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Tendi EA, Morello G, Guarnaccia M, La Cognata V, Petralia S, Messina MA, Meli C, Fiumara A, Ruggieri M, Cavallaro S. Detection of Single-Nucleotide and Copy Number Defects Underlying Hyperphenylalaninemia by Next-Generation Sequencing. Biomedicines 2023; 11:1899. [PMID: 37509538 PMCID: PMC10377317 DOI: 10.3390/biomedicines11071899] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Revised: 06/27/2023] [Accepted: 06/29/2023] [Indexed: 07/30/2023] Open
Abstract
Hyperphenylalaninemia (HPA) is the most common inherited amino acid metabolism disorder characterized by serious clinical manifestations, including irreversible brain damage, intellectual deficiency and epilepsy. Due to its extensive genic and allelic heterogeneity, next-generation sequencing (NGS) technology may help to identify the molecular basis of this genetic disease. Herein, we describe the development and validation of a targeted NGS (tNGS) approach for the simultaneous detection of single-nucleotide changes and copy number variations (CNVs) in genes associated with HPA (PAH, GCH1, PTS, QDPR, PCBD1, DNAJC12) or useful for its differential diagnosis (SPR). Our tNGS approach offers the possibility to detail, with a high accuracy and in a single workflow, the combined effect of a broader spectrum of genomic variants in a comprehensive view, providing a significant step forward in the development of optimized patient care and management.
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Affiliation(s)
- Elisabetta Anna Tendi
- Biomedical Sciences Department, Institute for Biomedical Research and Innovation, National Research Council, Via Paolo Gaifami 18, 95026 Catania, Italy
| | - Giovanna Morello
- Biomedical Sciences Department, Institute for Biomedical Research and Innovation, National Research Council, Via Paolo Gaifami 18, 95026 Catania, Italy
| | - Maria Guarnaccia
- Biomedical Sciences Department, Institute for Biomedical Research and Innovation, National Research Council, Via Paolo Gaifami 18, 95026 Catania, Italy
| | - Valentina La Cognata
- Biomedical Sciences Department, Institute for Biomedical Research and Innovation, National Research Council, Via Paolo Gaifami 18, 95026 Catania, Italy
| | - Salvatore Petralia
- Department of Drug and Health Sciences, University of Catania, 95125 Catania, Italy
| | - Maria Anna Messina
- Regional Reference Center for the Treatment and Control of Congenital Metabolic Diseases of Childhood, Department of Clinical and Experimental Medicine, University Hospital Policlinico "Rodolico-San Marco", 95123 Catania, Italy
| | - Concetta Meli
- Regional Reference Center for the Treatment and Control of Congenital Metabolic Diseases of Childhood, Department of Clinical and Experimental Medicine, University Hospital Policlinico "Rodolico-San Marco", 95123 Catania, Italy
| | - Agata Fiumara
- Regional Reference Center for the Treatment and Control of Congenital Metabolic Diseases of Childhood, Department of Clinical and Experimental Medicine, University Hospital Policlinico "Rodolico-San Marco", 95123 Catania, Italy
| | - Martino Ruggieri
- Unit of Rare Diseases of the Nervous System in Childhood, Section of Pediatrics and Child Neuropsychiatry, Department of Clinical and Experimental Medicine, University Hospital Policlinico "Rodolico-San Marco", 95123 Catania, Italy
| | - Sebastiano Cavallaro
- Biomedical Sciences Department, Institute for Biomedical Research and Innovation, National Research Council, Via Paolo Gaifami 18, 95026 Catania, Italy
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Nishioka K, Imai Y, Yoshino H, Li Y, Funayama M, Hattori N. Clinical Manifestations and Molecular Backgrounds of Parkinson's Disease Regarding Genes Identified From Familial and Population Studies. Front Neurol 2022; 13:764917. [PMID: 35720097 PMCID: PMC9201061 DOI: 10.3389/fneur.2022.764917] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Accepted: 04/29/2022] [Indexed: 11/13/2022] Open
Abstract
Over the past 20 years, numerous robust analyses have identified over 20 genes related to familial Parkinson's disease (PD), thereby uncovering its molecular underpinnings and giving rise to more sophisticated approaches to investigate its pathogenesis. α-Synuclein is a major component of Lewy bodies (LBs) and behaves in a prion-like manner. The discovery of α-Synuclein enables an in-depth understanding of the pathology behind the generation of LBs and dopaminergic neuronal loss. Understanding the pathophysiological roles of genes identified from PD families is uncovering the molecular mechanisms, such as defects in dopamine biosynthesis and metabolism, excessive oxidative stress, dysfunction of mitochondrial maintenance, and abnormalities in the autophagy–lysosome pathway, involved in PD pathogenesis. This review summarizes the current knowledge on familial PD genes detected by both single-gene analyses obeying the Mendelian inheritance and meta-analyses of genome-wide association studies (GWAS) from genome libraries of PD. Studying the functional role of these genes might potentially elucidate the pathological mechanisms underlying familial PD and sporadic PD and stimulate future investigations to decipher the common pathways between the diseases.
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Affiliation(s)
- Kenya Nishioka
- Department of Neurology, Juntendo University School of Medicine, Tokyo, Japan
- *Correspondence: Kenya Nishioka
| | - Yuzuru Imai
- Department of Neurology, Juntendo University School of Medicine, Tokyo, Japan
- Department of Research for Parkinson's Disease, Juntendo University Graduate School of Medicine, Tokyo, Japan
- Yuzuru Imai
| | - Hiroyo Yoshino
- Research Institute for Diseases of Old Age, Graduate School of Medicine, Juntendo University, Tokyo, Japan
| | - Yuanzhe Li
- Department of Neurology, Juntendo University School of Medicine, Tokyo, Japan
| | - Manabu Funayama
- Department of Neurology, Juntendo University School of Medicine, Tokyo, Japan
- Research Institute for Diseases of Old Age, Graduate School of Medicine, Juntendo University, Tokyo, Japan
| | - Nobutaka Hattori
- Department of Neurology, Juntendo University School of Medicine, Tokyo, Japan
- Department of Research for Parkinson's Disease, Juntendo University Graduate School of Medicine, Tokyo, Japan
- Research Institute for Diseases of Old Age, Graduate School of Medicine, Juntendo University, Tokyo, Japan
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Larbalestier H, Keatinge M, Watson L, White E, Gowda S, Wei W, Koler K, Semenova SA, Elkin AM, Rimmer N, Sweeney ST, Mazzolini J, Sieger D, Hide W, McDearmid J, Panula P, MacDonald RB, Bandmann O. GCH1 Deficiency Activates Brain Innate Immune Response and Impairs Tyrosine Hydroxylase Homeostasis. J Neurosci 2022; 42:702-716. [PMID: 34876467 PMCID: PMC8805627 DOI: 10.1523/jneurosci.0653-21.2021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Revised: 10/08/2021] [Accepted: 11/03/2021] [Indexed: 11/21/2022] Open
Abstract
The Parkinson's disease (PD) risk gene GTP cyclohydrolase 1 (GCH1) catalyzes the rate-limiting step in tetrahydrobiopterin (BH4) synthesis, an essential cofactor in the synthesis of monoaminergic neurotransmitters. To investigate the mechanisms by which GCH1 deficiency may contribute to PD, we generated a loss of function zebrafish gch1 mutant (gch1-/-), using CRISPR/Cas technology. gch1-/- zebrafish develop marked monoaminergic neurotransmitter deficiencies by 5 d postfertilization (dpf), movement deficits by 8 dpf and lethality by 12 dpf. Tyrosine hydroxylase (Th) protein levels were markedly reduced without loss of ascending dopaminergic (DAergic) neurons. L-DOPA treatment of gch1-/- larvae improved survival without ameliorating the motor phenotype. RNAseq of gch1-/- larval brain tissue identified highly upregulated transcripts involved in innate immune response. Subsequent experiments provided morphologic and functional evidence of microglial activation in gch1-/- The results of our study suggest that GCH1 deficiency may unmask early, subclinical parkinsonism and only indirectly contribute to neuronal cell death via immune-mediated mechanisms. Our work highlights the importance of functional validation for genome-wide association studies (GWAS) risk factors and further emphasizes the important role of inflammation in the pathogenesis of PD.SIGNIFICANCE STATEMENT Genome-wide association studies have now identified at least 90 genetic risk factors for sporadic Parkinson's disease (PD). Zebrafish are an ideal tool to determine the mechanistic role of genome-wide association studies (GWAS) risk genes in a vertebrate animal model. The discovery of GTP cyclohydrolase 1 (GCH1) as a genetic risk factor for PD was counterintuitive, GCH1 is the rate-limiting enzyme in the synthesis of dopamine (DA), mutations had previously been described in the non-neurodegenerative movement disorder dopa-responsive dystonia (DRD). Rather than causing DAergic cell death (as previously hypothesized by others), we now demonstrate that GCH1 impairs tyrosine hydroxylase (Th) homeostasis and activates innate immune mechanisms in the brain and provide evidence of microglial activation and phagocytic activity.
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Affiliation(s)
- Hannah Larbalestier
- Sheffield Institute for Translational Neuroscience (SITraN), University of Sheffield, Sheffield S10 2HQ, United Kingdom
- Bateson Centre, Firth Court, University of Sheffield, Sheffield S10 2TN, United Kingdom
| | - Marcus Keatinge
- Sheffield Institute for Translational Neuroscience (SITraN), University of Sheffield, Sheffield S10 2HQ, United Kingdom
- Bateson Centre, Firth Court, University of Sheffield, Sheffield S10 2TN, United Kingdom
- Centre for Discovery Brain Sciences, Chancellor's Building, The University of Edinburgh, Edinburgh EH16 4SB, United Kingdom
| | - Lisa Watson
- Sheffield Institute for Translational Neuroscience (SITraN), University of Sheffield, Sheffield S10 2HQ, United Kingdom
- Bateson Centre, Firth Court, University of Sheffield, Sheffield S10 2TN, United Kingdom
| | - Emma White
- Sheffield Institute for Translational Neuroscience (SITraN), University of Sheffield, Sheffield S10 2HQ, United Kingdom
- Bateson Centre, Firth Court, University of Sheffield, Sheffield S10 2TN, United Kingdom
| | - Siri Gowda
- Sheffield Institute for Translational Neuroscience (SITraN), University of Sheffield, Sheffield S10 2HQ, United Kingdom
- Bateson Centre, Firth Court, University of Sheffield, Sheffield S10 2TN, United Kingdom
| | - Wenbin Wei
- Sheffield Institute for Translational Neuroscience (SITraN), University of Sheffield, Sheffield S10 2HQ, United Kingdom
| | - Katjusa Koler
- Sheffield Institute for Translational Neuroscience (SITraN), University of Sheffield, Sheffield S10 2HQ, United Kingdom
| | - Svetlana A Semenova
- Department of Anatomy, University of Helsinki, Helsinki, Finland, 00014
- Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland 20892
| | - Adam M Elkin
- Department of Biology, University of York, York YO10 5DD, United Kingdom
| | - Neal Rimmer
- Department of Neuroscience, Psychology and Behaviour, University of Leicester, Leicester LE1 7RH, United Kingdom
| | - Sean T Sweeney
- Department of Biology, University of York, York YO10 5DD, United Kingdom
| | - Julie Mazzolini
- Centre for Discovery Brain Sciences, Chancellor's Building, The University of Edinburgh, Edinburgh EH16 4SB, United Kingdom
| | - Dirk Sieger
- Centre for Discovery Brain Sciences, Chancellor's Building, The University of Edinburgh, Edinburgh EH16 4SB, United Kingdom
| | - Winston Hide
- Sheffield Institute for Translational Neuroscience (SITraN), University of Sheffield, Sheffield S10 2HQ, United Kingdom
- Department of Pathology, Beth Israel Medical Center, Boston, Massachusetts 02215
- Harvard Medical School, Boston, Massachusetts 02115
| | - Jonathan McDearmid
- Department of Neuroscience, Psychology and Behaviour, University of Leicester, Leicester LE1 7RH, United Kingdom
| | - Pertti Panula
- Department of Anatomy, University of Helsinki, Helsinki, Finland, 00014
| | - Ryan B MacDonald
- Bateson Centre, Firth Court, University of Sheffield, Sheffield S10 2TN, United Kingdom
| | - Oliver Bandmann
- Sheffield Institute for Translational Neuroscience (SITraN), University of Sheffield, Sheffield S10 2HQ, United Kingdom
- Bateson Centre, Firth Court, University of Sheffield, Sheffield S10 2TN, United Kingdom
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4
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Varghaei P, Yoon G, Estiar MA, Veyron S, Leveille E, Dupré N, Trempe JF, Rouleau GA, Gan-Or Z. GCH1 mutations in hereditary spastic paraplegia. Clin Genet 2021; 100:51-58. [PMID: 33713342 DOI: 10.1111/cge.13955] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Revised: 03/02/2021] [Accepted: 03/05/2021] [Indexed: 01/09/2023]
Abstract
GCH1 mutations have been associated with dopa-responsive dystonia (DRD), Parkinson's disease (PD) and tetrahydrobiopterin (BH4 )-deficient hyperphenylalaninemia B. Recently, GCH1 mutations have been reported in five patients with hereditary spastic paraplegia (HSP). Here, we analyzed a total of 400 HSP patients (291 families) from different centers across Canada by whole exome sequencing (WES). Three patients with heterozygous GCH1 variants were identified: monozygotic twins with a p.(Ser77_Leu82del) variant, and a patient with a p.(Val205Glu) variant. The former variant is predicted to be likely pathogenic and the latter is pathogenic. The three patients presented with childhood-onset lower limb spasticity, hyperreflexia and abnormal plantar responses. One of the patients had diurnal fluctuations, and none had parkinsonism or dystonia. Phenotypic differences between the monozygotic twins were observed, who responded well to levodopa treatment. Pathway enrichment analysis suggested that GCH1 shares processes and pathways with other HSP-associated genes, and structural analysis of the variants indicated a disruptive effect. In conclusion, GCH1 mutations may cause HSP; therefore, we suggest a levodopa trial in HSP patients and including GCH1 in the screening panels of HSP genes. Clinical differences between monozygotic twins suggest that environmental factors, epigenetics, and stochasticity could play a role in the clinical presentation.
