1
|
Key J, Mueller AK, Gispert S, Matschke L, Wittig I, Corti O, Münch C, Decher N, Auburger G. Ubiquitylome profiling of Parkin-null brain reveals dysregulation of calcium homeostasis factors ATP1A2, Hippocalcin and GNA11, reflected by altered firing of noradrenergic neurons. Neurobiol Dis 2019; 127:114-130. [PMID: 30763678 DOI: 10.1016/j.nbd.2019.02.008] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [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: 10/15/2018] [Revised: 12/05/2018] [Accepted: 02/08/2019] [Indexed: 02/06/2023] Open
Abstract
Parkinson's disease (PD) is the second most frequent neurodegenerative disorder in the old population. Among its monogenic variants, a frequent cause is a mutation in the Parkin gene (Prkn). Deficient function of Parkin triggers ubiquitous mitochondrial dysfunction and inflammation in the brain, but it remains unclear how selective neural circuits become vulnerable and finally undergo atrophy. We attempted to go beyond previous work, mostly done in peripheral tumor cells, which identified protein targets of Parkin activity, an ubiquitin E3 ligase. Thus, we now used aged Parkin-knockout (KO) mouse brain for a global quantification of ubiquitylated peptides by mass spectrometry (MS). This approach confirmed the most abundant substrate to be VDAC3, a mitochondrial outer membrane porin that modulates calcium flux, while uncovering also >3-fold dysregulations for neuron-specific factors. Ubiquitylation decreases were prominent for Hippocalcin (HPCA), Calmodulin (CALM1/CALML3), Pyruvate Kinase (PKM2), sodium/potassium-transporting ATPases (ATP1A1/2/3/4), the Rab27A-GTPase activating protein alpha (TBC1D10A) and an ubiquitin ligase adapter (DDB1), while strong increases occurred for calcium transporter ATP2C1 and G-protein subunits G(i)/G(o)/G(Tr). Quantitative immunoblots validated elevated abundance for the electrogenic pump ATP1A2, for HPCA as neuron-specific calcium sensor, which stimulates guanylate cyclases and modifies axonal slow afterhyperpolarization (sAHP), and for the calcium-sensing G-protein GNA11. We assessed if compensatory molecular regulations become insufficient over time, leading to functional deficits. Patch clamp experiments in acute Parkin-KO brain slices indeed revealed alterations of the electrophysiological properties in aged noradrenergic locus coeruleus (LC) neurons. LC neurons of aged Parkin-KO brain showed an acceleration of the spontaneous pacemaker frequency, a reduction in sAHP and shortening of action potential duration, without modulation of KCNQ potassium currents. These findings indicate altered calcium-dependent excitability in a PARK2 model of PD, mediated by diminished turnover of potential Parkin targets such as ATP1A2 and HPCA. The data also identified further novel Parkin substrate candidates like SIRT2, OTUD7B and CUL5. Our elucidation of neuron-specific mechanisms of PD pathogenesis helps to explain the known exceptional susceptibility of noradrenergic and dopaminergic projections to alterations of calcium homeostasis and its mitochondrial buffering.
Collapse
Affiliation(s)
- J Key
- Exp. Neurology, Goethe University Medical School, 60590 Frankfurt am Main, Germany
| | - A K Mueller
- Institute for Physiology and Pathophysiology, Vegetative Physiology and Marburg Center for Mind, Brain and Behavior - MCMBB; Clinic for Neurology, Philipps-University Marburg, 35037 Marburg, Germany
| | - S Gispert
- Exp. Neurology, Goethe University Medical School, 60590 Frankfurt am Main, Germany
| | - L Matschke
- Institute for Physiology and Pathophysiology, Vegetative Physiology and Marburg Center for Mind, Brain and Behavior - MCMBB; Clinic for Neurology, Philipps-University Marburg, 35037 Marburg, Germany
| | - I Wittig
- Functional Proteomics, SFB 815 Core Unit, Goethe University Medical School, 60590 Frankfurt am Main, Germany
| | - O Corti
- Institut du Cerveau et de la Moelle épinière, ICM, Paris, F-75013, France; Inserm, U1127, Paris, F-75013, France; CNRS, UMR 7225, Paris, F-75013, France; Sorbonne Universités, Paris, F-75013, France
| | - C Münch
- Institute of Biochemistry II, Goethe University Medical School, 60590 Frankfurt am Main, Germany
| | - N Decher
- Institute for Physiology and Pathophysiology, Vegetative Physiology and Marburg Center for Mind, Brain and Behavior - MCMBB; Clinic for Neurology, Philipps-University Marburg, 35037 Marburg, Germany.
| | - G Auburger
- Exp. Neurology, Goethe University Medical School, 60590 Frankfurt am Main, Germany.
