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Gruenenfelder FI, McLaughlin M, Griffiths IR, Garbern J, Thomson G, Kuzman P, Barrie JA, McCulloch ML, Penderis J, Stassart R, Nave KA, Edgar JM. Neural stem cells restore myelin in a demyelinating model of Pelizaeus-Merzbacher disease. Brain 2020; 143:1383-1399. [PMID: 32419025 PMCID: PMC7462093 DOI: 10.1093/brain/awaa080] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2019] [Revised: 01/20/2020] [Accepted: 02/05/2020] [Indexed: 12/13/2022] Open
Abstract
Pelizaeus-Merzbacher disease is a fatal X-linked leukodystrophy caused by mutations in the PLP1 gene, which is expressed in the CNS by oligodendrocytes. Disease onset, symptoms and mortality span a broad spectrum depending on the nature of the mutation and thus the degree of CNS hypomyelination. In the absence of an effective treatment, direct cell transplantation into the CNS to restore myelin has been tested in animal models of severe forms of the disease with failure of developmental myelination, and more recently, in severely affected patients with early disease onset due to point mutations in the PLP1 gene, and absence of myelin by MRI. In patients with a PLP1 duplication mutation, the most common cause of Pelizaeus-Merzbacher disease, the pathology is poorly defined because of a paucity of autopsy material. To address this, we examined two elderly patients with duplication of PLP1 in whom the overall syndrome, including end-stage pathology, indicated a complex disease involving dysmyelination, demyelination and axonal degeneration. Using the corresponding Plp1 transgenic mouse model, we then tested the capacity of transplanted neural stem cells to restore myelin in the context of PLP overexpression. Although developmental myelination and axonal coverage by endogenous oligodendrocytes was extensive, as assessed using electron microscopy (n = 3 at each of four end points) and immunostaining (n = 3 at each of four end points), wild-type neural precursors, transplanted into the brains of the newborn mutants, were able to effectively compete and replace the defective myelin (n = 2 at each of four end points). These data demonstrate the potential of neural stem cell therapies to restore normal myelination and protect axons in patients with PLP1 gene duplication mutation and further, provide proof of principle for the benefits of stem cell transplantation for other fatal leukodystrophies with 'normal' developmental myelination.
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Affiliation(s)
- Fredrik I Gruenenfelder
- School of Veterinary Medicine, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, G12 8TA, UK
| | - Mark McLaughlin
- School of Veterinary Medicine, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, G12 8TA, UK
| | - Ian R Griffiths
- School of Veterinary Medicine, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, G12 8TA, UK
| | - James Garbern
- Department of Neurology and Center for Molecular Medicine and Genetics, Wayne State University, Detroit, MI 48201, USA
| | - Gemma Thomson
- School of Veterinary Medicine, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, G12 8TA, UK
| | - Peter Kuzman
- Department of Neuropathology, University Clinic Leipzig, D-04103 Leipzig, Germany
| | - Jennifer A Barrie
- School of Veterinary Medicine, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, G12 8TA, UK.,Institute of Infection, Immunity and Inflammation, University of Glasgow, Glasgow, G12 8TA, UK
| | - Maj-Lis McCulloch
- School of Veterinary Medicine, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, G12 8TA, UK
| | - Jacques Penderis
- School of Veterinary Medicine, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, G12 8TA, UK
| | - Ruth Stassart
- Department of Neuropathology, University Clinic Leipzig, D-04103 Leipzig, Germany
| | - Klaus-Armin Nave
- Max Planck Institute for Experimental Medicine, D-37075 Goettingen, Germany
| | - Julia M Edgar
- School of Veterinary Medicine, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, G12 8TA, UK.,Institute of Infection, Immunity and Inflammation, University of Glasgow, Glasgow, G12 8TA, UK.,Max Planck Institute for Experimental Medicine, D-37075 Goettingen, Germany