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Affiliation(s)
- Parizad Varghaei
- Division of Experimental Medicine, Department of Medicine, McGill University, Montreal, Quebec, Canada.,Montreal Neurological Institute and Hospital, McGill University, Montreal, Quebec, Canada
| | - Grace Yoon
- Divisions of Neurology and Clinical and Metabolic Genetics, Department of Pediatrics, University of Toronto, The Hospital for Sick Children, Toronto, Canada
| | - Mehrdad A Estiar
- Montreal Neurological Institute and Hospital, McGill University, Montreal, Quebec, Canada.,Department of Human Genetics, McGill University, Montreal, Quebec, Canada
| | - Simon Veyron
- Department of Pharmacology & Therapeutics and Centre de Recherche en Biologie Structurale - FRQS, McGill University, Montréal, Canada
| | - Etienne Leveille
- Faculty of Medicine, McGill University, Montreal, Quebec, Canada
| | - Nicolas Dupré
- Axe Neurosciences, CHU de Québec-Université Laval, Quebec City, Québec, Canada.,Department of Medicine, Faculty of Medicine, Université Laval, Quebec City, Quebec, Canada
| | - Jean-François Trempe
- Department of Pharmacology & Therapeutics and Centre de Recherche en Biologie Structurale - FRQS, McGill University, Montréal, Canada
| | - Guy A Rouleau
- Montreal Neurological Institute and Hospital, McGill University, Montreal, Quebec, Canada.,Department of Human Genetics, McGill University, Montreal, Quebec, Canada.,Department of Neurology and Neurosurgery, McGill University, Montreal, Quebec, Canada
| | - Ziv Gan-Or
- Montreal Neurological Institute and Hospital, McGill University, Montreal, Quebec, Canada.,Department of Human Genetics, McGill University, Montreal, Quebec, Canada.,Department of Neurology and Neurosurgery, McGill University, Montreal, Quebec, Canada
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Klaus F, Guetter K, Schlegel R, Seifritz E, Rassi A, Thöny B, Cathomas F, Kaiser S. Peripheral biopterin and neopterin in schizophrenia and depression. Psychiatry Res 2021; 297:113745. [PMID: 33524773 DOI: 10.1016/j.psychres.2021.113745] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Accepted: 01/19/2021] [Indexed: 01/21/2023]
Abstract
Increasing evidence points to a causal involvement of inflammation in the pathogenesis of neuropsychiatric disorders, including major depressive disorder (MDD) and schizophrenia (SZ). Neopterin and biopterin may link peripheral immune system activation and central neurotransmitter alterations. However, it is not fully established whether these alterations are transdiagnostic or disorder-specific and whether they are associated with reward-related psychopathologies. We investigated group differences in neopterin and biopterin in the plasma of healthy comparison (HC) (n=19), SZ (n=45) and MDD (n=43) participants. We then correlated plasma proteins with CRP as a measure for inflammation. Lastly, plasma proteins were correlated with the reward-related psychopathological domain apathy. We found a trend-level difference in biopterin levels and no significant difference in neopterin levels between groups. Within both patient groups, but not HC, we show a significant positive correlation of CRP with neopterin but not with biopterin. Further, we observed no significant correlations of plasma proteins with reward-related psychopathology in HC, MDD or SZ. While our study shows trend-level alterations of biopterin with relevance for future research, it does not support the hypothesis that peripheral neopterin or biopterin are associated with reward-related psychopathology.
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Affiliation(s)
- Federica Klaus
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Lenggstrasse 31, 8032 Zurich, Switzerland; Department of Psychiatry, University of California San Diego, 9500 Gilman Drive, San Diego, USA.
| | - Karoline Guetter
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Lenggstrasse 31, 8032 Zurich, Switzerland
| | - Rebecca Schlegel
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Lenggstrasse 31, 8032 Zurich, Switzerland
| | - Erich Seifritz
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Lenggstrasse 31, 8032 Zurich, Switzerland
| | - Anahita Rassi
- Divisions of Metabolism and of Clinical Chemistry and Biochemistry and Children's Research Center, University Children's Hospital Zurich, Steinwiesstrasse 75, 8032 Zurich, Switzerland
| | - Beat Thöny
- Divisions of Metabolism and of Clinical Chemistry and Biochemistry and Children's Research Center, University Children's Hospital Zurich, Steinwiesstrasse 75, 8032 Zurich, Switzerland
| | - Flurin Cathomas
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Lenggstrasse 31, 8032 Zurich, Switzerland; Fishberg Department of Neuroscience, Friedman Brain Institute, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy P, New York, USA
| | - Stefan Kaiser
- Division of Adult Psychiatry, Department of Psychiatry, Geneva University Hospitals, Chemin du Petit-Bel-Air, 1225 Chêne-Bourg, Switzerland
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Abstract
The genetic combined dystonias are a clinically and genetically heterogeneous group of neurologic disorders defined by the overlap of dystonia and other movement disorders such as parkinsonism or myoclonus. The number of genes associated with combined dystonia syndromes has been increasing due to the wider recognition of clinical features and broader use of genetic testing. Nevertheless, these diseases are still rare and represent only a small subgroup among all dystonias. Dopa-responsive dystonia (DYT/PARK-GCH1), rapid-onset dystonia-parkinsonism (DYT/PARK-ATP1A3), X-linked dystonia-parkinsonism (XDP, DYT/PARK-TAF1), and young-onset dystonia-parkinsonism (DYT/PARK-PRKRA) are monogenic combined dystonias accompanied by parkinsonian features. Meanwhile, MYC/DYT-SGCE and MYC/DYT-KCTD17 are characterized by dystonia in combination with myoclonus. In the past, common molecular pathways between these syndromes were the center of interest. Although the encoded proteins rather affect diverse cellular functions, recent neurophysiological evidence suggests similarities in the underlying mechanism in a subset. This review summarizes recent developments in the combined dystonias, focusing on clinico-genetic features and neurophysiologic findings. Disease-modifying therapies remain unavailable to date; an overview of symptomatic therapies for these disorders is also presented.
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Affiliation(s)
- Anne Weissbach
- Institute of Neurogenetics, University of Lübeck, Lübeck, Germany.,Institute of Systems Motor Science, University of Lübeck, Lübeck, Germany
| | - Gerard Saranza
- Edmond J. Safra Program in Parkinson's Disease and the Morton and Gloria Shulman Movement Disorders Clinic, Toronto Western Hospital, Toronto, ON, Canada
| | - Aloysius Domingo
- Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, USA. .,Collaborative Center for X-Linked Dystonia-Parkinsonism, Department of Neurology, Massachusetts General Hospital, Boston, MA, USA.
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Kawahata I, Fukunaga K. Degradation of Tyrosine Hydroxylase by the Ubiquitin-Proteasome System in the Pathogenesis of Parkinson's Disease and Dopa-Responsive Dystonia. Int J Mol Sci 2020; 21:ijms21113779. [PMID: 32471089 PMCID: PMC7312529 DOI: 10.3390/ijms21113779] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Revised: 05/19/2020] [Accepted: 05/25/2020] [Indexed: 12/16/2022] Open
Abstract
Nigrostriatal dopaminergic systems govern physiological functions related to locomotion, and their dysfunction leads to movement disorders, such as Parkinson’s disease and dopa-responsive dystonia (Segawa disease). Previous studies revealed that expression of the gene encoding nigrostriatal tyrosine hydroxylase (TH), a rate-limiting enzyme of dopamine biosynthesis, is reduced in Parkinson’s disease and dopa-responsive dystonia; however, the mechanism of TH depletion in these disorders remains unclear. In this article, we review the molecular mechanism underlying the neurodegeneration process in dopamine-containing neurons and focus on the novel degradation pathway of TH through the ubiquitin-proteasome system to advance our understanding of the etiology of Parkinson’s disease and dopa-responsive dystonia. We also introduce the relation of α-synuclein propagation with the loss of TH protein in Parkinson’s disease as well as anticipate therapeutic targets and early diagnosis of these diseases.
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Affiliation(s)
- Ichiro Kawahata
- Correspondence: (I.K.); (K.F.); Tel.: +81-22-795-6838 (I.K.); +81-22-795-6836 (K.F.); Fax: +81-22-795-6835 (I.K. & K.F.)
| | - Kohji Fukunaga
- Correspondence: (I.K.); (K.F.); Tel.: +81-22-795-6838 (I.K.); +81-22-795-6836 (K.F.); Fax: +81-22-795-6835 (I.K. & K.F.)
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Abstract
Genetic atypical Parkinson's disease (PD) describes monogenic forms of PD that resemble idiopathic PD but feature prominent atypical clinical signs and symptoms and can be sub-grouped into i) atypical monogenic forms caused by mutations in the ATP13A2, DNAJC6, FBXO7, SYNJ1, VPS13C, and DCTN genes; ii) monogenic PD more closely resembling idiopathic PD, but associated with atypical features in at least a subset of cases (SNCA-, LRRK2-, VPS35-, Parkin-, PINK1-, and DJ-1-linked PD; iii) carriers of mutations in genes that are usually associated with other movement disorders but may present with parkinsonism, such as dopa-responsive dystonia. Some atypical features are shared by almost all forms, such as an overall early age at onset. Other clinical signs are present in carriers of mutations across several different genes, such as for example, early cognitive decline. Finally, several clinical features can serve as red flags for specific forms of atypical PD including a supranuclear gaze palsy in ATP13A2 mutation carriers or hypoventilation linked to mutations in the DCTN1 gene.
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Affiliation(s)
- Anne Weissbach
- Institute of Neurogenetics, University of Lübeck, Lübeck, Germany
| | - Christina Wittke
- Institute of Neurogenetics, University of Lübeck, Lübeck, Germany
| | - Meike Kasten
- Institute of Neurogenetics, University of Lübeck, Lübeck, Germany; Department of Psychiatry and Psychotherapy, University of Lübeck, Lübeck, Germany
| | - Christine Klein
- Institute of Neurogenetics, University of Lübeck, Lübeck, Germany
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9
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Niemann N, Jankovic J. Juvenile parkinsonism: Differential diagnosis, genetics, and treatment. Parkinsonism Relat Disord 2019; 67:74-89. [DOI: 10.1016/j.parkreldis.2019.06.025] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2019] [Revised: 05/24/2019] [Accepted: 06/28/2019] [Indexed: 12/12/2022]
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10
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Ahn TB, Chung SJ, Koh SB, Park HY, Cho JW, Lee JH, Hong JY, Kwon DY, Shin C, Lee JY, Lee WW, Jeon B. Residual signs of dopa-responsive dystonia with GCH1 mutation following levodopa treatment are uncommon in Korean patients. Parkinsonism Relat Disord 2019; 65:248-251. [DOI: 10.1016/j.parkreldis.2019.06.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2019] [Revised: 05/24/2019] [Accepted: 06/04/2019] [Indexed: 11/27/2022]
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Shetty AS, Bhatia KP, Lang AE. Dystonia and Parkinson's disease: What is the relationship? Neurobiol Dis 2019; 132:104462. [PMID: 31078682 DOI: 10.1016/j.nbd.2019.05.001] [Citation(s) in RCA: 59] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2019] [Revised: 04/15/2019] [Accepted: 05/07/2019] [Indexed: 01/30/2023] Open
Abstract
Dystonia and Parkinson's disease are closely linked disorders sharing many pathophysiological overlaps. Dystonia can be seen in 30% or more of the patients suffering with PD and sometimes can precede the overt parkinsonism. The response of early dystonia to the introduction of dopamine replacement therapy (levodopa, dopamine agonists) is variable; dystonia commonly occurs in PD patients following levodopa initiation. Similarly, parkinsonism is commonly seen in patients with mutations in various DYT genes including those involved in the dopamine synthesis pathway. Pharmacological blockade of dopamine receptors can cause both tardive dystonia and parkinsonism and these movement disorders syndromes can occur in many other neurodegenerative, genetic, toxic and metabolic diseases. Pallidotomy in the past and currently deep brain stimulation largely involving the GPi are effective treatment options for both dystonia and parkinsonism. However, the physiological mechanisms underlying the response of these two different movement disorder syndromes are poorly understood. Interestingly, DBS for PD can cause dystonia such as blepharospasm and bilateral pallidal DBS for dystonia can result in features of parkinsonism. Advances in our understanding of these responses may provide better explanations for the relationship between dystonia and Parkinson's disease.
