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Sajan SA, Gradisch R, Vogel FD, Coffey AJ, Salyakina D, Soler D, Jayakar P, Jayakar A, Bianconi SE, Cooper AH, Liu S, William N, Benkel-Herrenbrück I, Maiwald R, Heller C, Biskup S, Leiz S, Westphal DS, Wagner M, Clarke A, Stockner T, Ernst M, Kesari A, Krenn M. De novo variants in GABRA4 are associated with a neurological phenotype including developmental delay, behavioral abnormalities and epilepsy. Eur J Hum Genet 2024; 32:912-919. [PMID: 38565639 PMCID: PMC11291759 DOI: 10.1038/s41431-024-01600-3] [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: 11/18/2023] [Revised: 02/03/2024] [Accepted: 03/19/2024] [Indexed: 04/04/2024] Open
Abstract
Nine out of 19 genes encoding GABAA receptor subunits have been linked to monogenic syndromes characterized by seizures and developmental disorders. Previously, we reported the de novo variant p.(Thr300Ile) in GABRA4 in a patient with epilepsy and neurodevelopmental abnormalities. However, no new cases have been reported since then. Through an international collaboration, we collected molecular and phenotype data of individuals carrying de novo variants in GABRA4. Patients and their parents were investigated either by exome or genome sequencing, followed by targeted Sanger sequencing in some cases. All variants within the transmembrane domain, including the previously reported p.(Thr300Ile) variant, were characterized in silico and analyzed by molecular dynamics (MD) simulation studies. We identified three novel de novo missense variants in GABRA4 (NM_000809.4): c.797 C > T, p.(Pro266Leu), c.899 C > A, p.(Thr300Asn), and c.634 G > A, p.(Val212Ile). The p.(Thr300Asn) variant impacts the same codon as the previously reported variant p.(Thr300Ile) and likely arose post-zygotically as evidenced by sequencing oral mucosal cells. Overlapping phenotypes among affected individuals included developmental delay (4/4), epileptiform EEG abnormalities (3/4), attention deficits (3/4), seizures (2/4), autistic features (2/4) and structural brain abnormalities (2/4). MD simulations of the three variants within the transmembrane domain of the receptor indicate that sub-microsecond scale dynamics differ between wild-type and mutated subunits. Taken together, our findings further corroborate an association between GABRA4 and a neurological phenotype including variable neurodevelopmental, behavioral and epileptic abnormalities.
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Affiliation(s)
- Samin A Sajan
- Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Ralph Gradisch
- Center for Physiology and Pharmacology, Medical University of Vienna, Vienna, Austria
- Institute of Pharmacology and Toxicology, University of Zurich, Zurich, Switzerland
| | - Florian D Vogel
- Department of Pathobiology of the Nervous System, Center for Brain Research, Medical University of Vienna, Vienna, Austria
| | - Alison J Coffey
- lllumina Clinical Services Laboratory, Illumina Inc., San Diego, CA, USA
| | - Daria Salyakina
- Personalized Medicine and Health Outcomes Research, Nicklaus Children's Hospital, Miami, FL, USA
| | - Diana Soler
- Personalized Medicine and Health Outcomes Research, Nicklaus Children's Hospital, Miami, FL, USA
| | - Parul Jayakar
- Division of Genetics and Metabolism, Nicklaus Children's Hospital, Miami, FL, USA
| | - Anuj Jayakar
- Department of Neurology, Division of Epilepsy, Nicklaus Children's Hospital, Miami, FL, USA
| | | | | | | | | | | | - Robert Maiwald
- Medizinisches Versorgungszentrum für Gerinnungsdiagnostik und Medizinische Genetik Köln, Köln, Germany
| | | | - Saskia Biskup
- Zentrum für Humangenetik, Tübingen, Germany
- Center for Genomics and Transcriptomics (CeGaT), Tübingen, Germany
| | - Steffen Leiz
- Division of Neuropediatrics, Klinikum Dritter Orden, Munich, Germany
| | - Dominik S Westphal
- Institute of Human Genetics, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
- Department of Internal Medicine I, School of Medicine & Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Matias Wagner
- Institute of Human Genetics, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Amy Clarke
- Center for Physiology and Pharmacology, Medical University of Vienna, Vienna, Austria
| | - Thomas Stockner
- Center for Physiology and Pharmacology, Medical University of Vienna, Vienna, Austria
| | - Margot Ernst
- Department of Pathobiology of the Nervous System, Center for Brain Research, Medical University of Vienna, Vienna, Austria
| | - Akanchha Kesari
- lllumina Clinical Services Laboratory, Illumina Inc., San Diego, CA, USA
| | - Martin Krenn
- Department of Neurology, Medical University of Vienna, Vienna, Austria.
