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Cacace R, Zhou L, Hendrickx Van de Craen E, Buist A, Hoogmartens J, Sieben A, Cras P, Vandenberghe R, De Deyn PP, Oehlrich D, De Bondt A, Engelborghs S, Moechars D, Van Broeckhoven C. Mutated Toll-like receptor 9 increases Alzheimer's disease risk by compromising innate immunity protection. Mol Psychiatry 2023; 28:5380-5389. [PMID: 37433968 PMCID: PMC11041692 DOI: 10.1038/s41380-023-02166-0] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Revised: 06/09/2023] [Accepted: 06/23/2023] [Indexed: 07/13/2023]
Abstract
The development of Alzheimer's disease (AD) involves central and peripheral immune deregulation. Gene identification and studies of AD genetic variants of peripheral immune components may aid understanding of peripheral-central immune crosstalk and facilitate new opportunities for therapeutic intervention. In this study, we have identified in a Flanders-Belgian family a novel variant p.E317D in the Toll-like receptor 9 gene (TLR9), co-segregating with EOAD in an autosomal dominant manner. In human, TLR9 is an essential innate and adaptive immune component predominantly expressed in peripheral immune cells. The p.E317D variant caused 50% reduction in TLR9 activation in the NF-κB luciferase assay suggesting that p.E317D is a loss-of-function mutation. Cytokine profiling of human PBMCs upon TLR9 activation revealed a predominantly anti-inflammatory response in contrast to the inflammatory responses from TLR7/8 activation. The cytokines released upon TLR9 activation suppressed inflammation and promoted phagocytosis of Aβ42 oligomers in human iPSC-derived microglia. Transcriptome analysis identified upregulation of AXL, RUBICON and associated signaling pathways, which may underline the effects of TLR9 signaling-induced cytokines in regulating the inflammatory status and phagocytic property of microglia. Our data suggest a protective role of TLR9 signaling in AD pathogenesis, and we propose that TLR9 loss-of-function may disrupt a peripheral-central immune crosstalk that promotes dampening of inflammation and clearance of toxic protein species, leading to the build-up of neuroinflammation and pathogenic protein aggregates in AD development.
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Affiliation(s)
- Rita Cacace
- Neurodegenerative Brain Diseases, VIB Center for Molecular Neurology, VIB, Antwerp, Belgium
- Department of Biomedical Sciences, University of Antwerp, Antwerp, Belgium
| | - Lujia Zhou
- Department of Neuroscience, Janssen Research & Development, a Division of Janssen Pharmaceutica NV, Beerse, Belgium
| | - Elisabeth Hendrickx Van de Craen
- Neurodegenerative Brain Diseases, VIB Center for Molecular Neurology, VIB, Antwerp, Belgium
- Department of Biomedical Sciences, University of Antwerp, Antwerp, Belgium
- Department of Neurology, University Hospital Antwerp, Edegem, Belgium
| | - Arjan Buist
- Department of Neuroscience, Janssen Research & Development, a Division of Janssen Pharmaceutica NV, Beerse, Belgium
| | - Julie Hoogmartens
- Neurodegenerative Brain Diseases, VIB Center for Molecular Neurology, VIB, Antwerp, Belgium
- Department of Biomedical Sciences, University of Antwerp, Antwerp, Belgium
| | - Anne Sieben
- Department of Pathology, University Hospital Antwerp, Edegem, Belgium
| | - Patrick Cras
- Department of Neurology, University Hospital Antwerp, Edegem, Belgium
- Institute Born-Bunge, Antwerp, Belgium
| | - Rik Vandenberghe
- Department of Neurology, University Hospitals Leuven, and Department of Neurosciences, KU Leuven, Leuven, Belgium
| | - Peter P De Deyn
- Department of Biomedical Sciences, University of Antwerp, Antwerp, Belgium
- Institute Born-Bunge, Antwerp, Belgium
- Department of Neurology and Memory Clinic, Hospital Network Antwerp, Antwerp, Belgium
| | - Daniel Oehlrich
- Discovery Sciences, Janssen Research & Development, a Division of Janssen Pharmaceutica NV, Beerse, Belgium
| | - An De Bondt
- Discovery Sciences, Janssen Research & Development, a Division of Janssen Pharmaceutica NV, Beerse, Belgium
| | - Sebastiaan Engelborghs
- Department of Biomedical Sciences, University of Antwerp, Antwerp, Belgium
- Department of Neurology, Universitair Ziekenhuis Brussel, and Center for Neurosciences, Vrije Universiteit Brussel, Brussels, Belgium
| | - Diederik Moechars
- Department of Neuroscience, Janssen Research & Development, a Division of Janssen Pharmaceutica NV, Beerse, Belgium
| | - Christine Van Broeckhoven
- Neurodegenerative Brain Diseases, VIB Center for Molecular Neurology, VIB, Antwerp, Belgium.