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Affiliation(s)
- Aakash S Shetty
- Edmond J. Safra Program in Parkinson's Disease and the Morton and Gloria Shulman Movement Disorders Clinic, Toronto Western Hospital, University of Toronto, Toronto, Canada
| | - Kailash P Bhatia
- Department of Clinical Movement Disorders and Motor Neuroscience, University College London (UCL), Institute of Neurology, Queen Square, London, United Kingdom
| | - Anthony E Lang
- Edmond J. Safra Program in Parkinson's Disease and the Morton and Gloria Shulman Movement Disorders Clinic, Toronto Western Hospital, University of Toronto, Toronto, Canada.
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12
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Abstract
Background Dystonia is characterized by sustained or intermittent muscle contractions resulting in abnormal, often repetitive, movements, postures, or both. Neuropathologic research has been essential in understanding the etiology and disease progression of other movement disorders, including Parkinson’s disease and cerebellar ataxias. In the field of dystonia, however, research is stymied by the paucity of post-mortem tissue available and the phenotypic heterogeneity found in those with dystonia. Methods A PubMed search was conducted using the term “neuropathology of dystonia”. The resulting list of references was limited to English-language human neuropathology articles. A total of 20 publications were retrieved and reviewed. Results Historically, based on study of acquired forms of dystonia, lesions of the putamen and globus pallidus have been identified as causing dystonia. After the identification of genetic causes of dystonia and the study of limited tissue available from those cases, as well as findings from cases of isolated focal and segmental dystonia, there is evidence that brainstem cholinergic neurons and specific cell populations within the cerebellum also play a role in the pathophysiology of dystonia. Discussion Based on limited available brain tissue, there is evidence that the pathophysiology of dystonia may involve a combination of dysfunction within neurons of the brainstem, cerebellum, putamen, and globus pallidus. In order to gain a better understanding of the pathophysiology of dystonia, a prospective, quantitative study in well-phenotyped subjects with different types of genetic and isolated dystonia is required.
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Affiliation(s)
- Nutan Sharma
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, US.,Yale University, USA
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Schneider SA, Alcalay RN. Neuropathology of genetic synucleinopathies with parkinsonism: Review of the literature. Mov Disord 2017; 32:1504-1523. [PMID: 29124790 PMCID: PMC5726430 DOI: 10.1002/mds.27193] [Citation(s) in RCA: 203] [Impact Index Per Article: 29.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2017] [Revised: 08/18/2017] [Accepted: 09/13/2017] [Indexed: 12/27/2022] Open
Abstract
Clinical-pathological studies remain the gold-standard for the diagnosis of Parkinson's disease (PD). However, mounting data from genetic PD autopsies challenge the diagnosis of PD based on Lewy body pathology. Most of the confirmed genetic risks for PD show heterogenous neuropathology, even within kindreds, which may or may not include Lewy body pathology. We review the literature of genetic PD autopsies from cases with molecularly confirmed PD or parkinsonism and summarize main findings on SNCA (n = 25), Parkin (n = 20, 17 bi-allelic and 3 heterozygotes), PINK1 (n = 5, 1 bi-allelic and 4 heterozygotes), DJ-1 (n = 1), LRRK2 (n = 55), GBA (n = 10 Gaucher disease patients with parkinsonism), DNAJC13, GCH1, ATP13A2, PLA2G6 (n = 8 patients, 2 with PD), MPAN (n = 2), FBXO7, RAB39B, and ATXN2 (SCA2), as well as on 22q deletion syndrome (n = 3). Findings from autopsies of heterozygous mutation carriers of genes that are traditionally considered recessively inherited are also discussed. Lewy bodies may be present in syndromes clinically distinctive from PD (eg, MPAN-related neurodegeneration) and absent in patients with clinical PD syndrome (eg, LRRK2-PD or Parkin-PD). Therefore, the authors can conclude that the presence of Lewy bodies are not specific to the diagnosis of PD and that PD can be diagnosed even in the absence of Lewy body pathology. Interventions that reduce alpha-synuclein load may be more justified in SNCA-PD or GBA-PD than in other genetic forms of PD. The number of reported genetic PD autopsies remains small, and there are limited genotype-clinical-pathological-phenotype studies. Therefore, larger series of autopsies from genetic PD patients are required. © 2017 International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Susanne A Schneider
- Department of Neurology, Ludwig-Maximilians-University of München, Munich, Germany
| | - Roy N. Alcalay
- Department of Neurology, Columbia University Medical Center, New York, New York
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Rose SJ, Harrast P, Donsante C, Fan X, Joers V, Tansey MG, Jinnah HA, Hess EJ. Parkinsonism without dopamine neuron degeneration in aged l-dopa-responsive dystonia knockin mice. Mov Disord 2017; 32:1694-1700. [PMID: 28949038 DOI: 10.1002/mds.27169] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2017] [Revised: 08/10/2017] [Accepted: 08/13/2017] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Recent neuroimaging studies implicate nigrostriatal degeneration as a critical factor in producing late-onset parkinsonism in patients with l-dopa-responsive dystonia-causing mutations. However, postmortem anatomical studies do not reveal neurodegeneration in l-dopa-responsive dystonia patients. These contrasting findings make it unclear how parkinsonism develops in l-dopa-responsive dystonia mutation carriers. METHODS We prospectively assessed motor dysfunction, responses to dopaminergic challenge, and dopamine neuron degeneration with aging in a validated knockin mouse model bearing a l-dopa-responsive dystonia-causing mutation found in humans. RESULTS As l-dopa-responsive dystonia mice aged, dystonic movements waned while locomotor activity decreased and initiation of movements slowed. Despite the age-related reduction in movement, there was no evidence for degeneration of midbrain dopamine neurons. Presynaptically mediated dopaminergic responses did not change with age in l-dopa-responsive dystonia mice, but responses to D1 dopamine receptor agonists decreased with age. CONCLUSIONS We have demonstrated for the first time the co-occurrence of dystonia and Parkinson's-like features (mainly consisting of hypokinesia) in a genetic mouse model. In this model we show that these features evolve without dopaminergic neurodegeneration, suggesting that postsynaptic plasticity, rather than presynaptic degeneration, may contribute to the development of parkinsonism in patients with l-dopa-responsive dystonia. © 2017 International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Samuel J Rose
- Department of Pharmacology, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Porter Harrast
- Department of Pharmacology, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Christine Donsante
- Department of Pharmacology, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Xueliang Fan
- Department of Pharmacology, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Valerie Joers
- Department of Physiology, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Malú G Tansey
- Department of Physiology, Emory University School of Medicine, Atlanta, Georgia, USA
| | - H A Jinnah
- Department of Neurology, Emory University School of Medicine, Atlanta, Georgia, USA
- Department of Human Genetics, Emory University School of Medicine, Atlanta, Georgia, USA
- Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Ellen J Hess
- Department of Pharmacology, Emory University School of Medicine, Atlanta, Georgia, USA
- Department of Neurology, Emory University School of Medicine, Atlanta, Georgia, USA
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Ishikawa T, Imamura K, Kondo T, Koshiba Y, Hara S, Ichinose H, Furujo M, Kinoshita M, Oeda T, Takahashi J, Takahashi R, Inoue H. Genetic and pharmacological correction of aberrant dopamine synthesis using patient iPSCs with BH4 metabolism disorders. Hum Mol Genet 2016; 25:5188-5197. [PMID: 27798097 PMCID: PMC5886044 DOI: 10.1093/hmg/ddw339] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2016] [Revised: 09/14/2016] [Accepted: 09/30/2016] [Indexed: 11/17/2022] Open
Abstract
Dopamine (DA) is a neurotransmitter in the brain, playing a central role in several disease conditions, including tetrahydrobiopterin (BH4) metabolism disorders and Parkinson's disease (PD). BH4 metabolism disorders present a variety of clinical manifestations including motor disturbance via altered DA metabolism, since BH4 is a cofactor for tyrosine hydroxylase (TH), a rate-limiting enzyme for DA synthesis. Genetically, BH4 metabolism disorders are, in an autosomal recessive pattern, caused by a variant in genes encoding enzymes for BH4 synthesis or recycling, including 6-pyruvoyltetrahydropterin synthase (PTPS) or dihydropteridine reductase (DHPR), respectively. Although BH4 metabolism disorders and its metabolisms have been studied, it is unclear how gene variants cause aberrant DA synthesis in patient neurons. Here, we generated induced pluripotent stem cells (iPSCs) from BH4 metabolism disorder patients with PTPS or DHPR variants, corrected the gene variant in the iPSCs using the CRISPR/Cas9 system, and differentiated the BH4 metabolism disorder patient- and isogenic control iPSCs into midbrain DA neurons. We found that by the gene correction, the BH4 amount, TH protein level and extracellular DA level were restored in DA neuronal culture using PTPS deficiency iPSCs. Furthermore, the pharmacological correction by BH4 precursor sepiapterin treatment also improved the phenotypes of PTPS deficiency. These results suggest that patient iPSCs with BH4 metabolism disorders provide an opportunity for screening substances for treating aberrant DA synthesis-related disorders.
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Affiliation(s)
- Taizo Ishikawa
- Center for iPS Cell Research and Application (CiRA), Kyoto University, 53 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto, Japan
- Sumitomo Dainippon Pharma, 3-1-98 Kasugadenaka, Konohana-ku, Osaka, Japan
| | - Keiko Imamura
- Center for iPS Cell Research and Application (CiRA), Kyoto University, 53 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto, Japan
| | - Takayuki Kondo
- Center for iPS Cell Research and Application (CiRA), Kyoto University, 53 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto, Japan
| | - Yasushi Koshiba
- Center for iPS Cell Research and Application (CiRA), Kyoto University, 53 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto, Japan
- Department of Neurology, Kyoto University Graduate School of Medicine, 54 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto, Japan
| | - Satoshi Hara
- School of Life Science and Technology, Tokyo Institute of Technology, Yokohama, Japan
| | - Hiroshi Ichinose
- School of Life Science and Technology, Tokyo Institute of Technology, Yokohama, Japan
| | - Mahoko Furujo
- Department of Pediatrics, Okayama Medical Center, National Hospital Organization, Okayama, Japan
| | - Masako Kinoshita
- Department of Neurology, Utano National Hospital, National Hospital Organization, Kyoto, Japan
| | - Tomoko Oeda
- Department of Neurology, Utano National Hospital, National Hospital Organization, Kyoto, Japan
| | - Jun Takahashi
- Center for iPS Cell Research and Application (CiRA), Kyoto University, 53 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto, Japan
| | - Ryosuke Takahashi
- Department of Neurology, Kyoto University Graduate School of Medicine, 54 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto, Japan
| | - Haruhisa Inoue
- Center for iPS Cell Research and Application (CiRA), Kyoto University, 53 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto, Japan
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Svetel M, Tomić A, Mijajlović M, Dobričić V, Novaković I, Pekmezović T, Brajković L, Kostić VS. Transcranial sonography in dopa-responsive dystonia. Eur J Neurol 2016; 24:161-166. [DOI: 10.1111/ene.13172] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2016] [Accepted: 08/29/2016] [Indexed: 01/18/2023]
Affiliation(s)
- M. Svetel
- Clinic of Neurology; Clinical Center of Serbia; Faculty of Medicine; University of Belgrade; Belgrade Serbia
| | - A. Tomić
- Clinic of Neurology; Clinical Center of Serbia; Faculty of Medicine; University of Belgrade; Belgrade Serbia
| | - M. Mijajlović
- Clinic of Neurology; Clinical Center of Serbia; Faculty of Medicine; University of Belgrade; Belgrade Serbia
| | - V. Dobričić
- Clinic of Neurology; Clinical Center of Serbia; Faculty of Medicine; University of Belgrade; Belgrade Serbia
| | - I. Novaković
- Institute for Human Genetics; Faculty of Medicine; University of Belgrade; Belgrade Serbia
| | - T. Pekmezović
- Institute of Epidemiology; Faculty of Medicine; University of Belgrade; Belgrade Serbia
| | - L. Brajković
- Institute for Nuclear Medicine; Clinical Center of Serbia; Belgrade Serbia
| | - V. S. Kostić
- Clinic of Neurology; Clinical Center of Serbia; Faculty of Medicine; University of Belgrade; Belgrade Serbia
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Kish SJ, Boileau I, Callaghan RC, Tong J. Brain dopamine neurone 'damage': methamphetamine users vs. Parkinson's disease - a critical assessment of the evidence. Eur J Neurosci 2016; 45:58-66. [PMID: 27519465 DOI: 10.1111/ejn.13363] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2016] [Revised: 07/28/2016] [Accepted: 08/09/2016] [Indexed: 12/31/2022]
Abstract
The objective of this review is to evaluate the evidence that recreational methamphetamine exposure might damage dopamine neurones in human brain, as predicted by experimental animal findings. Brain dopamine marker data in methamphetamine users can now be compared with those in Parkinson's disease, for which the Oleh Hornykiewicz discovery in Vienna of a brain dopamine deficiency is established. Whereas all examined striatal (caudate and putamen) dopamine neuronal markers are decreased in Parkinson's disease, levels of only some (dopamine, dopamine transporter) but not others (dopamine metabolites, synthetic enzymes, vesicular monoamine transporter 2) are below normal in methamphetamine users. This suggests that loss of dopamine neurones might not be characteristic of methamphetamine exposure in at least some human drug users. In methamphetamine users, dopamine loss was more marked in caudate than in putamen, whereas in Parkinson's disease, the putamen is distinctly more affected. Substantia nigra loss of dopamine-containing cell bodies is characteristic of Parkinson's disease, but similar neuropathological studies have yet to be conducted in methamphetamine users. Similarly, it is uncertain whether brain gliosis, a common feature of brain damage, occurs after methamphetamine exposure in humans. Preliminary epidemiological findings suggest that methamphetamine use might increase risk of subsequent development of Parkinson's disease. We conclude that the available literature is insufficient to indicate that recreational methamphetamine exposure likely causes loss of dopamine neurones in humans but does suggest presence of a striatal dopamine deficiency that, in principle, could be corrected by dopamine substitution medication if safety and subject selection considerations can be resolved.
