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Ding H, Zhang Q, Tian B, Yang Q. A case of Hereditary diffuse leukoencephalopathy with spherical axons in a patient with mental disorders as the initial symptom. Asian J Surg 2023; 46:5586-5587. [PMID: 37635022 DOI: 10.1016/j.asjsur.2023.08.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Accepted: 08/06/2023] [Indexed: 08/29/2023] Open
Affiliation(s)
- Hui Ding
- Department of Radiology, The Second People's Hospital of Guizhou Province, Guiyang, 550004, China.
| | - Qin Zhang
- Department of Radiology, The Second People's Hospital of Guizhou Province, Guiyang, 550004, China.
| | - Bin Tian
- Department of Radiology, The Second People's Hospital of Guizhou Province, Guiyang, 550004, China
| | - Qian Yang
- Department of Radiology, The Second People's Hospital of Guizhou Province, Guiyang, 550004, China
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2
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Chitu V, Gökhan Ş, Stanley ER. Modeling CSF-1 receptor deficiency diseases - how close are we? FEBS J 2022; 289:5049-5073. [PMID: 34145972 PMCID: PMC8684558 DOI: 10.1111/febs.16085] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Revised: 05/17/2021] [Accepted: 06/18/2021] [Indexed: 12/11/2022]
Abstract
The role of colony-stimulating factor-1 receptor (CSF-1R) in macrophage and organismal development has been extensively studied in mouse. Within the last decade, mutations in the CSF1R have been shown to cause rare diseases of both pediatric (Brain Abnormalities, Neurodegeneration, and Dysosteosclerosis, OMIM #618476) and adult (CSF1R-related leukoencephalopathy, OMIM #221820) onset. Here we review the genetics, penetrance, and histopathological features of these diseases and discuss to what extent the animal models of Csf1r deficiency currently available provide systems in which to study the underlying mechanisms involved.
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Affiliation(s)
- Violeta Chitu
- Department of Developmental and Molecular Biology, Albert Einstein College of Medicine, Bronx, N.Y. 10461, USA
| | - Şölen Gökhan
- Institute for Brain Disorders and Neural Regeneration, Department of Neurology, Albert Einstein College of Medicine, Bronx, N.Y. 10461, USA
| | - E. Richard Stanley
- Department of Developmental and Molecular Biology, Albert Einstein College of Medicine, Bronx, N.Y. 10461, USA
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3
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Mickeviciute GC, Valiuskyte M, Plattén M, Wszolek ZK, Andersen O, Danylaité Karrenbauer V, Ineichen BV, Granberg T. Neuroimaging phenotypes of CSF1R-related leukoencephalopathy: Systematic review, meta-analysis, and imaging recommendations. J Intern Med 2022; 291:269-282. [PMID: 34875121 DOI: 10.1111/joim.13420] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
Colony-stimulating factor 1 receptor (CSF1R)-related leukoencephalopathy is a rare but fatal microgliopathy. The diagnosis is often delayed due to multifaceted symptoms that can mimic several other neurological disorders. Imaging provides diagnostic clues that help identify cases. The objective of this study was to integrate the literature on neuroimaging phenotypes of CSF1R-related leukoencephalopathy. A systematic review and meta-analysis were performed for neuroimaging findings of CSF1R-related leukoencephalopathy via PubMed, Web of Science, and Embase on 25 August 2021. The search included cases with confirmed CSF1R mutations reported under the previous terms hereditary diffuse leukoencephalopathy with spheroids, pigmentary orthochromatic leukodystrophy, and adult-onset leukoencephalopathy with axonal spheroids and pigmented glia. In 78 studies providing neuroimaging data, 195 cases were identified carrying CSF1R mutations in 14 exons and five introns. Women had a statistically significant earlier age of onset (p = 0.041, 40 vs 43 years). Mean delay between symptom onset and neuroimaging was 2.3 years. Main magnetic resonance imaging (MRI) findings were frontoparietal white matter lesions, callosal thinning, and foci of restricted diffusion. The hallmark computed tomography (CT) finding was white matter calcifications. Widespread cerebral hypometabolism and hypoperfusion were reported using positron emission tomography and single-photon emission computed tomography. In conclusion, CSF1R-related leukoencephalopathy is associated with progressive white matter lesions and brain atrophy that can resemble other neurodegenerative/-inflammatory disorders. However, long-lasting diffusion restriction and parenchymal calcifications are more specific findings that can aid the differential diagnosis. Native brain CT and brain MRI (with and without a contrast agent) are recommended with proposed protocols and pictorial examples are provided.
