, CNRS, APHP, Hôpital de la Pitié Salpêtrière, Sorbonne Université, Paris, France
| | - Isabelle Le Roux
- Institut du Cerveau-Paris Brain Institute-ICM, Inserm, CNRS, Sorbonne Université, Paris, France
| | - Mehdi Touat
- AP-HP, Institut du Cerveau-Paris Brain Institute-ICM, Inserm, CNRS, Hôpitaux Universitaires La Pitié Salpêtrière-Charles Foix, Department of Neurology 2-Mazarin, Sorbonne Université, Paris, France
| | - Sophie Dupont
- IAP-HP, Institut du Cerveau-Paris Brain Institute-ICM, Inserm, CNRS, Hôpitaux Universitaires La Pitié Salpêtrière, Rehabilitation Unit, Sorbonne Université, Paris, France
| | | | - Vincent Navarro
- AP-HP, Institut du Cerveau-Paris Brain Institute-ICM, Inserm, CNRS, Hôpitaux Universitaires La Pitié Salpêtrière-Charles Foix, Epilepsy Unit, Department of Neurology and EEG Unit, Department of Clinical Neurophysiology, Reference Center for Rare Epilepsies, Sorbonne Université, Paris, France
| | - Franck Bielle
- AP-HP, Institut du Cerveau-Paris Brain Institute-ICM, Inserm, CNRS, Hôpitaux Universitaires La Pitié Salpêtrière-Charles Foix, Department of Neuropathology, Sorbonne Université, Paris, France
- AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière-Charles Foix, Onconeurotek, Paris, France
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