| |
Collapse
|
2
|
Almaguer-Mederos L, Mesa J, González-Zaldívar Y, Almaguer-Gotay D, Cuello-Almarales D, Aguilera-Rodríguez R, Falcón N, Gispert S, Auburger G, Velázquez-Pérez L. Factors associated with ATXN2
CAG/CAA repeat intergenerational instability in Spinocerebellar ataxia type 2. Clin Genet 2018; 94:346-350. [DOI: 10.1111/cge.13380] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2018] [Accepted: 05/01/2018] [Indexed: 12/13/2022]
Affiliation(s)
- L.E. Almaguer-Mederos
- Center for Investigation and Rehabilitation of Hereditary Ataxias; Holguín Cuba
- Medical University of Holguín; Holguín Cuba
| | - J.M.L. Mesa
- Center for Investigation and Rehabilitation of Hereditary Ataxias; Holguín Cuba
| | - Y. González-Zaldívar
- Center for Investigation and Rehabilitation of Hereditary Ataxias; Holguín Cuba
- Medical University of Holguín; Holguín Cuba
| | - D. Almaguer-Gotay
- Center for Investigation and Rehabilitation of Hereditary Ataxias; Holguín Cuba
- Medical University of Holguín; Holguín Cuba
| | - D. Cuello-Almarales
- Center for Investigation and Rehabilitation of Hereditary Ataxias; Holguín Cuba
| | - R. Aguilera-Rodríguez
- Center for Investigation and Rehabilitation of Hereditary Ataxias; Holguín Cuba
- Medical University of Holguín; Holguín Cuba
| | - N.S. Falcón
- Center for Investigation and Rehabilitation of Hereditary Ataxias; Holguín Cuba
| | - S. Gispert
- Experimental Neurology; Goethe University Medical School; Frankfurt am Main Germany
| | - G. Auburger
- Experimental Neurology; Goethe University Medical School; Frankfurt am Main Germany
| | - L. Velázquez-Pérez
- Center for Investigation and Rehabilitation of Hereditary Ataxias; Holguín Cuba
- Medical University of Holguín; Holguín Cuba
| |
Collapse
|
3
|
Fittschen M, Lastres-Becker I, Halbach MV, Damrath E, Gispert S, Azizov M, Walter M, Müller S, Auburger G. Genetic ablation of ataxin-2 increases several global translation factors in their transcript abundance but decreases translation rate. Neurogenetics 2015; 16:181-92. [PMID: 25721894 PMCID: PMC4475250 DOI: 10.1007/s10048-015-0441-5] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2015] [Accepted: 02/10/2015] [Indexed: 12/12/2022]
Abstract
Spinocerebellar ataxia type 2 (SCA2) and amyotrophic lateral sclerosis (ALS) are neurodegenerative disorders, caused or modified by an unstable CAG-repeat expansion in the SCA2 gene, which encodes a polyglutamine (polyQ) domain expansion in ataxin-2 (ATXN2). ATXN2 is an RNA-binding protein and interacts with the poly(A)-binding protein PABPC1, localizing to ribosomes at the rough endoplasmic reticulum. Under cell stress, ATXN2, PABPC1 and small ribosomal subunits are relocated to stress granules, where mRNAs are protected from translation and from degradation. It is unknown whether ATXN2 associates preferentially with specific mRNAs or how it modulates RNA processing. Here, we investigated the RNA profile of the liver and cerebellum from Atxn2 knockout (Atxn2 (-/-)) mice at two adult ages, employing oligonucleotide microarrays. Prominent increases were observed for Lsm12/Paip1 (>2-fold), translation modulators known as protein interactor/competitor of ATXN2 and for Plin3/Mttp (>1.3-fold), known as apolipoprotein modulators in agreement with the hepatosteatosis phenotype of the Atxn2 (-/-) mice. Consistent modest upregulations were also observed for many factors in the ribosome and the translation/secretion apparatus. Quantitative reverse transcriptase PCR in liver tissue validated >1.2-fold upregulations for the ribosomal biogenesis modulator Nop10, the ribosomal components Rps10, Rps18, Rpl14, Rpl18, Gnb2l1, the translation initiation factors Eif2s2, Eif3s6, Eif4b, Pabpc1 and the rER translocase factors Srp14, Ssr1, Sec61b. Quantitative immunoblots substantiated the increased abundance of NOP10, RPS3, RPS6, RPS10, RPS18, GNB2L1 in SDS protein fractions, and of PABPC1. In mouse embryonal fibroblasts, ATXN2 absence also enhanced phosphorylation of the ribosomal protein S6 during growth stimulation, while impairing the rate of overall protein synthesis rates, suggesting a block between the enhanced translation drive and the impaired execution. Thus, the physiological role of ATXN2 subtly modifies the abundance of cellular translation factors as well as global translation.
