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McLeish E, Sooda A, Slater N, Beer K, Cooper I, Mastaglia FL, Needham M, Coudert JD. Identification of distinct immune signatures in inclusion body myositis by peripheral blood immunophenotyping using machine learning models. Clin Transl Immunology 2024; 13:e1504. [PMID: 38585335 PMCID: PMC10990804 DOI: 10.1002/cti2.1504] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Revised: 02/13/2024] [Accepted: 03/25/2024] [Indexed: 04/09/2024] Open
Abstract
Objective Inclusion body myositis (IBM) is a progressive late-onset muscle disease characterised by preferential weakness of quadriceps femoris and finger flexors, with elusive causes involving immune, degenerative, genetic and age-related factors. Overlapping with normal muscle ageing makes diagnosis and prognosis problematic. Methods We characterised peripheral blood leucocytes in 81 IBM patients and 45 healthy controls using flow cytometry. Using a random forest classifier, we identified immune changes in IBM compared to HC. K-means clustering and the random forest one-versus-rest model classified patients into three immunophenotypic clusters. Functional outcome measures including mTUG, 2MWT, IBM-FRS, EAT-10, knee extension and grip strength were assessed across clusters. Results The random forest model achieved a 94% AUC ROC with 82.76% specificity and 100% sensitivity. Significant differences were found in IBM patients, including increased CD8+ T-bet+ cells, CD4+ T cells skewed towards a Th1 phenotype and altered γδ T cell repertoire with a reduced proportion of Vγ9+Vδ2+ cells. IBM patients formed three clusters: (i) activated and inflammatory CD8+ and CD4+ T-cell profile and the highest proportion of anti-cN1A-positive patients in cluster 1; (ii) limited inflammation in cluster 2; (iii) highly differentiated, pro-inflammatory T-cell profile in cluster 3. Additionally, no significant differences in patients' age and gender were detected between immunophenotype clusters; however, worsening trends were detected with several functional outcomes. Conclusion These findings unveil distinct immune profiles in IBM, shedding light on underlying pathological mechanisms for potential immunoregulatory therapeutic development.
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Affiliation(s)
- Emily McLeish
- Centre for Molecular Medicine and Innovative TherapeuticsMurdoch UniversityMurdochWAAustralia
| | - Anuradha Sooda
- Centre for Molecular Medicine and Innovative TherapeuticsMurdoch UniversityMurdochWAAustralia
| | - Nataliya Slater
- Centre for Molecular Medicine and Innovative TherapeuticsMurdoch UniversityMurdochWAAustralia
| | - Kelly Beer
- Centre for Molecular Medicine and Innovative TherapeuticsMurdoch UniversityMurdochWAAustralia
- Perron Institute for Neurological and Translational ScienceNedlandsWAAustralia
| | - Ian Cooper
- Centre for Molecular Medicine and Innovative TherapeuticsMurdoch UniversityMurdochWAAustralia
- Perron Institute for Neurological and Translational ScienceNedlandsWAAustralia
| | - Frank L Mastaglia
- Perron Institute for Neurological and Translational ScienceNedlandsWAAustralia
| | - Merrilee Needham
- Centre for Molecular Medicine and Innovative TherapeuticsMurdoch UniversityMurdochWAAustralia
- Perron Institute for Neurological and Translational ScienceNedlandsWAAustralia
- School of MedicineUniversity of Notre Dame AustraliaFremantleWAAustralia
- Department of NeurologyFiona Stanley HospitalMurdochWAAustralia
| | - Jerome D Coudert
- Centre for Molecular Medicine and Innovative TherapeuticsMurdoch UniversityMurdochWAAustralia
- Perron Institute for Neurological and Translational ScienceNedlandsWAAustralia
- School of MedicineUniversity of Notre Dame AustraliaFremantleWAAustralia
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Paramalingam S, Needham M, Mastaglia FL, Keen HI. A longitudinal study using B mode ultrasound and power Doppler as monitoring imaging tools in inclusion body myositis. Clin Exp Rheumatol 2024; 42:351-357. [PMID: 37877419 DOI: 10.55563/clinexprheumatol/qkjmy8] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2023] [Accepted: 09/26/2023] [Indexed: 10/26/2023]
Abstract
OBJECTIVES There is growing interest in ultrasound (US) as an outcome measure in IBM. Our study aimed to determine the ability of B mode US and power Doppler (PD) to detect changes in affected muscles over time and if US domains correlate with disease progression. METHODS Participants attended on four occasions over a median follow-up period of 26 months. All completed a patient self-reported health assessment questionnaire (HAQ), patient visual analogue scale (pVAS), manual muscle testing (MMT), and US (fascial thickness-FT, muscle bulk, echogenicity, and PD) on deltoid and vastus lateralis (VL) muscles at each visit. RESULTS This longitudinal observational study had 35 participants: 21 (60%) males, median age 70 (IQR (64-76), and the majority (85.7%) not on immunosuppression. When analysed for sex differences at baseline, males had lower FT-VL (p=0.018) and higher muscle bulk (p=0.002) than females. Only FT-deltoid (p<0.001) increased significantly over time with follow-up. When participants were stratified into progressors and non-progressors, FT at baseline was lower in progressors (0.06 vs. 0.09, p=0.017), who were predominantly male. There were no significant differences in other US domains. CONCLUSIONS Our study highlights previously unreported sex differences in US findings in IBM. Certain US domains, such as FT, showed measurable changes over time and correlated with disease progression. However, further studies with longer follow-up periods and larger patient cohorts will need to be performed to determine whether B mode US could be a useful disease outcome measure for therapeutic trials.
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Affiliation(s)
- Shereen Paramalingam
- University of Notre Dame Australia, Fremantle, Western Australia, and Department of Rheumatology, Fiona Stanley Hospital, Murdoch, Western Australia, Australia.
| | - Merrilee Needham
- University Notre Dame Australia, Fremantle, Western Australia; Institute for Immunology and Infectious Diseases, Murdoch University, Murdoch, Western Australia, and Department of Neurology, Fiona Stanley Hospital, Murdoch, Western Australia, Australia
| | - Frank L Mastaglia
- Perron Institute for Neurological and Translational Science, University of Western Australia, Australia
| | - Helen I Keen
- Department of Rheumatology, Fiona Stanley Hospital, Murdoch, Western Australia, and School of Medicine, University of Western Australia, Australia
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Paramalingam S, Needham M, Bulsara M, Mastaglia FL, Keen HI. The longitudinal study of muscle changes with ultrasound: differential changes in idiopathic inflammatory myopathy subgroups. Rheumatology (Oxford) 2024; 63:490-497. [PMID: 37225404 DOI: 10.1093/rheumatology/kead239] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Revised: 04/21/2023] [Accepted: 05/13/2023] [Indexed: 05/26/2023] Open
Abstract
OBJECTIVES We investigated shear wave elastography (SWE), B mode US and power Doppler (PDUS) as imaging biomarkers for longitudinal follow-up in idiopathic inflammatory myopathy (IIM), with a particular focus on immune-mediated necrotizing myopathy (IMNM) and DM. METHODS Participants had serial SWE, PDUS on the deltoid (D) and vastus lateralis (VL) muscles on four occasions at intervals of 3-6 months. Clinical assessments included manual muscle testing, and patient- and physician-reported outcome scales. RESULTS Thirty-three participants were included: IMNM = 17, DM = 12, overlap myositis = 3, PM = 1. Twenty were in a prevalent clinic group, and 13 were recently treated cases in an incident group. Differential changes in SWS and US domains occurred with time in both the prevalent and incident groups. In the VL-prevalent subgroup, echogenicity increased over time (P = 0.040), while in the incident cases there was a trend for reduction to normal over time (P = 0.097) with treatment. Muscle bulk reduced in the D-prevalent subgroup over time (P = 0.096), suggesting atrophy. SWS also reduced in the VL-incident subgroup over time (P = 0.096), suggesting a trend towards improvement in muscle stiffness with treatment. CONCLUSION SWE and US appear promising as imaging biomarkers for patient follow-up in IIM and indicate changes over time, especially with echogenicity, muscle bulk and SWS in the VL. Due to the limitations of the participant numbers, additional studies with a larger cohort are needed to help evaluate these US domains further and outline specific characteristics within the IIM subgroups.
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Affiliation(s)
- Shereen Paramalingam
- University of Notre Dame Australia, Fremantle, Western Australia, Australia
- Department of Rheumatology, Fiona Stanley Hospital, Murdoch, Western Australia, Australia
| | - Merrilee Needham
- University of Notre Dame Australia, Fremantle, Western Australia, Australia
- Institute for Immunology and Infectious Diseases, Murdoch University, Murdoch, Western Australia, Australia
- Department of Neurology, Fiona Stanley Hospital, Murdoch, Western Australia, Australia
| | - Max Bulsara
- Institute for Health Research, Notre Dame Australia, Fremantle, Western Australia, Australia
| | - Frank L Mastaglia
- Perron Institute for Neurological and Translational Science, University of Western Australia, Australia
| | - Helen I Keen
- Department of Rheumatology, Fiona Stanley Hospital, Murdoch, Western Australia, Australia
- School of Medicine, University of Western Australia, Australia
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Slater N, Sooda A, McLeish E, Beer K, Brusch A, Shakya R, Bundell C, James I, Chopra A, Mastaglia FL, Needham M, Coudert JD. High-resolution HLA genotyping in inclusion body myositis refines 8.1 ancestral haplotype association to DRB1*03:01:01 and highlights pathogenic role of arginine-74 of DRβ1 chain. J Autoimmun 2024; 142:103150. [PMID: 38043487 DOI: 10.1016/j.jaut.2023.103150] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Revised: 11/01/2023] [Accepted: 11/15/2023] [Indexed: 12/05/2023]
Abstract
OBJECTIVES Inclusion body myositis (IBM) is a progressive inflammatory-degenerative muscle disease of older individuals, with some patients producing anti-cytosolic 5'-nucleotidase 1A (NT5C1A, aka cN1A) antibodies. Human Leukocyte Antigens (HLA) is the highest genetic risk factor for developing IBM. In this study, we aimed to further define the contribution of HLA alleles to IBM and the production of anti-cN1A antibodies. METHODS We HLA haplotyped a Western Australian cohort of 113 Caucasian IBM patients and 112 ethnically matched controls using Illumina next-generation sequencing. Allele frequency analysis and amino acid alignments were performed using the Genentech/MiDAS bioinformatics package. Allele frequencies were compared using Fisher's exact test. Age at onset analysis was performed using the ggstatsplot package. All analysis was carried out in RStudio version 1.4.1717. RESULTS Our findings validated the independent association of HLA-DRB1*03:01:01 with IBM and attributed the risk to an arginine residue in position 74 within the DRβ1 protein. Conversely, DRB4*01:01:01 and DQA1*01:02:01 were found to have protective effects; the carriers of DRB1*03:01:01 that did not possess these alleles had a fourteenfold increased risk of developing IBM over the general Caucasian population. Furthermore, patients with the abovementioned genotype developed symptoms on average five years earlier than patients without. We did not find any HLA associations with anti-cN1A antibody production. CONCLUSIONS High-resolution HLA sequencing more precisely characterised the alleles associated with IBM and defined a haplotype linked to earlier disease onset. Identification of the critical amino acid residue by advanced biostatistical analysis of immunogenetics data offers mechanistic insights and future directions into uncovering IBM aetiopathogenesis.