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Affiliation(s)
- Goda-Camille Mickeviciute
- Department of Physical Medicine and Rehabilitation, Vilnius University Hospital Santaros Klinikos, Vilnius, Lithuania
| | - Monika Valiuskyte
- Department of Skin and Venereal Diseases, Hospital of Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Michael Plattén
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.,Department of Neuroradiology, Karolinska University Hospital, Stockholm, Sweden.,School of Chemistry, Biotechnology, and Health, Royal Institute of Technology, Stockholm, Sweden
| | | | - Oluf Andersen
- Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Department of Neurology, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Virginija Danylaité Karrenbauer
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.,Department of Neurology, Karolinska University Hospital, Stockholm, Sweden
| | - Benjamin V Ineichen
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.,Department of Neuroradiology, Karolinska University Hospital, Stockholm, Sweden
| | - Tobias Granberg
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.,Department of Neuroradiology, Karolinska University Hospital, Stockholm, Sweden
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4
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Manjunath V, Nadaf S, Chakor RT, Bolegave V. Hereditary Diffuse Leukoencephalopathy with Spheroids: Diffusion Restriction on Magnetic Resonance Imaging and Novel Mutation in an Indian Patient. Ann Indian Acad Neurol 2022; 25:309-311. [PMID: 35693647 PMCID: PMC9175393 DOI: 10.4103/aian.aian_401_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2021] [Accepted: 09/01/2021] [Indexed: 11/04/2022] Open
Affiliation(s)
- Varun Manjunath
- Department of Neurology, T.N.M.C and B.Y.L Nair Ch. Hospital, Mumbai, Maharashtra, India
| | - Swaleha Nadaf
- Department of Neurology, T.N.M.C and B.Y.L Nair Ch. Hospital, Mumbai, Maharashtra, India
| | - Rahul T Chakor
- Department of Neurology, T.N.M.C and B.Y.L Nair Ch. Hospital, Mumbai, Maharashtra, India
| | - Vyankatesh Bolegave
- RGMC and CSM Hospital Kalwa, Department of Medicine, Thane, Maharashtra, India
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5
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Wu X, Sun C, Wang X, Liu Y, Wu W, Jia G. Identification of a de novo splicing mutation in the CSF1R gene in a Chinese patient with hereditary diffuse leukoencephalopathy with spheroids. Neurol Sci 2021; 43:3265-3272. [PMID: 34791569 PMCID: PMC9018673 DOI: 10.1007/s10072-021-05755-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2021] [Accepted: 11/12/2021] [Indexed: 11/26/2022]
Abstract
Objective To report a de novo splicing mutation in the CSF1R gene in a patient with hereditary diffuse leukoencephalopathy with spheroids (HDLS). Methods A 42-year-old Chinese woman with constant weakness on her left lower extremity was recruited in the current study. Detail medical history and clinical characteristics were reviewed. Brain magnetic resonance imaging (MRI), whole-exome sequencing, and Sanger sequencing were performed with bioinformatics analysis. Results The Chinese HDLS patient with no HDLS family history exhibited a de novo splicing mutation (c.1754-10 T > A) in the CSF1R gene. This mutation was located at the splice site of intron 12 and resulted in the skipping of exon 13 from the CSF1R mRNA. This finding constitutes the first de novo splicing mutation ever reported in HDLS. Furthermore, MRI abnormalities had been reported at least 6 months prior to the onset of the patient’s clinical phenotype. Conclusion Our study indicates that the diagnosis of HDLS should be considered even in the absence of a family history and can help deepen the clinical and genetic understanding of HDLS.