Collapse
Affiliation(s)
- M Fittschen
- Experimental Neurology, Goethe University Medical School, Theodor Stern Kai 7, 60590, Frankfurt am Main, Germany
| | | | | | | | | | | | | | | | | |
Collapse
|
4
|
Almaguer-Mederos LE, Aguilera Rodríguez R, González Zaldivar Y, Almaguer Gotay D, Cuello Almarales D, Laffita Mesa J, Vázquez Mojena Y, Zayas Feria P, Auburger G, Gispert S, Velásquez Pérez L. Estimation of survival in Spinocerebellar Ataxia type 2 Cuban patients. Clin Genet 2013; 83:293-4. [DOI: 10.1111/j.1399-0004.2012.01902.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2012] [Revised: 04/03/2012] [Accepted: 05/28/2012] [Indexed: 12/14/2022]
Affiliation(s)
- LE Almaguer-Mederos
- Center for Investigation and Rehabilitation of Hereditary Ataxias (CIRAH); Holguín province Cuba
| | - R Aguilera Rodríguez
- Center for Investigation and Rehabilitation of Hereditary Ataxias (CIRAH); Holguín province Cuba
| | - Y González Zaldivar
- Center for Investigation and Rehabilitation of Hereditary Ataxias (CIRAH); Holguín province Cuba
| | - D Almaguer Gotay
- Center for Investigation and Rehabilitation of Hereditary Ataxias (CIRAH); Holguín province Cuba
| | - D Cuello Almarales
- Center for Investigation and Rehabilitation of Hereditary Ataxias (CIRAH); Holguín province Cuba
| | - J Laffita Mesa
- Center for Investigation and Rehabilitation of Hereditary Ataxias (CIRAH); Holguín province Cuba
| | - Y Vázquez Mojena
- Center for Investigation and Rehabilitation of Hereditary Ataxias (CIRAH); Holguín province Cuba
| | - P Zayas Feria
- Center for Investigation and Rehabilitation of Hereditary Ataxias (CIRAH); Holguín province Cuba
| | - G Auburger
- Section of Molecular Neurogenetics, Department of Neurology; Building 89, 3rd floor, J.W. Goethe University Medical School; Theodor Stern Kai 7 60590 Frankfurt am Main Germany
| | - S Gispert
- Section of Molecular Neurogenetics, Department of Neurology; Building 89, 3rd floor, J.W. Goethe University Medical School; Theodor Stern Kai 7 60590 Frankfurt am Main Germany
| | - L Velásquez Pérez
- Center for Investigation and Rehabilitation of Hereditary Ataxias (CIRAH); Holguín province Cuba
| |
Collapse
|
5
|
Klinkenberg M, Gispert S, Dominguez-Bautista JA, Braun I, Auburger G, Jendrach M. Restriction of trophic factors and nutrients induces PARKIN expression. Neurogenetics 2011; 13:9-21. [PMID: 22028146 PMCID: PMC3274670 DOI: 10.1007/s10048-011-0303-8] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2011] [Accepted: 10/10/2011] [Indexed: 11/21/2022]
Abstract
Parkinson’s disease (PD) is the most frequent neurodegenerative movement disorder and manifests at old age. While many details of its pathogenesis remain to be elucidated, in particular the protein and mitochondrial quality control during stress responses have been implicated in monogenic PD variants. Especially the mitochondrial kinase PINK1 and the ubiquitin ligase PARKIN are known to cooperate in autophagy after mitochondrial damage. As autophagy is also induced by loss of trophic signaling and PINK1 gene expression is modulated after deprivation of cytokines, we analyzed to what extent trophic signals and starvation stress regulate PINK1 and PARKIN expression. Time course experiments with serum deprivation and nutrient starvation of human SH-SY5Y neuroblastoma cells and primary mouse neurons demonstrated phasic induction of PINK1 transcript up to twofold and PARKIN transcript levels up to sixfold. The corresponding threefold starvation induction of PARKIN protein was limited by its translocation to lysosomes. Analysis of primary mouse cells from PINK1-knockout mice indicated that PARKIN induction and lysosomal translocation occurred independent of PINK1. Suppression of the PI3K-Akt-mTOR signaling by pharmacological agents modulated PARKIN expression accordingly. In conclusion, this expression survey demonstrates that PARKIN and PINK1 are coregulated during starvation and suggest a role of both PD genes in response to trophic signals and starvation stress.
Collapse
Affiliation(s)
- M Klinkenberg
- Experimental Neurology, Department of Neurology, University Medical School, Goethe University, Heinrich-Hoffmann-Str. 7, 60528, Frankfurt am Main, Germany
| | | | | | | | | | | |
Collapse
|
6
|
Kurz A, Wöhr M, Walter M, Bonin M, Auburger G, Gispert S, Schwarting R. Alpha-synuclein deficiency affects brain Foxp1 expression and ultrasonic vocalization. Neuroscience 2010; 166:785-95. [DOI: 10.1016/j.neuroscience.2009.12.054] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2009] [Revised: 12/22/2009] [Accepted: 12/23/2009] [Indexed: 12/17/2022]
|
7
|
Klinkenberg M, Thurow N, Gispert S, Ricciardi F, Eich F, Prehn JHM, Auburger G, Kögel D. Enhanced vulnerability of PARK6 patient skin fibroblasts to apoptosis induced by proteasomal stress. Neuroscience 2010; 166:422-34. [PMID: 20045449 DOI: 10.1016/j.neuroscience.2009.12.068] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2009] [Revised: 12/11/2009] [Accepted: 12/28/2009] [Indexed: 12/21/2022]
Abstract
Proteasomal dysfunction and apoptosis are major hallmarks in the pathophysiology of Parkinson's disease (PD). PARK6 which is caused by mutations in the mitochondrial protein kinase PINK1 is a rare autosomal-recessively inherited disorder mimicking the clinical picture of PD. To investigate the cytoprotective physiological function of PINK1, we used primary fibroblasts from three patients homozygous for G309D-PINK1 as well as SHEP neuroblastoma cells stably overexpressing GFP-tagged wild type (wt) PINK1. Here we demonstrate that overexpression of wt PINK1 inhibits activation of Bax and release of cytochrome c, thereby diminishing caspase 9 processing and effector caspase activity after induction of proteasomal stress with the proteasome inhibitor (PI) MG132 in SHEP cells. Conversely, effector caspase activation induced by PIs, but not by the unrelated apoptotic stimulus staurosporine was potently enhanced in primary fibroblasts from homozygous PARK6 patients in comparison to those of heterozygous carriers or unaffected siblings. SHEP cells overexpressing wt PINK1 showed an elevated expression of the cytoprotective gene parkin, whereas PARK6 fibroblasts displayed significantly decreased expression of parkin in comparison to wild type control cells. Interestingly, overexpressed GFP-PINK1 was exclusively localized in the mitochondria of SHEP cells, but was redistributed to the cytoplasm under conditions of proteasomal stress. Our data indicate that PINK1 plays an important and specific physiological role in protecting cells from proteasomal stress, and suggest that PINK1 might exert its cytoprotective effects upstream of mitochondria engagement.