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Affiliation(s)
- Stephen J Kish
- Human Brain Laboratory, Research Imaging Centre, Centre for Addiction and Mental Health, 250 College Street, Toronto, ON, Canada
| | - Isabelle Boileau
- Addiction Imaging Research Group, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Russell C Callaghan
- Northern Medical Program, University of Northern British Columbia (UNBC), Prince George, BC, Canada
| | - Junchao Tong
- Human Brain Laboratory, Research Imaging Centre, Centre for Addiction and Mental Health, 250 College Street, Toronto, ON, Canada.,Addiction Imaging Research Group, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada
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Furukawa Y, Rajput AH, Tong J, Tomizawa Y, Hornykiewicz O, Kish SJ. A marked contrast between serotonergic and dopaminergic changes in dopa-responsive dystonia. Neurology 2016; 87:1060-1. [PMID: 27488599 DOI: 10.1212/wnl.0000000000003065] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2016] [Accepted: 05/19/2016] [Indexed: 11/15/2022] Open
Affiliation(s)
- Yoshiaki Furukawa
- From the Department of Neurology (Y.F., Y.T.), Juntendo Tokyo Koto Geriatric Medical Center, Tokyo; Department of Neurology (Y.F., Y.T.), Juntendo University Graduate School of Medicine, Tokyo, Japan; Human Brain Laboratory (Y.F., J.T., S.J.K.) and Research Imaging Centre (J.T., S.J.K.), Centre for Addiction and Mental Health, Toronto; Movement Disorders Program Saskatchewan (A.H.R.), University of Saskatchewan/Saskatoon Health Region, Canada; Center for Brain Research (O.H.), University of Vienna, Austria; Departments of Psychiatry and Pharmacology (S.J.K.), University of Toronto, Canada.
| | - Ali H Rajput
- From the Department of Neurology (Y.F., Y.T.), Juntendo Tokyo Koto Geriatric Medical Center, Tokyo; Department of Neurology (Y.F., Y.T.), Juntendo University Graduate School of Medicine, Tokyo, Japan; Human Brain Laboratory (Y.F., J.T., S.J.K.) and Research Imaging Centre (J.T., S.J.K.), Centre for Addiction and Mental Health, Toronto; Movement Disorders Program Saskatchewan (A.H.R.), University of Saskatchewan/Saskatoon Health Region, Canada; Center for Brain Research (O.H.), University of Vienna, Austria; Departments of Psychiatry and Pharmacology (S.J.K.), University of Toronto, Canada
| | - Junchao Tong
- From the Department of Neurology (Y.F., Y.T.), Juntendo Tokyo Koto Geriatric Medical Center, Tokyo; Department of Neurology (Y.F., Y.T.), Juntendo University Graduate School of Medicine, Tokyo, Japan; Human Brain Laboratory (Y.F., J.T., S.J.K.) and Research Imaging Centre (J.T., S.J.K.), Centre for Addiction and Mental Health, Toronto; Movement Disorders Program Saskatchewan (A.H.R.), University of Saskatchewan/Saskatoon Health Region, Canada; Center for Brain Research (O.H.), University of Vienna, Austria; Departments of Psychiatry and Pharmacology (S.J.K.), University of Toronto, Canada
| | - Yuji Tomizawa
- From the Department of Neurology (Y.F., Y.T.), Juntendo Tokyo Koto Geriatric Medical Center, Tokyo; Department of Neurology (Y.F., Y.T.), Juntendo University Graduate School of Medicine, Tokyo, Japan; Human Brain Laboratory (Y.F., J.T., S.J.K.) and Research Imaging Centre (J.T., S.J.K.), Centre for Addiction and Mental Health, Toronto; Movement Disorders Program Saskatchewan (A.H.R.), University of Saskatchewan/Saskatoon Health Region, Canada; Center for Brain Research (O.H.), University of Vienna, Austria; Departments of Psychiatry and Pharmacology (S.J.K.), University of Toronto, Canada
| | - Oleh Hornykiewicz
- From the Department of Neurology (Y.F., Y.T.), Juntendo Tokyo Koto Geriatric Medical Center, Tokyo; Department of Neurology (Y.F., Y.T.), Juntendo University Graduate School of Medicine, Tokyo, Japan; Human Brain Laboratory (Y.F., J.T., S.J.K.) and Research Imaging Centre (J.T., S.J.K.), Centre for Addiction and Mental Health, Toronto; Movement Disorders Program Saskatchewan (A.H.R.), University of Saskatchewan/Saskatoon Health Region, Canada; Center for Brain Research (O.H.), University of Vienna, Austria; Departments of Psychiatry and Pharmacology (S.J.K.), University of Toronto, Canada
| | - Stephen J Kish
- From the Department of Neurology (Y.F., Y.T.), Juntendo Tokyo Koto Geriatric Medical Center, Tokyo; Department of Neurology (Y.F., Y.T.), Juntendo University Graduate School of Medicine, Tokyo, Japan; Human Brain Laboratory (Y.F., J.T., S.J.K.) and Research Imaging Centre (J.T., S.J.K.), Centre for Addiction and Mental Health, Toronto; Movement Disorders Program Saskatchewan (A.H.R.), University of Saskatchewan/Saskatoon Health Region, Canada; Center for Brain Research (O.H.), University of Vienna, Austria; Departments of Psychiatry and Pharmacology (S.J.K.), University of Toronto, Canada
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Rose SJ, Hess EJ. A commentary on the utility of a new L-DOPA-responsive dystonia mouse model. Rare Dis 2015; 4:e1128617. [PMID: 27141408 PMCID: PMC4838313 DOI: 10.1080/21675511.2015.1128617] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2015] [Revised: 11/11/2015] [Accepted: 12/01/2015] [Indexed: 11/26/2022] Open
Abstract
In a recent issue of Brain, we reported on the generation and characterization of a mouse model of the rare disease L-DOPA-responsive dystonia (DRD). Here, we discuss the utility of these mice for understanding broader disease processes and treatment strategies. Using specific experimental designs that either work “forward” from genetic etiology or “backward” from the symptomatic presentation, we discuss how our data and future work can be used to understand broader themes.
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Affiliation(s)
- Samuel J Rose
- Department of Pharmacology, Emory University School of Medicine , Atlanta, GA, USA
| | - Ellen J Hess
- Department of Pharmacology, Emory University School of Medicine, Atlanta, GA, USA; Department of Neurology, Emory University School of Medicine, Atlanta, GA, USA
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21
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22
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Affiliation(s)
- Yoshiaki Furukawa
- 1 Department of Neurology, Juntendo Tokyo Koto Geriatric Medical Center, Tokyo, Japan 2 Department of Neurology, Faculty of Medicine, University and Postgraduate University of Juntendo, Tokyo, Japan
| | - Stephen J Kish
- 3 Human Brain Laboratory, Research Imaging Centre, Centre for Addiction and Mental Health, Toronto, Ontario, Canada 4 Departments of Psychiatry and Pharmacology, University of Toronto, Toronto, Ontario, Canada
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Mencacci NE, Pittman AM, Isaias IU, Hardy J, Klebe S, Bhatia KP, Wood NW. Reply: Parkinson's disease in GTP cyclohydrolase 1 mutation carriers. Brain 2014; 138:e352. [PMID: 25398234 PMCID: PMC4407186 DOI: 10.1093/brain/awu309] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Affiliation(s)
- Niccolo E Mencacci
- 1 Department of Molecular Neuroscience, UCL Institute of Neurology, London WC1N 3BG, UK 2 IRCCS Istituto Auxologico Italiano, Department of Neurology and Laboratory of Neuroscience - Department of Pathophysiology and Transplantation, 'Dino Ferrari' Centre, Universita` degli Studi di Milano, 20149 Milan, Italy
| | - Alan M Pittman
- 1 Department of Molecular Neuroscience, UCL Institute of Neurology, London WC1N 3BG, UK 3 Reta Lila Weston Institute of Neurological Studies, UCL Institute of Neurology, London WC1N 3BG, UK
| | - Ioannis U Isaias
- 4 Department of Neurology, University Hospital, 97080 Würzburg, Germany 5 Parkinson Institute, Istituti Clinici di Perfezionamento, 20126 Milan, Italy
| | - John Hardy
- 1 Department of Molecular Neuroscience, UCL Institute of Neurology, London WC1N 3BG, UK 3 Reta Lila Weston Institute of Neurological Studies, UCL Institute of Neurology, London WC1N 3BG, UK
| | - Stephan Klebe
- 4 Department of Neurology, University Hospital, 97080 Würzburg, Germany
| | - Kailash P Bhatia
- 6 Sobell Department of Motor Neuroscience and Movement Disorders, UCL Institute of Neurology, London WC1N 3BG, UK
| | - Nicholas W Wood
- 1 Department of Molecular Neuroscience, UCL Institute of Neurology, London WC1N 3BG, UK
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24
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Mencacci NE, Isaias IU, Reich MM, Ganos C, Plagnol V, Polke JM, Bras J, Hersheson J, Stamelou M, Pittman AM, Noyce AJ, Mok KY, Opladen T, Kunstmann E, Hodecker S, Münchau A, Volkmann J, Samnick S, Sidle K, Nanji T, Sweeney MG, Houlden H, Batla A, Zecchinelli AL, Pezzoli G, Marotta G, Lees A, Alegria P, Krack P, Cormier-Dequaire F, Lesage S, Brice A, Heutink P, Gasser T, Lubbe SJ, Morris HR, Taba P, Koks S, Majounie E, Raphael Gibbs J, Singleton A, Hardy J, Klebe S, Bhatia KP, Wood NW. Parkinson's disease in GTP cyclohydrolase 1 mutation carriers. Brain 2014; 137:2480-92. [PMID: 24993959 PMCID: PMC4132650 DOI: 10.1093/brain/awu179] [Citation(s) in RCA: 140] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2013] [Revised: 05/16/2014] [Accepted: 05/23/2014] [Indexed: 11/27/2022] Open
Abstract
GTP cyclohydrolase 1, encoded by the GCH1 gene, is an essential enzyme for dopamine production in nigrostriatal cells. Loss-of-function mutations in GCH1 result in severe reduction of dopamine synthesis in nigrostriatal cells and are the most common cause of DOPA-responsive dystonia, a rare disease that classically presents in childhood with generalized dystonia and a dramatic long-lasting response to levodopa. We describe clinical, genetic and nigrostriatal dopaminergic imaging ([(123)I]N-ω-fluoropropyl-2β-carbomethoxy-3β-(4-iodophenyl) tropane single photon computed tomography) findings of four unrelated pedigrees with DOPA-responsive dystonia in which pathogenic GCH1 variants were identified in family members with adult-onset parkinsonism. Dopamine transporter imaging was abnormal in all parkinsonian patients, indicating Parkinson's disease-like nigrostriatal dopaminergic denervation. We subsequently explored the possibility that pathogenic GCH1 variants could contribute to the risk of developing Parkinson's disease, even in the absence of a family history for DOPA-responsive dystonia. The frequency of GCH1 variants was evaluated in whole-exome sequencing data of 1318 cases with Parkinson's disease and 5935 control subjects. Combining cases and controls, we identified a total of 11 different heterozygous GCH1 variants, all at low frequency. This list includes four pathogenic variants previously associated with DOPA-responsive dystonia (Q110X, V204I, K224R and M230I) and seven of undetermined clinical relevance (Q110E, T112A, A120S, D134G, I154V, R198Q and G217V). The frequency of GCH1 variants was significantly higher (Fisher's exact test P-value 0.0001) in cases (10/1318 = 0.75%) than in controls (6/5935 = 0.1%; odds ratio 7.5; 95% confidence interval 2.4-25.3). Our results show that rare GCH1 variants are associated with an increased risk for Parkinson's disease. These findings expand the clinical and biological relevance of GTP cycloydrolase 1 deficiency, suggesting that it not only leads to biochemical striatal dopamine depletion and DOPA-responsive dystonia, but also predisposes to nigrostriatal cell loss. Further insight into GCH1-associated pathogenetic mechanisms will shed light on the role of dopamine metabolism in nigral degeneration and Parkinson's disease.
