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Hilton JBW, Kysenius K, Liddell JR, Mercer SW, Paul B, Beckman JS, McLean CA, White AR, Donnelly PS, Bush AI, Hare DJ, Roberts BR, Crouch PJ. Evidence for disrupted copper availability in human spinal cord supports Cu II(atsm) as a treatment option for sporadic cases of ALS. Sci Rep 2024; 14:5929. [PMID: 38467696 PMCID: PMC10928073 DOI: 10.1038/s41598-024-55832-w] [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: 07/01/2023] [Accepted: 02/28/2024] [Indexed: 03/13/2024] Open
Abstract
The copper compound CuII(atsm) has progressed to phase 2/3 testing for treatment of the neurodegenerative disease amyotrophic lateral sclerosis (ALS). CuII(atsm) is neuroprotective in mutant SOD1 mouse models of ALS where its activity is ascribed in part to improving availability of essential copper. However, SOD1 mutations cause only ~ 2% of ALS cases and therapeutic relevance of copper availability in sporadic ALS is unresolved. Herein we assessed spinal cord tissue from human cases of sporadic ALS for copper-related changes. We found that when compared to control cases the natural distribution of spinal cord copper was disrupted in sporadic ALS. A standout feature was decreased copper levels in the ventral grey matter, the primary anatomical site of neuronal loss in ALS. Altered expression of genes involved in copper handling indicated disrupted copper availability, and this was evident in decreased copper-dependent ferroxidase activity despite increased abundance of the ferroxidases ceruloplasmin and hephaestin. Mice expressing mutant SOD1 recapitulate salient features of ALS and the unsatiated requirement for copper in these mice is a biochemical target for CuII(atsm). Our results from human spinal cord indicate a therapeutic mechanism of action for CuII(atsm) involving copper availability may also be pertinent to sporadic cases of ALS.
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Affiliation(s)
- James B W Hilton
- Department of Anatomy and Physiology, The University of Melbourne, Victoria, 3010, Australia
| | - Kai Kysenius
- Department of Anatomy and Physiology, The University of Melbourne, Victoria, 3010, Australia
| | - Jeffrey R Liddell
- Department of Anatomy and Physiology, The University of Melbourne, Victoria, 3010, Australia
| | - Stephen W Mercer
- Department of Anatomy and Physiology, The University of Melbourne, Victoria, 3010, Australia
| | - Bence Paul
- School of Geography, Earth and Atmospheric Sciences, The University of Melbourne, Victoria, 3010, Australia
- Elemental Scientific Lasers, LLC, 685 Old Buffalo Trail, Bozeman, MT, 59715, USA
| | - Joseph S Beckman
- Linus Pauling Institute and Department of Biochemistry and Biophysics, Oregon State University, Corvallis, OR, 97331, USA
| | - Catriona A McLean
- Department of Anatomical Pathology, The Alfred Hospital, Victoria, 3004, Australia
| | - Anthony R White
- Mental Health Program, Department of Cell and Molecular Biology, Queensland Institute of Biomedical Research Berghofer, Herston, QLD, 4006, Australia
| | - Paul S Donnelly
- School of Chemistry and Bio21 Molecular Science and Biotechnology Institute, The University of Melbourne, Victoria, 3010, Australia
| | - Ashley I Bush
- Melbourne Dementia Research Centre, The University of Melbourne and Florey Institute of Neuroscience and Mental Health, Victoria, 3010, Australia
| | - Dominic J Hare
- Atomic Medicine Initiative, University of Technology Sydney, Ultimo, NSW, 2007, Australia
| | - Blaine R Roberts
- Department of Biochemistry, Emory University School of Medicine, Atlanta, GA, 30322, USA
| | - Peter J Crouch
- Department of Anatomy and Physiology, The University of Melbourne, Victoria, 3010, Australia.
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Barker MS, Ceslis A, Argall R, McCombe P, Henderson RD, Robinson GA. Verbal and nonverbal fluency in amyotrophic lateral sclerosis. J Neuropsychol 2023. [PMID: 37997256 DOI: 10.1111/jnp.12354] [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: 05/01/2023] [Revised: 10/29/2023] [Accepted: 10/30/2023] [Indexed: 11/25/2023]
Abstract
Amyotrophic lateral sclerosis (ALS) is a multi-system disorder that commonly affects cognition and behaviour. Verbal fluency impairments are consistently reported in ALS patients, and we aimed to investigate whether this deficit extends beyond the verbal domain. We further aimed to determine whether deficits are underpinned by a primary intrinsic response generation impairment (i.e., a global reduction across tasks), potentially related to apathy, or an inability to maintain responding over time (i.e., a 'drop off' pattern). Twenty-two ALS patients and 21 demographically-matched controls completed verbal and nonverbal fluency tasks (phonemic/semantic word fluency, design fluency, gesture fluency and ideational fluency), requiring the generation of responses over a specified time period. Fluency performance was analysed in terms of the overall number of novel items produced, as well as the number of items produced in the first 'initiation' and the remaining 'maintenance' time periods. ALS patients' overall performance was not globally reduced across tasks. Patients were impaired only on meaningful gesture fluency, which requires the generation of gestures that communicate meaning (e.g., waving). On phonemic fluency, ALS patients showed a 'drop off' pattern of performance, where they had difficulty maintaining responding over time, but this pattern was not evident on the other fluency tasks. Apathy did not appear to be related to fluency performance. The selective meaningful gesture fluency deficit, in the context of preserved meaningless gesture fluency, highlights that the retrieval of action knowledge may be weakened in early ALS.