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Affiliation(s)
- Nataliya Slater
- Murdoch University, Centre for Molecular Medicine and Innovative Therapeutics, Murdoch, WA, Australia
| | - Anuradha Sooda
- Murdoch University, Centre for Molecular Medicine and Innovative Therapeutics, Murdoch, WA, Australia
| | - Emily McLeish
- Murdoch University, Centre for Molecular Medicine and Innovative Therapeutics, Murdoch, WA, Australia
| | - Kelly Beer
- Murdoch University, Centre for Molecular Medicine and Innovative Therapeutics, Murdoch, WA, Australia; Perron Institute for Neurological and Translational Science, Nedlands, WA, Australia
| | - Anna Brusch
- PathWest Laboratory Medicine, Dept of Clinical Immunology, QEII Medical Centre, Nedlands, WA, Australia
| | - Rakesh Shakya
- PathWest Laboratory Medicine, Dept of Clinical Immunology, QEII Medical Centre, Nedlands, WA, Australia
| | - Christine Bundell
- PathWest Laboratory Medicine, Dept of Clinical Immunology, QEII Medical Centre, Nedlands, WA, Australia
| | - Ian James
- Perron Institute for Neurological and Translational Science, Nedlands, WA, Australia; Murdoch University, Institute for Immunology and Infection Diseases, Murdoch, WA, Australia
| | - Abha Chopra
- Murdoch University, Institute for Immunology and Infection Diseases, Murdoch, WA, Australia
| | - Frank L Mastaglia
- Perron Institute for Neurological and Translational Science, Nedlands, WA, Australia; University of Western Australia, Centre for Neuromuscular & Neurological Disorders, Crawley, WA, Australia
| | - Merrilee Needham
- Murdoch University, Centre for Molecular Medicine and Innovative Therapeutics, Murdoch, WA, Australia; Perron Institute for Neurological and Translational Science, Nedlands, WA, Australia; University of Notre Dame Australia, School of Medicine, Fremantle, WA, Australia; Fiona Stanley Hospital, Department of Neurology, Murdoch, WA, Australia
| | - Jerome D Coudert
- Murdoch University, Centre for Molecular Medicine and Innovative Therapeutics, Murdoch, WA, Australia; Perron Institute for Neurological and Translational Science, Nedlands, WA, Australia; University of Notre Dame Australia, School of Medicine, Fremantle, WA, Australia.
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McLeish E, Slater N, Mastaglia FL, Needham M, Coudert JD. From data to diagnosis: how machine learning is revolutionizing biomarker discovery in idiopathic inflammatory myopathies. Brief Bioinform 2023; 25:bbad514. [PMID: 38243695 PMCID: PMC10796252 DOI: 10.1093/bib/bbad514] [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: 10/05/2023] [Revised: 11/29/2023] [Accepted: 12/17/2023] [Indexed: 01/21/2024] Open
Abstract
Idiopathic inflammatory myopathies (IIMs) are a heterogeneous group of muscle disorders including adult and juvenile dermatomyositis, polymyositis, immune-mediated necrotising myopathy and sporadic inclusion body myositis, all of which present with variable symptoms and disease progression. The identification of effective biomarkers for IIMs has been challenging due to the heterogeneity between IIMs and within IIM subgroups, but recent advances in machine learning (ML) techniques have shown promises in identifying novel biomarkers. This paper reviews recent studies on potential biomarkers for IIM and evaluates their clinical utility. We also explore how data analytic tools and ML algorithms have been used to identify biomarkers, highlighting their potential to advance our understanding and diagnosis of IIM and improve patient outcomes. Overall, ML techniques have great potential to revolutionize biomarker discovery in IIMs and lead to more effective diagnosis and treatment.
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Affiliation(s)
- Emily McLeish
- Murdoch University, Centre for Molecular Medicine and Innovative Therapeutics, Murdoch, Western Australia (WA), Australia
| | - Nataliya Slater
- Murdoch University, Centre for Molecular Medicine and Innovative Therapeutics, Murdoch, Western Australia (WA), Australia
| | - Frank L Mastaglia
- Perron Institute for Neurological and Translational Science, Nedlands, WA, Australia
| | - Merrilee Needham
- Murdoch University, Centre for Molecular Medicine and Innovative Therapeutics, Murdoch, Western Australia (WA), Australia
- Perron Institute for Neurological and Translational Science, Nedlands, WA, Australia
- University of Notre Dame Australia, School of Medicine, Fremantle, WA, Australia
- Fiona Stanley Hospital, Department of Neurology, Murdoch, WA, Australia
| | - Jerome D Coudert
- Murdoch University, Centre for Molecular Medicine and Innovative Therapeutics, Murdoch, Western Australia, WA, Australia
- Perron Institute for Neurological and Translational Science, Nedlands, WA, Australia
- University of Notre Dame Australia, School of Medicine, Fremantle, WA, Australia
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6
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Jeyadevan A, Bakeberg M, Byrnes M, Kenna J, McGregor S, Ghosh S, Horne MK, Stell R, Evans T, Mastaglia FL, Anderton R. Quality of life implications for elevated trait impulsivity in people with Parkinson's disease. Qual Life Res 2023; 32:1143-1150. [PMID: 36637657 PMCID: PMC10063484 DOI: 10.1007/s11136-022-03321-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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/05/2022] [Indexed: 01/14/2023]
Abstract
BACKGROUND Several non-motor features of Parkinson's disease (PD) are known to adversely affect patient health-related quality of life (HRQL). However, the specific impact of neuropsychiatric complications, such as impulsive behaviour, is yet to be elucidated. OBJECTIVES The present cross-sectional, observational study aimed to investigate the effects of heightened trait impulsivity on HRQL in individuals with PD. METHODS A total of 322 people with idiopathic PD were sequentially recruited from Movement Disorder clinics across Australia. Trait impulsivity in patients was determined by Barratt's Impulsiveness Scale Version 11 (BIS-11), and grouped into tertiles (low, medium, and high). Patient HRQL was determined by the 39-item Parkinson's Disease Questionnaire (PDQ-39), complemented by the Cambridge Behavioural Inventory-Revised (CBI-R) indicating caregivers' perception of patient HRQL. RESULTS When total BIS-11 scores were grouped into tertiles, patient perceived and caregiver-perceived HRQL were 1.7-fold (p < .001) and 2.2-fold (p < .001) worse in the high BIS-11 group when compared to patients in the low group. Univariate analysis revealed significant associations between second-order attentional (p < .001) and non-planning (p < .001) impulsivity domains with PDQ-39 scores. When controlling for confounding demographic and clinical variables, a multivariate linear regression model revealed second-order attentional impulsivity was independently predictive of poor patient perceived HRQL (p < .001). CONCLUSION These findings suggest that increasing trait impulsivity is significantly associated with patient perceived HRQL in PD. Improved knowledge and recognition of subclinical impulsivity may guide clinicians' treatment and reduce disease burden for patients experiencing PD symptoms.
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Affiliation(s)
- Ashani Jeyadevan
- Faculty of Medicine, School of Nursing and Midwifery, and Health Sciences, University of Notre Dame Australia, Fremantle, WA, Australia
| | - Megan Bakeberg
- Faculty of Medicine, School of Nursing and Midwifery, and Health Sciences, University of Notre Dame Australia, Fremantle, WA, Australia
- Centre for Neuromuscular and Neurological Disorders, University of Western Australia, Nedlands, WA, Australia
| | - Michelle Byrnes
- Centre for Neuromuscular and Neurological Disorders, University of Western Australia, Nedlands, WA, Australia
| | - Jade Kenna
- Faculty of Medicine, School of Nursing and Midwifery, and Health Sciences, University of Notre Dame Australia, Fremantle, WA, Australia
- Centre for Neuromuscular and Neurological Disorders, University of Western Australia, Nedlands, WA, Australia
- Perron Institute for Neurological and Translational Sciences Nedlands, Nedlands, WA, Australia
| | - Sarah McGregor
- Centre for Clinical Neurosciences and Neurological Research, St Vincent's Hospital Melbourne, Fitzroy, VIC, Australia
| | - Soumya Ghosh
- Centre for Neuromuscular and Neurological Disorders, University of Western Australia, Nedlands, WA, Australia
- Perron Institute for Neurological and Translational Sciences Nedlands, Nedlands, WA, Australia
| | - Malcom K Horne
- Centre for Clinical Neurosciences and Neurological Research, St Vincent's Hospital Melbourne, Fitzroy, VIC, Australia
- Florey Institute for Neuroscience and Mental Health, University of Melbourne, Parkville, VIC, Australia
| | - Rick Stell
- Centre for Neuromuscular and Neurological Disorders, University of Western Australia, Nedlands, WA, Australia
- Perron Institute for Neurological and Translational Sciences Nedlands, Nedlands, WA, Australia
| | - Tess Evans
- Faculty of Medicine, School of Nursing and Midwifery, and Health Sciences, University of Notre Dame Australia, Fremantle, WA, Australia
| | - Frank L Mastaglia
- Centre for Neuromuscular and Neurological Disorders, University of Western Australia, Nedlands, WA, Australia
- Perron Institute for Neurological and Translational Sciences Nedlands, Nedlands, WA, Australia
| | - Ryan Anderton
- Faculty of Medicine, School of Nursing and Midwifery, and Health Sciences, University of Notre Dame Australia, Fremantle, WA, Australia.
- Centre for Neuromuscular and Neurological Disorders, University of Western Australia, Nedlands, WA, Australia.
- Institute of Health Research, University of Notre Dame Australia, Fremantle, WA, Australia.