Collapse
Affiliation(s)
- M Klinkenberg
- Experimental Neurosurgery, Center for Neurology and Neurosurgery, Goethe University Hospital, Theodor-Stern-Kai 7, Frankfurt am Main, Germany
| | | | | | | | | | | | | | | |
Collapse
|
8
|
Almaguer-Mederos LE, Falcón NS, Almira YR, Zaldivar YG, Almarales DC, Góngora EM, Herrera MP, Batallán KE, Armiñán RR, Manresa MV, Cruz GS, Laffita-Mesa J, Cyuz TM, Chang V, Auburger G, Gispert S, Pérez LV. Estimation of the age at onset in spinocerebellar ataxia type 2 Cuban patients by survival analysis. Clin Genet 2009; 78:169-74. [DOI: 10.1111/j.1399-0004.2009.01358.x] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
9
|
Lafflta-Mesa J, Velasquez-Perez L, Auburger G, Gispert S, Serrano L, Sánchez-Cruz G. P3.036 The Cuban pathological CAG mutation causing SCA2 was introduced between 1408CE and 1733CE in the Cuban population. Parkinsonism Relat Disord 2009. [DOI: 10.1016/s1353-8020(09)70600-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
|
10
|
Thurow N, Gispert S, Auburger G, Kögel D. Mutations in the familial Parkinson's disease gene PINK1 enhance the sensitivity to apoptosis induced by proteasomal stress. Akt Neurol 2005. [DOI: 10.1055/s-2005-919308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
|
11
|
Auburger G, Kessler KR, Kang JS, Gispert S, Stoltenburg G, Braak H. Klinik und Neuropathologie der autosomal dominanten I93M-Mutation des UCH-L1-Gens (PARK5). Akt Neurol 2005. [DOI: 10.1055/s-2005-866633] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
|
12
|
Auburger G, Kessler K, Kang JS, Gispert S, Stoltenburg G, Braak H. Die PARK5 I93M-Mutation verursacht Parkinson'sche Krankheit mit kognitiver Einschränkung und Lewy-Pathologie. Akt Neurol 2005. [DOI: 10.1055/s-2005-866628] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
|
13
|
Gispert S, Trenkwalder C, Mota-Vieira L, Kostic V, Auburger G. Fehlen von alpha-Synuklein-Gendosis-Änderungen in 190 Patienten mit familiärer Parkinson-Krankheit. Akt Neurol 2005. [DOI: 10.1055/s-2005-866629] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
|
14
|
Kessler KR, Morales B, Gispert S, Hamscho N, Ziemann U, Steinmetz H, Auburger G. Klinische und diagnostische Merkmale eines autosomal rezessiven Parkinson-Syndroms (PARK6) in einer spanischen Familie. Akt Neurol 2005. [DOI: 10.1055/s-2005-866635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
|
15
|
Gispert S, Cabin D, Murphy D, Auburger G, Myers R, Nussbaum R. Die Expression von humanem A53T alpha-Synuklein in einem Maushintergrund ohne murines alpha-Synuklein exazerbiert die Synukleinopathie. Akt Neurol 2005. [DOI: 10.1055/s-2005-866630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
|
16
|
Tuin I, Kessler KR, Voss U, Morales B, Gispert S, Steinmetz H, Auburger G. Gibt es Schlafstörungen bei Patienten mit PARK6-Parkinson-Syndrom? Akt Neurol 2005. [DOI: 10.1055/s-2005-866636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
|
17
|
Kessler KR, Hamscho N, Morales B, Menzel C, Barrero F, Vives F, Gispert S, Auburger G. Dopaminergic function in a family with the PARK6 form of autosomal recessive Parkinson’s syndrome. J Neural Transm (Vienna) 2005; 112:1345-53. [PMID: 15785866 DOI: 10.1007/s00702-005-0281-9] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.5] [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: 11/23/2004] [Accepted: 01/08/2005] [Indexed: 10/25/2022]
Abstract
A G309D mutation in the PINK1 gene in a consanguineous Spanish kindred with seven siblings, three of whom are clinically affected, has recently been shown to be a cause of the PARK6 form of autosomal-recessive Parkinson's syndrome. In this family, we studied pre- and postsynaptic dopaminergic function using 123I-FP-CIT- and 123I-iodobenzamide-SPECT to determine binding to the presynaptic dopamine transporter (DAT) and postsynaptic D2 receptors respectively. All three PARK6 patients showed reduced striatal DAT binding with posterior preponderance similar to sporadic idiopathic PD, but only one patient showed significant striatal asymmetry. In two of the siblings, DAT binding was markedly increased. IBZM-SPECT was normal in both patients and sibs. Our findings indicate that 123I-FP-CIT-SPECT shows similar DAT binding in PARK6 patients compared to idiopathic Parkinson's disease. The increased DAT binding in heterozygous PARK6 carriers may be a new very early preclinical finding, but its significance is still unclear.