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Affiliation(s)
- Megan S Barker
- School of Psychology, The University of Queensland, Brisbane, Queensland, Australia
- Queensland Brain Institute, The University of Queensland, Brisbane, Queensland, Australia
| | - Amelia Ceslis
- School of Psychology, The University of Queensland, Brisbane, Queensland, Australia
- Neuropsychology and Neurology, Royal Brisbane and Women's Hospital, Herston, Queensland, Australia
| | - Rosemary Argall
- School of Psychology, The University of Queensland, Brisbane, Queensland, Australia
- Neuropsychology and Neurology, Royal Brisbane and Women's Hospital, Herston, Queensland, Australia
| | - Pamela McCombe
- Neuropsychology and Neurology, Royal Brisbane and Women's Hospital, Herston, Queensland, Australia
- Centre for Clinical Research, The University of Queensland, Brisbane, Queensland, Australia
| | - Robert D Henderson
- Neuropsychology and Neurology, Royal Brisbane and Women's Hospital, Herston, Queensland, Australia
- Centre for Clinical Research, The University of Queensland, Brisbane, Queensland, Australia
- Wesley Medical Research, The Wesley Hospital, Brisbane, Queensland, Australia
| | - Gail A Robinson
- School of Psychology, The University of Queensland, Brisbane, Queensland, Australia
- Queensland Brain Institute, The University of Queensland, Brisbane, Queensland, Australia
- Neuropsychology and Neurology, Royal Brisbane and Women's Hospital, Herston, Queensland, Australia
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Sheers NL, Howard ME, Rochford PD, Rautela L, Chao C, McKim DA, Berlowitz DJ. A Randomized Controlled Clinical Trial of Lung Volume Recruitment in Adults with Neuromuscular Disease. Ann Am Thorac Soc 2023; 20:1445-1455. [PMID: 37390359 PMCID: PMC10559144 DOI: 10.1513/annalsats.202212-1062oc] [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: 12/30/2022] [Accepted: 06/30/2023] [Indexed: 07/02/2023] Open
Abstract
Rationale: Clinical care guidelines advise that lung volume recruitment (LVR) be performed routinely by people with neuromuscular disease (NMD) to maintain lung and chest wall flexibility and slow lung function decline. However, the evidence base is limited, and no randomized controlled trials of regular LVR in adults have been published. Objectives: To evaluate the effect of regular LVR on respiratory function and quality of life in adults with NMD. Methods: A randomized controlled trial with assessor blinding was conducted between September 2015 and May 2019. People (>14 years old) with NMD and vital capacity <80% predicted were eligible, stratified by disease subgroup (amyotrophic lateral sclerosis/motor neuron disease or other NMDs), and randomized to 3 months of twice-daily LVR or breathing exercises. The primary outcome was change in maximum insufflation capacity (MIC) from baseline to 3 months, analyzed using a linear mixed model approach. Results: Seventy-six participants (47% woman; median age, 57 [31-68] years; mean baseline vital capacity, 40 ± 18% predicted) were randomized (LVR, n = 37). Seventy-three participants completed the study. There was a statistically significant difference in MIC between groups (linear model interaction effect P = 0.002, observed mean difference, 0.19 [0.00-0.39] L). MIC increased by 0.13 (0.01-0.25) L in the LVR group, predominantly within the first month. No interaction or treatment effects were observed in secondary outcomes of lung volumes, respiratory system compliance, and quality of life. No adverse events were reported. Conclusions: Regular LVR increased MIC in a sample of LVR-naive participants with NMD. We found no direct evidence that regular LVR modifies respiratory mechanics or slows the rate of lung volume decline. The implications of increasing MIC are unclear, and the change in MIC may represent practice. Prospective long-term clinical cohorts with comprehensive follow-up, objective LVR use, and clinically meaningful outcome data are needed. Clinical trial registered with anzctr.org.au (ACTRN12615000565549).
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Affiliation(s)
- Nicole L. Sheers
- Department of Respiratory and Sleep Medicine and
- Institute for Breathing and Sleep, Heidelberg, Victoria, Australia
- The University of Melbourne, Parkville, Victoria, Australia
| | - Mark E. Howard
- Department of Respiratory and Sleep Medicine and
- Institute for Breathing and Sleep, Heidelberg, Victoria, Australia
- The University of Melbourne, Parkville, Victoria, Australia
- Turner Institute of Brain and Mental Health, Monash University, Clayton, Victoria, Australia
| | | | - Linda Rautela
- Department of Physiotherapy, Austin Health, Heidelberg, Victoria, Australia
- Institute for Breathing and Sleep, Heidelberg, Victoria, Australia
| | - Caroline Chao
- Department of Physiotherapy, Austin Health, Heidelberg, Victoria, Australia
- Institute for Breathing and Sleep, Heidelberg, Victoria, Australia
| | - Douglas A. McKim
- Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada
- Ottawa Hospital Research Institute, Ottawa, Ontario, Canada; and
- CANVent Respiratory Rehabilitation Services, Ottawa Hospital Rehabilitation Centre, Ottawa, Ontario, Canada
| | - David J. Berlowitz
- Department of Respiratory and Sleep Medicine and
- Department of Physiotherapy, Austin Health, Heidelberg, Victoria, Australia
- Institute for Breathing and Sleep, Heidelberg, Victoria, Australia
- The University of Melbourne, Parkville, Victoria, Australia
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4
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Stevenson R, Samokhina E, Mangat A, Rossetti I, Purushotham SS, Malladi CS, Morley JW, Buskila Y. Astrocytic K + clearance during disease progression in amyotrophic lateral sclerosis. Glia 2023. [PMID: 37395323 DOI: 10.1002/glia.24435] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Revised: 06/12/2023] [Accepted: 06/16/2023] [Indexed: 07/04/2023]
Abstract
Amyotrophic lateral sclerosis (ALS) is a neurodegenerative disorder in which patients lose motor functions due to progressive loss of motor neurons in the cortex, brainstem, and spinal cord. Whilst the loss of neurons is central to the disease, it is becoming clear that glia, specifically astrocytes, contribute to the onset and progression of neurodegeneration. Astrocytes play an important role in maintaining ion homeostasis in the extracellular milieu and regulate multiple brain functions by altering their extracellular concentrations. In this study, we have investigated the ability of astrocytes to maintain K+ homeostasis in the brain via direct measurement of the astrocytic K+ clearance rate in the motor and somatosensory cortices of an ALS mouse model (SOD1G93A ). Using electrophysiological recordings from acute brain slices, we show region-specific alterations in the K+ clearance rate, which was significantly reduced in the primary motor cortex but not the somatosensory cortex. This decrease was accompanied by significant changes in astrocytic morphology, impaired conductivity via Kir4.1 channels and low coupling ratio in astrocytic networks in the motor cortex, which affected their ability to form the K+ gradient needed to disperse K+ through the astrocytic syncytium. These findings indicate that the supportive function astrocytes typically provide to motoneurons is diminished during disease progression and provides a potential explanation for the increased vulnerability of motoneurons in ALS.