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7
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Li D, Mastaglia FL, Yau WY, Chen S, Wilton SD, Akkari PA. Targeted Molecular Therapeutics for Parkinson's Disease: A Role for Antisense Oligonucleotides? Mov Disord 2022; 37:2184-2190. [PMID: 36036206 PMCID: PMC9804368 DOI: 10.1002/mds.29201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Revised: 07/26/2022] [Accepted: 08/03/2022] [Indexed: 01/05/2023] Open
Affiliation(s)
- Dunhui Li
- Perron Institute for Neurological and Translational ScienceThe University of Western AustraliaNedlandsAustralia,Centre for Molecular Medicine and Innovative TherapeuticsMurdoch UniversityMurdochAustralia,College of Nursing and HealthZhengzhou UniversityZhengzhouChina
| | - Frank L. Mastaglia
- Perron Institute for Neurological and Translational ScienceThe University of Western AustraliaNedlandsAustralia,Centre for Molecular Medicine and Innovative TherapeuticsMurdoch UniversityMurdochAustralia
| | - Wai Yan Yau
- Perron Institute for Neurological and Translational ScienceThe University of Western AustraliaNedlandsAustralia
| | - Shengdi Chen
- Department of Neurology and Institute of NeurologyRuijin Hospital Affiliated to Shanghai Jiao Tong University School of MedicineShanghaiChina
| | - Steve D. Wilton
- Perron Institute for Neurological and Translational ScienceThe University of Western AustraliaNedlandsAustralia,Centre for Molecular Medicine and Innovative TherapeuticsMurdoch UniversityMurdochAustralia
| | - Patrick A. Akkari
- Perron Institute for Neurological and Translational ScienceThe University of Western AustraliaNedlandsAustralia,Centre for Molecular Medicine and Innovative TherapeuticsMurdoch UniversityMurdochAustralia,Department of NeurologyDuke UniversityDurhamNorth CarolinaUSA
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Coudert JD, Slater N, Sooda A, Beer K, Lim EM, Boyder C, Zhang R, Mastaglia FL, Learmonth YC, Fairchild TJ, Yeap BB, Needham M. Immunoregulatory effects of testosterone supplementation combined with exercise training in men with Inclusion Body Myositis: a double-blind, placebo-controlled, cross-over trial. Clin Transl Immunology 2022; 11:e1416. [PMID: 36188123 PMCID: PMC9495304 DOI: 10.1002/cti2.1416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Revised: 08/08/2022] [Accepted: 09/07/2022] [Indexed: 11/09/2022] Open
Abstract
Objectives Sporadic Inclusion Body Myositis (IBM) is an inflammatory muscle disease affecting individuals over the age of 45, leading to progressive muscle wasting, disability and loss of independence. Histologically, IBM is characterised by immune changes including myofibres expressing major histocompatibility complex molecules and invaded by CD8+ T cells and macrophages, and by degenerative changes including protein aggregates organised in inclusion bodies, rimmed vacuoles and mitochondrial abnormalities. There is currently no cure, and regular exercise is currently the only recognised treatment effective at limiting muscle weakening, atrophy and loss of function. Testosterone exerts anti-inflammatory effects, inhibiting effector T-cell differentiation and pro-inflammatory cytokine production. Methods We conducted a double-blind, placebo-controlled, cross-over trial in men with IBM, to assess whether a personalised progressive exercise training combined with application of testosterone, reduced the inflammatory immune response associated with this disease over and above exercise alone. To assess intervention efficacy, we immunophenotyped blood immune cells by flow cytometry, and measured serum cytokines and chemokines by Luminex immunoassay. Results Testosterone supplementation resulted in modest yet significant count reduction in the classical monocyte subset as well as eosinophils. Testosterone-independent immunoregulatory effects attributed to exercise included altered proportions of some monocyte, T- and B-cell subsets, and reduced IL-12, IL-17, TNF-α, MIP-1β and sICAM-1 in spite of interindividual variability. Conclusion Overall, our findings indicate anti-inflammatory effects of exercise training in IBM patients, whilst concomitant testosterone supplementation provides some additional changes. Further studies combining testosterone and exercise would be worthwhile in larger cohorts and longer testosterone administration periods.
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Affiliation(s)
- Jerome D Coudert
- Centre for Molecular Medicine and Innovative Therapeutics Murdoch University Murdoch WA Australia.,Perron Institute for Neurological and Translational Science Nedlands WA Australia.,School of Medicine University of Notre Dame Fremantle WA Australia
| | - Nataliya Slater
- Centre for Molecular Medicine and Innovative Therapeutics Murdoch University Murdoch WA Australia
| | - Anuradha Sooda
- Centre for Molecular Medicine and Innovative Therapeutics Murdoch University Murdoch WA Australia
| | - Kelly Beer
- Centre for Molecular Medicine and Innovative Therapeutics Murdoch University Murdoch WA Australia.,Perron Institute for Neurological and Translational Science Nedlands WA Australia
| | - Ee Mun Lim
- Department of Clinical Biochemistry, Pharmacology and Toxicology, PathWest Laboratory Medicine QEII Medical Centre Nedlands WA Australia
| | - Conchita Boyder
- Department of Clinical Biochemistry, Pharmacology and Toxicology, PathWest Laboratory Medicine QEII Medical Centre Nedlands WA Australia
| | - Rui Zhang
- Department of Clinical Biochemistry, Pharmacology and Toxicology, PathWest Laboratory Medicine QEII Medical Centre Nedlands WA Australia
| | - Frank L Mastaglia
- Perron Institute for Neurological and Translational Science Nedlands WA Australia
| | - Yvonne C Learmonth
- Centre for Molecular Medicine and Innovative Therapeutics Murdoch University Murdoch WA Australia.,Perron Institute for Neurological and Translational Science Nedlands WA Australia.,Discipline of Exercise Science Murdoch University Murdoch WA Australia
| | - Timothy J Fairchild
- Centre for Molecular Medicine and Innovative Therapeutics Murdoch University Murdoch WA Australia.,Discipline of Exercise Science Murdoch University Murdoch WA Australia
| | - Bu B Yeap
- Medical School University of Western Australia Perth WA Australia.,Department of Endocrinology and Diabetes Fiona Stanley Hospital Perth WA Australia
| | - Merrilee Needham
- Centre for Molecular Medicine and Innovative Therapeutics Murdoch University Murdoch WA Australia.,Perron Institute for Neurological and Translational Science Nedlands WA Australia.,School of Medicine University of Notre Dame Fremantle WA Australia.,Department of Neurology Fiona Stanley Hospital Perth WA Australia
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9
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Theunissen F, Anderton RS, Mastaglia FL, James I, Bedlack R, Akkari PA. Intronic NEFH variant is associated with reduced risk for sporadic ALS and later age of disease onset. Sci Rep 2022; 12:14739. [PMID: 36042248 PMCID: PMC9427846 DOI: 10.1038/s41598-022-18942-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 03/16/2022] [Accepted: 08/22/2022] [Indexed: 11/30/2022] Open
Abstract
Neurofilament heavy (NEFH) is one of the critical proteins required for the formation of the neuronal cytoskeleton and polymorphisms in NEFH are reported as a rare cause of sporadic ALS (sALS). In the current study, a candidate tetranucleotide (TTTA) repeat variant in NEFH was selected using an in-silico short structural variant (SSV) evaluation algorithm and investigated in two cohorts of North American sALS patients, both separately and combined (Duke cohort n = 138, Coriell cohort n = 333; combined cohort n = 471), compared to a group of healthy controls from the Coriell Institute biobank (n = 496). Stratification according to site of disease onset revealed that the 9 TTTA allele was associated with reduced disease risk, specifically confined to spinal-onset sALS patients in the Duke cohort (p = 0.001). Furthermore, carriage of the 10 TTTA allele was associated with a 2.7 year later age of disease onset in the larger combined sALS cohort (p = 0.02). These results suggest that the 9 and 10 TTTA motif length may have a protective advantage for potentially lowering the risk of sALS and delaying the age of disease onset, however, these results need to be replicated in larger multicenter and multi-ethnic cohorts.
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Affiliation(s)
- Frances Theunissen
- Perron Institute for Neurological and Translational Science, First floor, RR block, QEII Medical Centre, 8 Verdun St, Nedlands, WA, 6009, Australia.,Centre for Molecular Medicine and Innovative Therapeutics, Murdoch University, Perth, WA, Australia
| | - Ryan S Anderton
- Perron Institute for Neurological and Translational Science, First floor, RR block, QEII Medical Centre, 8 Verdun St, Nedlands, WA, 6009, Australia.,Centre for Neuromuscular and Neurological Disorders, University of Western Australia, Nedlands, WA, Australia.,School of Health Sciences and Institute for Health Research, University of Notre Dame Australia, Fremantle, WA, Australia
| | - Frank L Mastaglia
- Perron Institute for Neurological and Translational Science, First floor, RR block, QEII Medical Centre, 8 Verdun St, Nedlands, WA, 6009, Australia.,Centre for Neuromuscular and Neurological Disorders, University of Western Australia, Nedlands, WA, Australia
| | - Ian James
- Institute for Immunology and Infectious Diseases, Murdoch University, Perth, WA, Australia
| | | | - P Anthony Akkari
- Perron Institute for Neurological and Translational Science, First floor, RR block, QEII Medical Centre, 8 Verdun St, Nedlands, WA, 6009, Australia. .,Centre for Neuromuscular and Neurological Disorders, University of Western Australia, Nedlands, WA, Australia. .,Centre for Molecular Medicine and Innovative Therapeutics, Murdoch University, Perth, WA, Australia. .,Department of Neurology, Duke University, Durham, NC, USA.
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10
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Fabis-Pedrini MJ, Kuhle J, Roberts KMA, Trend S, Jones AP, Maceski A, Carroll WM, Lucas RM, Mastaglia FL, Hart PH, Kermode AG. Changes in serum neurofilament light chain levels following narrowband ultraviolet B phototherapy in clinically isolated syndrome. Brain Behav 2022; 12:e2494. [PMID: 35084124 PMCID: PMC8865160 DOI: 10.1002/brb3.2494] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Revised: 12/23/2021] [Accepted: 12/30/2021] [Indexed: 11/08/2022] Open
Abstract
OBJECTIVE To determine whether serum neurofilament light chain (sNfL) levels are suppressed in patients with the clinically isolated syndrome (CIS) following narrowband ultraviolet B phototherapy (UVB-PT). METHODS sNfL levels were measured using a sensitive single-molecule array assay at baseline and up to 12 months in 17 patients with CIS, 10 of whom received UVB-PT, and were compared with healthy control (HC) and early relapsing remitting multiple sclerosis (RRMS) group. sNfL levels were correlated with magnetic resonance imaging total lesion volume (LV) determined using icobrain version 4.4.1 and with clinical outcomes. RESULTS Baseline median sNfL levels were significantly higher in the CIS (20.6 pg/mL, interquartile range [IQR] 13.7-161.4) and RRMS groups (36.6 pg/ml [IQR] 16.2-212.2) than in HC (10.7 pg/ml [IQR] 4.9-21.5) (p = .012 and p = .0002, respectively), and were strongly correlated with T2 and T1 LV at 12 months (r = .800; p = .014 and r = .833; p = .008, respectively) in the CIS group. Analysis of changes in sNfL levels over time in the CIS group showed a significant cumulative suppressive effect of UVB-PT in the first 3 months (UVB-PT -10.6% vs non-UVB-PT +58.3%; p = .04) following which the levels in the two groups converged and continued to fall. CONCLUSIONS Our findings provide the basis for further studies to determine the utility of sNfL levels as a marker of neuro-axonal damage in CIS and early MS and for assessing the efficacy of new therapeutic interventions such as UVB-PT.