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Affiliation(s)
- Xinwei Wu
- Department of Geriatrics, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Shan Dong, Jinan, 250012, China
| | - Congcong Sun
- Department of Neurology, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Shan Dong, Jinan, 250012, China
| | - Xingbang Wang
- Department of Geriatrics, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Shan Dong, Jinan, 250012, China
| | - Ying Liu
- Department of Neurology, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Shan Dong, Jinan, 250012, China
| | - Wei Wu
- Department of Neurology, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Shan Dong, Jinan, 250012, China
| | - Guoyong Jia
- Department of Neurology, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Shan Dong, Jinan, 250012, China.
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Chu M, Wang DX, Cui Y, Kong Y, Liu L, Xie KX, Xia TX, Zhang J, Gao R, Zhou AH, Wang CD, Wu LY. Three novel mutations in Chinese patients with CSF1R-related leukoencephalopathy. ANNALS OF TRANSLATIONAL MEDICINE 2021; 9:1072. [PMID: 34422984 PMCID: PMC8339872 DOI: 10.21037/atm-21-217] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Accepted: 04/08/2021] [Indexed: 12/30/2022]
Abstract
Background CSF1R-related encephalopathy refers to adult-onset leukodystrophy with neuroaxonal spheroids and pigmented glia (ALSP) due to CSF1R mutations, which is a rare autosomal dominant white matter disease including two pathological entities, hereditary diffuse leukoencephalopathy with spheroids (HDLS) and pigmentary orthochromatic leukodystrophy (POLD). The aim of this study was to identify additional causative mutations in the CSF1R gene and clarify their pathogenic effects. Methods Whole-exome sequencing was conducted for nine Chinese patients diagnosed with possible ALSP based on clinical and neuroimaging findings from March 2014 to June 2020 at Xuanwu Hospital (Beijing, China). Variant pathogenicity was assessed according to the American College of Medical Genetics and Genomics and Association for Molecular Pathology (ACMG/AMP) Standards and Guidelines. Results Mean ± standard deviation (range) age of disease onset in the nine patients was 39.22±9.63 [25-54] years. Four of the nine patients were male, and four out of nine had a remarkable family history. Seven CSF1R mutations were identified in the nine patients; four (p.G17C, p.R579Q, p.I794T and c.2909_2910insATCA) have been previously reported, while three (p.V613L, p.W821R and c.2442+2_2442+3dupT) were novel. Of the latter, two (p.V613L and p.W821R) were likely pathogenic and 1 (c.2442+2_2442+3dupT) was of uncertain significance according to ACMG/AMP criteria. Conclusions These findings expand the mutational spectrum of ALSP and provide a basis for future investigations on etiologic factors and potential management strategies for this disease.