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Affiliation(s)
- Rebecca Stevenson
- School of Medicine, Western Sydney University, Campbelltown, New South Wales, Australia
| | - Evgeniia Samokhina
- School of Medicine, Western Sydney University, Campbelltown, New South Wales, Australia
| | - Armaan Mangat
- School of Medicine, Western Sydney University, Campbelltown, New South Wales, Australia
| | - Ilaria Rossetti
- School of Medicine, Western Sydney University, Campbelltown, New South Wales, Australia
| | | | - Chandra S Malladi
- School of Medicine, Western Sydney University, Campbelltown, New South Wales, Australia
| | - John W Morley
- School of Medicine, Western Sydney University, Campbelltown, New South Wales, Australia
| | - Yossi Buskila
- School of Medicine, Western Sydney University, Campbelltown, New South Wales, Australia
- The MARCS Institute, Western Sydney University, Penrith, New South Wales, Australia
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5
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Tse NY, Tu S, Chen Y, Caga J, Dobson-Stone C, Kwok JB, Halliday GM, Ahmed RM, Hodges JR, Piguet O, Kiernan MC, Devenney EM. Schizotypal traits across the amyotrophic lateral sclerosis-frontotemporal dementia spectrum: pathomechanistic insights. J Neurol 2022; 269:4241-4252. [PMID: 35279757 PMCID: PMC9294025 DOI: 10.1007/s00415-022-11049-3] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Revised: 02/22/2022] [Accepted: 02/23/2022] [Indexed: 11/27/2022]
Abstract
BACKGROUND Psychiatric presentations similar to that observed in primary psychiatric disorders are well described across the amyotrophic lateral sclerosis-frontotemporal dementia (ALS-FTD) spectrum. Despite this, schizotypal personality traits associated with increased risks of clinical psychosis development and poor psychosocial outcomes have never been examined. The current study aimed to provide the first exploration of schizotypal traits and its neural underpinnings in the ALS-FTD spectrum to gain insights into a broader spectrum of psychiatric overlap with psychiatric disorders. METHODS Schizotypal traits were assessed using the targeted Schizotypal Personality Questionnaire in 99 participants (35 behavioural variant FTD, 10 ALS-FTD and 37 ALS patients, and 17 age-, sex- and education-matched healthy controls). Voxel-based morphometry analysis of whole-brain grey matter volume was conducted. RESULTS Relative to controls, pervasive schizotypal personality traits across positive and negative schizotypy and disorganised thought disorders were identified in behavioural variant FTD, ALS (with the exception of negative schizotypy) and ALS-FTDALS-FTD patients (all p < .013), suggesting the presence of a wide spectrum of subclinical schizotypal symptoms beyond classic psychotic symptoms. Atrophy in frontal, anterior cingulate and insular cortices, and caudate and thalamus was involved in positive schizotypy, while integrity of the cerebellum was associated with disorganised thought disorder traits. CONCLUSIONS The frontal-striatal-limbic regions underpinning manifestation of schizotypy in the ALS-FTDALS-FTD spectrum are similar to that established in previous schizophrenia research. This finding expands the concept of a psychiatric overlap in ALS-FTD and schizophrenia, and suggests potentially common underlying mechanisms involving disruptions to frontal-striatal-limbic networks, warranting a transdiagnostic approach for future investigations.
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Affiliation(s)
- Nga Yan Tse
- The Brain and Mind Centre, University of Sydney; and Royal Prince Alfred Hospital, 94 Mallet Street, Camperdown, Sydney, NSW, 2050, Australia
| | - Sicong Tu
- The Brain and Mind Centre, University of Sydney; and Royal Prince Alfred Hospital, 94 Mallet Street, Camperdown, Sydney, NSW, 2050, Australia
| | - Yu Chen
- School of Psychology and Brain and Mind Centre, The University of Sydney, Sydney, Australia
| | - Jashelle Caga
- The Brain and Mind Centre, University of Sydney; and Royal Prince Alfred Hospital, 94 Mallet Street, Camperdown, Sydney, NSW, 2050, Australia
| | - Carol Dobson-Stone
- The Brain and Mind Centre, University of Sydney; and Royal Prince Alfred Hospital, 94 Mallet Street, Camperdown, Sydney, NSW, 2050, Australia
| | - John B Kwok
- The Brain and Mind Centre, University of Sydney; and Royal Prince Alfred Hospital, 94 Mallet Street, Camperdown, Sydney, NSW, 2050, Australia
| | - Glenda M Halliday
- The Brain and Mind Centre, University of Sydney; and Royal Prince Alfred Hospital, 94 Mallet Street, Camperdown, Sydney, NSW, 2050, Australia
- Neuroscience Research Australia, Randwick, Australia
| | - Rebekah M Ahmed
- The Brain and Mind Centre, University of Sydney; and Royal Prince Alfred Hospital, 94 Mallet Street, Camperdown, Sydney, NSW, 2050, Australia
- Memory and Cognition Clinic, Department of Clinical Neurosciences, Royal Prince Alfred Hospital, Sydney, Australia
| | - John R Hodges
- The Brain and Mind Centre, University of Sydney; and Royal Prince Alfred Hospital, 94 Mallet Street, Camperdown, Sydney, NSW, 2050, Australia
| | - Olivier Piguet
- School of Psychology and Brain and Mind Centre, The University of Sydney, Sydney, Australia
| | - Matthew C Kiernan
- The Brain and Mind Centre, University of Sydney; and Royal Prince Alfred Hospital, 94 Mallet Street, Camperdown, Sydney, NSW, 2050, Australia
| | - Emma M Devenney
- The Brain and Mind Centre, University of Sydney; and Royal Prince Alfred Hospital, 94 Mallet Street, Camperdown, Sydney, NSW, 2050, Australia.