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Affiliation(s)
- Marzena J Fabis-Pedrini
- Perron Institute for Neurological and Translational Science, University of Western Australia, Perth, Australia.,Centre for Molecular Medicine and Innovative Therapeutics, Murdoch University, Perth, Australia
| | - Jens Kuhle
- Neurology Clinic and Policlinic, MS Centre and Research Centre for Clinical Neuroimmunology and Neuroscience Basel, University of Basel, Basel, Switzerland
| | - Katherine M A Roberts
- Perron Institute for Neurological and Translational Science, University of Western Australia, Perth, Australia
| | - Stephanie Trend
- Perron Institute for Neurological and Translational Science, University of Western Australia, Perth, Australia.,Telethon Kids Institute, University of Western Australia, Perth, Australia
| | - Anderson P Jones
- Telethon Kids Institute, University of Western Australia, Perth, Australia
| | - Aleksandra Maceski
- Neurology Clinic and Policlinic, MS Centre and Research Centre for Clinical Neuroimmunology and Neuroscience Basel, University of Basel, Basel, Switzerland
| | - William M Carroll
- Perron Institute for Neurological and Translational Science, University of Western Australia, Perth, Australia
| | - Robyn M Lucas
- National Centre for Epidemiology & Population Health, Research School of Population Health, Australian National University, Canberra, Australia.,Centre for Ophthalmology and Visual Science, University of Western Australia, Perth, Australia
| | - Frank L Mastaglia
- Perron Institute for Neurological and Translational Science, University of Western Australia, Perth, Australia.,Centre for Molecular Medicine and Innovative Therapeutics, Murdoch University, Perth, Australia
| | - Prue H Hart
- Telethon Kids Institute, University of Western Australia, Perth, Australia
| | - Allan G Kermode
- Perron Institute for Neurological and Translational Science, University of Western Australia, Perth, Australia.,Centre for Molecular Medicine and Innovative Therapeutics, Murdoch University, Perth, Australia.,Institute for Immunology and Infectious Disease, Murdoch University, Perth, Australia
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11
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Kenna JE, Chua EG, Bakeberg M, Tay A, McGregor S, Gorecki A, Horne M, Marshall B, Mastaglia FL, Anderton RS. Changes in the Gut Microbiome and Predicted Functional Metabolic Effects in an Australian Parkinson's Disease Cohort. Front Neurosci 2021; 15:756951. [PMID: 34776854 PMCID: PMC8588830 DOI: 10.3389/fnins.2021.756951] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Accepted: 10/01/2021] [Indexed: 01/03/2023] Open
Abstract
Background: There has been increasing recognition of the importance of the gut microbiome in Parkinson's disease (PD), but the influence of geographic location has received little attention. The present study characterized the gut microbiota and associated changes in host metabolic pathways in an Australian cohort of people with PD (PwP). Methods: The study involved recruitment and assessment of 87 PwP from multiple Movement Disorders Clinics in Australia and 47 healthy controls. Illumina sequencing of the V3 and V4 regions of the 16S rRNA gene was used to distinguish inter-cohort differences in gut microbiota; KEGG analysis was subsequently performed to predict functional changes in host metabolic pathways. Results: The current findings identified significant differences in relative abundance and diversity of microbial operational taxonomic units (OTUs), and specific bacterial taxa between PwP and control groups. Alpha diversity was significantly reduced in PwP when compared to controls. Differences were found in two phyla (Synergistetes and Proteobacteria; both increased in PwP), and five genera (Colidextribacter, Intestinibacter, Kineothrix, Agathobaculum, and Roseburia; all decreased in PwP). Within the PD cohort, there was no association identified between microbial composition and gender, constipation or use of gastrointestinal medication. Furthermore, KEGG analysis identified 15 upregulated and 11 downregulated metabolic pathways which were predicted to be significantly altered in PwP. Conclusion: This study provides the first comprehensive characterization of the gut microbiome and predicted functional metabolic effects in a southern hemisphere PD population, further exploring the possible mechanisms whereby the gut microbiota may exert their influence on this disease, and providing evidence for the incorporation of such data in future individualized therapeutic strategies.
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Affiliation(s)
- Jade E Kenna
- School of Medicine, The University of Western Australia, Nedlands, WA, Australia.,Centre for Neuromuscular and Neurological Disorders, The University of Western Australia, Nedlands, WA, Australia.,Centre for Clinical Neurosciences and Neurological Research, St. Vincent's Hospital Melbourne, Fitzroy, VIC, Australia.,Perron Institute for Neurological and Translational Science, Nedlands, WA, Australia
| | - Eng Guan Chua
- School of Biological Sciences, The University of Western Australia, Crawley, WA, Australia.,Marshall Centre for Infectious Diseases Research and Training, The University of Western Australia, Nedlands, WA, Australia
| | - Megan Bakeberg
- Centre for Neuromuscular and Neurological Disorders, The University of Western Australia, Nedlands, WA, Australia.,School of Medicine, University of Notre Dame Australia, Fremantle, WA, Australia
| | - Alfred Tay
- School of Biological Sciences, The University of Western Australia, Crawley, WA, Australia.,Marshall Centre for Infectious Diseases Research and Training, The University of Western Australia, Nedlands, WA, Australia
| | - Sarah McGregor
- Centre for Clinical Neurosciences and Neurological Research, St. Vincent's Hospital Melbourne, Fitzroy, VIC, Australia
| | - Anastazja Gorecki
- Perron Institute for Neurological and Translational Science, Nedlands, WA, Australia.,School of Biological Sciences, The University of Western Australia, Crawley, WA, Australia
| | - Malcolm Horne
- Centre for Clinical Neurosciences and Neurological Research, St. Vincent's Hospital Melbourne, Fitzroy, VIC, Australia.,Florey Institute of Neuroscience and Mental Health, The University of Melbourne, Parkville, VIC, Australia
| | - Barry Marshall
- School of Biological Sciences, The University of Western Australia, Crawley, WA, Australia.,Marshall Centre for Infectious Diseases Research and Training, The University of Western Australia, Nedlands, WA, Australia
| | - Frank L Mastaglia
- Centre for Neuromuscular and Neurological Disorders, The University of Western Australia, Nedlands, WA, Australia.,Perron Institute for Neurological and Translational Science, Nedlands, WA, Australia
| | - Ryan S Anderton
- Centre for Neuromuscular and Neurological Disorders, The University of Western Australia, Nedlands, WA, Australia.,Institute for Health Research, University of Notre Dame Australia, Fremantle, WA, Australia.,School of Nursing, Midwifery, Health Sciences and Physiotherapy, The University of Notre Dame Australia, Fremantle, WA, Australia
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12
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Bakeberg MC, Gorecki AM, Kenna JE, Jefferson A, Byrnes M, Ghosh S, Horne MK, McGregor S, Stell R, Walters S, Mastaglia FL, Anderton RS. Elevated HDL Levels Linked to Poorer Cognitive Ability in Females With Parkinson's Disease. Front Aging Neurosci 2021; 13:656623. [PMID: 34177552 PMCID: PMC8226251 DOI: 10.3389/fnagi.2021.656623] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Accepted: 05/10/2021] [Indexed: 11/13/2022] Open
Abstract
Introduction Cholesterol levels have been associated with age-related cognitive decline, however, such an association has not been comprehensively explored in people with Parkinson's disease (PD). To address this uncertainty, the current cross-sectional study examined the cholesterol profile and cognitive performance in a cohort of PD patients. Methods Cognitive function was evaluated using two validated assessments (ACE-R and SCOPA-COG) in 182 people with PD from the Australian Parkinson's Disease Registry. Total cholesterol (TC), high-density lipoprotein (HDL), low-density lipoprotein (LDL), and Triglyceride (TRG) levels were examined within this cohort. The influence of individual lipid subfractions on domain-specific cognitive performance was investigated using covariate-adjusted generalised linear models. Results Females with PD exhibited significantly higher lipid subfraction levels (TC, HDL, and LDL) when compared to male counterparts. While accounting for covariates, HDL levels were strongly associated with poorer performance across multiple cognitive domains in females but not males. Conversely, TC and LDL levels were not associated with cognitive status in people with PD. Conclusion Higher serum HDL associates with poorer cognitive function in females with PD and presents a sex-specific biomarker for cognitive impairment in PD.
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Affiliation(s)
- Megan C Bakeberg
- Perron Institute for Neurological and Translational Science, Nedlands, WA, Australia.,Centre for Neuromuscular and Neurological Disorders, The University of Western Australia, Perth, WA, Australia
| | - Anastazja M Gorecki
- Perron Institute for Neurological and Translational Science, Nedlands, WA, Australia.,School of Biological Sciences, The University of Western Australia, Perth, WA, Australia
| | - Jade E Kenna
- Perron Institute for Neurological and Translational Science, Nedlands, WA, Australia.,Centre for Neuromuscular and Neurological Disorders, The University of Western Australia, Perth, WA, Australia
| | - Alexa Jefferson
- Perron Institute for Neurological and Translational Science, Nedlands, WA, Australia
| | - Michelle Byrnes
- Perron Institute for Neurological and Translational Science, Nedlands, WA, Australia.,Centre for Neuromuscular and Neurological Disorders, The University of Western Australia, Perth, WA, Australia
| | - Soumya Ghosh
- Perron Institute for Neurological and Translational Science, Nedlands, WA, Australia.,Centre for Neuromuscular and Neurological Disorders, The University of Western Australia, Perth, WA, Australia
| | - Malcolm K Horne
- The Florey Institute of Neuroscience and Mental Health, University of Melbourne, Parkville, VIC, Australia.,Centre for Clinical Neurosciences and Neurological Research, St Vincent's Hospital Melbourne, Fitzroy, VIC, Australia
| | - Sarah McGregor
- Centre for Clinical Neurosciences and Neurological Research, St Vincent's Hospital Melbourne, Fitzroy, VIC, Australia
| | - Rick Stell
- Perron Institute for Neurological and Translational Science, Nedlands, WA, Australia.,Centre for Neuromuscular and Neurological Disorders, The University of Western Australia, Perth, WA, Australia
| | - Sue Walters
- Perron Institute for Neurological and Translational Science, Nedlands, WA, Australia
| | - Frank L Mastaglia
- Perron Institute for Neurological and Translational Science, Nedlands, WA, Australia.,Centre for Neuromuscular and Neurological Disorders, The University of Western Australia, Perth, WA, Australia
| | - Ryan S Anderton
- Perron Institute for Neurological and Translational Science, Nedlands, WA, Australia.,Centre for Neuromuscular and Neurological Disorders, The University of Western Australia, Perth, WA, Australia.,School of Health Sciences, Institute for Health Research, The University of Notre Dame Australia, Fremantle, WA, Australia
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13
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Theunissen F, Anderton RS, Mastaglia FL, Flynn LL, Winter SJ, James I, Bedlack R, Hodgetts S, Fletcher S, Wilton SD, Laing NG, MacShane M, Needham M, Saunders A, Mackay-Sim A, Melamed Z, Ravits J, Cleveland DW, Akkari PA. Novel STMN2 Variant Linked to Amyotrophic Lateral Sclerosis Risk and Clinical Phenotype. Front Aging Neurosci 2021; 13:658226. [PMID: 33841129 PMCID: PMC8033025 DOI: 10.3389/fnagi.2021.658226] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Accepted: 03/02/2021] [Indexed: 12/19/2022] Open
Abstract
Objective There is a critical need to establish genetic markers that explain the complex phenotypes and pathogenicity of ALS. This study identified a polymorphism in the Stathmin-2 gene and investigated its association with sporadic ALS (sALS) disease risk, age-of onset and survival duration. Methods The candidate CA repeat was systematically analyzed using PCR, Sanger sequencing and high throughput capillary separation for genotyping. Stathmin-2 expression was investigated using RT-PCR in patient olfactory neurosphere-derived (ONS) cells and RNA sequencing in laser-captured spinal motor neurons. Results In a case-control analysis of a combined North American sALS cohort (n = 321) and population control group (n = 332), long/long CA genotypes were significantly associated with disease risk (p = 0.042), and most strongly when one allele was a 24 CA repeat (p = 0.0023). In addition, longer CA allele length was associated with earlier age-of-onset (p = 0.039), and shorter survival duration in bulbar-onset cases (p = 0.006). In an Australian longitudinal sALS cohort (n = 67), ALS functional rating scale scores were significantly lower in carriers of the long/long genotype (p = 0.034). Stathmin-2 mRNA expression was reduced in sporadic patient ONS cells. Additionally, sALS patients and controls exhibited variable expression of Stathmin-2 mRNA according to CA genotype in laser-captured spinal motor neurons. Conclusions We report a novel non-coding CA repeat in Stathmin-2 which is associated with sALS disease risk and has disease modifying effects. The potential value of this variant as a disease marker and tool for cohort enrichment in clinical trials warrants further investigation.