Collapse
Affiliation(s)
- K R Kessler
- Department of Neurology, J.W. Goethe University, Frankfurt/Main, Germany
| | | | | | | | | | | | | | | |
Collapse
|
18
|
Valente E, Abou-Sleiman P, Caputo V, Muqit M, Gispert S, Ali Z, Del Turco D, Wingerter O, Bentivoglio A, Healy D, Albanese A, Nussbaum R, Gonzalez-Maldonado R, Deller T, Mülsch A, Bratzke H, Salvi S, Cortelli P, Gilks W, Latchman D, Auburger G, Wood N. Die PARK6-Form der Parkinson'schen Krankheit wird ausgelöst durch Mutationen in einer mitochondrialen Protein-Kinase. Akt Neurol 2004. [DOI: 10.1055/s-2004-832984] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
|
19
|
Gispert S, Dutra A, Lieberman A, Friedlich D, Nussbaum RL. Cloning and genomic organization of the mouse gene slc23a1 encoding a vitamin C transporter. DNA Res 2000; 7:339-45. [PMID: 11214969 DOI: 10.1093/dnares/7.6.339] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Vitamin C is known to exist in particularly high concentrations in brain tissue, and its free radical scavenging function is thought to represent a major antioxidative defense system. We have cloned, sequenced and analyzed the genomic structure of a mouse sodium-dependent vitamin C transporter gene, Slc23a1 (also known as Svct2). The mouse Slc23a1 cDNA is 6.4 kb long and was cloned directly from a mouse brain RNA preparation. Hybridization screening of a mouse genomic BAC library identified BAC 53L21 which contains at least the entire coding sequence of the mouse Slc23a1 gene. Determination of the exon-intron structure of the gene revealed 17 exons ranging from 58 bp to 4407 bp extending over 50 kb of the mouse genome, with the translation start codon located in exon 3. Its 1944 nucleotide open reading frame encodes a polypeptide of 647 aa, which is highly similar to rat and human orthologs. The mouse gene was assigned to chromosome 2qG2 by fluorescence in situ hybridization analysis. Expression of this gene was demonstrated in a wide range of tissues, with especially high levels in brain. Neurodegenerative diseases with an established role for oxidative stress in the cytoplasm may therefore be conditions of SLC23A1 dysfunction. Key words: gene structure; Vitamin C; transporter; oxidative stress
Collapse
Affiliation(s)
- S Gispert
- Genetic Disease Research Branch, National Human Genome Research Institute, and Howard Hughes Medical Institute, NIH, Bethesda, Maryland 20892-4472, USA
| | | | | | | | | |
Collapse
|
20
|
Aguiar J, Santurlidis S, Nowok J, Alexander C, Rudnicki D, Gispert S, Schulz W, Auburger G. Identification of the physiological promoter for spinocerebellar ataxia 2 gene reveals a CpG island for promoter activity situated into the exon 1 of this gene and provides data about the origin of the nonmethylated state of these types of islands. Biochem Biophys Res Commun 1999; 254:315-8. [PMID: 9918835 DOI: 10.1006/bbrc.1998.9929] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.5] [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: 01/23/2023]
Abstract
In order to further use the spinocerebellar ataxia 2 (SCA2) promoter for transgenic mice models of "CAG repeat" neurodegeneration, different fragments of this 5' end were ligated into pGL3-Luc plasmid to obtain the better promoter-activity of the physiological promoter for SCA2. Base-par composition of the SCA2-5' region, and promoter prediction algorithms such as TSSW and TSSG, together with the high firefly luciferase expression after 48 hours of transient transfection in mammalian cells lines, showed a typical CpG island for promoter-activity. The promoter activity was specifically localized into the exon 1 of the SCA2 gene. The higher expression of firefly luciferase in the embryonal F9 cells by the use of SCA2 promoter, rather than by the use of CMV promoter may be related with the origin of the nonmethylated CpG island during the early embryogenesis. Analysis of the 5' region from HD gene revealed to a CpG island, which could be containing the physiological promoter for this gene.
Collapse
Affiliation(s)
- J Aguiar
- Division of Neurology, University Hospital, Düsseldorf, D-40225, Germany.
| | | | | | | | | | | | | | | |
Collapse
|
21
|
Schöls L, Gispert S, Vorgerd M, Menezes Vieira-Saecker AM, Blanke P, Auburger G, Amoiridis G, Meves S, Epplen JT, Przuntek H, Pulst SM, Riess O. Spinocerebellar ataxia type 2. Genotype and phenotype in German kindreds. Arch Neurol 1997; 54:1073-80. [PMID: 9311350 DOI: 10.1001/archneur.1997.00550210011007] [Citation(s) in RCA: 96] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
BACKGROUND Spinocerebellar ataxia type 2 (SCA2) is an autosomal dominant cerebellar ataxia (ADCA) for which the disease-causing mutation has recently been characterized as an expanded CAG trinucleotide repeat. We investigated 64 families of German ancestry with ADCA and 55 patients with sporadic ataxia for the SCA2 mutation. RESULTS Expanded alleles were found in 6 of the 64 families and in 1 patient with sporadic ataxia. This patient had a de novo mutation from an intermediate paternal allele. Length of repeats in 21 patients with SCA2 ranged from 36 to 52 CAG motifs and was inversely correlated with age at onset and progression of the disease. Expanded alleles were unstable during meiosis; paternal transmission especially caused significant anticipation of onset up to 26 years earlier. The SCA2 phenotype differed from those of SCA1 and SCA3 with higher frequencies of slowed ocular movements, postural and action tremor, myoclonus, and hyporeflexia. However, no single feature was sufficient to permit a specific clinical diagnosis. CONCLUSIONS Spinocerebellar ataxia type 2 accounts for about 10% of German families with ADCA but may also be present in sporadic ataxia due to de novo mutations. Clinical features are highly variable among and even within families. However, the size of the expanded repeat influences the phenotype and is relevant for course and prognosis of the disease.