- Comprehensive Center for Clinical Neurosciences & Mental Health, Medical University of Vienna, Vienna, Austria.
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Bäckström T, Bengtsson SKS, Sjöstedt J, Malinina E, Johansson M, Ragagnin G, Ekberg K, Lundgren P. Isoallopregnanolone Inhibits Estrus Cycle-Dependent Aggressive Behavior. Biomolecules 2023; 13:1017. [PMID: 37371597 PMCID: PMC10296718 DOI: 10.3390/biom13061017] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Revised: 06/11/2023] [Accepted: 06/15/2023] [Indexed: 06/29/2023] Open
Abstract
Among female rats, some individuals show estrus cycle-dependent irritability/aggressive behaviors, and these individual rats may be used as a model for premenstrual dysphoric disorder (PMDD). We wanted to investigate if these behaviors are related to the estrus cycle phase containing moderately increased levels of positive GABA-A receptor-modulating steroids (steroid-PAM), especially allopregnanolone (ALLO), and if the adverse behavior can be antagonized. The electrophysiology studies in this paper show that isoallopregnanolone (ISO) is a GABA-A-modulating steroid antagonist (GAMSA), meaning that ISO can antagonize the agonistic effects of positive GABA-A receptor-modulating steroids in both α1β2γ2L and α4β3δ GABA-A receptor subtypes. In this study, we also investigated whether ISO could antagonize the estrus cycle-dependent aggressive behaviors in female Wistar rats using a resident-intruder test. Our results confirmed previous reports of estrus cycle-dependent behaviors in that 42% of the tested rats showed higher levels of irritability/aggression at diestrus compared to those at estrus. Furthermore, we found that, during the treatment with ISO, the aggressive behavior at diestrus was alleviated to a level comparable to that of estrus. We noticed an 89% reduction in the increase in aggressive behavior at diestrus compared to that at estrus. Vehicle treatment in the same animals showed a minimal effect on the diestrus-related aggressive behavior. In conclusion, we showed that ISO can antagonize Steroid-PAM both in α1β2γ2L and α4β3δ GABA-A receptor subtypes and inhibit estrus cycle-dependent aggressive behavior.
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Affiliation(s)
- Torbjörn Bäckström
- Umeå Neurosteroid Research Center, Department of Clinical Science, Umeå University, SE-901 85 Umea, Sweden
| | - Sara K. S. Bengtsson
- Umeå Neurosteroid Research Center, Department of Clinical Science, Umeå University, SE-901 85 Umea, Sweden
| | - Jessica Sjöstedt
- Umeå Neurosteroid Research Center, Department of Clinical Science, Umeå University, SE-901 85 Umea, Sweden
| | - Evgenya Malinina
- Umeå Neurosteroid Research Center, Department of Clinical Science, Umeå University, SE-901 85 Umea, Sweden
| | - Maja Johansson
- Umeå Neurosteroid Research Center, Department of Clinical Science, Umeå University, SE-901 85 Umea, Sweden
| | - Gianna Ragagnin
- Umeå Neurosteroid Research Center, Department of Clinical Science, Umeå University, SE-901 85 Umea, Sweden
| | - Karin Ekberg
- Asarina Pharma AB, Fogdevreten 2, SE-171 65 Solna, Sweden
| | - Per Lundgren
- Umeå Neurosteroid Research Center, Department of Clinical Science, Umeå University, SE-901 85 Umea, Sweden
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3
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Vogel FD, Krenn M, Westphal DS, Graf E, Wagner M, Leiz S, Koniuszewski F, Augé‐Stock M, Kramer G, Scholze P, Ernst M. A de novo missense variant in
GABRA4
alters receptor function in an epileptic and neurodevelopmental phenotype. Epilepsia 2022; 63:e35-e41. [PMID: 35152403 PMCID: PMC9304230 DOI: 10.1111/epi.17188] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Revised: 01/06/2022] [Accepted: 01/31/2022] [Indexed: 11/26/2022]
Abstract
Variants in γ‐aminobutyric acid A (GABAA) receptor genes cause different forms of epilepsy and neurodevelopmental disorders. To date, GABRA4, encoding the α4‐subunit, has not been associated with a monogenic condition. However, preclinical evidence points toward seizure susceptibility. Here, we report a de novo missense variant in GABRA4 (c.899C>T, p.Thr300Ile) in an individual with early‐onset drug‐resistant epilepsy and neurodevelopmental abnormalities. An electrophysiological characterization of the variant, which is located in the pore‐forming domain, shows accelerated desensitization and a lack of seizure‐protective neurosteroid function. In conclusion, our findings strongly suggest an association between de novo variation in GABRA4 and a neurodevelopmental disorder with epilepsy.