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Affiliation(s)
- Frances Theunissen
- Perron Institute for Neurological and Translational Science, Nedlands, WA, Australia.,Centre for Molecular Medicine and Innovative Therapeutics, Murdoch University, Perth, WA, Australia
| | - Ryan S Anderton
- Perron Institute for Neurological and Translational Science, Nedlands, WA, Australia.,Centre for Neuromuscular and Neurological Disorders, University of Western Australia, Nedlands, WA, Australia.,School of Health Sciences, Institute for Health Research, The University of Notre Dame Australia, Fremantle, WA, Australia
| | - Frank L Mastaglia
- Perron Institute for Neurological and Translational Science, Nedlands, WA, Australia.,Centre for Neuromuscular and Neurological Disorders, University of Western Australia, Nedlands, WA, Australia
| | - Loren L Flynn
- Perron Institute for Neurological and Translational Science, Nedlands, WA, Australia.,Centre for Molecular Medicine and Innovative Therapeutics, Murdoch University, Perth, WA, Australia.,Centre for Neuromuscular and Neurological Disorders, University of Western Australia, Nedlands, WA, Australia
| | - Samantha J Winter
- Perron Institute for Neurological and Translational Science, Nedlands, WA, Australia.,School of Health Sciences, Institute for Health Research, The University of Notre Dame Australia, Fremantle, WA, Australia
| | - Ian James
- Institute for Immunology and Infectious Disease, Murdoch University, Perth, WA, Australia
| | - Richard Bedlack
- Department of Neurology, Duke University, Durham, NC, United States
| | - Stuart Hodgetts
- Perron Institute for Neurological and Translational Science, Nedlands, WA, Australia.,School of Human Sciences, University of Western Australia, Nedlands, WA, Australia
| | - Sue Fletcher
- Centre for Molecular Medicine and Innovative Therapeutics, Murdoch University, Perth, WA, Australia.,Centre for Neuromuscular and Neurological Disorders, University of Western Australia, Nedlands, WA, Australia
| | - Steve D Wilton
- Perron Institute for Neurological and Translational Science, Nedlands, WA, Australia.,Centre for Molecular Medicine and Innovative Therapeutics, Murdoch University, Perth, WA, Australia.,Centre for Neuromuscular and Neurological Disorders, University of Western Australia, Nedlands, WA, Australia
| | - Nigel G Laing
- Centre for Medical Research, Harry Perkins Institute of Medical Research, The University of Western Australia, Perth, WA, Australia
| | - Mandi MacShane
- Centre for Medical Research, Harry Perkins Institute of Medical Research, The University of Western Australia, Perth, WA, Australia
| | - Merrilee Needham
- Centre for Molecular Medicine and Innovative Therapeutics, Murdoch University, Perth, WA, Australia.,Faculty of Medicine, The University of Notre Dame Australia, Fremantle, WA, Australia.,Department of Neurology, Fiona Stanley Hospital, Murdoch, WA, Australia
| | - Ann Saunders
- Zinfandel Pharmaceuticals, Chapel Hill, NC, United States
| | - Alan Mackay-Sim
- Perron Institute for Neurological and Translational Science, Nedlands, WA, Australia.,Griffith Institute for Drug Discovery, Griffith University, Nathan, QLD, Australia
| | - Ze'ev Melamed
- Ludwig Institute for Cancer Research, University of California, San Diego, La Jolla, CA, United States.,Department of Cellular and Molecular Medicine, University of California, San Diego, La Jolla, CA, United States
| | - John Ravits
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States
| | - Don W Cleveland
- Ludwig Institute for Cancer Research, University of California, San Diego, La Jolla, CA, United States.,Department of Cellular and Molecular Medicine, University of California, San Diego, La Jolla, CA, United States.,Department of Neurosciences, University of California, San Diego, La Jolla, CA, United States
| | - P Anthony Akkari
- Perron Institute for Neurological and Translational Science, Nedlands, WA, Australia.,Centre for Molecular Medicine and Innovative Therapeutics, Murdoch University, Perth, WA, Australia.,Centre for Neuromuscular and Neurological Disorders, University of Western Australia, Nedlands, WA, Australia.,Department of Neurology, Duke University, Durham, NC, United States
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14
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Bakeberg MC, Hoes ME, Gorecki AM, Theunissen F, Pfaff AL, Kenna JE, Plunkett K, Kõks S, Akkari PA, Mastaglia FL, Anderton RS. The TOMM40 '523' polymorphism in disease risk and age of symptom onset in two independent cohorts of Parkinson's disease. Sci Rep 2021; 11:6363. [PMID: 33737565 PMCID: PMC7973542 DOI: 10.1038/s41598-021-85510-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [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: 12/01/2020] [Accepted: 02/22/2021] [Indexed: 01/31/2023] Open
Abstract
Abnormal mitochondrial function is a key process in the pathogenesis of Parkinson's disease (PD). The central pore-forming protein TOM40 of the mitochondria is encoded by the translocase of outer mitochondrial membrane 40 homologue gene (TOMM40). The highly variant '523' poly-T repeat is associated with age-related cognitive decline and age of onset in Alzheimer's disease, but whether it plays a role in modifying the risk or clinical course of PD it yet to be elucidated. The TOMM40 '523' allele length was determined in 634 people with PD and 422 healthy controls from an Australian cohort and the Parkinson's Progression Markers Initiative (PPMI) cohort, using polymerase chain reaction or whole genome sequencing analysis. Genotype and allele frequencies of TOMM40 '523' and APOE ε did not differ significantly between the cohorts. Analyses revealed TOMM40 '523' allele groups were not associated with disease risk, while considering APOE ε genotype. Regression analyses revealed the TOMM40 S/S genotype was associated with a significantly later age of symptom onset in the PPMI PD cohort, but not after correction for covariates, or in the Australian cohort. Whilst variation in the TOMM40 '523' polymorphism was not associated with PD risk, the possibility that it may be a modifying factor for age of symptom onset warrants further investigation in other PD populations.
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Affiliation(s)
- Megan C Bakeberg
- Perron Institute for Neurological and Translational Science, Nedlands, WA, Australia
- Centre for Neuromuscular and Neurological Disorders, University of Western Australia, Nedlands, WA, Australia
| | - Madison E Hoes
- Perron Institute for Neurological and Translational Science, Nedlands, WA, Australia
| | - Anastazja M Gorecki
- Perron Institute for Neurological and Translational Science, Nedlands, WA, Australia
- School of Biological Sciences, University of Western Australia, Crawley, WA, Australia
| | - Frances Theunissen
- Perron Institute for Neurological and Translational Science, Nedlands, WA, Australia
- The Centre for Molecular Medicine and Innovative Therapeutics, Murdoch University, Murdoch, WA, Australia
| | - Abigail L Pfaff
- Perron Institute for Neurological and Translational Science, Nedlands, WA, Australia
- The Centre for Molecular Medicine and Innovative Therapeutics, Murdoch University, Murdoch, WA, Australia
| | - Jade E Kenna
- Perron Institute for Neurological and Translational Science, Nedlands, WA, Australia
- Centre for Neuromuscular and Neurological Disorders, University of Western Australia, Nedlands, WA, Australia
| | - Kai Plunkett
- Perron Institute for Neurological and Translational Science, Nedlands, WA, Australia
| | - Sulev Kõks
- Perron Institute for Neurological and Translational Science, Nedlands, WA, Australia
- The Centre for Molecular Medicine and Innovative Therapeutics, Murdoch University, Murdoch, WA, Australia
| | - P Anthony Akkari
- Perron Institute for Neurological and Translational Science, Nedlands, WA, Australia
- Centre for Neuromuscular and Neurological Disorders, University of Western Australia, Nedlands, WA, Australia
- The Centre for Molecular Medicine and Innovative Therapeutics, Murdoch University, Murdoch, WA, Australia
| | - Frank L Mastaglia
- Perron Institute for Neurological and Translational Science, Nedlands, WA, Australia
- Centre for Neuromuscular and Neurological Disorders, University of Western Australia, Nedlands, WA, Australia
- The Centre for Molecular Medicine and Innovative Therapeutics, Murdoch University, Murdoch, WA, Australia
| | - Ryan S Anderton
- Perron Institute for Neurological and Translational Science, Nedlands, WA, Australia.
- Centre for Neuromuscular and Neurological Disorders, University of Western Australia, Nedlands, WA, Australia.
- Institute for Health Research and School of Health Sciences, University of Notre Dame Australia, 19 Mouat Street, Fremantle, WA, 6959, Australia.
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15
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Kenna JE, Bakeberg MC, Gorecki AM, Chin Yen Tay A, Winter S, Mastaglia FL, Anderton RS. Characterization of Gastrointestinal Symptom Type and Severity in Parkinson's Disease: A Case-Control Study in an Australian Cohort. Mov Disord Clin Pract 2021; 8:245-253. [PMID: 33553495 DOI: 10.1002/mdc3.13134] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2020] [Revised: 11/19/2020] [Accepted: 12/02/2020] [Indexed: 12/15/2022] Open
Abstract
Background While constipation is a well-known non-motor symptom which may precede the onset of the classical motor symptoms of PD, there have been few comprehensive studies of gastrointestinal (GI) symptoms in people with PD (PwP). Objectives To investigate the spectrum of GI symptoms in an Australian PwP cohort and their relationship to use of anti-parkinsonian medications dietary habits and smoking. Methods The prevalence and severity of GI symptoms were compared in a group of 163 PwP and 113 healthy control subjects using the Gastrointestinal Symptom Rating Scale (GSRS). Corrected linear regression models were used to determine differences between PwP and controls, and to investigate the influence of different classes of anti-Parkinsonian medications. Results PwP reported a greater frequency of constipation and GI-associated illnesses when compared to healthy controls. Total GSRS scores (P < 0.0001), upper GI symptoms (P < 0.0001), and hypoactive GI Symptoms (P < 0.0001) were all significantly greater in the PD cohort than controls. Further analyses revealed a positive association between the use of anti-Parkinsonian medications and total GSRS scores (P < 0.001), as well as upper GI symptoms (P < 0.001) and hypoactive GI function (P < 0.001). Conclusions This study illustrates the frequency and array of GI symptoms in a large PD cohort. The findings indicate that anti-parkinsonian medications play an important role in the presentation and development of GI symptoms.