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6
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Lum JS, Brown ML, Farrawell NE, McAlary L, Ly D, Chisholm CG, Snow J, Vine KL, Karl T, Kreilaus F, McInnes LE, Nikseresht S, Donnelly PS, Crouch PJ, Yerbury JJ. CuATSM improves motor function and extends survival but is not tolerated at a high dose in SOD1 G93A mice with a C57BL/6 background. Sci Rep 2021; 11:19392. [PMID: 34588483 PMCID: PMC8481268 DOI: 10.1038/s41598-021-98317-w] [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] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Accepted: 09/07/2021] [Indexed: 02/08/2023] Open
Abstract
The synthetic copper-containing compound, CuATSM, has emerged as one of the most promising drug candidates developed for the treatment of amyotrophic lateral sclerosis (ALS). Multiple studies have reported CuATSM treatment provides therapeutic efficacy in various mouse models of ALS without any observable adverse effects. Moreover, recent results from an open label clinical study suggested that daily oral dosing with CuATSM slows disease progression in patients with both sporadic and familial ALS, providing encouraging support for CuATSM in the treatment of ALS. Here, we assessed CuATSM in high copy SOD1G93A mice on the congenic C57BL/6 background, treating at 100 mg/kg/day by gavage, starting at 70 days of age. This dose in this specific model has not been assessed previously. Unexpectedly, we report a subset of mice initially administered CuATSM exhibited signs of clinical toxicity, that necessitated euthanasia in extremis after 3-51 days of treatment. Following a 1-week washout period, the remaining mice resumed treatment at the reduced dose of 60 mg/kg/day. At this revised dose, treatment with CuATSM slowed disease progression and increased survival relative to vehicle-treated littermates. This work provides the first evidence that CuATSM produces positive disease-modifying outcomes in high copy SOD1G93A mice on a congenic C57BL/6 background. Furthermore, results from the 100 mg/kg/day phase of the study support dose escalation determination of tolerability as a prudent step when assessing treatments in previously unassessed models or genetic backgrounds.
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Affiliation(s)
- Jeremy S Lum
- Illawarra Health and Medical Research Institute, Wollongong, NSW, Australia
- School of Chemistry and Molecular Bioscience, Molecular Horizons, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, NSW, 2522, Australia
| | - Mikayla L Brown
- Illawarra Health and Medical Research Institute, Wollongong, NSW, Australia
- School of Chemistry and Molecular Bioscience, Molecular Horizons, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, NSW, 2522, Australia
| | - Natalie E Farrawell
- Illawarra Health and Medical Research Institute, Wollongong, NSW, Australia
- School of Chemistry and Molecular Bioscience, Molecular Horizons, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, NSW, 2522, Australia
| | - Luke McAlary
- Illawarra Health and Medical Research Institute, Wollongong, NSW, Australia
- School of Chemistry and Molecular Bioscience, Molecular Horizons, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, NSW, 2522, Australia
| | - Diane Ly
- Illawarra Health and Medical Research Institute, Wollongong, NSW, Australia
- School of Chemistry and Molecular Bioscience, Molecular Horizons, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, NSW, 2522, Australia
| | - Christen G Chisholm
- Illawarra Health and Medical Research Institute, Wollongong, NSW, Australia
- School of Chemistry and Molecular Bioscience, Molecular Horizons, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, NSW, 2522, Australia
| | - Josh Snow
- School of Chemistry and Molecular Bioscience, Molecular Horizons, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, NSW, 2522, Australia
| | - Kara L Vine
- Illawarra Health and Medical Research Institute, Wollongong, NSW, Australia
- School of Chemistry and Molecular Bioscience, Molecular Horizons, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, NSW, 2522, Australia
| | - Tim Karl
- School of Medicine, Western Sydney University, Campbelltown, NSW, 2560, Australia
| | - Fabian Kreilaus
- School of Medicine, Western Sydney University, Campbelltown, NSW, 2560, Australia
| | - Lachlan E McInnes
- School of Chemistry and Bio21 Molecular Science and Biotechnology Institute, University of Melbourne, Parkville, VIC, Australia
| | - Sara Nikseresht
- Department of Biochemistry and Pharmacology, University of Melbourne, Parkville, VIC, 3010, Australia
| | - Paul S Donnelly
- School of Chemistry and Bio21 Molecular Science and Biotechnology Institute, University of Melbourne, Parkville, VIC, Australia
| | - Peter J Crouch
- Department of Biochemistry and Pharmacology, University of Melbourne, Parkville, VIC, 3010, Australia
| | - Justin J Yerbury
- Illawarra Health and Medical Research Institute, Wollongong, NSW, Australia.
- School of Chemistry and Molecular Bioscience, Molecular Horizons, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, NSW, 2522, Australia.
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7
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Foster AD, Flynn LL, Cluning C, Cheng F, Davidson JM, Lee A, Polain N, Mejzini R, Farrawell N, Yerbury JJ, Layfield R, Akkari PA, Rea SL. p62 overexpression induces TDP-43 cytoplasmic mislocalisation, aggregation and cleavage and neuronal death. Sci Rep 2021; 11:11474. [PMID: 34075102 PMCID: PMC8169680 DOI: 10.1038/s41598-021-90822-2] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [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: 08/08/2020] [Accepted: 05/11/2021] [Indexed: 11/21/2022] Open
Abstract
Amyotrophic lateral sclerosis (ALS) and frontotemporal lobar degeneration (FTLD) that exist on a spectrum of neurodegenerative disease. A hallmark of pathology is cytoplasmic TDP-43 aggregates within neurons, observed in 97% of ALS cases and ~ 50% of FTLD cases. This mislocalisation from the nucleus into the cytoplasm and TDP-43 cleavage are associated with pathology, however, the drivers of these changes are unknown. p62 is invariably also present within these aggregates. We show that p62 overexpression causes TDP-43 mislocalisation into cytoplasmic aggregates, and aberrant TDP-43 cleavage that was dependent on both the PB1 and ubiquitin-associated (UBA) domains of p62. We further show that p62 overexpression induces neuron death. We found that stressors (proteasome inhibition and arsenic) increased p62 expression and that this shifted the nuclear:cytoplasmic TDP-43 ratio. Overall, our study suggests that environmental factors that increase p62 may thereby contribute to TDP-43 pathology in ALS and FTLD.
