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Tremblay M, Girard-Côté L, Brais B, Gagnon C. Documenting manifestations and impacts of autosomal recessive spastic ataxia of Charlevoix-Saguenay to develop patient-reported outcome. Orphanet J Rare Dis 2022; 17:369. [PMID: 36183078 PMCID: PMC9526980 DOI: 10.1186/s13023-022-02497-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Accepted: 08/17/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Autosomal recessive cerebellar ataxias (ARCA) are a group of rare inherited disorders characterized by degeneration or abnormal development of the cerebellum. Autosomal recessive spastic ataxia of Charlevoix-Saguenay (ARSACS) is one of the most prevalent in Europe. OBJECTIVES The aim of this study is to provide a better understanding of the manifestations and impacts of ARSACS. METHODS A systematic review of the literature was conducted, followed by a qualitative study using semistructured interviews and discussion groups to obtain the experience of people affected. RESULTS According to the PROMIS framework, the results show manifestations and impacts in three components of health: physical, mental, and social. Fatigue and struggles with balance and dexterity are the physical manifestations of the disease most often cited by participants. Negative affects such as frustration and depression are among the mental health impacts with some loss in cognitive abilities. Social health is the least documented component; nonetheless, people with the disease report significant impacts in terms of social relationships, activities and work. CONCLUSIONS These findings shed new light on the experience of people with recessive ataxia and identify key aspects to assess to improve their overall health.
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Affiliation(s)
- Marjolaine Tremblay
- Université de Sherbrooke, 2500, boulevard de l'Université, Sherbrooke, QC, J1K 2R1, Canada. .,Groupe de recherche interdisciplinaire sur les maladies neuromusculaires, 2230 de l'Hôpital cp 1200, Jonquière, QC, G7X 7X2, Canada.
| | - Laura Girard-Côté
- Groupe de recherche interdisciplinaire sur les maladies neuromusculaires, 2230 de l'Hôpital cp 1200, Jonquière, QC, G7X 7X2, Canada.,Université du Québec à Chicoutimi, 555, boulevard de l'Université, Chicoutimi, QC, G7H 2B1, Canada
| | - Bernard Brais
- McGill University, 845 Sherbrooke Street West, Montréal, QC, H3A 0G4, Canada.,Montreal Neurological Institute and Hospital, 3801 University Street, Montreal, QC, H3A 2B4, Canada
| | - Cynthia Gagnon
- Université de Sherbrooke, 2500, boulevard de l'Université, Sherbrooke, QC, J1K 2R1, Canada.,Groupe de recherche interdisciplinaire sur les maladies neuromusculaires, 2230 de l'Hôpital cp 1200, Jonquière, QC, G7X 7X2, Canada.,Centre de recherche du Centre hospitalier universitaire de Sherbrooke, 3001, 12e Avenue Nord, aile 9, porte 6, Sherbrooke, QC, J1H 5N4, Canada
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Longo F, De Ritis D, Miluzio A, Fraticelli D, Baets J, Scarlato M, Santorelli FM, Biffo S, Maltecca F. Assessment of Sacsin Turnover in Patients With ARSACS: Implications for Molecular Diagnosis and Pathogenesis. Neurology 2021; 97:e2315-e2327. [PMID: 34649874 PMCID: PMC8665432 DOI: 10.1212/wnl.0000000000012962] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Accepted: 10/07/2021] [Indexed: 11/15/2022] Open
Abstract
Background and Objectives Autosomal recessive spastic ataxia of Charlevoix-Saguenay (ARSACS) is caused by variations in SACS gene encoding sacsin, a huge multimodular protein of unknown function. More than 200 SACS variations have been described worldwide to date. Because ARSACS presents phenotypic variability, previous empirical studies attempted to correlate the nature and position of SACS variations with the age at onset or with disease severity, although not considering the effect of the various variations on protein stability. In this work, we studied genotype-phenotype correlation in ARSACS at a functional level. Methods We analyzed a large set of skin fibroblasts derived from patients with ARSACS, including both new and already published cases, carrying variations of different types affecting diverse domains of the protein. Results We found that sacsin is almost absent in patients with ARSACS, regardless of the nature of the variation. As expected, we did not detect sacsin in patients with truncating variations. We found it strikingly reduced or absent also in compound heterozygotes carrying diverse missense variations. In this case, we excluded SACS mRNA decay, defective translation, or faster posttranslational degradation as possible causes of protein reduction. Conversely, our results demonstrate that nascent mutant sacsin protein undergoes cotranslational ubiquitination and degradation. Discussion Our results provide a mechanistic explanation for the lack of genotype-phenotype correlation in ARSACS. We also propose a new and unambiguous criterion for ARSACS diagnosis that is based on the evaluation of sacsin level. Last, we identified preemptive degradation of a mutant protein as a novel cause of a human disease.