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Woodward KJ, Cundall M, Sperle K, Sistermans EA, Ross M, Howell G, Gribble SM, Burford DC, Carter NP, Hobson DL, Garbern JY, Kamholz J, Heng H, Hodes ME, Malcolm S, Hobson GM. Heterogeneous duplications in patients with Pelizaeus-Merzbacher disease suggest a mechanism of coupled homologous and nonhomologous recombination. Am J Hum Genet 2005; 77:966-87. [PMID: 16380909 PMCID: PMC1285180 DOI: 10.1086/498048] [Citation(s) in RCA: 83] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2005] [Accepted: 09/12/2005] [Indexed: 11/04/2022] Open
Abstract
We describe genomic structures of 59 X-chromosome segmental duplications that include the proteolipid protein 1 gene (PLP1) in patients with Pelizaeus-Merzbacher disease. We provide the first report of 13 junction sequences, which gives insight into underlying mechanisms. Although proximal breakpoints were highly variable, distal breakpoints tended to cluster around low-copy repeats (LCRs) (50% of distal breakpoints), and each duplication event appeared to be unique (100 kb to 4.6 Mb in size). Sequence analysis of the junctions revealed no large homologous regions between proximal and distal breakpoints. Most junctions had microhomology of 1-6 bases, and one had a 2-base insertion. Boundaries between single-copy and duplicated DNA were identical to the reference genomic sequence in all patients investigated. Taken together, these data suggest that the tandem duplications are formed by a coupled homologous and nonhomologous recombination mechanism. We suggest repair of a double-stranded break (DSB) by one-sided homologous strand invasion of a sister chromatid, followed by DNA synthesis and nonhomologous end joining with the other end of the break. This is in contrast to other genomic disorders that have recurrent rearrangements formed by nonallelic homologous recombination between LCRs. Interspersed repetitive elements (Alu elements, long interspersed nuclear elements, and long terminal repeats) were found at 18 of the 26 breakpoint sequences studied. No specific motif that may predispose to DSBs was revealed, but single or alternating tracts of purines and pyrimidines that may cause secondary structures were common. Analysis of the 2-Mb region susceptible to duplications identified proximal-specific repeats and distal LCRs in addition to the previously reported ones, suggesting that the unique genomic architecture may have a role in nonrecurrent rearrangements by promoting instability.
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Affiliation(s)
- Karen J. Woodward
- Clinical and Molecular Genetics, Institute of Child Health, London; Western Diagnostic Pathology, Perth, Australia; Nemours Biomedical Research, Alfred I. duPont Hospital for Children, Nemours Children’s Clinic, Wilmington, DE; Department of Human Genetics, Radboud University, Nijmegen, The Netherlands; The Wellcome Trust Sanger Institute, Wellcome Trust Genome Campus, Hinxton, United Kingdom; Department of Neurology and Center for Molecular Medicine and Genetics, Wayne State University, Detroit; Department of Medical & Molecular Genetics, Indiana University School of Medicine, Indianapolis; and Department of Pediatrics, Thomas Jefferson University, Philadelphia
| | - Maria Cundall
- Clinical and Molecular Genetics, Institute of Child Health, London; Western Diagnostic Pathology, Perth, Australia; Nemours Biomedical Research, Alfred I. duPont Hospital for Children, Nemours Children’s Clinic, Wilmington, DE; Department of Human Genetics, Radboud University, Nijmegen, The Netherlands; The Wellcome Trust Sanger Institute, Wellcome Trust Genome Campus, Hinxton, United Kingdom; Department of Neurology and Center for Molecular Medicine and Genetics, Wayne State University, Detroit; Department of Medical & Molecular Genetics, Indiana University School of Medicine, Indianapolis; and Department of Pediatrics, Thomas Jefferson University, Philadelphia
| | - Karen Sperle
- Clinical and Molecular Genetics, Institute of Child Health, London; Western Diagnostic Pathology, Perth, Australia; Nemours Biomedical Research, Alfred I. duPont Hospital for Children, Nemours Children’s Clinic, Wilmington, DE; Department of Human Genetics, Radboud University, Nijmegen, The Netherlands; The Wellcome Trust Sanger Institute, Wellcome Trust Genome Campus, Hinxton, United Kingdom; Department of Neurology and Center for Molecular Medicine and Genetics, Wayne State University, Detroit; Department of Medical & Molecular Genetics, Indiana University School of Medicine, Indianapolis; and Department of Pediatrics, Thomas Jefferson University, Philadelphia
| | - Erik A. Sistermans