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Affiliation(s)
- A D Foster
- Department of Endocrinology and Diabetes, Sir Charles Gairdner Hospital, Nedlands, WA, Australia
- Harry Perkins Institute of Medical Research, University of Western Australia, Crawley, WA, Australia
| | - L L Flynn
- Perron Institute for Neurological and Translational Science, Centre for Neuromuscular and Neurological Disorders, The University of Western Australia, Nedlands, WA, 6009, Australia
- Centre for Molecular Medicine and Innovative Therapeutics, Murdoch University, Health Research Building, Discovery Way, Murdoch, WA, 6150, Australia
| | - C Cluning
- Department of Endocrinology and Diabetes, Sir Charles Gairdner Hospital, Nedlands, WA, Australia
| | - F Cheng
- Department of Biomedical Sciences, Macquarie University, Sydney, Australia
| | - J M Davidson
- Department of Biomedical Sciences, Macquarie University, Sydney, Australia
| | - A Lee
- Department of Biomedical Sciences, Macquarie University, Sydney, Australia
| | - N Polain
- Perron Institute for Neurological and Translational Science, Centre for Neuromuscular and Neurological Disorders, The University of Western Australia, Nedlands, WA, 6009, Australia
- Centre for Molecular Medicine and Innovative Therapeutics, Murdoch University, Health Research Building, Discovery Way, Murdoch, WA, 6150, Australia
| | - R Mejzini
- Perron Institute for Neurological and Translational Science, Centre for Neuromuscular and Neurological Disorders, The University of Western Australia, Nedlands, WA, 6009, Australia
- Centre for Molecular Medicine and Innovative Therapeutics, Murdoch University, Health Research Building, Discovery Way, Murdoch, WA, 6150, Australia
| | - N Farrawell
- School of Biological Sciences, University of Wollongong, Wollongong, 2522, Australia
| | - J J Yerbury
- School of Biological Sciences, University of Wollongong, Wollongong, 2522, Australia
| | - R Layfield
- School of Life Sciences, University of Nottingham, Nottingham, UK
| | - P A Akkari
- Perron Institute for Neurological and Translational Science, Centre for Neuromuscular and Neurological Disorders, The University of Western Australia, Nedlands, WA, 6009, Australia
- Centre for Molecular Medicine and Innovative Therapeutics, Murdoch University, Health Research Building, Discovery Way, Murdoch, WA, 6150, Australia
| | - S L Rea
- Harry Perkins Institute of Medical Research, University of Western Australia, Crawley, WA, Australia.
- Perron Institute for Neurological and Translational Science, Centre for Neuromuscular and Neurological Disorders, The University of Western Australia, Nedlands, WA, 6009, Australia.
- Centre for Molecular Medicine and Innovative Therapeutics, Murdoch University, Health Research Building, Discovery Way, Murdoch, WA, 6150, Australia.
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8
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Don EK, Maschirow A, Radford RAW, Scherer NM, Vidal-Itriago A, Hogan A, Maurel C, Formella I, Stoddart JJ, Hall TE, Lee A, Shi B, Cole NJ, Laird AS, Badrock AP, Chung RS, Morsch M. In vivo Validation of Bimolecular Fluorescence Complementation (BiFC) to Investigate Aggregate Formation in Amyotrophic Lateral Sclerosis (ALS). Mol Neurobiol 2021; 58:2061-2074. [PMID: 33415684 PMCID: PMC8018926 DOI: 10.1007/s12035-020-02238-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 07/28/2020] [Accepted: 11/25/2020] [Indexed: 10/28/2022]
Abstract
Amyotrophic lateral sclerosis (ALS) is a form of motor neuron disease (MND) that is characterized by the progressive loss of motor neurons within the spinal cord, brainstem, and motor cortex. Although ALS clinically manifests as a heterogeneous disease, with varying disease onset and survival, a unifying feature is the presence of ubiquitinated cytoplasmic protein inclusion aggregates containing TDP-43. However, the precise mechanisms linking protein inclusions and aggregation to neuronal loss are currently poorly understood. Bimolecular fluorescence complementation (BiFC) takes advantage of the association of fluorophore fragments (non-fluorescent on their own) that are attached to an aggregation-prone protein of interest. Interaction of the proteins of interest allows for the fluorescent reporter protein to fold into its native state and emit a fluorescent signal. Here, we combined the power of BiFC with the advantages of the zebrafish system to validate, optimize, and visualize the formation of ALS-linked aggregates in real time in a vertebrate model. We further provide in vivo validation of the selectivity of this technique and demonstrate reduced spontaneous self-assembly of the non-fluorescent fragments in vivo by introducing a fluorophore mutation. Additionally, we report preliminary findings on the dynamic aggregation of the ALS-linked hallmark proteins Fus and TDP-43 in their corresponding nuclear and cytoplasmic compartments using BiFC. Overall, our data demonstrates the suitability of this BiFC approach to study and characterize ALS-linked aggregate formation in vivo. Importantly, the same principle can be applied in the context of other neurodegenerative diseases and has therefore critical implications to advance our understanding of pathologies that underlie aberrant protein aggregation.
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Affiliation(s)
- Emily K Don
- Centre for Motor Neuron Disease Research, Faculty of Medicine, Health and Human Sciences, Department of Biomedical Sciences, Macquarie University, Sydney, NSW, 2109, Australia
| | - Alina Maschirow
- Centre for Motor Neuron Disease Research, Faculty of Medicine, Health and Human Sciences, Department of Biomedical Sciences, Macquarie University, Sydney, NSW, 2109, Australia
| | - Rowan A W Radford
- Centre for Motor Neuron Disease Research, Faculty of Medicine, Health and Human Sciences, Department of Biomedical Sciences, Macquarie University, Sydney, NSW, 2109, Australia
| | - Natalie M Scherer
- Centre for Motor Neuron Disease Research, Faculty of Medicine, Health and Human Sciences, Department of Biomedical Sciences, Macquarie University, Sydney, NSW, 2109, Australia
| | - Andrés Vidal-Itriago
- Centre for Motor Neuron Disease Research, Faculty of Medicine, Health and Human Sciences, Department of Biomedical Sciences, Macquarie University, Sydney, NSW, 2109, Australia
| | - Alison Hogan
- Centre for Motor Neuron Disease Research, Faculty of Medicine, Health and Human Sciences, Department of Biomedical Sciences, Macquarie University, Sydney, NSW, 2109, Australia
| | - Cindy Maurel
- Centre for Motor Neuron Disease Research, Faculty of Medicine, Health and Human Sciences, Department of Biomedical Sciences, Macquarie University, Sydney, NSW, 2109, Australia
| | - Isabel Formella
- Centre for Motor Neuron Disease Research, Faculty of Medicine, Health and Human Sciences, Department of Biomedical Sciences, Macquarie University, Sydney, NSW, 2109, Australia
| | - Jack J Stoddart
- Centre for Motor Neuron Disease Research, Faculty of Medicine, Health and Human Sciences, Department of Biomedical Sciences, Macquarie University, Sydney, NSW, 2109, Australia
| | - Thomas E Hall
- Institute for Molecular Bioscience, The University of Queensland, QLD, St Lucia, 4072, Australia
| | - Albert Lee
- Centre for Motor Neuron Disease Research, Faculty of Medicine, Health and Human Sciences, Department of Biomedical Sciences, Macquarie University, Sydney, NSW, 2109, Australia
| | - Bingyang Shi
- Centre for Motor Neuron Disease Research, Faculty of Medicine, Health and Human Sciences, Department of Biomedical Sciences, Macquarie University, Sydney, NSW, 2109, Australia
| | - Nicholas J Cole
- Centre for Motor Neuron Disease Research, Faculty of Medicine, Health and Human Sciences, Department of Biomedical Sciences, Macquarie University, Sydney, NSW, 2109, Australia
| | - Angela S Laird
- Centre for Motor Neuron Disease Research, Faculty of Medicine, Health and Human Sciences, Department of Biomedical Sciences, Macquarie University, Sydney, NSW, 2109, Australia
| | - Andrew P Badrock
- Centre for Motor Neuron Disease Research, Faculty of Medicine, Health and Human Sciences, Department of Biomedical Sciences, Macquarie University, Sydney, NSW, 2109, Australia.