Collapse
Affiliation(s)
- L Schöls
- Department of Neurology, St Josef Hospital, Bochum, Germany
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
22
|
Riess O, Laccone FA, Gispert S, Schöls L, Zühlke C, Vieira-Saecker AM, Herlt S, Wessel K, Epplen JT, Weber BH, Kreuz F, Chahrokh-Zadeh S, Meindl A, Lunkes A, Aguiar J, Macek M, Krebsová A, Macek M, Bürk K, Tinschert S, Schreyer I, Pulst SM, Auburger G. SCA2 trinucleotide expansion in German SCA patients. Neurogenetics 1997; 1:59-64. [PMID: 10735276 DOI: 10.1007/s100480050009] [Citation(s) in RCA: 66] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Autosomal dominant spinocerebellar ataxias (SCA) are a group of clinically and genetically heterogeneous neurodegenerative disorders which lead to progressive cerebellar ataxia. A gene responsible for SCA type 2 has been mapped to human chromosome 12 and the disease causing mutation has been identified as an unstable and expanded (CAG)n trinucleotide repeat. We investigated the (CAG)n repeat length of the SCA2 gene in 842 patients with sporadic ataxia and in 96 German families with dominantly inherited SCA which do not harbor the SCA1 or MJD1/SCA3 mutation, respectively. The SCA2 (CAG)n expansion was identified in 71 patients from 54 families. The (CAG)n stretch of the affected allele varied between 36 and 64 trinucleotide units. Significant repeat expansions occurred most commonly during paternal transmission. Analysis of the (CAG)n repeat lengths with the age of onset in 41 patients revealed an inverse correlation. Two hundred and forty-one apparently healthy octogenerians carried alleles between 16 and 31 repeats. One 50-year old, healthy individual had 34 repeats; she had transmitted an expanded allele to her child. The small difference between 'normal' and disease alleles makes it necessary to define the extreme values of their ranges. With one exception, the trinucleotide expansion was not observed in 842 ataxia patients without a family history of the disease. The SCA2 mutation causes the disease in nearly 14% of autosomal dominant SCA in Germany.
Collapse
Affiliation(s)
- O Riess
- Molecular Human Genetics, Ruhr-University, Bochum, Germany.
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
23
|
Pulst SM, Nechiporuk A, Nechiporuk T, Gispert S, Chen XN, Lopes-Cendes I, Pearlman S, Starkman S, Orozco-Diaz G, Lunkes A, DeJong P, Rouleau GA, Auburger G, Korenberg JR, Figueroa C, Sahba S. Moderate expansion of a normally biallelic trinucleotide repeat in spinocerebellar ataxia type 2. Nat Genet 1996; 14:269-76. [PMID: 8896555 DOI: 10.1038/ng1196-269] [Citation(s) in RCA: 742] [Impact Index Per Article: 26.5] [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: 02/02/2023]
Abstract
The gene for spinocerebellar ataxia type 2 (SCA2) has been mapped to 12q24.1. A 1.1-megabase contig in the candidate region was assembled in P1 artificial chromosome and bacterial artificial chromosome clones. Using this contig, we identified a CAG trinucleotide repeat with CAA interruptions that was expanded in patients with SCA2. In contrast to other unstable trinucleotide repeats, this CAG repeat was not highly polymorphic in normal individuals. In SCA2 patients, the repeat was perfect and expanded to 36-52 repeats. The most common disease allele contained (CAG)37, one of the shortest expansions seen in a CAG expansion syndrome. The repeat occurs in the 5'-coding region of SCA2 which is a member of a novel gene family.
Collapse
Affiliation(s)
- S M Pulst
- Rose Moss Laboratory for Parkinson's and Neurodegenerative Diseases, CSMC Burns and Allen Research Institute, Los Angeles, California, USA
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
24
|
Gispert S, Lunkes A, Santos N, Orozco G, Ha-Hao D, Ratzlaff T, Aguiar J, Torrens I, Heredero L, Brice A. Localization of the candidate gene D-amino acid oxidase outside the refined I-cM region of spinocerebellar ataxia 2. Am J Hum Genet 1995; 57:972-5. [PMID: 7573064 PMCID: PMC1801506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
|
25
|
Hernández A, Magariño C, Gispert S, Santos N, Lunkes A, Orozco G, Heredero L, Beckmann J, Auburger G. Genetic mapping of the spinocerebellar ataxia 2 (SCA2) locus on chromosome 12q23-q24.1. Genomics 1995; 25:433-5. [PMID: 7789976 DOI: 10.1016/0888-7543(95)80043-l] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
A refined genetic map of the spinocerebellar ataxia 2 locus was constructed through linkage and haplotype analysis of 11 large pedigrees from the Holguín SCA2 family collective. Three-point analysis makes a localization of the SCA2 mutation in the 6-cM interval D12S84-D12S79 likely. This is consistent with haplotype results indicating a crossover event between two branches of the SCA2 family Rs and placing the mutation on the telomeric side of D12S84. The microsatellite D12S105 within this interval shows a peak two-point lod score of Z = 16.14 at theta = 0.00 recombination and complete linkage disequilibrium among affected individuals. These data together with the observation of a common disease haplotype among all family ancestors support the notion of an SCA2 founder effect in Holguín province.