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Affiliation(s)
- Niccolò E Mencacci
- 1 Department of Molecular Neuroscience, UCL Institute of Neurology, London WC1N 3BG, UK2 IRCCS Istituto Auxologico Italiano, Department of Neurology and Laboratory of Neuroscience - Department of Pathophysiology and Transplantation, "Dino Ferrari" Centre, Università degli Studi di Milano, 20149 Milan, Italy
| | - Ioannis U Isaias
- 3 Department of Neurology, University Hospital, 97080 Würzburg, Germany4 Parkinson Institute, Istituti Clinici di Perfezionamento, 20126 Milan, Italy
| | - Martin M Reich
- 3 Department of Neurology, University Hospital, 97080 Würzburg, Germany
| | - Christos Ganos
- 5 Sobell Department of Motor Neuroscience and Movement Disorders, UCL Institute of Neurology, London WC1N 3BG, UK6 Department of Neurology, University Medical Centre Hamburg-Eppendorf, 20246 Hamburg, Germany7 Department of Paediatric and Adult Movement Disorders and Neuropsychiatry, Institute of Neurogenetics, University of Lübeck, 23538 Lübeck, Germany
| | | | - James M Polke
- 9 Neurogenetics Unit, National Hospital for Neurology and Neurosurgery, London WC1N 3BG, UK
| | - Jose Bras
- 1 Department of Molecular Neuroscience, UCL Institute of Neurology, London WC1N 3BG, UK
| | - Joshua Hersheson
- 1 Department of Molecular Neuroscience, UCL Institute of Neurology, London WC1N 3BG, UK
| | - Maria Stamelou
- 5 Sobell Department of Motor Neuroscience and Movement Disorders, UCL Institute of Neurology, London WC1N 3BG, UK10 Neurology Clinic, Attiko Hospital, University of Athens, 126 42 Haidari, Athens, Greece11 Neurology Clinic, Philipps University, 35032 Marburg, Germany
| | - Alan M Pittman
- 1 Department of Molecular Neuroscience, UCL Institute of Neurology, London WC1N 3BG, UK12 Reta Lila Weston Institute of Neurological Studies, UCL Institute of Neurology, London WC1N 3BG, UK
| | - Alastair J Noyce
- 1 Department of Molecular Neuroscience, UCL Institute of Neurology, London WC1N 3BG, UK12 Reta Lila Weston Institute of Neurological Studies, UCL Institute of Neurology, London WC1N 3BG, UK
| | - Kin Y Mok
- 1 Department of Molecular Neuroscience, UCL Institute of Neurology, London WC1N 3BG, UK
| | - Thomas Opladen
- 13 Division of Inborn Errors of Metabolism, University Children's Hospital Heidelberg, 69120 Heidelberg, Germany
| | - Erdmute Kunstmann
- 14 Institut of Human Genetics, Julius-Maximilian-University, 97070 Würzburg, Germany
| | - Sybille Hodecker
- 6 Department of Neurology, University Medical Centre Hamburg-Eppendorf, 20246 Hamburg, Germany
| | - Alexander Münchau
- 7 Department of Paediatric and Adult Movement Disorders and Neuropsychiatry, Institute of Neurogenetics, University of Lübeck, 23538 Lübeck, Germany
| | - Jens Volkmann
- 4 Parkinson Institute, Istituti Clinici di Perfezionamento, 20126 Milan, Italy
| | - Samuel Samnick
- 15 Department of Nuclear Medicine, University Hospital, 97080 Würzburg, Germany
| | - Katie Sidle
- 1 Department of Molecular Neuroscience, UCL Institute of Neurology, London WC1N 3BG, UK
| | - Tina Nanji
- 9 Neurogenetics Unit, National Hospital for Neurology and Neurosurgery, London WC1N 3BG, UK
| | - Mary G Sweeney
- 9 Neurogenetics Unit, National Hospital for Neurology and Neurosurgery, London WC1N 3BG, UK
| | - Henry Houlden
- 1 Department of Molecular Neuroscience, UCL Institute of Neurology, London WC1N 3BG, UK
| | - Amit Batla
- 5 Sobell Department of Motor Neuroscience and Movement Disorders, UCL Institute of Neurology, London WC1N 3BG, UK
| | - Anna L Zecchinelli
- 4 Parkinson Institute, Istituti Clinici di Perfezionamento, 20126 Milan, Italy
| | - Gianni Pezzoli
- 4 Parkinson Institute, Istituti Clinici di Perfezionamento, 20126 Milan, Italy
| | - Giorgio Marotta
- 16 Department of Nuclear Medicine, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, 20122 Milano, Italy
| | - Andrew Lees
- 12 Reta Lila Weston Institute of Neurological Studies, UCL Institute of Neurology, London WC1N 3BG, UK
| | - Paulo Alegria
- 17 Serviço de Neurologia, Hospital Beatriz Ângelo, 2674-514 Loures, Portugal
| | - Paul Krack
- 18 Movement Disorder Unit, CHU Grenoble, Joseph Fourier University, and INSERM U836, Grenoble Institute Neuroscience, F-38043 Grenoble, France
| | - Florence Cormier-Dequaire
- 19 Université Pierre et Marie Curie-Paris6, Centre de Recherche de l'Institut du Cerveau et de la Moelle épinière, UMR-S975; Inserm, U975, Cnrs, UMR 7225, Paris, France20 Centre d'Investigation Clinique (CIC-9503), Département de Neurologie, Hôpital Pitié-Salpétriêre, AP-HP, Paris, France
| | - Suzanne Lesage
- 19 Université Pierre et Marie Curie-Paris6, Centre de Recherche de l'Institut du Cerveau et de la Moelle épinière, UMR-S975; Inserm, U975, Cnrs, UMR 7225, Paris, France
| | - Alexis Brice
- 19 Université Pierre et Marie Curie-Paris6, Centre de Recherche de l'Institut du Cerveau et de la Moelle épinière, UMR-S975; Inserm, U975, Cnrs, UMR 7225, Paris, France21 Département de Génétique et Cytogénétique, Pitié-Salpêtrière hospital, 75013 Paris, France
| | - Peter Heutink
- 22 DZNE-Deutsches Zentrum für Neurodegenerative Erkrankungen (German Centre for Neurodegenerative Diseases), Hertie Institute for Clinical Brain Research, University of Tübingen, 72076 Tübingen, Germany
| | - Thomas Gasser
- 22 DZNE-Deutsches Zentrum für Neurodegenerative Erkrankungen (German Centre for Neurodegenerative Diseases), Hertie Institute for Clinical Brain Research, University of Tübingen, 72076 Tübingen, Germany
| | - Steven J Lubbe
- 23 Department of Clinical Neuroscience, UCL Institute of Neurology, London WC1N 3BG, UK
| | - Huw R Morris
- 23 Department of Clinical Neuroscience, UCL Institute of Neurology, London WC1N 3BG, UK
| | - Pille Taba
- 24 Department of Neurology and Neurosurgery, University of Tartu, 50090 Tartu, Estonia
| | - Sulev Koks
- 25 Department of Pathophysiology, Centre of Excellence for Translational Medicine, University of Tartu, 50411 Tartu, Estonia
| | - Elisa Majounie
- 26 Laboratory of Neurogenetics, National Institute on Aging, Bethesda, MD 20892, USA
| | - J Raphael Gibbs
- 26 Laboratory of Neurogenetics, National Institute on Aging, Bethesda, MD 20892, USA
| | - Andrew Singleton
- 26 Laboratory of Neurogenetics, National Institute on Aging, Bethesda, MD 20892, USA
| | - John Hardy
- 1 Department of Molecular Neuroscience, UCL Institute of Neurology, London WC1N 3BG, UK12 Reta Lila Weston Institute of Neurological Studies, UCL Institute of Neurology, London WC1N 3BG, UK
| | - Stephan Klebe
- 3 Department of Neurology, University Hospital, 97080 Würzburg, Germany
| | - Kailash P Bhatia
- 5 Sobell Department of Motor Neuroscience and Movement Disorders, UCL Institute of Neurology, London WC1N 3BG, UK
| | - Nicholas W Wood
- 1 Department of Molecular Neuroscience, UCL Institute of Neurology, London WC1N 3BG, UK
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Göttle M, Prudente CN, Fu R, Sutcliffe D, Pang H, Cooper D, Veledar E, Glass JD, Gearing M, Visser JE, Jinnah HA. Loss of dopamine phenotype among midbrain neurons in Lesch-Nyhan disease. Ann Neurol 2014; 76:95-107. [PMID: 24891139 PMCID: PMC4827147 DOI: 10.1002/ana.24191] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2014] [Revised: 05/26/2014] [Accepted: 05/26/2014] [Indexed: 01/07/2023]
Abstract
OBJECTIVE Lesch-Nyhan disease (LND) is caused by congenital deficiency of the purine recycling enzyme, hypoxanthine-guanine phosphoribosyltransferase (HGprt). Affected patients have a peculiar neurobehavioral syndrome linked with reductions of dopamine in the basal ganglia. The purpose of the current studies was to determine the anatomical basis for the reduced dopamine in human brain specimens collected at autopsy. METHODS Histopathological studies were conducted using autopsy tissue from 5 LND cases and 6 controls. Specific findings were replicated in brain tissue from an HGprt-deficient knockout mouse using immunoblots, and in a cell model of HGprt deficiency by flow-activated cell sorting (FACS). RESULTS Extensive histological studies of the LND brains revealed no signs suggestive of a degenerative process or other consistent abnormalities in any brain region. However, neurons of the substantia nigra from the LND cases showed reduced melanization and reduced immunoreactivity for tyrosine hydroxylase (TH), the rate-limiting enzyme in dopamine synthesis. In the HGprt-deficient mouse model, immunohistochemical stains for TH revealed no obvious loss of midbrain dopamine neurons, but quantitative immunoblots revealed reduced TH expression in the striatum. Finally, 10 independent HGprt-deficient mouse MN9D neuroblastoma lines showed no signs of impaired viability, but FACS revealed significantly reduced TH immunoreactivity compared to the control parent line. INTERPRETATION These results reveal an unusual phenomenon in which the neurochemical phenotype of dopaminergic neurons is not linked with a degenerative process. They suggest an important relationship between purine recycling pathways and the neurochemical integrity of the dopaminergic phenotype.