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Affiliation(s)
- Fabiana Longo
- Mitochondrial Dysfunctions in Neurodegeneration Unit, Ospedale San Raffaele, Milan, Italy
| | - Daniele De Ritis
- Mitochondrial Dysfunctions in Neurodegeneration Unit, Ospedale San Raffaele, Milan, Italy
| | - Annarita Miluzio
- Istituto Nazionale di Genetica Molecolare, INGM, "Romeo ed Enrica Invernizzi", Milan, Italy
| | - Davide Fraticelli
- Mitochondrial Dysfunctions in Neurodegeneration Unit, Ospedale San Raffaele, Milan, Italy
| | - Jonathan Baets
- Laboratory of Neuromuscular Pathology, Institute Born-Bunge, University of Antwerp, Antwerpen, Belgium.,Neuromuscular Reference Centre, Department of Neurology, Antwerp University Hospital, Antwerpen, Belgium
| | - Marina Scarlato
- Department of Neurology, Ospedale San Raffaele, Milan, Italy
| | | | - Stefano Biffo
- Istituto Nazionale di Genetica Molecolare, INGM, "Romeo ed Enrica Invernizzi", Milan, Italy.,Department of Biosciences, University of Milan, Milan, Italy
| | - Francesca Maltecca
- Mitochondrial Dysfunctions in Neurodegeneration Unit, Ospedale San Raffaele, Milan, Italy .,Università Vita-Salute San Raffaele, Milan, Italy
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Rudenskaya GE, Kadnikova VA, Ryzhkova OP. [Spastic ataxia of Charlevoix-Saguenay: the first Russian case report and literature review]. Zh Nevrol Psikhiatr Im S S Korsakova 2020; 120:85-91. [PMID: 32307416 DOI: 10.17116/jnevro202012002185] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Spastic ataxia of Charlevoix-Saguenay (ARSACS) is a rare autosomal recessive neurodegenerative disease related to SACS gene and characterized by cerebellar, pyramidal and some other signs. The disease was delineated in Quebec, where it cumulates due to founder effect and has similar phenotype with very early onset. ARSACS in other populations is more variable. The first Russian case of ARSACS in a 37-year-old woman, an only patient in a Lak (one of Dagestan ethnicities) family, is presented. Along with main typical features, she had atypical late disease onset (in 32 years) and moderate cognitive decline. MPS-panel 'hereditary paraplegias' detected an earlier reported homo- or hemizygous mutation c.72276C>T (p.Arg2426Stop) in SACS exon 10.
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Affiliation(s)
| | - V A Kadnikova
- Research Centre for Medical Genetics, Moscow, Russia
| | - O P Ryzhkova
- Research Centre for Medical Genetics, Moscow, Russia
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Artero Castro A, Machuca C, Rodriguez Jimenez FJ, Jendelova P, Erceg S. Short Review: Investigating ARSACS: models for understanding cerebellar degeneration. Neuropathol Appl Neurobiol 2019; 45:531-537. [PMID: 30636067 DOI: 10.1111/nan.12540] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2018] [Accepted: 12/19/2018] [Indexed: 11/29/2022]
Abstract
Autosomal recessive spastic ataxia of Charlevoix-Saguenay (ARSACS) is an early-onset neurodegenerative disease that includes progressive cerebellar dysfunction. ARSACS is caused by an autosomal recessive loss-of-function mutation in the SACS gene, which encodes for SACSIN. Although animal models are still necessary to investigate the role of SACSIN in the pathology of this disease, more reliable human cellular models need to be generated to better understand the cerebellar pathophysiology of ARSACS. The discovery of human induced pluripotent stem cells (hiPSC) has permitted the derivation of patient-specific cells. These cells have an unlimited self-renewing capacity and the ability to differentiate into different neural cell types, allowing studies of disease mechanism, drug discovery and cell replacement therapies. In this study, we discuss how the hiPSC-derived cerebellar organoid culture offers novel strategies for targeting the pathogenic mutations related to ARSACS. We also highlight the advantages and challenges of this 3D cellular model, as well as the questions that still remain unanswered.