Collapse
Affiliation(s)
- A Hernández
- Department of Neurology, University Hospital, Düsseldorf, Germany
| | | | | | | | | | | | | | | | | |
Collapse
|
26
|
Gispert S, Santos N, Damen R, Voit T, Schulz J, Klockgether T, Orozco G, Kreuz F, Weissenbach J, Auburger G. Autosomal dominant familial spastic paraplegia: reduction of the FSP1 candidate region on chromosome 14q to 7 cM and locus heterogeneity. Am J Hum Genet 1995; 56:183-7. [PMID: 7825576 PMCID: PMC1801298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
Three large pedigrees of German descent with autosomal dominant "pure" familial spastic paraplegia (FSP) were characterized clinically and genetically. Haplotype and linkage analyses, with microsatellites covering the FSP region on chromosome 14q (locus FSP1), were performed. In pedigree W, we found a haplotype that cosegregates with the disease and observed three crossing-over events, reducing the FSP1 candidate region to 7 cM; in addition, the observation of apparent anticipation in this family suggests a trinucleotide repeat expansion as the mutation. In pedigrees D and S, the gene locus could be excluded from the whole FSP1 region, confirming the locus heterogeneity of autosomal dominant FSP.
Collapse
Affiliation(s)
- S Gispert
- Department of Neurology, University Hospital, Düsseldorf, Germany
| | | | | | | | | | | | | | | | | | | |
Collapse
|
27
|
Collazo T, Magarino C, Chavez R, Suardiaz B, Gispert S, Gomez M, Rojo M, Heredero L. Frequency of delta-F508 mutation and XV2C/KM19 haplotypes in Cuban cystic fibrosis families. Hum Hered 1995; 45:55-7. [PMID: 7896301 DOI: 10.1159/000154256] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
We tested the frequency of the delta F508 mutation and haplotypes linked to the cystic fibrosis (CF) gene in Cuba. The delta F508 deletion was detected in 34.0% of the CF chromosomes. There was a shortage of delta F508 heterozygotes, suggesting non-randomness in mating patterns. Haplotype B (XV2C/KM19 1/2) was found on 40.5% of the CF chromosomes (71.5% of delta F508 chromosomes, 28.3% of non-delta F508 CF chromosomes) against 13.5% of non-CF chromosomes.
Collapse
Affiliation(s)
- T Collazo
- National Center of Medical Genetics, Higher Institute of Medical Sciences of Havana, Cuba
| | | | | | | | | | | | | | | |
Collapse
|
28
|
Granda H, Gispert S, Martinez G, Gomez M, Ferreira R, Collazo T, Magariño C, Heredero L. Results from a reference laboratory for prenatal diagnosis of sickle cell disorders in Cuba. Prenat Diagn 1994; 14:659-62. [PMID: 7991507 DOI: 10.1002/pd.1970140803] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [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: 01/28/2023]
Abstract
A nationwide programme for the prevention of sickle cell (SS and SC) disorders was initiated in Cuba in 1983. Couples at risk were identified by screening pregnant women and the partners of those who carry an abnormal haemoglobin, followed by genetic counselling and the offer of prenatal diagnosis. Prenatal diagnosis was performed in one laboratory, which had carried out 1068 prenatal tests for Hb SS and SC disorders by the end of 1992. The centralization of the service has permitted rapid identification and resolution of problems.
Collapse
Affiliation(s)
- H Granda
- National Centre of Medical Genetics, Ciudad de la Habana, Cuba
| | | | | | | | | | | | | | | |
Collapse
|
29
|
Silveira I, Manaia A, Melki J, Magariño C, Lunkes A, Hernandez A, Gispert S, Burlet P, Rozet JM, Coutinho P. Machado-Joseph disease is genetically different from Holguin dominant ataxia (SCA2). Genomics 1993; 17:556-9. [PMID: 7902323 DOI: 10.1006/geno.1993.1371] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Machado-Joseph disease (MJD) and Holguin ataxia (SCA2) are autosomal dominant multisystem degenerations with spinocerebellar involvement that are predominant among people of Portuguese-Azorean and of Cuban descent, respectively. Their clinical distinction may at times be difficult to make in individual patients, due to significant phenotypic overlapping (similar overall age-of-onset and duration of cerebellar ataxia, eye movement, and, often, other common problems. The recent mapping of SCA2 to chromosome 12q provided another candidate region for linkage studies of MJD. Original data on 10 families with Holguin ataxia show that the locus for phenylalanine hydroxylase (PAH) on chromosome 12q is linked to SCA2 at 4 cM and is thus far its closest marker. The exclusion of linkage 15 cM on each side of PAH in 16 families with MJD shows that these two forms of dominant ataxia are genetically distinct and at different chromosomal locations (nonallelic).