| | - Roger S Chung
- Centre for Motor Neuron Disease Research, Faculty of Medicine, Health and Human Sciences, Department of Biomedical Sciences, Macquarie University, Sydney, NSW, 2109, Australia
| | - Marco Morsch
- Centre for Motor Neuron Disease Research, Faculty of Medicine, Health and Human Sciences, Department of Biomedical Sciences, Macquarie University, Sydney, NSW, 2109, Australia.
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9
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Oxley TJ, Yoo PE, Rind GS, Ronayne SM, Lee CMS, Bird C, Hampshire V, Sharma RP, Morokoff A, Williams DL, MacIsaac C, Howard ME, Irving L, Vrljic I, Williams C, John SE, Weissenborn F, Dazenko M, Balabanski AH, Friedenberg D, Burkitt AN, Wong YT, Drummond KJ, Desmond P, Weber D, Denison T, Hochberg LR, Mathers S, O'Brien TJ, May CN, Mocco J, Grayden DB, Campbell BCV, Mitchell P, Opie NL. Motor neuroprosthesis implanted with neurointerventional surgery improves capacity for activities of daily living tasks in severe paralysis: first in-human experience. J Neurointerv Surg 2021; 13:102-108. [PMID: 33115813 PMCID: PMC7848062 DOI: 10.1136/neurintsurg-2020-016862] [Citation(s) in RCA: 75] [Impact Index Per Article: 25.0] [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: 09/11/2020] [Revised: 10/07/2020] [Accepted: 10/09/2020] [Indexed: 12/20/2022]
Abstract
BACKGROUND Implantable brain-computer interfaces (BCIs), functioning as motor neuroprostheses, have the potential to restore voluntary motor impulses to control digital devices and improve functional independence in patients with severe paralysis due to brain, spinal cord, peripheral nerve or muscle dysfunction. However, reports to date have had limited clinical translation. METHODS Two participants with amyotrophic lateral sclerosis (ALS) underwent implant in a single-arm, open-label, prospective, early feasibility study. Using a minimally invasive neurointervention procedure, a novel endovascular Stentrode BCI was implanted in the superior sagittal sinus adjacent to primary motor cortex. The participants undertook machine-learning-assisted training to use wirelessly transmitted electrocorticography signal associated with attempted movements to control multiple mouse-click actions, including zoom and left-click. Used in combination with an eye-tracker for cursor navigation, participants achieved Windows 10 operating system control to conduct instrumental activities of daily living (IADL) tasks. RESULTS Unsupervised home use commenced from day 86 onwards for participant 1, and day 71 for participant 2. Participant 1 achieved a typing task average click selection accuracy of 92.63% (100.00%, 87.50%-100.00%) (trial mean (median, Q1-Q3)) at a rate of 13.81 (13.44, 10.96-16.09) correct characters per minute (CCPM) with predictive text disabled. Participant 2 achieved an average click selection accuracy of 93.18% (100.00%, 88.19%-100.00%) at 20.10 (17.73, 12.27-26.50) CCPM. Completion of IADL tasks including text messaging, online shopping and managing finances independently was demonstrated in both participants. CONCLUSION We describe the first-in-human experience of a minimally invasive, fully implanted, wireless, ambulatory motor neuroprosthesis using an endovascular stent-electrode array to transmit electrocorticography signals from the motor cortex for multiple command control of digital devices in two participants with flaccid upper limb paralysis.
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Affiliation(s)
- Thomas J Oxley
- Vascular Bionics Laboratory, Departments of Medicine, Neurology and Surgery, Melbourne Brain Centre at the Royal Melbourne Hospital, The University of Melbourne, Melbourne, Victoria, Australia
- Synchron, Inc, Campbell, California, USA
| | - Peter E Yoo
- Vascular Bionics Laboratory, Departments of Medicine, Neurology and Surgery, Melbourne Brain Centre at the Royal Melbourne Hospital, The University of Melbourne, Melbourne, Victoria, Australia
- Synchron, Inc, Campbell, California, USA
| | - Gil S Rind
- Vascular Bionics Laboratory, Departments of Medicine, Neurology and Surgery, Melbourne Brain Centre at the Royal Melbourne Hospital, The University of Melbourne, Melbourne, Victoria, Australia
- Synchron, Inc, Campbell, California, USA
| | - Stephen M Ronayne
- Vascular Bionics Laboratory, Departments of Medicine, Neurology and Surgery, Melbourne Brain Centre at the Royal Melbourne Hospital, The University of Melbourne, Melbourne, Victoria, Australia
- Synchron, Inc, Campbell, California, USA
| | - C M Sarah Lee
- Neurology, Calvary Health Care Bethlehem, South Caulfield, Victoria, Australia
| | - Christin Bird
- Vascular Bionics Laboratory, Departments of Medicine, Neurology and Surgery, Melbourne Brain Centre at the Royal Melbourne Hospital, The University of Melbourne, Melbourne, Victoria, Australia
| | | | - Rahul P Sharma
- Interventional Cardiology, Cardiovascular Medicine Faculty, Stanford University, Stanford, California, USA
| | - Andrew Morokoff
- Vascular Bionics Laboratory, Departments of Medicine, Neurology and Surgery, Melbourne Brain Centre at the Royal Melbourne Hospital, The University of Melbourne, Melbourne, Victoria, Australia
- Neurosurgery, Melbourne Health, Parkville, Victoria, Australia
| | | | | | - Mark E Howard
- Institute for Breathing and Sleep, Austin Health, Heidelberg, Victoria, Australia
| | - Lou Irving
- Respiratory Medicine, Melbourne Health, Parkville, Victoria, Australia
| | - Ivan Vrljic
- Radiology, Melbourne Health, Parkville, Victoria, Australia