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Affiliation(s)
- Jade E Kenna
- Perron Institute for Neurological and Translational Science Nedlands Western Australia Australia.,Centre for Neuromuscular and Neurological Disorders University of Western Australia Perth Western Australia Australia.,Centre for Clinical Neurosciences and Neurological Research St. Vincent's Hospital Melbourne Melbourne Australia
| | - Megan C Bakeberg
- Perron Institute for Neurological and Translational Science Nedlands Western Australia Australia.,Centre for Neuromuscular and Neurological Disorders University of Western Australia Perth Western Australia Australia
| | - Anastazja M Gorecki
- Perron Institute for Neurological and Translational Science Nedlands Western Australia Australia.,School of Biological Sciences University of Western Australia Perth Australia
| | - Alfred Chin Yen Tay
- School of Biological Sciences University of Western Australia Perth Australia.,Marshall Centre for Infectious Diseases Research and Training Nedlands Western Australia Australia
| | - Samantha Winter
- Perron Institute for Neurological and Translational Science Nedlands Western Australia Australia.,Institute for Health Research and School of Health Sciences University of Notre Dame Australia Fremantle Western Australia Australia
| | - Frank L Mastaglia
- Perron Institute for Neurological and Translational Science Nedlands Western Australia Australia.,Centre for Neuromuscular and Neurological Disorders University of Western Australia Perth Western Australia Australia
| | - Ryan S Anderton
- Perron Institute for Neurological and Translational Science Nedlands Western Australia Australia.,Centre for Neuromuscular and Neurological Disorders University of Western Australia Perth Western Australia Australia.,Institute for Health Research and School of Health Sciences University of Notre Dame Australia Fremantle Western Australia Australia
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16
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Bakeberg MC, Gorecki AM, Kenna JE, Jefferson A, Byrnes M, Ghosh S, Horne MK, McGregor S, Stell R, Walters S, Chivers P, Winter SJ, Mastaglia FL, Anderton RS. Differential effects of sex on longitudinal patterns of cognitive decline in Parkinson's disease. J Neurol 2021; 268:1903-1912. [PMID: 33399968 PMCID: PMC8068663 DOI: 10.1007/s00415-020-10367-8] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Revised: 12/08/2020] [Accepted: 12/10/2020] [Indexed: 01/12/2023]
Abstract
Background Cognitive impairment is an important and diverse symptom of Parkinson’s disease (PD). Sex is a purported risk variable for cognitive decline in PD, but has not been comprehensively investigated.
Objectives This cross-sectional and longitudinal study examined sex differences in global and domain-specific cognitive performance in a large PD cohort. Methods Cognitive function was evaluated using the Addenbrooke’s Cognitive Examination in 392 people with PD (PwP) from the Australian Parkinson’s Disease Registry. The influence of sex on domain-specific cognitive performance was investigated using covariate-corrected generalised linear models. In a repeated measures longitudinal subset of 127 PwP, linear mixed models were used to assess the impact of sex on cognition over time, while accounting for covariates.
Results Cross-sectional-corrected modelling revealed that sex was significantly predictive of cognitive performance, with males performing worse than females on global cognition, and memory and fluency domains. Longitudinally, sex was significantly predictive of cognitive decline, with males exhibiting a greater reduction in global cognition and language, whereas females showed a greater decline in attention/orientation, memory and visuospatial domains, despite starting with higher baseline scores. At follow-up, a significantly higher proportion of males than females fulfilled criteria for mild cognitive impairment or PD dementia. Conclusions Sex was revealed as a significant determinant of overall cognitive performance as well as specific cognitive domains, with a differential pattern of decline in male and female participants. Such sex-specific findings appear to explain some of the heterogeneity observed in PD, warranting further investigation of mechanisms underlying this sexual dimorphism. Supplementary Information The online version contains supplementary material available at 10.1007/s00415-020-10367-8.
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Affiliation(s)
- Megan C Bakeberg
- Perron Institute for Neurological and Translational Science, Nedlands, WA, Australia.,Centre for Neuromuscular and Neurological Disorders, University of Western Australia, Nedlands, WA, Australia
| | - Anastazja M Gorecki
- Perron Institute for Neurological and Translational Science, Nedlands, WA, Australia.,School of Biological Sciences, University of Western Australia, Crawley, WA, Australia
| | - Jade E Kenna
- Perron Institute for Neurological and Translational Science, Nedlands, WA, Australia.,Centre for Neuromuscular and Neurological Disorders, University of Western Australia, Nedlands, WA, Australia
| | - Alexa Jefferson
- Perron Institute for Neurological and Translational Science, Nedlands, WA, Australia
| | - Michelle Byrnes
- Perron Institute for Neurological and Translational Science, Nedlands, WA, Australia.,Centre for Neuromuscular and Neurological Disorders, University of Western Australia, Nedlands, WA, Australia
| | - Soumya Ghosh
- Perron Institute for Neurological and Translational Science, Nedlands, WA, Australia.,Centre for Neuromuscular and Neurological Disorders, University of Western Australia, Nedlands, WA, Australia
| | - Malcolm K Horne
- Florey Institute for Neuroscience and Mental Health, University of Melbourne, Parkville, VIC, Australia.,Centre for Clinical Neurosciences and Neurological Research, St Vincent's Hospital Melbourne, Fitzroy, VIC, Australia
| | - Sarah McGregor
- Centre for Clinical Neurosciences and Neurological Research, St Vincent's Hospital Melbourne, Fitzroy, VIC, Australia
| | - Rick Stell
- Perron Institute for Neurological and Translational Science, Nedlands, WA, Australia.,Centre for Neuromuscular and Neurological Disorders, University of Western Australia, Nedlands, WA, Australia
| | - Sue Walters
- Perron Institute for Neurological and Translational Science, Nedlands, WA, Australia
| | - Paola Chivers
- Institute for Health Research and School of Health Sciences, University of Notre Dame Australia, Fremantle, WA, Australia.,Exercise Medicine Research Institute and School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA, Australia
| | - Samantha J Winter
- Perron Institute for Neurological and Translational Science, Nedlands, WA, Australia.,Institute for Health Research and School of Health Sciences, University of Notre Dame Australia, Fremantle, WA, Australia
| | - Frank L Mastaglia
- Perron Institute for Neurological and Translational Science, Nedlands, WA, Australia.,Centre for Neuromuscular and Neurological Disorders, University of Western Australia, Nedlands, WA, Australia
| | - Ryan S Anderton
- Perron Institute for Neurological and Translational Science, Nedlands, WA, Australia. .,Centre for Neuromuscular and Neurological Disorders, University of Western Australia, Nedlands, WA, Australia. .,Institute for Health Research and School of Health Sciences, University of Notre Dame Australia, Fremantle, WA, Australia.
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17
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Gorecki AM, Bakeberg MC, Theunissen F, Kenna JE, Hoes ME, Pfaff AL, Akkari PA, Dunlop SA, Kõks S, Mastaglia FL, Anderton RS. Single Nucleotide Polymorphisms Associated With Gut Homeostasis Influence Risk and Age-at-Onset of Parkinson's Disease. Front Aging Neurosci 2020; 12:603849. [PMID: 33328979 PMCID: PMC7718032 DOI: 10.3389/fnagi.2020.603849] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Accepted: 10/20/2020] [Indexed: 12/18/2022] Open
Abstract
Research is increasingly focusing on gut inflammation as a contributor to Parkinson's disease (PD). Such gut inflammation is proposed to arise from a complex interaction between various genetic, environmental, and lifestyle factors, however these factors are under-characterized. This study investigated the association between PD and single-nucleotide polymorphisms (SNPs) in genes responsible for binding of bacterial metabolites and intestinal homeostasis, which have been implicated in intestinal infections or inflammatory bowel disease. A case-control analysis was performed utilizing the following cohorts: (i) patients from the Australian Parkinson's Disease Registry (APDR) (n = 212); (ii) a Caucasian subset of the Parkinson's Progression Markers Initiative (PPMI) cohort (n = 376); (iii) a combined control group (n = 404). The following SNPs were analyzed: PGLYRP2 rs892145, PGLYRP4 rs10888557, TLR1 rs4833095, TLR2 rs3804099, TLR4 rs7873784, CD14 rs2569190, MUC1 rs4072037, MUC2 rs11825977, CLDN2 rs12008279 and rs12014762, and CLDN4 rs8629. PD risk was significantly associated with PGLYRP4 rs10888557 genotype in both cohorts. PGLYRP2 rs892145 and TLR1 rs4833095 were also associated with disease risk in the APDR cohort, and TLR2 rs3804099 and MUC2 rs11825977 genotypes in the PPMI cohort. Interactive risk effects between PGLYRP2/PGLYRP4 and PGLYRP4/TLR2 were evident in the APDR and PPMI cohorts, respectively. In the APDR cohort, the PGLYRP4 GC genotype was significantly associated with age of symptom onset, independently of gender, toxin exposure or smoking status. This study demonstrates that genetic variation in the bacterial receptor PGLYRP4 may modulate risk and age-of-onset in idiopathic PD, while variants in PGLYRP2, TLR1/2, and MUC2 may also influence PD risk. Overall, this study provides evidence to support the role of dysregulated host-microbiome signaling and gut inflammation in PD, and further investigation of these SNPs and proteins may help identify people at risk of developing PD or increase understanding of early disease mechanisms.
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Affiliation(s)
- Anastazja M Gorecki
- Perron Institute for Neurological and Translational Science, Nedlands, WA, Australia.,School of Biological Sciences, University of Western Australia, Crawley, WA, Australia
| | - Megan C Bakeberg
- Perron Institute for Neurological and Translational Science, Nedlands, WA, Australia.,Centre for Neuromuscular and Neurological Disorders, University of Western Australia, Nedlands, WA, Australia
| | - Frances Theunissen
- Perron Institute for Neurological and Translational Science, Nedlands, WA, Australia.,The Centre for Molecular Medicine and Innovative Therapeutics, Murdoch University, Murdoch, WA, Australia
| | - Jade E Kenna
- Perron Institute for Neurological and Translational Science, Nedlands, WA, Australia.,Centre for Neuromuscular and Neurological Disorders, University of Western Australia, Nedlands, WA, Australia
| | - Madison E Hoes
- Perron Institute for Neurological and Translational Science, Nedlands, WA, Australia
| | - Abigail L Pfaff
- Perron Institute for Neurological and Translational Science, Nedlands, WA, Australia.,The Centre for Molecular Medicine and Innovative Therapeutics, Murdoch University, Murdoch, WA, Australia
| | - P Anthony Akkari
- Perron Institute for Neurological and Translational Science, Nedlands, WA, Australia.,Centre for Neuromuscular and Neurological Disorders, University of Western Australia, Nedlands, WA, Australia.,The Centre for Molecular Medicine and Innovative Therapeutics, Murdoch University, Murdoch, WA, Australia
| | - Sarah A Dunlop
- School of Biological Sciences, University of Western Australia, Crawley, WA, Australia.,Minderoo Foundation, Perth, WA, Australia
| | - Sulev Kõks
- Perron Institute for Neurological and Translational Science, Nedlands, WA, Australia.,The Centre for Molecular Medicine and Innovative Therapeutics, Murdoch University, Murdoch, WA, Australia
| | - Frank L Mastaglia
- Perron Institute for Neurological and Translational Science, Nedlands, WA, Australia.,Centre for Neuromuscular and Neurological Disorders, University of Western Australia, Nedlands, WA, Australia
| | - Ryan S Anderton
- Perron Institute for Neurological and Translational Science, Nedlands, WA, Australia.,Centre for Neuromuscular and Neurological Disorders, University of Western Australia, Nedlands, WA, Australia.,Institute for Health Research, University of Notre Dame Australia, Fremantle, WA, Australia.,School of Health Sciences, University of Notre Dame Australia, Fremantle, WA, Australia
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18
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Abstract
Drug-induced myopathies are a group of disorders whose importance lies in the fact that they are potentially treatable and usually reversible if the causative agent is identified and withdrawn. A wide variety of medications used in many different branches of medicine have been recognised as causing muscle adverse effects, ranging from myalgia and asymptomatic hyperCKaemia to severe weakness and at times fatal rhabdomyolysis. There has been increased awareness of these complications since the introduction of the 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitor group of drugs (statins) in the 1980s, and their subsequent association with a range of necrotising and immune-mediated inflammatory myopathies and muscle symptoms. More recently, since the introduction of the immune checkpoint inhibitors for the treatment of advanced malignancies, it has been increasingly recognised that these drugs also have a propensity to induce or exacerbate a variety of immune-mediated myopathies, neuropathies, myasthenic disorders and atypical overlap syndromes, and it is anticipated that these complications will become even more prevalent with increasing use of these medications in the future. This review focusses mainly on these two groups of drugs, and on cytokine-based therapies and VEGF inhibitors which have also been implicated in the induction of immune-mediated inflammatory myopathies.