Collapse
|
30
|
Gispert S, Twells R, Orozco G, Brice A, Weber J, Heredero L, Scheufler K, Riley B, Allotey R, Nothers C. Chromosomal assignment of the second locus for autosomal dominant cerebellar ataxia (SCA2) to chromosome 12q23-24.1. Nat Genet 1993; 4:295-9. [PMID: 8358438 DOI: 10.1038/ng0793-295] [Citation(s) in RCA: 188] [Impact Index Per Article: 6.1] [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: 01/30/2023]
Abstract
The autosomal dominant cerebellar ataxias (ADCA) are a group of neurodegenerative disorders characterized by onset with gait ataxia, dysarthria, dysmetria and dysdiadochokinesia. We have demonstrated previously genetic heterogeneity within these disorders by excluding the disease locus from the documented spinocerebellar ataxia locus (SCA1) on chromosome 6p in a large Cuban founder population. We now report the assignment of a second locus for ADCA (SCA2) to chromosome 12q23-24.1 following linkage analyses carried out for the Cuban pedigrees, with probable flanking markers D12S58 and phospholipase A2. Investigation of linkage to the interval containing SCA2 for seven French ADCA families, previously excluded from linkage to SCA1, provides preliminary data suggesting the existence of a third ADCA locus (SCA3).
Collapse
Affiliation(s)
- S Gispert
- Department of Neurology, University Hospital, Duesseldorf, Germany
| | | | | | | | | | | | | | | | | | | |
Collapse
|
31
|
Lunkes A, Gispert S, Enczmann J, Auburger G. Molecular heterogeneity of autosomal dominant cerebellar ataxia: analysis of flanking microsatellites of the spinocerebellar ataxia 1 locus in a northern European family unequivocally demonstrates non-linkage. Hum Genet 1993; 91:362-6. [PMID: 8099059 DOI: 10.1007/bf00217357] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [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: 01/28/2023]
Abstract
This study addresses the question whether the different forms of autosomal dominant cerebellar ataxia (ADCA) are related to different ethnic/geographical regions in Europe. One mutation in families originating from Holland, Prussia and Italy has previously been localized to chromosome 6p (SCA1 locus), whereas the mutation in families of Iberic origin has been excluded from chromosome 6p. In a Danish five-generation pedigree with ADCA and in which previous HLA-serotyping had shown inconclusive linkage results, the present study shows unequivocal exclusion from the SCA1 locus, firstly through the use of the new, highly informative microsatellites D6S89 and D6S109, which closely flank the SCA1 locus, and secondly through the manifestation of disease in four pedigree members previously scored as unaffected. Additional molecular genetic analysis of the HLA DRbeta and F13A polymorphisms also argue against a cluster of ADCA genes on chromosome 6p. Since this study demonstrates the existence of non-SCA1 families and therefore heterogeneity in the North-European population, molecular family counselling remains restricted to the few known SCA1 families.
Collapse
Affiliation(s)
- A Lunkes
- Department of Neurology, University Hospital, Düsseldorf, Germany
| | | | | | | |
Collapse
|
32
|
Gispert S, Nothers C, Orozco G, Auburger G. Search for the chromosomal location of autosomal dominant cerebellar ataxia from Holguin, Cuba: exclusion from candidate regions on chromosome 4 and 11q. Hum Hered 1993; 43:12-20. [PMID: 8514320 DOI: 10.1159/000154107] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [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: 01/31/2023] Open
Abstract
A gene locus for autosomal dominant cerebellar ataxia (ADCA) has been found on chromosome 6p and named spinocerebellar ataxia 1. However, linkage exclusion from chromosome 6p and thus locus heterogeneity has been proven in Cuban ADCA, the largest known collective of ADCA patients, probably due to a founder effect. Two chromosomal regions were analyzed for linkage to Cuban ADCA: chromosome 4, since a pericentromeric inversion has been reported in a member of a European ADCA family, and chromosome 11q22-23, since it is known to contain the gene locus for ataxia telangiectasia, the main autosomal recessive disorder of cerebellar degeneration. In neither region was evidence for linkage found.
Collapse
Affiliation(s)
- S Gispert
- National Center of Medical Genetics, Havanna, Cuba
| | | | | | | |
Collapse
|
33
|
Abstract
The percentage of carriers of the sickle cell gene in Cuba ranges from 3 to 7% in different regions. In 1983 the National Medical Genetics Centre initiated a programme for the control of sickle cell disease, which was started in Havana and later extended nationwide. The programme is based on mass education, screening and supportive genetic counselling, care of affected individuals, and availability of prenatal diagnosis. 806,935 pregnant women had been screened by the end of 1989: 29,913 (3.7%) were heterozygous, homozygous or doubly heterozygous for abnormal haemoglobin. 19,686 fathers (67%) were also tested: 1268 at-risk couples were detected. 531 elected to have prenatal diagnosis; 404 results were obtained and 98 affected fetuses (SS or SC) found. In 72 cases the pregnancy was terminated.
Collapse
Affiliation(s)
- H Granda
- National Centre of Medical Genetics, Higher Institute of Medical Science, Havana, Cuba
| | | | | | | | | | | | | | | | | | | |
Collapse
|