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Affiliation(s)
- Martin Göttle
- Department of Neurology, Emory University, Atlanta, GA
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26
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Abstract
Background A great proportion of the variation in pain experience and chronicity is caused by heritable factors. Within the last decades several candidate genes have been discovered either increasing or decreasing pain sensitivity or the risk of chronic pain in humans. One of the most studied genes is the GCH1 gene coding for the enzyme GTP cyclohydrolase 1 (GCH1). GCH1 catalyses the initial and rate-limiting step in the biosynthesis of tetrahydrobiopterin (BH4). The main function of BH4 is regulation of monoamine and nitric oxide biosynthesis, all involved in nociceptive signalling. Methods In this topical review we focus on the implication of the GCH1 gene and BH4 in painful conditions. We discuss experimental evidence from our group in relation to relevant research publications evaluating the BH4 pathway in pain. Studies assessing the role of GCH1 and BH4 in pain consist of human and animal studies, including DOPA-responsive dystonia (DRD) patients and hph-1 mice (a genetic mouse model of DRD) having mutations in the GCH1 gene as well as preclinical studies with the GCH1 inhibitor 2,4-diamino-6-hydroxypyrimidine (DAHP). The hypothesis is that genetic and pharmacological reduction of GCH1 would result in lower pain sensitivity. Results Previous studies have demonstrated that a particular "pain protective" GCH1 haplotype, found in 15% of the general human population, is linked to decreased pain sensitivity. We further support these findings in DRD patients, showing normal thresholds to mechanical and thermal stimuli, whereas a trend towards lower pain sensitivity is seen following chemical pain sensitisation. Consistent with these observations, non-injured hph-1 mice displayed normal mechano- and thermosensation compared to wild-type mice. After peripheral inflammation with Complete Freund' Adjuvant or sensitisation with capsaicin the mutant mice exhibited lower sensitivity to mechanical and heat stimuli. Moreover, hph-1 mice showed decreased nociception in the first phase of the formalin test. Several studies report analgesic effects of GCH1 inhibition with 90-270 mg/kg DAHP in rat models of inflammatory and neuropathic pain. However, we could not completely replicate these findings in mice. Fairly higher doses of DAHP (≥270 mg/kg) were needed to reduce inflammatory pain in mice, but the window between antinociception and toxic effects was small, since 400 mg/kg DAHP affected motor performance and general appearance. Also, the analgesic effects were marginal in mice compared to that observed in rats. Conclusions Variations in the GCH1 gene in both humans and mice appear to regulate pain sensitivity and pain behaviours, particularly after pain sensitisation, whereas pain sensitivity to phasic mechanical and thermal stimuli is normal. Moreover, pharmacological inhibition of GCH1 shows antinociceptive effects in preclinical pain studies, though our studies imply that GCH1 inhibition may have a small therapeutic index. Implications The implication of the GCH1 gene in pain may increase our understanding of the risk factors of chronic pain development and improve current pain therapy by personalised medicine. In addition, inhibition of GCH1 provides a potential target for analgesic drug development, though GCH1 inhibitors should possess local or partial effects to avoid serious side-effects to the central nervous system and cardiovascular system.
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Affiliation(s)
- Arafat Nasser
- Applied Human Molecular Genetics, Kennedy Center, Copenhagen University Hospital, Rigshospitalet, Glostrup, Denmark.,Department of Drug Design and Pharmacology, Faculty of Health and Medical Sciences, Copenhagen University, Copenhagen, Denmark
| | - Lisbeth Birk Møller
- Applied Human Molecular Genetics, Kennedy Center, Copenhagen University Hospital, Rigshospitalet, Glostrup, Denmark
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Goodchild RE, Grundmann K, Pisani A. New genetic insights highlight 'old' ideas on motor dysfunction in dystonia. Trends Neurosci 2013; 36:717-25. [PMID: 24144882 DOI: 10.1016/j.tins.2013.09.003] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2013] [Revised: 09/12/2013] [Accepted: 09/13/2013] [Indexed: 12/13/2022]
Abstract
Primary dystonia is a poorly understood but common movement disorder. Recently, several new primary dystonia genes were identified that provide new insight into dystonia pathogenesis. The GNAL dystonia gene is central for striatal responses to dopamine (DA) and is a component of a molecular pathway already implicated in DOPA-responsive dystonia (DRD). Furthermore, this pathway is also dysfunctional and pathogenically linked to mTOR signaling in L-DOPA-induced dyskinesias (LID). These new data suggest that striatal DA responses are central to primary dystonia, even when symptoms do not benefit from DA therapies. Here we integrate these new findings with current understanding of striatal microcircuitry and other dystonia-causing insults to develop new ideas on the pathophysiology of this incapacitating movement disorder.
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Affiliation(s)
- Rose E Goodchild
- Vlaams Instituut voor Biotechnologie (VIB) Centre for the Biology of Disease and KU Leuven, Department of Human Genetics, Campus Gasthuisberg, 3000 Leuven, Belgium
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Casper C, Kalliolia E, Warner TT. Recent advances in the molecular pathogenesis of dystonia-plus syndromes and heredodegenerative dystonias. Curr Neuropharmacol 2013; 11:30-40. [PMID: 23814535 PMCID: PMC3580789 DOI: 10.2174/157015913804999432] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2012] [Revised: 08/17/2012] [Accepted: 08/29/2012] [Indexed: 12/04/2022] Open
Abstract
The majority of studies investigating the molecular pathogenesis and cell biology underlying dystonia have been performed in individuals with primary dystonia. This includes monogenic forms such as DYT1and DYT6 dystonia, and primary focal dystonia which is likely to be multifactorial in origin. In recent years there has been renewed interest in non-primary forms of dystonia including the dystonia-plus syndromes and heredodegenerative disorders. These are caused by a variety of genetic mutations and their study has contributed to our understanding of the neuronal dysfunction that leads to dystonia These findings have reinforced themes identified from study of primary dystonia including abnormal dopaminergic signalling, cellular trafficking and mitochondrial function. In this review we highlight recent advances in the understanding of the dystonia-plus syndromes and heredodegenerative dystonias.
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Affiliation(s)
- Catharina Casper
- Department of Clinical Neurosciences, UCL Institute of Neurology, Royal Free Campus, Rowland Hill Street, London NW3 2PF, United Kingdom
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Abstract
Segawa disease is a dopa-responsive generalized dystonia, caused by abnormalities of the gene GCH-1 located on chromosomes 14q22.1–q22.2. Clinically, there are two types, postural type and action type, depending on the family. Cases of action type show focal or segmental dystonia after adolescence. In families of action type, there are cases starting with focal or segmental dystonia in adulthood or parkinsonism in older age. Both types show symptoms of dopamine decrement due to the deficiency of tyrosine hydroxylase in the terminal of the nigrostriatal dopamine neuron, which is caused by GCH-1 deficiency. With an onset in childhood, stagnation of body length develops. For these symptoms, L-dopa demonstrates dramatic effects. In early-onset cases, tryptophan hydroxylase is also affected and patients show symptoms of serotonine deficiency. More than 100 mutations of the GCH-1 gene are detected; they are particular for each family. However, there is no particular mutation for postural and action type.
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Affiliation(s)
- Masaya Segawa
- Segawa Neurological Clinic for Children, 2–8 Surugadai, Kanda, Chiyoda-ku, Tokyo 101-0062, Japan
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30
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Kapatos G. The neurobiology of tetrahydrobiopterin biosynthesis: a model for regulation of GTP cyclohydrolase I gene transcription within nigrostriatal dopamine neurons. IUBMB Life 2013; 65:323-33. [PMID: 23457032 DOI: 10.1002/iub.1140] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2012] [Accepted: 01/07/2013] [Indexed: 12/31/2022]
Abstract
Within the brain, the reduced pteridine cofactor 6R-L-erythro-5,6,7,8-tetrahydrobiopterin (BH4) is absolutely required for the synthesis of the monoamine (MA) neurotransmitters dopamine (DA), norepinephrine, epinephrine (E), and serotonin (5-HT), the novel gaseous neurotransmitter nitric oxide and the production of yet to be identified 1-O-alkylglycerol-derived lipids. GTP cyclohydrolase I (GTPCH) catalyzes the first and limiting step in the BH4 biosynthetic pathway, which is now thought to involve up to eight different proteins supporting six alternate de novo and two alternate salvage pathways. Gene expression analysis across different regions of the human brain shows the abundance of transcripts coding for all eight of these proteins to be highly correlated with each other and to be enriched within human MA neurons. The potential for multiple routes for BH4 synthesis therefore exists within the human brain. GTPCH expression is particularly heterogeneous across different populations of human and rodent MA-containing neurons, with low expression levels and therefore BH4 being a characteristic of nigrostriatal DA (NSDA) neurons. Basic knowledge of how GCH1 gene transcription is controlled within NSDA neurons may explain the distinctive susceptibility of these neurons to human genetic mutations that result in BH4 deficiency. A model for cyclic adenosine monophosphate-dependent GCH1 transcription is described that involves a unique combination of DNA regulatory sequences and transcription factors. This model proposes that low levels of GCH1 transcription within NSDA neurons are driven by their distinctive physiology, suggesting that pharmacological manipulation of GCH1 gene transcription can be used to modify BH4 levels and therefore DA synthesis in the basal ganglia.
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Affiliation(s)
- Gregory Kapatos
- Department of Pharmacology, Center for Molecular Medicine and Genetics, Wayne State University School of Medicine, Detroit, MI 48201, USA.
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32
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Naiya T, Misra AK, Biswas A, Das SK, Ray K, Ray J. Occurrence of GCH1 gene mutations in a group of Indian dystonia patients. J Neural Transm (Vienna) 2012; 119:1343-50. [PMID: 22373569 DOI: 10.1007/s00702-012-0777-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2011] [Accepted: 02/16/2012] [Indexed: 11/27/2022]
Abstract
The aim of this study is to examine the role of GCH1 among Indians affected with dopa responsive dystonia (DRD) and early onset Parkinson's disease (EOPD). The patients (n = 76 including 19 DRD and 36 EOPD) and controls (n = 138) were screened for variants in GCH1 by PCR amplification of exons, splice junctions and 1 kb upstream region followed by SSCP and DNA sequencing. Four novel variants (p.Met1Val, p.Val204_205del, IVS3+68A>G, and IVS5-6T>G) were identified in 10 patients but not in the controls. In addition to two nonsynonymous changes, identified in four DRD patients in heterozygous condition, one intronic variant (IVS5-6T>G) could be linked to pathogenesis of the disease since it has the potential of altering the splice site as assessed by in silico analysis. Patients carrying different nonsynonymous variants had remarkable variation in clinical phenotype. Consistent with earlier reports, severity of clinical phenotype and the age of onset varied among family members harboring the same mutation. No mutation was detected in the EOPD patients. Three novel mutations in GCH1 gene have been found and are shown to be associated with variable clinical phenotypes mostly within the spectrum of DRD. The mutations identified represent 15.79% (3/19) of east Indian DRD patient cohort.
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Affiliation(s)
- Tufan Naiya
- S. N. Pradhan Centre for Neurosciences, University of Calcutta, 35, Ballygunge Circular Road, Kolkata 700019, India
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Belik J, McIntyre BAS, Enomoto M, Pan J, Grasemann H, Vasquez-Vivar J. Pulmonary hypertension in the newborn GTP cyclohydrolase I-deficient mouse. Free Radic Biol Med 2011; 51:2227-33. [PMID: 21982896 PMCID: PMC5050525 DOI: 10.1016/j.freeradbiomed.2011.09.012] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2011] [Revised: 09/10/2011] [Accepted: 09/13/2011] [Indexed: 11/30/2022]
Abstract
Tetrahydrobiopterin (BH4) is a regulator of endothelial nitric oxide synthase (eNOS) activity. Deficient levels result in eNOS uncoupling, with a shift from nitric oxide to superoxide generation. The hph-1 mutant mouse has deficient GTP cyclohydrolase I (GTPCH1) activity, resulting in low BH4 tissue content. The adult hph-1 mouse has pulmonary hypertension, but whether such condition is present from birth is not known. Thus, we evaluated newborn animals' pulmonary arterial medial thickness, biopterin content (BH4+BH2), H(2)O(2) and eNOS, right ventricle-to-left ventricle+septum (RV/LV+septum) ratio, near-resistance pulmonary artery agonist-induced force, and endothelium-dependent and -independent relaxation. The lung biopterin content was inversely related to age for both types, but significantly lower in hph-1 mice, compared to wild-type animals. As judged by the RV/LV+septum ratio, newborn hph-1 mice have pulmonary hypertension and, after a 2-week 13% oxygen exposure, the ratios were similar in both types. The pulmonary arterial agonist-induced force was reduced (P<0.01) in hph-1 animals and no type-dependent difference in endothelium-dependent or -independent vasorelaxation was observed. Compared to wild-type mice, the lung H(2)O(2) content was increased, whereas the eNOS expression was decreased (P<0.01) in hph-1 animals. The pulmonary arterial medial thickness, a surrogate marker of vascular remodeling, was increased (P<0.01) in hph-1 compared to wild-type mice. In conclusion, our data suggest that pulmonary hypertension is present from birth in the GTPCH1-deficient mice, not as a result of impaired vasodilation, but secondary to vascular remodeling.
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Affiliation(s)
- Jaques Belik
- Department of Paediatrics, The Hospital for Sick Children Research Institute, University of Toronto, Toronto, ON M5G 1X8, Canada.