- Clinical and Molecular Genetics, Institute of Child Health, London; Western Diagnostic Pathology, Perth, Australia; Nemours Biomedical Research, Alfred I. duPont Hospital for Children, Nemours Children’s Clinic, Wilmington, DE; Department of Human Genetics, Radboud University, Nijmegen, The Netherlands; The Wellcome Trust Sanger Institute, Wellcome Trust Genome Campus, Hinxton, United Kingdom; Department of Neurology and Center for Molecular Medicine and Genetics, Wayne State University, Detroit; Department of Medical & Molecular Genetics, Indiana University School of Medicine, Indianapolis; and Department of Pediatrics, Thomas Jefferson University, Philadelphia
| | - Mark Ross
- Clinical and Molecular Genetics, Institute of Child Health, London; Western Diagnostic Pathology, Perth, Australia; Nemours Biomedical Research, Alfred I. duPont Hospital for Children, Nemours Children’s Clinic, Wilmington, DE; Department of Human Genetics, Radboud University, Nijmegen, The Netherlands; The Wellcome Trust Sanger Institute, Wellcome Trust Genome Campus, Hinxton, United Kingdom; Department of Neurology and Center for Molecular Medicine and Genetics, Wayne State University, Detroit; Department of Medical & Molecular Genetics, Indiana University School of Medicine, Indianapolis; and Department of Pediatrics, Thomas Jefferson University, Philadelphia
| | - Gareth Howell
- Clinical and Molecular Genetics, Institute of Child Health, London; Western Diagnostic Pathology, Perth, Australia; Nemours Biomedical Research, Alfred I. duPont Hospital for Children, Nemours Children’s Clinic, Wilmington, DE; Department of Human Genetics, Radboud University, Nijmegen, The Netherlands; The Wellcome Trust Sanger Institute, Wellcome Trust Genome Campus, Hinxton, United Kingdom; Department of Neurology and Center for Molecular Medicine and Genetics, Wayne State University, Detroit; Department of Medical & Molecular Genetics, Indiana University School of Medicine, Indianapolis; and Department of Pediatrics, Thomas Jefferson University, Philadelphia
| | - Susan M. Gribble
- Clinical and Molecular Genetics, Institute of Child Health, London; Western Diagnostic Pathology, Perth, Australia; Nemours Biomedical Research, Alfred I. duPont Hospital for Children, Nemours Children’s Clinic, Wilmington, DE; Department of Human Genetics, Radboud University, Nijmegen, The Netherlands; The Wellcome Trust Sanger Institute, Wellcome Trust Genome Campus, Hinxton, United Kingdom; Department of Neurology and Center for Molecular Medicine and Genetics, Wayne State University, Detroit; Department of Medical & Molecular Genetics, Indiana University School of Medicine, Indianapolis; and Department of Pediatrics, Thomas Jefferson University, Philadelphia
| | - Deborah C. Burford
- Clinical and Molecular Genetics, Institute of Child Health, London; Western Diagnostic Pathology, Perth, Australia; Nemours Biomedical Research, Alfred I. duPont Hospital for Children, Nemours Children’s Clinic, Wilmington, DE; Department of Human Genetics, Radboud University, Nijmegen, The Netherlands; The Wellcome Trust Sanger Institute, Wellcome Trust Genome Campus, Hinxton, United Kingdom; Department of Neurology and Center for Molecular Medicine and Genetics, Wayne State University, Detroit; Department of Medical & Molecular Genetics, Indiana University School of Medicine, Indianapolis; and Department of Pediatrics, Thomas Jefferson University, Philadelphia
| | - Nigel P. Carter
- Clinical and Molecular Genetics, Institute of Child Health, London; Western Diagnostic Pathology, Perth, Australia; Nemours Biomedical Research, Alfred I. duPont Hospital for Children, Nemours Children’s Clinic, Wilmington, DE; Department of Human Genetics, Radboud University, Nijmegen, The Netherlands; The Wellcome Trust Sanger Institute, Wellcome Trust Genome Campus, Hinxton, United Kingdom; Department of Neurology and Center for Molecular Medicine and Genetics, Wayne State University, Detroit; Department of Medical & Molecular Genetics, Indiana University School of Medicine, Indianapolis; and Department of Pediatrics, Thomas Jefferson University, Philadelphia
| | - Donald L. Hobson
- Clinical and Molecular Genetics, Institute of Child Health, London; Western Diagnostic Pathology, Perth, Australia; Nemours Biomedical Research, Alfred I. duPont Hospital for Children, Nemours Children’s Clinic, Wilmington, DE; Department of Human Genetics, Radboud University, Nijmegen, The Netherlands; The Wellcome Trust Sanger Institute, Wellcome Trust Genome Campus, Hinxton, United Kingdom; Department of Neurology and Center for Molecular Medicine and Genetics, Wayne State University, Detroit; Department of Medical & Molecular Genetics, Indiana University School of Medicine, Indianapolis; and Department of Pediatrics, Thomas Jefferson University, Philadelphia