- Department of Biomedical Sciences, University of Antwerp, Antwerp, Belgium.
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Gossye H, Van Mossevelde S, Sieben A, Bjerke M, Van de Craen EH, van der Zee J, De Deyn PP, De Bleecker J, Versijpt J, van den Ende J, Deryck O, Bourgeois P, Bier JC, Goethals M, Vandenberghe R, Engelborghs S, Van Broeckhoven C. Patients carrying the mutation p.R406W in MAPT present with non-conforming phenotypic spectrum. Brain 2022; 146:1624-1636. [PMID: 36171642 PMCID: PMC10115352 DOI: 10.1093/brain/awac362] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Revised: 08/11/2022] [Accepted: 09/09/2022] [Indexed: 11/13/2022] Open
Abstract
The missense mutation p.R406W in microtubule-associated protein tau leads to frontotemporal lobar degeneration with an amnestic, Alzheimer's disease-like phenotype with an autosomal dominant pattern of inheritance. In 2003, we described the pedigree of a Belgian family, labeled ADG, with 28 p.R406W patients. Over 18 years follow-up, we extended the family with 10 p.R406W carriers and provided an in-depth clinical description of the patients. Additionally, genetic screening was used to identify p.R406W carriers in Belgian cohorts of frontotemporal dementia and Alzheimer's disease patients and to calculate p.R406W frequency. In the frontotemporal dementia cohort, we found four p.R406W carriers (n = 647,0.62%) and three in the Alzheimer's disease cohort (n = 1134, 0.26%). Haplotype sharing analysis showed evidence of a shared haplotype suggesting that they are descendants of a common ancestor. Of the p.R406W patients, we describe characteristics of neuropsychological, imaging and fluid biomarkers as well as neuropathologic examination. Intriguingly, the phenotypic spectrum among the p.R406W patients ranged from typical behavioral variant frontotemporal dementia to clinical Alzheimer's disease, based on CSF biomarker analysis and amyloid PET scan. Heterogeneous overlap syndromes existed in between, with highly common neuropsychiatric symptoms like disinhibition and aggressiveness, which occurred in 100% of frontotemporal dementia and 58% of clinical Alzheimer's disease patients. This was also the case for memory problems, 89% in frontotemporal dementia and 100% in clinical Alzheimer's disease patients. Median age at death was significantly lower in patients with frontotemporal dementia (68 years) compared to clinical Alzheimer's disease patients (79 years), though the sizes of the sub-cohorts are limited and do not allow prognostic predictions. Postmortem brain analysis of one p.R406W patient with behavioral variant frontotemporal dementia revealed frontotemporal lobar degeneration with tau pathology. Notably, neuropathological investigation showed only 3R tau isoforms in the absence of 4R tau reactivity, an unusual finding in microtubule-associated protein tau-related frontotemporal lobar degeneration. No traces of amyloid pathology were present. Prevalence of the p.R406W mutation was relatively high in both frontotemporal dementia and Alzheimer's disease Belgian patient cohorts. These findings grant new insights into genotype-phenotype correlations of p.R406W carriers. They may help in further unraveling of the pathophysiology of this tauopathy and to facilitate the identification of patients with p.R406W-related frontotemporal lobar degeneration, both in clinical diagnostic and research settings.