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Affiliation(s)
- Florian D. Vogel
- Department of Pathobiology of the Nervous System Center for Brain Research Medical University Vienna Vienna Austria
| | - Martin Krenn
- Department of Neurology Medical University of Vienna Vienna Austria
- Institute of Human Genetics School of Medicine Klinikum rechts der Isar Technical University of Munich Munich Germany
| | - Dominik S. Westphal
- Institute of Human Genetics School of Medicine Klinikum rechts der Isar Technical University of Munich Munich Germany
- Department of Internal Medicine I School of Medicine Klinikum rechts der Isar Technical University of Munich Munich Germany
| | - Elisabeth Graf
- Institute of Human Genetics School of Medicine Klinikum rechts der Isar Technical University of Munich Munich Germany
| | - Matias Wagner
- Institute of Human Genetics School of Medicine Klinikum rechts der Isar Technical University of Munich Munich Germany
- Institute of Neurogenomics Helmholtz Zentrum München Neuherberg Germany
- Department of Pediatrics Dr. von Hauner Children's Hospital LMU University Hospital Munich Germany
- Division of Pediatric Neurology LMU Center for Development and Children with Medical Complexity Ludwig‐Maximilians‐University Munich Munich Germany
| | - Steffen Leiz
- Divison of Neuropediatrics Klinikum Dritter Orden Munich Germany
| | - Filip Koniuszewski
- Department of Pathobiology of the Nervous System Center for Brain Research Medical University Vienna Vienna Austria
| | - Maximilian Augé‐Stock
- Department of Pathobiology of the Nervous System Center for Brain Research Medical University Vienna Vienna Austria
| | - Georg Kramer
- Department of Pathobiology of the Nervous System Center for Brain Research Medical University Vienna Vienna Austria
| | - Petra Scholze
- Department of Pathobiology of the Nervous System Center for Brain Research Medical University Vienna Vienna Austria
| | - Margot Ernst
- Department of Pathobiology of the Nervous System Center for Brain Research Medical University Vienna Vienna Austria
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Falk-Petersen CB, Søgaard R, Madsen KL, Klein AB, Frølund B, Wellendorph P. Development of a Robust Mammalian Cell-based Assay for Studying Recombinant α 4 β 1/3 δ GABA A Receptor Subtypes. Basic Clin Pharmacol Toxicol 2017; 121:119-129. [PMID: 28299900 DOI: 10.1111/bcpt.12778] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2017] [Accepted: 03/10/2017] [Indexed: 11/29/2022]
Abstract
δ-Containing GABAA receptors are located extrasynaptically and mediate tonic inhibition. Their involvement in brain physiology positions them as interesting drug targets. There is thus a continued interest in establishing reliable recombinant expression systems for δ-containing GABAA receptors. Inconveniently, the recombinant expression of especially α4 β1/3 δ receptors has been found to be notoriously difficult, resulting in mixed receptor populations and/or stoichiometries and differential pharmacology depending on the expression system used. With the aim of developing a facile and robust 96-well format cell-based assay for extrasynaptic α4 β1/3 δ receptors, we have engineered and validated a HEK293 Flp-In™ cell line stably expressing the human GABAA δ-subunit. Upon co-transfection of α4 and β1/3 subunits, at optimized ratios, we have established a well-defined system for expressing α4 β1/3 δ receptors and used the fluorescence-based FLIPR Membrane Potential (FMP) assay to evaluate their pharmacology. Using the known reference compounds GABA and THIP, ternary α4 β1/3 δ and binary α4 β1/3 receptors could be distinguished based on potency and kinetic profiles but not efficacy. As expected, DS2 was able to potentiate only δ-containing receptors, whereas Zn2+ had an inhibitory effect only at binary receptors. By contrast, the hitherto reported δ-selective compounds, AA29504 and 3-OH-2'MeO6MF, were non-selective. The expression system was further validated using patch clamp electrophysiology, in which the superagonism of THIP was confirmed. The established FMP assay set-up, based on transient expression of human α4 and β1/3 subunits into a δ-subunit stable HEK293 Flp-In™ cell line, portrays a simple 96-well format assay as a useful supplement to electrophysiological recordings on δ-containing GABAA receptors.