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López-laso E, Sánchez-raya A, Moriana JA, Martínez-gual E, Camino-león R, Mateos-gonzález ME, Pérez-navero JL, Ochoa-sepúlveda JJ, Ormazabal A, Opladen T, Klein C, Lao-villadóniga JI, Beyer K, Artuch R. Neuropsychiatric symptoms and intelligence quotient in autosomal dominant Segawa disease. J Neurol 2011; 258:2155-62. [DOI: 10.1007/s00415-011-6079-9] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2010] [Accepted: 04/20/2011] [Indexed: 10/18/2022]
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Abstract
Hereditary progressive dystonia with marked diurnal fluctuation (HPD) is a dopa-responsive dystonia, now called autosomal dominant GTP cyclohydrolase 1 deficiency or Segawa disease, caused by mutation of the GCH-1 gene located on 14q22.1 to q22.2. Because of heterozygous mutation, partial deficiency of tetrahydrobiopterin affects tyrosine hydroxylase (TH) rather selectively and causes decrease of TH in the terminals of the nigrostriatal dopamine (NS DA) neurons, projecting to the D1 receptors on the striosome, the striatal direct pathways and the subthalamic nucleus (STN) and the D4 receptors of the tuberoinfundibular tract. The activities of TH in the terminal are high in early childhood decrease exponentially to the stational level around early twenties, and show circadian oscillatron. TH in HPD follows these variations with around 20% of normal levels and with development of the downstream structures show appears characteristic clinical symptoms age dependently. In late fetus period to early infancy, through the striosome-substantia nigra pars compacta pathway failure in morphogenesis of the DA neurons in substantia nigra, in childhood around 6 years postural dystonia through the D1 direct pathways and the descending output of the basal ganglia. Diurnal fluctuation is apparent in childhood but decrease its grade with age. TH deficiency at the terminal on the STN causes action dystonia from around 8 years and postural tremor from around 10 years, focal dystonia in adulthood. Adult onset cases in the family with action dystonia start with writer's cramp, torticollis or generalized rigid hypertonus with tremor but do not show postural dystonia. TH deficiency on the D4 receptors causes stagnation of the body length in childhood. With or without action dystonia depends on the locus of mutation. Postural dystonia is inhibitory disorder, while action dystonia is excitatory disorder. The TH deficiency at the terminal does not cause morphological changes or degenerative process. Thus, levodopa shows favorable effects without any relation to the duration of illness.
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Affiliation(s)
- Masaya Segawa
- Segawa Neurological Clinic for Children, Chiyoda-ku, Tokyo, Japan.
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36
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Homma D, Sumi-Ichinose C, Tokuoka H, Ikemoto K, Nomura T, Kondo K, Katoh S, Ichinose H. Partial biopterin deficiency disturbs postnatal development of the dopaminergic system in the brain. J Biol Chem 2011; 286:1445-52. [PMID: 21062748 PMCID: PMC3020753 DOI: 10.1074/jbc.m110.159426] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2010] [Revised: 10/29/2010] [Indexed: 11/06/2022] Open
Abstract
Postnatal development of dopaminergic system is closely related to the development of psychomotor function. Tyrosine hydroxylase (TH) is the rate-limiting enzyme in the biosynthesis of dopamine and requires tetrahydrobiopterin (BH4) as a cofactor. To clarify the effect of partial BH4 deficiency on postnatal development of the dopaminergic system, we examined two lines of mutant mice lacking a BH4-biosynthesizing enzyme, including sepiapterin reductase knock-out (Spr(-/-)) mice and genetically rescued 6-pyruvoyltetrahydropterin synthase knock-out (DPS-Pts(-/-)) mice. We found that biopterin contents in the brains of these knock-out mice were moderately decreased from postnatal day 0 (P0) and remained constant up to P21. In contrast, the effects of BH4 deficiency on dopamine and TH protein levels were more manifested during the postnatal development. Both of dopamine and TH protein levels were greatly increased from P0 to P21 in wild-type mice but not in those mutant mice. Serotonin levels in those mutant mice were also severely suppressed after P7. Moreover, striatal TH immunoreactivity in Spr(-/-) mice showed a drop in the late developmental stage, when those mice exhibited hind-limb clasping behavior, a type of motor dysfunction. Our results demonstrate a critical role of biopterin in the augmentation of TH protein in the postnatal period. The developmental manifestation of psychomotor symptoms in BH4 deficiency might be attributable at least partially to high dependence of dopaminergic development on BH4 availability.
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Affiliation(s)
- Daigo Homma
- From the Graduate School of Bioscience and Biotechnology, Tokyo Institute of Technology, Yokohama 226-8501, Japan
| | - Chiho Sumi-Ichinose
- the Department of Pharmacology, Fujita Health University School of Medicine, Toyoake 470-1192, Japan, and
| | - Hirofumi Tokuoka
- From the Graduate School of Bioscience and Biotechnology, Tokyo Institute of Technology, Yokohama 226-8501, Japan
| | - Kazuhisa Ikemoto
- the Department of Pharmacology, Fujita Health University School of Medicine, Toyoake 470-1192, Japan, and
| | - Takahide Nomura
- the Department of Pharmacology, Fujita Health University School of Medicine, Toyoake 470-1192, Japan, and
| | - Kazunao Kondo
- the Department of Pharmacology, Fujita Health University School of Medicine, Toyoake 470-1192, Japan, and
| | - Setsuko Katoh
- the Meikai University School of Dentistry, Sakado, Saitama 350-0283, Japan
| | - Hiroshi Ichinose
- From the Graduate School of Bioscience and Biotechnology, Tokyo Institute of Technology, Yokohama 226-8501, Japan
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Abstract
Clinical characteristics and pahophysiologies of dopa-responsive dystonia are discussed by reviewing autosomal-dominant GTP cyclohydrolase-I deficiency (AD GCHI D), recessive deficiencies of enzymes of pteridine metabolism, and recessive tyrosine hydroxylase (TH). Pteridine and TH metabolism involve TH activities in the terminals of the nigrostriatal dopamine neuron which show high in early childhood and decrease exponentially with age, attaining stational low levels by the early 20s. In these disorders, TH in the terminals follows this course with low levels and develops particular symptoms with functional maturation of the downstream structures of the basal ganglia; postural dystonia through the direct pathway and descending output matured earlier in early childhood and parkinsonism in TH deficiency in teens through the D2 indirect pathway ascending output matured later. In action-type AD GCHI D, deficiency of TH in the terminal on the subthalamic nucleus develops action dystonia through the descending output in childhood, focal and segmental dystonia and parkinsonism in adolescence and adulthood through the ascending pathway maturing later. Dysfunction of dopamine in the terminals does not cause degenerative changes or higher cortical dysfunction. In recessive disorders, hypofunction of serotonin and noradrenaline induces hypofunction of the dopamine in the perikaryon and shows cortical dysfunction.
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Affiliation(s)
- Masaya Segawa
- Segawa Neurological Clinic for Children, Tokyo, Japan.
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38
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Mayahi L, Mason L, Bleasdale-Barr K, Donald A, Trender-Gerhard I, Sweeney MG, Davis MB, Wood N, Mathias CJ, Watson L, Pellerin D, Heales S, Deanfield JE, Bhatia K, Murray-Rust J, Hingorani AD. Endothelial, sympathetic, and cardiac function in inherited (6R)-L-erythro-5,6,7,8-tetrahydro-L-biopterin deficiency. Circ Cardiovasc Genet 2010; 3:513-22. [PMID: 20937667 DOI: 10.1161/circgenetics.110.957605] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND (6R)-5,6,7,8-Tetrahydro-l-biopterin (BH4) is a cofactor for enzymes involved in catecholamine and nitric oxide generation whose synthesis is initiated by GTP cyclohydrolase I (GTPCH-1), encoded by GCH1. In the absence of a potent, specific GTPCH-1 inhibitor, natural BH4 deficiency caused by mutations in GCH1 in the rare movement disorder, DOPA-responsive dystonia (OMIM DYT5), offers the opportunity to study the role of endogenous BH4 in humans. METHODS AND RESULTS In 16 DOPA-responsive dystonia patients with mutations predicted to affect GTPCH-1 expression or function and in age- and sex-matched control subjects, we measured plasma biopterin and nitrogen oxides by high-performance liquid chromatography and the Griess reaction, respectively, endothelial function by brachial artery flow-mediated dilation (FMD), sympathetic function by measurement of plasma norepinephrine, epinephrine, and heart rate and blood pressure in response. Cardiac function and structure were assessed by echocardiography. Plasma biopterin was lower in patients (5.76±0.53 versus 8.43±0.85 nmol/L, P=0.03), but plasma NO(2)(-)/NO(3)(-) (NOx) (median, 9.06 [interquartile range, 5.35 to 11.04] versus 8.40 [interquartile range, 5.28 to 11.44] μmol/L, P=1) and FMD were not lower (7.7±0.8% versus 7.9±0.9%, P=0.91). In patients but not control subjects, FMD was insensitive to nitric oxide synthase inhibition (FMD at baseline, 6.7±2.1%; FMD during l-NMMA infusion, 6.2±2.5, P=0.68). The heart rate at rest was higher in patients, but the heart rate and blood pressure response to sympathetic stimulation did not differ in patients and control subjects despite lower concentrations of norepinepherine (264±8 pg/mL versus 226±9 pg/mL, P=0.006) and epinephrine (33.8±5.2 pg/mL versus 17.8±4.6 pg/mL, P=0.03) in patients. There was also no difference in cardiac function and structure. CONCLUSIONS Sympathetic, cardiac, and endothelial functions are preserved in patients with GCH1 mutations despite a neurological phenotype, reduced plasma biopterin, and norepinepherine and epinephrine concentrations. Lifelong endogenous BH4 deficiency may elicit developmental adaptation through mechanisms that are inaccessible during acquired BH4 deficiency in adulthood.
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Affiliation(s)
- Lila Mayahi
- Centre for Clinical Pharmacology, University College London, 5 University St., London, UK.
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Sumi-Ichinose C, Ichinose H, Ikemoto K, Nomura T, Kondo K. Advanced Research on Dopamine Signaling to Develop Drugs for the Treatment of Mental Disorders: Regulation of Dopaminergic Neural Transmission by Tyrosine Hydroxylase Protein at Nerve Terminals. J Pharmacol Sci 2010; 114:17-24. [DOI: 10.1254/jphs.09r28fm] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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Sato K, Sumi-Ichinose C, Kaji R, Ikemoto K, Nomura T, Nagatsu I, Ichinose H, Ito M, Sako W, Nagahiro S, Graybiel AM, Goto S. Differential involvement of striosome and matrix dopamine systems in a transgenic model of dopa-responsive dystonia. Proc Natl Acad Sci U S A 2008; 105:12551-6. [PMID: 18713855 DOI: 10.1073/pnas.0806065105] [Citation(s) in RCA: 69] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Dopa-responsive dystonia (DRD) is a hereditary dystonia characterized by a childhood onset of fixed dystonic posture with a dramatic and sustained response to relatively low doses of levodopa. DRD is thought to result from striatal dopamine deficiency due to a reduced synthesis and activity of tyrosine hydroxylase (TH), the synthetic enzyme for dopamine. The mechanisms underlying the genesis of dystonia in DRD present a challenge to models of basal ganglia movement control, given that striatal dopamine deficiency is the hallmark of Parkinson's disease. We report here behavioral and anatomical observations on a transgenic mouse model for DRD in which the gene for 6-pyruvoyl-tetrahydropterin synthase is targeted to render selective dysfunction of TH synthesis in the striatum. Mutant mice exhibited motor deficits phenotypically resembling symptoms of human DRD and manifested a major depletion of TH labeling in the striatum, with a marked posterior-to-anterior gradient resulting in near total loss caudally. Strikingly, within the regions of remaining TH staining in the striatum, there was a greater loss of TH labeling in striosomes than in the surrounding matrix. The predominant loss of TH expression in striosomes occurred during the early postnatal period, when motor symptoms first appeared. We suggest that the differential striosome-matrix pattern of dopamine loss could be a key to identifying the mechanisms underlying the genesis of dystonia in DRD.
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Abstract
The genetics and symptoms of Segawa's disease are described. The latter can show considerable variation, especially if the onset of the condition is delayed. It is usually of autosomal dominant inheritance, but a recessive form can occur. The dominant and recessive forms are caused by a gene mapped to chromosome 14. The fluctuating dystonia is typical, but is not essential for the diagnosis. Affected children can suffer from sleep disorders, such as excessive sleepiness and nightmares. In some children with this condition mutations in the GCH-1 gene coding for guanosine triphosphate cyclohydrolase 1 have been found. The enzyme catalyses the first step in the biosynthesis of tetrahydrobiopterin. A point mutation in the tyrosine hydrolase gene has been found in some of the recessive forms, and the gene mapped to chromosome 11, but this cannot be called Segawa's disease. The deficiency of guanosine triphosphate cyclohydrolase 1 causes a defect in serotonin metabolism and in the biosynthesis of tetrabiopterin and a disturbance of dopamine metabolism. This leads to a deficiency of dopamine in the striatum, and to the motor dysfunction of the syndrome. The diagnosis can be established by cerebrospinal fluid examination, and confirmed in some patients by genetic studies. Treatment is with levodopa, and the results are dramatic.
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Affiliation(s)
- N Gordon
- Children's Hospitals, Manchester, UK.