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Affiliation(s)
- Frank L. Mastaglia
- Correspondence Frank Mastaglia Perron Institute for Neurological and Translational Science, Block RR, QEII Medical Centre, Nedlands, 6009, Western Australia. Tel.: +61 08 417 180 866 E-mail:
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19
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Yuan J, Meloni BP, Shi T, Bonser A, Papadimitriou JM, Mastaglia FL, Zhang C, Zheng M, Gao J. The Potential Influence of Bone-Derived Modulators on the Progression of Alzheimer's Disease. J Alzheimers Dis 2020; 69:59-70. [PMID: 30932886 DOI: 10.3233/jad-181249] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Bone, the major structural scaffold of the human body, has recently been demonstrated to interact with several other organ systems through the actions of bone-derived cells and bone-derived cell secretory proteins. Interestingly, the brain is one organ that appears to fall into this interconnected network. Furthermore, the fact that osteoporosis and Alzheimer's disease are two common age-related disorders raises the possibility that these two organ systems are interconnected in terms of disease pathogenesis. This review focuses on the latest evidence demonstrating the impact of bone-derived cells and bone-derived proteins on the central nervous system, and on how this may be relevant in the progression of Alzheimer's disease and for the identification of novel therapeutic approaches to treat this neurodegenerative disorder.
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Affiliation(s)
- Jun Yuan
- Centre for Orthopaedic Research, Faculty of Health and Medical Sciences, The University of Western Australia, Nedlands, WA, Australia.,Perron Institute for Neurological and Translational Science, Nedlands, WA, Australia
| | - Bruno P Meloni
- Perron Institute for Neurological and Translational Science, Nedlands, WA, Australia.,Department of Neurosurgery, Sir Charles Gairdner Hospital, QEII Medical Centre, Nedlands, WA, Australia.,Centre for Neuromuscular and Neurological Disorders, The University of Western Australia, Nedlands, WA, Australia
| | - Tianxing Shi
- Department of Art as Applied to Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Anne Bonser
- Centre for Orthopaedic Research, Faculty of Health and Medical Sciences, The University of Western Australia, Nedlands, WA, Australia
| | - John M Papadimitriou
- Pathwest Laboratories and Faculty of Health and Medical Sciences, The University of Western Australia, Nedlands, WA, Australia
| | - Frank L Mastaglia
- Perron Institute for Neurological and Translational Science, Nedlands, WA, Australia.,Centre for Neuromuscular and Neurological Disorders, The University of Western Australia, Nedlands, WA, Australia
| | - Changqing Zhang
- Department of Orthopaedic Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
| | - Minghao Zheng
- Centre for Orthopaedic Research, Faculty of Health and Medical Sciences, The University of Western Australia, Nedlands, WA, Australia.,Perron Institute for Neurological and Translational Science, Nedlands, WA, Australia
| | - Junjie Gao
- Perron Institute for Neurological and Translational Science, Nedlands, WA, Australia.,Centre for Orthopaedic Research, Faculty of Health and Medical Sciences, The University of Western Australia, Nedlands, WA, Australia.,Department of Orthopaedic Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
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20
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Affiliation(s)
- Bruno P Meloni
- Perron Institute for Neurological and Translational Science , Nedlands, Australia.,Department of Neurosurgery, Sir Charles Gairdner Hospital, QEII Medical Centre , Nedlands, Western Australia, Australia.,Centre for Neuromuscular and Neurological Disorders, The University of Western Australia , Nedlands, Western Australia, Australia
| | - David J Blacker
- Perron Institute for Neurological and Translational Science , Nedlands, Australia.,Department of Neurosurgery, Sir Charles Gairdner Hospital, QEII Medical Centre , Nedlands, Western Australia, Australia.,Department of Neurology, Sir Charles Gairdner Hospital, QEII Medical Centre , Nedlands, Western Australia, Australia
| | - Frank L Mastaglia
- Perron Institute for Neurological and Translational Science , Nedlands, Australia.,Department of Neurosurgery, Sir Charles Gairdner Hospital, QEII Medical Centre , Nedlands, Western Australia, Australia
| | - Neville W Knuckey
- Perron Institute for Neurological and Translational Science , Nedlands, Australia.,Department of Neurosurgery, Sir Charles Gairdner Hospital, QEII Medical Centre , Nedlands, Western Australia, Australia.,Centre for Neuromuscular and Neurological Disorders, The University of Western Australia , Nedlands, Western Australia, Australia
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21
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Li D, Mastaglia FL, Fletcher S, Wilton SD. Progress in the molecular pathogenesis and nucleic acid therapeutics for Parkinson's disease in the precision medicine era. Med Res Rev 2020; 40:2650-2681. [PMID: 32767426 PMCID: PMC7589267 DOI: 10.1002/med.21718] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Revised: 07/02/2020] [Accepted: 07/25/2020] [Indexed: 12/16/2022]
Abstract
Parkinson's disease (PD) is one of the most common neurodegenerative disorders that manifest various motor and nonmotor symptoms. Although currently available therapies can alleviate some of the symptoms, the disease continues to progress, leading eventually to severe motor and cognitive decline and reduced life expectancy. The past two decades have witnessed rapid progress in our understanding of the molecular and genetic pathogenesis of the disease, paving the way for the development of new therapeutic approaches to arrest or delay the neurodegenerative process. As a result of these advances, biomarker‐driven subtyping is making it possible to stratify PD patients into more homogeneous subgroups that may better respond to potential genetic‐molecular pathway targeted disease‐modifying therapies. Therapeutic nucleic acid oligomers can bind to target gene sequences with very high specificity in a base‐pairing manner and precisely modulate downstream molecular events. Recently, nucleic acid therapeutics have proven effective in the treatment of a number of severe neurological and neuromuscular disorders, drawing increasing attention to the possibility of developing novel molecular therapies for PD. In this review, we update the molecular pathogenesis of PD and discuss progress in the use of antisense oligonucleotides, small interfering RNAs, short hairpin RNAs, aptamers, and microRNA‐based therapeutics to target critical elements in the pathogenesis of PD that could have the potential to modify disease progression. In addition, recent advances in the delivery of nucleic acid compounds across the blood–brain barrier and challenges facing PD clinical trials are also reviewed.
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Affiliation(s)
- Dunhui Li
- Centre for Molecular Medicine and Innovative Therapeutics, Murdoch University, Murdoch, Western Australia, Australia.,Perron Institute for Neurological and Translational Science, University of Western Australia, Nedlands, Western Australia, Australia
| | - Frank L Mastaglia
- Perron Institute for Neurological and Translational Science, University of Western Australia, Nedlands, Western Australia, Australia
| | - Sue Fletcher
- Centre for Molecular Medicine and Innovative Therapeutics, Murdoch University, Murdoch, Western Australia, Australia.,Perron Institute for Neurological and Translational Science, University of Western Australia, Nedlands, Western Australia, Australia
| | - Steve D Wilton
- Centre for Molecular Medicine and Innovative Therapeutics, Murdoch University, Murdoch, Western Australia, Australia.,Perron Institute for Neurological and Translational Science, University of Western Australia, Nedlands, Western Australia, Australia
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22
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Pytte J, Flynn LL, Anderton RS, Mastaglia FL, Theunissen F, James I, Pfaff A, Koks S, Saunders AM, Bedlack R, Burns DK, Lutz MW, Siddique N, Siddique T, Roses AD, Akkari PA. Disease-modifying effects of an SCAF4 structural variant in a predominantly SOD1 ALS cohort. Neurol Genet 2020; 6:e470. [PMID: 32754644 PMCID: PMC7357414 DOI: 10.1212/nxg.0000000000000470] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Accepted: 06/02/2020] [Indexed: 12/31/2022]
Abstract
OBJECTIVE To test the hypothesis that rs573116164 will have disease-modifying effects in patients with superoxide dismutase 1 (SOD1) familial amyotrophic lateral sclerosis (fALS), we characterized rs573116164 within a cohort of 190 patients with fALS and 560 healthy age-matched controls to assess the variant for association with various measures of disease. METHODS Using a previously described bioinformatics evaluation algorithm, a polymorphic short structural variant associated with SOD1 was identified according to its theoretical effect on gene expression. An 12-18 poly-T repeat (rs573116164) within the 3' untranslated region of serine and arginine rich proteins-related carboxy terminal domain associated factor 4 (SCAF4), a gene that is adjacent to SOD1, was assessed for disease association and influence on survival and age at onset in an fALS cohort using PCR, Sanger sequencing, and capillary separation techniques for allele detection. RESULTS In a North American cohort of predominantly SOD1 fALS patients (n =190) and age-matched healthy controls (n = 560), we showed that carriage of an 18T SCAF4 allele was associated with disease within this cohort (odds ratio [OR] 6.6; 95% confidence interval [CI] 3.9-11.2; p = 4.0e-11), but also within non-SOD1 cases (n = 27; OR 5.3; 95% CI 1.9-14.5; p = 0.0014). This finding suggests genetically SOD1-independent effects of SCAF4 on fALS susceptibility. Furthermore, carriage of an 18T allele was associated with a 26-month reduction in survival time (95% CI 6.6-40.8; p = 0.014), but did not affect age at onset of disease. CONCLUSIONS The findings in this fALS cohort suggest that rs573116164 could have SOD1-independent and broader relevance in ALS, warranting further investigation in other fALS and sporadic ALS cohorts, as well as studies of functional effects of the 18T variant on gene expression.