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Affiliation(s)
- Christina B Falk-Petersen
- Department of Drug Design and Pharmacology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Rikke Søgaard
- Department of Drug Design and Pharmacology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Kenneth L Madsen
- Molecular Neuropharmacology and Genetics Laboratory, Lundbeck Foundation Center for Biomembranes in Nanomedicine, Department of Neuroscience and Pharmacology, Faculty of Health and Medical Sciences, The Panum Institute, University of Copenhagen, Copenhagen, Denmark
| | - Anders B Klein
- Department of Drug Design and Pharmacology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Bente Frølund
- Department of Drug Design and Pharmacology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Petrine Wellendorph
- Department of Drug Design and Pharmacology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
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Persistent GABAA/C responses to gabazine, taurine and beta-alanine in rat hypoglossal motoneurons. Neuroscience 2016; 330:191-204. [PMID: 27246441 DOI: 10.1016/j.neuroscience.2016.05.048] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2016] [Revised: 05/19/2016] [Accepted: 05/24/2016] [Indexed: 11/22/2022]
Abstract
In hypoglossal motoneurons, a sustained anionic current, sensitive to a blocker of ρ-containing GABA receptors, (1,2,5,6-tetrahydropyridin-4-yl)methylphosphinic acid (TPMPA) and insensitive to bicuculline, was previously shown to be activated by gabazine. In order to better characterize the receptors involved, the sensitivity of this atypical response to pentobarbital (30μM), allopregnanolone (0.3μM) and midazolam (0.5μM) was first investigated. Pentobarbital potentiated the response, whereas the steroid and the benzodiazepine were ineffective. The results indicate the involvement of hybrid heteromeric receptors, including at least a GABA receptor ρ subunit and a γ subunit, accounting for the pentobarbital-sensitivity. The effects of the endogenous β amino acids, taurine and β-alanine, which are released under various pathological conditions and show neuroprotective properties, were then studied. In the presence of the glycine receptor blocker strychnine (1μM), both taurine (0.3-1mM) and β-alanine (0.3mM) activated sustained anionic currents, which were partly blocked by TPMPA (100μM). Thus, both β amino acids activated ρ-containing GABA receptors in hypoglossal motoneurons. Bicuculline (20μM) reduced responses to taurine and β-alanine, but small sustained responses persisted in the presence of both strychnine and bicuculline. Responses to β-alanine were slightly increased by allopregnanolone, indicating a contribution of the bicuculline- and neurosteroid-sensitive GABAA receptors underlying tonic inhibition in these motoneurons. Since sustained activation of anionic channels inhibits most mature principal neurons, the ρ-containing GABA receptors permanently activated by taurine and β-alanine might contribute to some of their neuroprotective properties under damaging overexcitatory situations.
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The 4-aminopyridine in vitro epilepsy model analyzed with a perforated multi-electrode array. Neuropharmacology 2010; 60:1142-53. [PMID: 20955719 DOI: 10.1016/j.neuropharm.2010.10.007] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2010] [Revised: 10/06/2010] [Accepted: 10/12/2010] [Indexed: 11/20/2022]
Abstract
Epileptiform discharges recorded in the 4-aminopyridine (4-AP) in vitro epilepsy model are mediated by glutamatergic and GABAergic signaling. Using a 60-channel perforated multi-electrode array (pMEA) on corticohippocampal slices from 2 to 3 week old mice we recorded interictal- and ictal-like events. When glutamatergic transmission was blocked, interictal-like events no longer initiated in the hilus or CA3/CA1 pyramidal layers but originated from the dentate gyrus granule and molecular layers. Furthermore, frequencies of interictal-like events were reduced and durations were increased in these regions while cortical discharges were completely blocked. Following GABA(A) receptor blockade interictal-like events no longer propagated to the dentate gyrus while their frequency in CA3 increased; in addition, ictal-like cortical events became shorter while increasing in frequency. Lastly, drugs that affect tonic and synaptic GABAergic conductance modulated the frequency, duration, initiation and propagation of interictal-like events. These findings confirm and expand on previous studies indicating that multiple synaptic mechanisms contribute to synchronize neuronal network activity in forebrain structures. This article is part of a Special Issue entitled 'Trends in neuropharmacology: in memory of Erminio Costa'.
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