| | | | - Sam E John
- Vascular Bionics Laboratory, Departments of Medicine, Neurology and Surgery, Melbourne Brain Centre at the Royal Melbourne Hospital, The University of Melbourne, Melbourne, Victoria, Australia
- Department of Biomedical Engineering, University of Melbourne, Melbourne, Victoria, Australia
| | - Frank Weissenborn
- Vascular Bionics Laboratory, Departments of Medicine, Neurology and Surgery, Melbourne Brain Centre at the Royal Melbourne Hospital, The University of Melbourne, Melbourne, Victoria, Australia
- Florey Institute of Neuroscience and Mental Health, University of Melbourne, Parkville, Victoria, Australia
| | - Madeleine Dazenko
- Neurology, Calvary Health Care Bethlehem, South Caulfield, Victoria, Australia
| | | | | | - Anthony N Burkitt
- Department of Biomedical Engineering, University of Melbourne, Melbourne, Victoria, Australia
| | - Yan T Wong
- Department of Electrical and Computer Systems Engineering, Monash University, Clayton, Victoria, Australia
| | - Katharine J Drummond
- Vascular Bionics Laboratory, Departments of Medicine, Neurology and Surgery, Melbourne Brain Centre at the Royal Melbourne Hospital, The University of Melbourne, Melbourne, Victoria, Australia
- Neurosurgery, Melbourne Health, Parkville, Victoria, Australia
| | - Patricia Desmond
- Vascular Bionics Laboratory, Departments of Medicine, Neurology and Surgery, Melbourne Brain Centre at the Royal Melbourne Hospital, The University of Melbourne, Melbourne, Victoria, Australia
- Radiology, Melbourne Health, Parkville, Victoria, Australia
| | - Douglas Weber
- Department of Mechanical Engineering and Neuroscience Institute, Carnegie Mellon University, Pittsburgh, Pennsylvania, USA
| | - Timothy Denison
- Synchron, Inc, Campbell, California, USA
- Institute of Biomedical Engineering, Oxford University, Oxford, Oxfordshire, UK
| | - Leigh R Hochberg
- Center for Neurotechnology and Neurorecovery, Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Harvard University, Cambridge, Massachusetts, USA
| | - Susan Mathers
- Neurology, Calvary Health Care Bethlehem, South Caulfield, Victoria, Australia
| | - Terence J O'Brien
- Vascular Bionics Laboratory, Departments of Medicine, Neurology and Surgery, Melbourne Brain Centre at the Royal Melbourne Hospital, The University of Melbourne, Melbourne, Victoria, Australia
- Neurology, Melbourne Health, Parkville, Victoria, Australia
| | - Clive N May
- Florey Institute of Neuroscience and Mental Health, University of Melbourne, Parkville, Victoria, Australia
| | - J Mocco
- Neurosurgery, The Mount Sinai Health System, New York, New York, USA
| | - David B Grayden
- Department of Biomedical Engineering, University of Melbourne, Melbourne, Victoria, Australia
| | - Bruce C V Campbell
- Medicine, University of Melbourne, Parkville, Victoria, Australia
- Neurology, Royal Melbourne Hospital, Melbourne, Victoria, Australia
| | - Peter Mitchell
- Radiology, Melbourne Health, Parkville, Victoria, Australia
| | - Nicholas L Opie
- Vascular Bionics Laboratory, Departments of Medicine, Neurology and Surgery, Melbourne Brain Centre at the Royal Melbourne Hospital, The University of Melbourne, Melbourne, Victoria, Australia
- Synchron, Inc, Campbell, California, USA
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10
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Lee JD, Levin SC, Willis EF, Li R, Woodruff TM, Noakes PG. Complement components are upregulated and correlate with disease progression in the TDP-43 Q331K mouse model of amyotrophic lateral sclerosis. J Neuroinflammation 2018; 15:171. [PMID: 29859100 PMCID: PMC5984816 DOI: 10.1186/s12974-018-1217-2] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2018] [Accepted: 05/24/2018] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Components of the innate immune complement system have been implicated in the pathogenesis of amyotrophic lateral sclerosis (ALS) specifically using hSOD1 transgenic animals; however, a comprehensive examination of complement expression in other transgenic ALS models has not been performed. This study therefore aimed to determine the expression of several key complement components and regulators in the lumbar spinal cord and tibialis anterior muscle of TDP-43Q331K mice during different disease ages. METHODS Non-transgenic, TDP-43WT and TDP-43Q331K mice were examined at three different ages of disease progression. Expression of complement components and their regulators were examined using real-time quantitative PCR and enzyme-linked immunosorbent assay. Localisation of terminal complement component receptor C5aR1 within the lumbar spinal cord was also investigated using immunohistochemistry. RESULTS Altered levels of several major complement factors, including C5a, in the spinal cord and tibialis anterior muscle of TDP-43Q331K mice were observed as disease progressed, suggesting overall increased complement activation in TDP-43Q331K mice. C5aR1 increased during disease progression, with immuno-localisation demonstrating expression on motor neurons and expression on microglia surrounding the regions of motor neuron death. There was a strong negative linear relationship between spinal cord C1qB, C3 and C5aR1 mRNA levels with hind-limb grip strength. CONCLUSIONS These results indicate that similar to SOD1 transgenic animals, local complement activation and increased expression of C5aR1 may contribute to motor neuron death and neuromuscular junction denervation in the TDP-43Q331K mouse ALS model. This further validates C5aR1 as a potential therapeutic target for ALS.