| | - James Y. Garbern
- Clinical and Molecular Genetics, Institute of Child Health, London; Western Diagnostic Pathology, Perth, Australia; Nemours Biomedical Research, Alfred I. duPont Hospital for Children, Nemours Children’s Clinic, Wilmington, DE; Department of Human Genetics, Radboud University, Nijmegen, The Netherlands; The Wellcome Trust Sanger Institute, Wellcome Trust Genome Campus, Hinxton, United Kingdom; Department of Neurology and Center for Molecular Medicine and Genetics, Wayne State University, Detroit; Department of Medical & Molecular Genetics, Indiana University School of Medicine, Indianapolis; and Department of Pediatrics, Thomas Jefferson University, Philadelphia
| | - John Kamholz
- Clinical and Molecular Genetics, Institute of Child Health, London; Western Diagnostic Pathology, Perth, Australia; Nemours Biomedical Research, Alfred I. duPont Hospital for Children, Nemours Children’s Clinic, Wilmington, DE; Department of Human Genetics, Radboud University, Nijmegen, The Netherlands; The Wellcome Trust Sanger Institute, Wellcome Trust Genome Campus, Hinxton, United Kingdom; Department of Neurology and Center for Molecular Medicine and Genetics, Wayne State University, Detroit; Department of Medical & Molecular Genetics, Indiana University School of Medicine, Indianapolis; and Department of Pediatrics, Thomas Jefferson University, Philadelphia
| | - Henry Heng
- Clinical and Molecular Genetics, Institute of Child Health, London; Western Diagnostic Pathology, Perth, Australia; Nemours Biomedical Research, Alfred I. duPont Hospital for Children, Nemours Children’s Clinic, Wilmington, DE; Department of Human Genetics, Radboud University, Nijmegen, The Netherlands; The Wellcome Trust Sanger Institute, Wellcome Trust Genome Campus, Hinxton, United Kingdom; Department of Neurology and Center for Molecular Medicine and Genetics, Wayne State University, Detroit; Department of Medical & Molecular Genetics, Indiana University School of Medicine, Indianapolis; and Department of Pediatrics, Thomas Jefferson University, Philadelphia
| | - M. E. Hodes
- Clinical and Molecular Genetics, Institute of Child Health, London; Western Diagnostic Pathology, Perth, Australia; Nemours Biomedical Research, Alfred I. duPont Hospital for Children, Nemours Children’s Clinic, Wilmington, DE; Department of Human Genetics, Radboud University, Nijmegen, The Netherlands; The Wellcome Trust Sanger Institute, Wellcome Trust Genome Campus, Hinxton, United Kingdom; Department of Neurology and Center for Molecular Medicine and Genetics, Wayne State University, Detroit; Department of Medical & Molecular Genetics, Indiana University School of Medicine, Indianapolis; and Department of Pediatrics, Thomas Jefferson University, Philadelphia
| | - Sue Malcolm
- Clinical and Molecular Genetics, Institute of Child Health, London; Western Diagnostic Pathology, Perth, Australia; Nemours Biomedical Research, Alfred I. duPont Hospital for Children, Nemours Children’s Clinic, Wilmington, DE; Department of Human Genetics, Radboud University, Nijmegen, The Netherlands; The Wellcome Trust Sanger Institute, Wellcome Trust Genome Campus, Hinxton, United Kingdom; Department of Neurology and Center for Molecular Medicine and Genetics, Wayne State University, Detroit; Department of Medical & Molecular Genetics, Indiana University School of Medicine, Indianapolis; and Department of Pediatrics, Thomas Jefferson University, Philadelphia
| | - Grace M. Hobson
- Clinical and Molecular Genetics, Institute of Child Health, London; Western Diagnostic Pathology, Perth, Australia; Nemours Biomedical Research, Alfred I. duPont Hospital for Children, Nemours Children’s Clinic, Wilmington, DE; Department of Human Genetics, Radboud University, Nijmegen, The Netherlands; The Wellcome Trust Sanger Institute, Wellcome Trust Genome Campus, Hinxton, United Kingdom; Department of Neurology and Center for Molecular Medicine and Genetics, Wayne State University, Detroit; Department of Medical & Molecular Genetics, Indiana University School of Medicine, Indianapolis; and Department of Pediatrics, Thomas Jefferson University, Philadelphia
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