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Ichinose H, Nomura T, Sumi-Ichinose C. Metabolism of tetrahydrobiopterin: its relevance in monoaminergic neurons and neurological disorders. CHEM REC 2008; 8:378-85. [PMID: 19107867 DOI: 10.1002/tcr.20166] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2008] [Accepted: 08/10/2008] [Indexed: 11/06/2022]
Abstract
(6R)-L-erythro-5,6,7,8-tetrahydrobiopterin (BH4) is an essential cofactor for aromatic amino acid hydroxylases, such as phenylalanine hydroxylase (PAH), tyrosine hydroxylase (TH), tryptophan hydroxylase, and nitric oxide synthase, which catalyze physiologically important reactions in mammals. The biosynthesis and metabolism of BH4 is usually studied mostly in the liver and only slightly in the brain, as the BH4 level in the liver is relatively high because BH4 is required for the reaction of PAH. We found that GTP (guanosine triphosphate) cyclohydrolase I, an enzyme for the biosynthesis of BH4, is a causative gene for DOPA (3,4-dihydroxyphenylalanine)-responsive dystonia (also called Segawa's disease), and that partial deficiency of BH4 leads to the dysfunction of the nigrostriatal dopaminergic neurons without hyperphenylalaninemia. We analyzed BH4-deficient mice that were produced by disruption of a BH4-synthesizing gene by a gene-knockout technique. We found that the protein amount of TH was highly dependent on the amount of BH4, especially in nerve terminals. Our research suggests that BH4 metabolism in the brain should be different from that in the liver, and that altered metabolism of BH4 should lead to neuropsychiatric disorders including Parkinson's disease.
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Affiliation(s)
- Hiroshi Ichinose
- Graduate School of Bioscience and Biotechnology, Tokyo Institute of Technology, Yokohama 226-8501, Japan.
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Richardson MA, Read LL, Reilly MA, Clelland JD, Clelland CLT. Analysis of plasma biopterin levels in psychiatric disorders suggests a common BH4 deficit in schizophrenia and schizoaffective disorder. Neurochem Res 2007; 32:107-13. [PMID: 17160504 DOI: 10.1007/s11064-006-9233-5] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2006] [Accepted: 11/16/2006] [Indexed: 10/23/2022]
Abstract
Tetrahydrobiopterin (BH4) is an essential cofactor for amine neurotransmitter synthesis. BH4 also stimulates and modulates the glutamatergic system, and regulates the synthesis of nitric oxide by nitric oxide synthases. A connection between BH4 deficiencies and psychiatric disorders has been previously reported; major depression and obsessive-compulsive disorder have been found in subjects with a BH4 deficiency disorder and more recently we have observed a robust plasma deficit of biopterin (a measure of BH4), in a large group of schizophrenic patients compared to control subjects. To extend our previous finding in schizophrenia, we analyzed plasma biopterin levels from patients with schizoaffective and bipolar disorders. A significant difference in biopterin was seen among the diagnostic groups (P < 0.0001). Post hoc analyses indicated significant biopterin deficits relative to the normal control group for the schizoaffective group, who had biopterin levels comparable to the schizophrenic group. Bipolar disorder subjects had plasma biopterin levels that were higher that the schizoaffective disorder group and significantly higher than the schizophrenic group. The demonstrated significant biopterin deficit in both schizophrenia and schizoaffective disorder, may suggest an etiological role of a BH4 deficit in these two disorders, via dysregulation of neurotransmitter systems.
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Affiliation(s)
- Mary Ann Richardson
- Movement Disorders and Molecular Psychiatry, The Nathan S. Kline Institute for Psychiatric Research, New York State Office of Mental Health, 140 Old Orangeburg Road, Orangeburg, NY 10962, USA
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Fedorow H, Halliday GM, Rickert CH, Gerlach M, Riederer P, Double KL. Evidence for specific phases in the development of human neuromelanin. Neurobiol Aging 2006; 27:506-12. [PMID: 15916835 DOI: 10.1016/j.neurobiolaging.2005.02.015] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2004] [Revised: 01/04/2005] [Accepted: 02/23/2005] [Indexed: 10/25/2022]
Abstract
Neuromelanin is a dark-coloured pigment which forms in the dopamine neurons of the human midbrain. The age-related development and regulation of neuromelanin within these dopamine neurons has not been previously described. Optical density and area measurements of unstained neuromelanin in ventral substantia nigra neurons from 29 people spanning the ages of 24 weeks to 95 years old, demonstrated three developmental phases. Neuromelanin was not present at birth and initiation of pigmentation began at approximately 3 years of age, followed by a period of increasing pigment granule number and increasing pigment granule colouration until age 20. In middle and later life the colour of the pigment granules continued to darken but was not associated with any substantial growth in pigment volume. The identification of three phases and changes in the rate of neuromelanin production over time suggests the regulation of neuromelanin production and turnover, possibly through enzymatic processes.
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Affiliation(s)
- H Fedorow
- Prince of Wales Medical Research Institute and the University of New South Wales, Barker Street, Randwick, Sydney, NSW 2031, Australia
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Halliday GM, Fedorow H, Rickert CH, Gerlach M, Riederer P, Double KL. Evidence for specific phases in the development of human neuromelanin. J Neural Transm (Vienna) 2006; 113:721-8. [PMID: 16604299 DOI: 10.1007/s00702-006-0449-y] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2005] [Accepted: 01/07/2006] [Indexed: 11/25/2022]
Abstract
Neuromelanin is a dark-coloured pigment which forms in the dopamine neurons of the human midbrain. Here we describe the age-related development and regulation of neuromelanin within these dopamine neurons. 10 microm sections from formalin-fixed midbrain from 29 people spanning the ages of 24 weeks to 95 years old were either stained with a basic Nissl substance stain (0.5% cresyl violet), or processed unstained. After locating the substantia nigra using the stained sections, digital photos were taken of individual ventral substantia nigra neurons in the unstained sections, and the cellular area occupied by pigment, and optical density were measured using computer software. These measurements demonstrated three developmental phases. Neuromelanin was not present at birth and initiation of pigmentation began at approximately 3 years of age, followed by a period of increasing pigment granule number and increasing pigment granule colouration until age 20. In middle and later life the colour of the pigment granules continued to darken but was not associated with any substantial growth in pigment volume. The identification of three phases and changes in the rate of neuromelanin production over time suggests the regulation of neuromelanin production and turnover, possibly through enzymatic processes.
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Affiliation(s)
- G M Halliday
- Prince of Wales Medical Research Institute and the University of New South Wales, Sydney, Australia
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Abstract
Functional neuroimaging, such as positron emission tomography (PET) and functional magnetic resonance imaging (fMRI), provides a valuable technique for detecting regional changes in brain metabolic activity associated with human disease. These techniques have been applied in different dystonic disorders including primary generalized dystonia and dopa-responsive dystonia (DRD), as well as focal dystonic syndromes such as torticollis, writer's cramp, and blepharospasm. A common finding is abnormality of the basal ganglia and associated outflow pathways to sensorimotor cortex and other regions involved with motor performance. Other recent imaging research has utilized diffusion-based MRI techniques to localize distinct microstructural abnormalities in dystonia patients and gene carriers. This presentation will focus on an integrated approach to understanding the pathophysiology of this genetic and biochemically diverse disorder.
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Affiliation(s)
- Kotaro Asanuma
- Center for Neurosciences, Institute for Medical Research, North Shore-Long Island Jewish Health System, Manhasset, NY 11030, and Department of Neurology, North Shore University Hospital, New York, NY, USA
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Van Hove JLK, Steyaert J, Matthijs G, Legius E, Theys P, Wevers R, Romstad A, Møller LB, Hedrich K, Goriounov D, Blau N, Klein C, Casaer P. Expanded motor and psychiatric phenotype in autosomal dominant Segawa syndrome due to GTP cyclohydrolase deficiency. J Neurol Neurosurg Psychiatry 2006; 77:18-23. [PMID: 16361586 PMCID: PMC2117403 DOI: 10.1136/jnnp.2004.051664] [Citation(s) in RCA: 67] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2004] [Revised: 03/14/2005] [Accepted: 04/14/2005] [Indexed: 11/04/2022]
Abstract
BACKGROUND Segawa syndrome due to GTP cyclohydrolase deficiency is an autosomal dominant disorder with variable expression, that is clinically characterised by l-dopa responsive, diurnally fluctuating dystonia and parkinsonian symptoms. OBJECTIVE To delineate the neurological and psychiatric phenotype in all affected individuals of three extended families. METHODS GTP cyclohydrolase deficiency was documented by biochemical analyses, enzymatic measurements in fibroblasts, and molecular investigations. All affected individuals were examined neurologically, and psychiatric data were systematically reviewed. RESULTS Eighteen affected patients from three families with proven GTP cyclohydrolase deficiency were identified. Eight patients presenting at less than 20 years of age had typical motor symptoms of dystonia with diurnal variation. Five family members had late-presenting mild dopa-responsive symptoms of rigidity, frequent falls, and tendonitis. Among mutation carriers older than 20 years of age, major depressive disorder, often recurrent, and obsessive-compulsive disorder were strikingly more frequent than observed in the general population. Patients responded well to medication increasing serotonergic neurotransmission and to l-dopa substitution. Sleep disorders including difficulty in sleep onset and maintenance, excessive sleepiness, and frequent disturbing nightmares were present in 55% of patients. CONCLUSION Physicians should be aware of this expanded phenotype in affected members of families with GTP cyclohydrolase deficiency.
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Affiliation(s)
- J L K Van Hove
- Department of Pediatrics, University of Colorado Health Sciences Center, Denver, CO, USA.
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Sumi-Ichinose C, Urano F, Shimomura A, Sato T, Ikemoto K, Shiraishi H, Senda T, Ichinose H, Nomura T. Genetically rescued tetrahydrobiopterin-depleted mice survive with hyperphenylalaninemia and region-specific monoaminergic abnormalities. J Neurochem 2005; 95:703-14. [PMID: 16135092 DOI: 10.1111/j.1471-4159.2005.03402.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
One of the possibly mutated genes in DOPA-responsive dystonia (DRD, Segawa's disease) is the gene encoding GTP cyclohydrolase I, which is the rate-limiting enzyme for tetrahydrobiopterin (BH4) biosynthesis. Based on our findings on 6-pyruvoyltetrahydropterin synthase (PTS) gene-disrupted (Pts(-/-)) mice, we suggested that the amount of tyrosine hydroxylase (TH) protein in dopaminergic nerve terminals is regulated by the intracellular concentration of BH4. In this present work, we rescued Pts(-/-) mice by transgenic introduction of human PTS cDNA under the control of the dopamine beta-hydroxylase promoter to examine regional differences in the sensitivity of dopaminergic neurons to BH4-insufficiency. The DPS-rescued (Pts(-/-), DPS) mice showed severe hyperphenylalaninemia. Human PTS was efficiently expressed in noradrenergic regions but only in a small number of dopaminergic neurons. Biopterin and dopamine contents, and TH activity in the striatum were poorly restored compared with those in the midbrain. TH-immunoreactivity in the lateral region of the striatum was far weaker than that in the medial region or in the nucleus accumbens. We concluded that dopaminergic nerve terminals projecting to the lateral region of the striatum are the most sensitive to BH4-insufficiency. Biochemical and pathological changes in DPS-rescued mice were similar to those in human malignant hyperphenylalaninemia and DRD.
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Affiliation(s)
- Chiho Sumi-Ichinose
- Department of Pharmacology, School of Medicine, Fujita Health University, Tokoake, Aichi, Japan.
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Abstract
The restless legs syndrome (RLS) is one of the commonest neurological sensorimotor disorders at least in the Western countries and is often associated with periodic limb movements (PLM) during sleep leading to severe insomnia. However, it remains largely underdiagnosed and its underlying pathogenesis is presently unknown. Women are more affected than men and early-onset disease is associated with familial cases. A genetic origin has been suggested but the mode of inheritance is unknown. Secondary causes of RLS may share a common underlying pathophysiology implicating iron deficiency or misuse. The excellent response to dopaminegic drugs points to a central role of dopamine in the pathophysiology of RLS. Iron may also represent a primary factor in the development of RLS, as suggested by recent pathological and brain imaging studies. However, the way dopamine and iron, and probably other compounds, interact to generate the circadian pattern in the occurrence of RLS and PLM symptoms remains unknown. The same is also the case for the level of interaction of the two compounds within the central nervous system (CNS). Recent electrophysiological and animals studies suggest that complex spinal mechanisms are involved in the generation of RLS and PLM symptomatology. Dopamine modulation of spinal reflexes through dopamine D3 receptors was recently highlighted in animal models. The present review suggests that RLS is a complex disorder that may result from a complex dysfunction of interacting neuronal networks at one or several levels of the CNS and involving numerous neurotransmitter systems.
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Affiliation(s)
- G Barrière
- Laboratoire de Neurophysiologie, UMR-CNRS 5543, Université Bordeaux 2, Bordeaux, France
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