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Affiliation(s)
- A Artero Castro
- Stem Cells Therapies in Neurodegenerative Diseases Lab, Research Center "Principe Felipe", Valencia, Spain
| | - C Machuca
- Stem Cells Therapies in Neurodegenerative Diseases Lab, Research Center "Principe Felipe", Valencia, Spain.,Unit of Genetics and Genomics of Neuromuscular and Neurodegenerative Disorders and Service of Genomics and Translational Genetics, Research Center "Principe Felipe", Valencia, Spain
| | - F J Rodriguez Jimenez
- Stem Cells Therapies in Neurodegenerative Diseases Lab, Research Center "Principe Felipe", Valencia, Spain
| | - P Jendelova
- Institute of Experimental Medicine, Department of Neuroscience, Academy of Science of the Czech Republic, Prague, Czech Republic
| | - S Erceg
- Stem Cells Therapies in Neurodegenerative Diseases Lab, Research Center "Principe Felipe", Valencia, Spain.,National Stem Cell Bank-Valencia Node, Platform for Proteomics, Genotyping and Cell Lines, PRB3, ISCIII, Research Center "Principe Felipe", Valencia, Spain
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Masciullo M, Silvestri G, Modoni A, Tessa A, Bianchi M, Santorelli F. Do not jump to easy conclusions! Lessons from pitfall in the molecular diagnosis of ARSACS. Clin Genet 2013; 86:396-7. [DOI: 10.1111/cge.12295] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2013] [Revised: 10/01/2013] [Accepted: 10/01/2013] [Indexed: 01/29/2023]
Affiliation(s)
- M. Masciullo
- Department of Neurorehabilitation; IRCCS San Raffaele Pisana; Rome Italy
- Department of Geriatrics, Orthopedics and Neuroscience, Institute of Neurology; Catholic University of Sacred Heart; Rome Italy
| | - G. Silvestri
- Department of Geriatrics, Orthopedics and Neuroscience, Institute of Neurology; Catholic University of Sacred Heart; Rome Italy
| | - A. Modoni
- Department of Geriatrics, Orthopedics and Neuroscience, Institute of Neurology; Catholic University of Sacred Heart; Rome Italy
| | - A. Tessa
- Molecular Medicine and Neurodegenerative Diseases; IRCCS Stella Maris; Pisa Italy
| | - M.L.E. Bianchi
- Department of Geriatrics, Orthopedics and Neuroscience, Institute of Neurology; Catholic University of Sacred Heart; Rome Italy
| | - F.M. Santorelli
- Molecular Medicine and Neurodegenerative Diseases; IRCCS Stella Maris; Pisa Italy
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Gregianin E, Vazza G, Scaramel E, Boaretto F, Vettori A, Leonardi E, Tosatto SCE, Manara R, Pegoraro E, Mostacciuolo ML. A novel SACS mutation results in non-ataxic spastic paraplegia and peripheral neuropathy. Eur J Neurol 2013; 20:1486-91. [PMID: 23800155 DOI: 10.1111/ene.12220] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2012] [Accepted: 05/16/2013] [Indexed: 11/30/2022]
Abstract
BACKGROUND AND PURPOSE Mutations in the SACS gene are commonly associated with autosomal recessive spastic ataxia of Charlevoix-Saguenay (ARSACS), a complex neurodegenerative disorder characterized by progressive degeneration of the cerebellum and spinal cord tracts. The aim of this study was to identify the genetic cause of the disease in an Italian family with spastic paraplegia and peripheral neuropathy. METHODS Affected subjects were subjected to a comprehensive neurological examination including electromyography and brain magnetic resonance imaging. Genetic studies included exclusion of known disease genes, genome-wide linkage analysis using high density single nucleotide polymorphism genotyping and candidate gene sequencing. RESULTS Molecular analyses revealed a novel missense mutation in the SACS gene (c.11,104A>G) occurring in a homozygous state in patients and absent in 700 Italian control chromosomes. The mutation led to the amino acid substitution p.Thr3702Ala in the sacsin protein, in a possible protein-protein interaction site of UBE3A binding domain. CONCLUSION This study broadens the genetic spectrum of SACS mutations and expands the clinical ARSACS phenotype suggesting that the SACS gene can be considered in patients with non-canonical ARSACS clinical presentations.
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Affiliation(s)
- E Gregianin
- Department of Biology, University of Padova, Padova, Italy
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