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Affiliation(s)
- John D. Lee
- School of Biomedical Sciences, the University of Queensland, St Lucia, Brisbane, QLD 4072 Australia
- University of Queensland Centre for Clinical Research, the University of Queensland, Herston, Brisbane, QLD 4029 Australia
| | - Samantha C. Levin
- School of Biomedical Sciences, the University of Queensland, St Lucia, Brisbane, QLD 4072 Australia
| | - Emily F. Willis
- School of Biomedical Sciences, the University of Queensland, St Lucia, Brisbane, QLD 4072 Australia
| | - Rui Li
- School of Biomedical Sciences, the University of Queensland, St Lucia, Brisbane, QLD 4072 Australia
| | - Trent M. Woodruff
- School of Biomedical Sciences, the University of Queensland, St Lucia, Brisbane, QLD 4072 Australia
| | - Peter G. Noakes
- School of Biomedical Sciences, the University of Queensland, St Lucia, Brisbane, QLD 4072 Australia
- Queensland Brain Institute, the University of Queensland, St Lucia, Brisbane, QLD 4072 Australia
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11
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Nagarajan SR, Brandon AE, McKenna JA, Shtein HC, Nguyen TQ, Suryana E, Poronnik P, Cooney GJ, Saunders DN, Hoy AJ. Insulin and diet-induced changes in the ubiquitin-modified proteome of rat liver. PLoS One 2017; 12:e0174431. [PMID: 28329008 PMCID: PMC5362237 DOI: 10.1371/journal.pone.0174431] [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] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2016] [Accepted: 03/08/2017] [Indexed: 12/14/2022] Open
Abstract
Ubiquitin is a crucial post-translational modification regulating numerous cellular processes, but its role in metabolic disease is not well characterized. In this study, we identified the in vivo ubiquitin-modified proteome in rat liver and determined changes in this ubiquitome under acute insulin stimulation and high-fat and sucrose diet-induced insulin resistance. We identified 1267 ubiquitinated proteins in rat liver across diet and insulin-stimulated conditions, with 882 proteins common to all conditions. KEGG pathway analysis of these proteins identified enrichment of metabolic pathways, TCA cycle, glycolysis/gluconeogenesis, fatty acid metabolism, and carbon metabolism, with similar pathways altered by diet and insulin resistance. Thus, the rat liver ubiquitome is sensitive to diet and insulin stimulation and this is perturbed in insulin resistance.
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Affiliation(s)
- Shilpa R. Nagarajan
- Discipline of Physiology, School of Medical Sciences & Bosch Institute, Charles Perkins Centre, University of Sydney, Sydney, NSW, Australia
| | - Amanda E. Brandon
- Diabetes and Metabolism Division, Garvan Institute of Medical Research, Darlinghurst, NSW, Australia
- St Vincent’s Clinical School, Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia
| | - Jessie A. McKenna
- Kinghorn Cancer Centre, Garvan Institute of Medical Research, Darlinghurst, NSW, Australia
- School of Medical Sciences, Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia
| | - Harrison C. Shtein
- Discipline of Physiology, School of Medical Sciences & Bosch Institute, Charles Perkins Centre, University of Sydney, Sydney, NSW, Australia
| | - Thinh Q. Nguyen
- Discipline of Physiology, School of Medical Sciences & Bosch Institute, Charles Perkins Centre, University of Sydney, Sydney, NSW, Australia
| | - Eurwin Suryana
- Diabetes and Metabolism Division, Garvan Institute of Medical Research, Darlinghurst, NSW, Australia
| | - Philip Poronnik
- Discipline of Physiology, School of Medical Sciences & Bosch Institute, Charles Perkins Centre, University of Sydney, Sydney, NSW, Australia
| | - Gregory J. Cooney
- Diabetes and Metabolism Division, Garvan Institute of Medical Research, Darlinghurst, NSW, Australia
- St Vincent’s Clinical School, Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia
| | - Darren N. Saunders
- Kinghorn Cancer Centre, Garvan Institute of Medical Research, Darlinghurst, NSW, Australia
- School of Medical Sciences, Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia
- * E-mail: (AJH); (DNS)
| | - Andrew J. Hoy
- Discipline of Physiology, School of Medical Sciences & Bosch Institute, Charles Perkins Centre, University of Sydney, Sydney, NSW, Australia
- * E-mail: (AJH); (DNS)
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12
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Abstract
The motor unit comprises the anterior horn cell, its axon, and the muscle fibers that it innervates. Although the true number of motor units is unknown, the number of motor units appears to vary greatly between different muscles and between different individuals. Assessment of the number and function of motor units is needed in diseases of the anterior horn cell and other motor nerve disorders. Amyotrophic lateral sclerosis is the most important disease of anterior horn cells. The need for an effective biomarker for assessing disease progression and for use in clinical trials in amyotrophic lateral sclerosis has stimulated the study of methods to measure the number of motor units. Since 1970 a number of different methods, including the incremental, F-wave, multipoint, and statistical methods, have been developed but none has achieved widespread applicability. Two methods (MUNIX and the multipoint incremental method) are in current use across multiple centres and are discussed in detail in this review, together with other recently published methods. Imaging with magnetic resonance and ultrasound is increasingly being applied to this area. Motor unit number estimates have also been applied to other neuromuscular diseases such as spinal muscular atrophy, compression neuropathies, and prior poliomyelitis. The need for an objective measure for the assessment of motor units remains tantalizingly close but unfulfilled in 2016.
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Affiliation(s)
- Robert D Henderson
- Department of Neurology, Royal Brisbane & Women's Hospital and University of Queensland Centre for Clinical Research, Herston, Brisbane, 4006, Australia.
| | - Pamela A McCombe
- Department of Neurology, Royal Brisbane & Women's Hospital and University of Queensland Centre for Clinical Research, Herston, Brisbane, 4006, Australia
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13
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Abstract
INTRODUCTION Motor neuron disease (MND) is a terminal, progressive, multisystem disorder. Well-timed decisions are key to effective symptom management. To date, there are few published decision support tools, also known as decision aids, to guide patients in making ongoing choices for symptom management and quality of life. This protocol is to develop and validate decision support tools for patients and families to use in conjunction with health professionals in MND multidisciplinary care. The tools will inform patients and families of the benefits and risks of each option, as well as the consequences of accepting or declining treatment. METHODS AND ANALYSIS The study is being conducted from June 2015 to May 2016, using a modified Delphi process. A 2-stage, 7-step process will be used to develop the tools, based on existing literature and stakeholder feedback. The first stage will be to develop the decision support tools, while the second stage will be to validate both the tools and the process used to develop them. Participants will form expert panels, to provide feedback on which the development and validation of the tools will be based. Participants will be drawn from patients with MND, family carers and health professionals, support association workers, peak body representatives, and MND and patient decision-making researchers. ETHICS AND DISSEMINATION Ethical approval for the study has been granted by Macquarie University Human Research Ethics Committee (HREC), approval number 5201500658. Knowledge translation will be conducted via publications, seminar and conference presentations to patients and families, health professionals and researchers.
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Affiliation(s)
- Anne Hogden
- Centre for Healthcare Resilience and Implementation Science, Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia
| | - David Greenfield
- Centre for Healthcare Resilience and Implementation Science, Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia
| | - Jashelle Caga
- Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia
| | - Xiongcai Cai
- School of Computer Science and Engineering, University of New South Wales, Sydney, New South Wales, Australia
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