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Affiliation(s)
- Min Chu
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Dong-Xin Wang
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China.,Department of Neurology, Shijiazhuang People's Hospital, Shijiazhuang, China
| | - Yue Cui
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Yu Kong
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Li Liu
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Ke-Xin Xie
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Tian-Xinyu Xia
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Jing Zhang
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Ran Gao
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Ai-Hong Zhou
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Chao-Dong Wang
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Li-Yong Wu
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China
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Chen J, Luo S, Li N, Li H, Han J, Ling L. A Novel Missense Mutation of the CSF1R Gene Causes Incurable CSF1R-Related Leukoencephalopathy: Case Report and Review of Literature. Int J Gen Med 2020; 13:1613-1620. [PMID: 33376386 PMCID: PMC7765750 DOI: 10.2147/ijgm.s286421] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Accepted: 12/07/2020] [Indexed: 12/21/2022] Open
Abstract
CSF1R-related leukoencephalopathy, mainly caused by the mutation of the colony stimulating factor 1 receptor (CSF1R) gene on chromosome 5, is an underestimated neurological disease typically presenting as early-onset cognitive decline and personality changes. Currently, there is no specific treatment for CSF1R-related leukoencephalopathy. Most clinicians failed to recognize this disease during an early disease stage, leading to a high rate of misdiagnosis. Although rare, an increasing amount of CSF1R-related leukoencephalopathy cases have been reported recently. In this study, we first report a 35-year-old woman with CSF1R-related leukoencephalopathy carrying a novel missense mutation c.2463G >C (p.W821C) of CSF1R. An extensive literature research was performed in order to better understand the broader genetic and clinical characteristics of CSF1R-related leukoencephalopathy. A total of 147 patients with CSF1R-related leukoencephalopathy confirmed either by the genetic test or brain biopsy were identified. Among them, 49 patients were sporadic, and the rest of individuals had a family history originating from 46 different families. Our study indicated that the average age of CSF1R-related leukoencephalopathy onset was 41.4 years. Typical clinical symptoms of CSF1R-related leukoencephalopathy include cognitive decline, movement disorders, behavior changes and mental disorders. Genetic studies have reported 93 missense mutations, 13 splicing mutations, 6 deletion/insertion mutations, 1 code shift mutation and 1 nonsense mutation of the CSF1R gene in patients with CSF1R-related leukoencephalopathy. Early genetic detection and brain biopsy would be helpful for a confirmed diagnosis, and more translational studies are needed to combat this devastating disease.
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Affiliation(s)
- Jie Chen
- Department of Neurology, Affiliated Hospital of Hebei University, Baoding, People's Republic of China
| | - Shiying Luo
- Department of Neurology, Affiliated Hospital of Hebei University, Baoding, People's Republic of China
| | - Ning Li
- Department of Neurology, Affiliated Hospital of Hebei University, Baoding, People's Republic of China
| | - Huimin Li
- Department of Neurology, Affiliated Hospital of Hebei University, Baoding, People's Republic of China
| | - Jinming Han
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Li Ling
- Department of Neurology, Affiliated Hospital of Hebei University, Baoding, People's Republic of China
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Han J, Sarlus H, Wszolek ZK, Karrenbauer VD, Harris RA. Microglial replacement therapy: a potential therapeutic strategy for incurable CSF1R-related leukoencephalopathy. Acta Neuropathol Commun 2020; 8:217. [PMID: 33287883 PMCID: PMC7720517 DOI: 10.1186/s40478-020-01093-3] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2020] [Accepted: 11/23/2020] [Indexed: 02/06/2023] Open
Abstract
CSF1R-related leukoencephalopathy is an adult-onset leukoencephalopathy with axonal spheroids and pigmented glia caused by colony stimulating factor 1 receptor (CSF1R) gene mutations. The disease has a global distribution and currently has no cure. Individuals with CSF1R-related leukoencephalopathy variably present clinical symptoms including cognitive impairment, progressive neuropsychiatric and motor symptoms. CSF1R is predominantly expressed on microglia within the central nervous system (CNS), and thus CSF1R-related leukoencephalopathy is now classified as a CNS primary microgliopathy. This urgent unmet medical need could potentially be addressed by using microglia-based immunotherapies. With the rapid recent progress in the experimental microglial research field, the replacement of an empty microglial niche following microglial depletion through either conditional genetic approaches or pharmacological therapies (CSF1R inhibitors) is being studied. Furthermore, hematopoietic stem cell transplantation offers an emerging means of exchanging dysfunctional microglia with the aim of reducing brain lesions, relieving clinical symptoms and prolonging the life of patients with CSF1R-related leukoencephalopathy. This review article introduces recent advances in microglial biology and CSF1R-related leukoencephalopathy. Potential therapeutic strategies by replacing microglia in order to improve the quality of life of CSF1R-related leukoencephalopathy patients will be presented.
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