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Affiliation(s)
- Helena Gossye
- VIB Center for Molecular Neurology, 2610 Antwerp, Belgium.,Department of Neurology, University Hospital Antwerp, 2650 Edegem, Belgium.,Department of Biomedical Sciences, University of Antwerp, 2610 Antwerp, Belgium
| | - Sara Van Mossevelde
- Department of Neurology, University Hospital Antwerp, 2650 Edegem, Belgium.,Institute Born-Bunge, 2610 Antwerp, Belgium.,Department of Neurology and Memory Clinic, Hospital Network Antwerp, 2000 Antwerp, Belgium.,Department of Translational Neurosciences, Faculty of Medicine and Health Sciences, University of Antwerp, 2610 Antwerp, Belgium
| | - Anne Sieben
- Institute Born-Bunge, 2610 Antwerp, Belgium.,Department of Anatomopathology, University Hospital Antwerp, 2650 Edegem, Belgium
| | - Maria Bjerke
- Department of Biomedical Sciences, University of Antwerp, 2610 Antwerp, Belgium.,Department of Clinical Chemistry, Universitair Ziekenhuis Brussel and Center for Neurosciences, Vrije Universiteit Brussel, 1000 Brussel, Belgium
| | - Elisabeth Hendrickx Van de Craen
- VIB Center for Molecular Neurology, 2610 Antwerp, Belgium.,Department of Neurology, University Hospital Antwerp, 2650 Edegem, Belgium.,Department of Biomedical Sciences, University of Antwerp, 2610 Antwerp, Belgium
| | - Julie van der Zee
- VIB Center for Molecular Neurology, 2610 Antwerp, Belgium.,Department of Biomedical Sciences, University of Antwerp, 2610 Antwerp, Belgium
| | - Peter P De Deyn
- Institute Born-Bunge, 2610 Antwerp, Belgium.,Department of Neurology and Alzheimer Center, University of Groningen, 9713 Groningen, The Netherlands
| | - Jan De Bleecker
- Department of Neurology, University Hospital Ghent, 9000 Gent, Belgium
| | - Jan Versijpt
- Department of Neurology, Universitair Ziekenhuis Brussel and Center for Neurosciences, Vrije Universiteit Brussel, 1000 Brussel, Belgium
| | - Jenneke van den Ende
- Department of Medical Genetics, University Hospital Antwerp, 2650 Edegem, Belgium
| | - Olivier Deryck
- Department of Neurology, General Hospital Sint-Jan, 8000 Brugge, Belgium
| | - Paul Bourgeois
- Department of Neurology, General Hospital Groeninge, 8500 Kortrijk, Belgium
| | - Jean Christophe Bier
- Department of Neurology, Erasmus Hospital, University Clinics of Brussels, 1000 Brussel, Belgium
| | - Maarten Goethals
- Department of Neurology, General Hospital Delta, 8800 Roeselare, Belgium
| | - Rik Vandenberghe
- Laboratory for Cognitive Neurology, Department of Neurosciences, University Hospital and University of Leuven, 3000 Leuven, Belgium.,Neurology Service, University Hospitals Leuven, 3000 Leuven, Belgium
| | - Sebastiaan Engelborghs
- Department of Biomedical Sciences, University of Antwerp, 2610 Antwerp, Belgium.,Department of Neurology, Universitair Ziekenhuis Brussel and Center for Neurosciences, Vrije Universiteit Brussel, 1000 Brussel, Belgium
| | - Christine Van Broeckhoven
- VIB Center for Molecular Neurology, 2610 Antwerp, Belgium.,Department of Biomedical Sciences, University of Antwerp, 2610 Antwerp, Belgium
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Bossaerts L, Hendrickx Van de Craen E, Cacace R, Asselbergh B, Van Broeckhoven C. Rare missense mutations in ABCA7 might increase Alzheimer's disease risk by plasma membrane exclusion. Acta Neuropathol Commun 2022; 10:43. [PMID: 35361255 PMCID: PMC8973822 DOI: 10.1186/s40478-022-01346-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Accepted: 03/11/2022] [Indexed: 11/10/2022] Open
Abstract
The adenosine triphosphate-binding cassette subfamily A member 7 gene (ABCA7) is associated with Alzheimer's disease (AD) in large genome-wide association studies. Targeted sequencing of ABCA7 suggests a role for rare premature termination codon (PTC) mutations in AD, with haploinsufficiency through nonsense-mediated mRNA decay as a plausible pathogenic mechanism. Since other classes of rare variants in ABCA7 are poorly understood, we investigated the contribution and pathogenicity of rare missense, indel and splice variants in ABCA7 in Belgian AD patient and control cohorts. We identified 8.36% rare variants in the patient cohort versus 6.05% in the control cohort. For 10 missense mutations identified in the Belgian cohort we analyzed the pathogenetic effect on protein localization in vitro using immunocytochemistry. Our results demonstrate that rare ABCA7 missense mutations can contribute to AD by inducing protein mislocalization, resulting in a lack of functional protein at the plasma membrane. In one pedigree, a mislocalization-inducing missense mutation in ABCA7 (p.G1820S) co-segregated with AD in an autosomal dominant inheritance pattern. Brain autopsy of six patient missense mutation carriers showed typical AD neuropathological characteristics including cerebral amyloid angiopathy type 1. Also, among the rare ABCA7 missense mutations, we observed mutations that affect amino acid residues that are conserved in ABCA1 and ABCA4, of which some correspond to established ABCA1 or ABCA4 disease-causing mutations involved in Tangier or Stargardt disease.
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