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Affiliation(s)
- Julia Pytte
- Centre for Neuromuscular and Neurological Disorders (J.P., L.L.F., R.S.A., F.L.M., F.T., A.P., S.K., P.A.A.), University of Western Australia, Crawley; Perron Institute for Neurological and Translational Science (J.P., L.L.F., R.S.A., F.L.M., F.T., A.P., S.K., P.A.A.), Nedlands; Centre for Molecular Medicine and Innovative Therapeutics (L.L.F., A.P., S.K., P.A.A.), Murdoch University; School of Health Sciences (R.S.A.), and Institute for Health Research (R.S.A.), University of Notre Dame Australia, Fremantle; Institute for Immunology and Infectious Diseases (I.J.), Murdoch University, Australia; Department of Neurology (A.M.S., R.B., M.W.L., A.D.R.), Duke University School of Medicine, Durham, NC; Zinfandel Pharmaceuticals, Inc. (A.M.S., D.K.B., A.D.R.), Durham, NC; ALS Clinic (R.B.), Duke University, Durham, NC; Departments of Neurology, Pathology and Cell and Molecular Biology (N.S., T.S.), the Les Turner ALS Center, Northwestern University Feinberg School of Medicine; and the Northwestern University Interdepartmental Neuroscience Program (N.S., T.S.), Chicago, IL
| | - Loren L Flynn
- Centre for Neuromuscular and Neurological Disorders (J.P., L.L.F., R.S.A., F.L.M., F.T., A.P., S.K., P.A.A.), University of Western Australia, Crawley; Perron Institute for Neurological and Translational Science (J.P., L.L.F., R.S.A., F.L.M., F.T., A.P., S.K., P.A.A.), Nedlands; Centre for Molecular Medicine and Innovative Therapeutics (L.L.F., A.P., S.K., P.A.A.), Murdoch University; School of Health Sciences (R.S.A.), and Institute for Health Research (R.S.A.), University of Notre Dame Australia, Fremantle; Institute for Immunology and Infectious Diseases (I.J.), Murdoch University, Australia; Department of Neurology (A.M.S., R.B., M.W.L., A.D.R.), Duke University School of Medicine, Durham, NC; Zinfandel Pharmaceuticals, Inc. (A.M.S., D.K.B., A.D.R.), Durham, NC; ALS Clinic (R.B.), Duke University, Durham, NC; Departments of Neurology, Pathology and Cell and Molecular Biology (N.S., T.S.), the Les Turner ALS Center, Northwestern University Feinberg School of Medicine; and the Northwestern University Interdepartmental Neuroscience Program (N.S., T.S.), Chicago, IL
| | - Ryan S Anderton
- Centre for Neuromuscular and Neurological Disorders (J.P., L.L.F., R.S.A., F.L.M., F.T., A.P., S.K., P.A.A.), University of Western Australia, Crawley; Perron Institute for Neurological and Translational Science (J.P., L.L.F., R.S.A., F.L.M., F.T., A.P., S.K., P.A.A.), Nedlands; Centre for Molecular Medicine and Innovative Therapeutics (L.L.F., A.P., S.K., P.A.A.), Murdoch University; School of Health Sciences (R.S.A.), and Institute for Health Research (R.S.A.), University of Notre Dame Australia, Fremantle; Institute for Immunology and Infectious Diseases (I.J.), Murdoch University, Australia; Department of Neurology (A.M.S., R.B., M.W.L., A.D.R.), Duke University School of Medicine, Durham, NC; Zinfandel Pharmaceuticals, Inc. (A.M.S., D.K.B., A.D.R.), Durham, NC; ALS Clinic (R.B.), Duke University, Durham, NC; Departments of Neurology, Pathology and Cell and Molecular Biology (N.S., T.S.), the Les Turner ALS Center, Northwestern University Feinberg School of Medicine; and the Northwestern University Interdepartmental Neuroscience Program (N.S., T.S.), Chicago, IL
| | - Frank L Mastaglia
- Centre for Neuromuscular and Neurological Disorders (J.P., L.L.F., R.S.A., F.L.M., F.T., A.P., S.K., P.A.A.), University of Western Australia, Crawley; Perron Institute for Neurological and Translational Science (J.P., L.L.F., R.S.A., F.L.M., F.T., A.P., S.K., P.A.A.), Nedlands; Centre for Molecular Medicine and Innovative Therapeutics (L.L.F., A.P., S.K., P.A.A.), Murdoch University; School of Health Sciences (R.S.A.), and Institute for Health Research (R.S.A.), University of Notre Dame Australia, Fremantle; Institute for Immunology and Infectious Diseases (I.J.), Murdoch University, Australia; Department of Neurology (A.M.S., R.B., M.W.L., A.D.R.), Duke University School of Medicine, Durham, NC; Zinfandel Pharmaceuticals, Inc. (A.M.S., D.K.B., A.D.R.), Durham, NC; ALS Clinic (R.B.), Duke University, Durham, NC; Departments of Neurology, Pathology and Cell and Molecular Biology (N.S., T.S.), the Les Turner ALS Center, Northwestern University Feinberg School of Medicine; and the Northwestern University Interdepartmental Neuroscience Program (N.S., T.S.), Chicago, IL
| | - Frances Theunissen
- Centre for Neuromuscular and Neurological Disorders (J.P., L.L.F., R.S.A., F.L.M., F.T., A.P., S.K., P.A.A.), University of Western Australia, Crawley; Perron Institute for Neurological and Translational Science (J.P., L.L.F., R.S.A., F.L.M., F.T., A.P., S.K., P.A.A.), Nedlands; Centre for Molecular Medicine and Innovative Therapeutics (L.L.F., A.P., S.K., P.A.A.), Murdoch University; School of Health Sciences (R.S.A.), and Institute for Health Research (R.S.A.), University of Notre Dame Australia, Fremantle; Institute for Immunology and Infectious Diseases (I.J.), Murdoch University, Australia; Department of Neurology (A.M.S., R.B., M.W.L., A.D.R.), Duke University School of Medicine, Durham, NC; Zinfandel Pharmaceuticals, Inc. (A.M.S., D.K.B., A.D.R.), Durham, NC; ALS Clinic (R.B.), Duke University, Durham, NC; Departments of Neurology, Pathology and Cell and Molecular Biology (N.S., T.S.), the Les Turner ALS Center, Northwestern University Feinberg School of Medicine; and the Northwestern University Interdepartmental Neuroscience Program (N.S., T.S.), Chicago, IL
| | - Ian James
- Centre for Neuromuscular and Neurological Disorders (J.P., L.L.F., R.S.A., F.L.M., F.T., A.P., S.K., P.A.A.), University of Western Australia, Crawley; Perron Institute for Neurological and Translational Science (J.P., L.L.F., R.S.A., F.L.M., F.T., A.P., S.K., P.A.A.), Nedlands; Centre for Molecular Medicine and Innovative Therapeutics (L.L.F., A.P., S.K., P.A.A.), Murdoch University; School of Health Sciences (R.S.A.), and Institute for Health Research (R.S.A.), University of Notre Dame Australia, Fremantle; Institute for Immunology and Infectious Diseases (I.J.), Murdoch University, Australia; Department of Neurology (A.M.S., R.B., M.W.L., A.D.R.), Duke University School of Medicine, Durham, NC; Zinfandel Pharmaceuticals, Inc. (A.M.S., D.K.B., A.D.R.), Durham, NC; ALS Clinic (R.B.), Duke University, Durham, NC; Departments of Neurology, Pathology and Cell and Molecular Biology (N.S., T.S.), the Les Turner ALS Center, Northwestern University Feinberg School of Medicine; and the Northwestern University Interdepartmental Neuroscience Program (N.S., T.S.), Chicago, IL
| | - Abigail Pfaff
- Centre for Neuromuscular and Neurological Disorders (J.P., L.L.F., R.S.A., F.L.M., F.T., A.P., S.K., P.A.A.), University of Western Australia, Crawley; Perron Institute for Neurological and Translational Science (J.P., L.L.F., R.S.A., F.L.M., F.T., A.P., S.K., P.A.A.), Nedlands; Centre for Molecular Medicine and Innovative Therapeutics (L.L.F., A.P., S.K., P.A.A.), Murdoch University; School of Health Sciences (R.S.A.), and Institute for Health Research (R.S.A.), University of Notre Dame Australia, Fremantle; Institute for Immunology and Infectious Diseases (I.J.), Murdoch University, Australia; Department of Neurology (A.M.S., R.B., M.W.L., A.D.R.), Duke University School of Medicine, Durham, NC; Zinfandel Pharmaceuticals, Inc. (A.M.S., D.K.B., A.D.R.), Durham, NC; ALS Clinic (R.B.), Duke University, Durham, NC; Departments of Neurology, Pathology and Cell and Molecular Biology (N.S., T.S.), the Les Turner ALS Center, Northwestern University Feinberg School of Medicine; and the Northwestern University Interdepartmental Neuroscience Program (N.S., T.S.), Chicago, IL
| | - Sulev Koks
- Centre for Neuromuscular and Neurological Disorders (J.P., L.L.F., R.S.A., F.L.M., F.T., A.P., S.K., P.A.A.), University of Western Australia, Crawley; Perron Institute for Neurological and Translational Science (J.P., L.L.F., R.S.A., F.L.M., F.T., A.P., S.K., P.A.A.), Nedlands; Centre for Molecular Medicine and Innovative Therapeutics (L.L.F., A.P., S.K., P.A.A.), Murdoch University; School of Health Sciences (R.S.A.), and Institute for Health Research (R.S.A.), University of Notre Dame Australia, Fremantle; Institute for Immunology and Infectious Diseases (I.J.), Murdoch University, Australia; Department of Neurology (A.M.S., R.B., M.W.L., A.D.R.), Duke University School of Medicine, Durham, NC; Zinfandel Pharmaceuticals, Inc. (A.M.S., D.K.B., A.D.R.), Durham, NC; ALS Clinic (R.B.), Duke University, Durham, NC; Departments of Neurology, Pathology and Cell and Molecular Biology (N.S., T.S.), the Les Turner ALS Center, Northwestern University Feinberg School of Medicine; and the Northwestern University Interdepartmental Neuroscience Program (N.S., T.S.), Chicago, IL
| | - Ann M Saunders
- Centre for Neuromuscular and Neurological Disorders (J.P., L.L.F., R.S.A., F.L.M., F.T., A.P., S.K., P.A.A.), University of Western Australia, Crawley; Perron Institute for Neurological and Translational Science (J.P., L.L.F., R.S.A., F.L.M., F.T., A.P., S.K., P.A.A.), Nedlands; Centre for Molecular Medicine and Innovative Therapeutics (L.L.F., A.P., S.K., P.A.A.), Murdoch University; School of Health Sciences (R.S.A.), and Institute for Health Research (R.S.A.), University of Notre Dame Australia, Fremantle; Institute for Immunology and Infectious Diseases (I.J.), Murdoch University, Australia; Department of Neurology (A.M.S., R.B., M.W.L., A.D.R.), Duke University School of Medicine, Durham, NC; Zinfandel Pharmaceuticals, Inc. (A.M.S., D.K.B., A.D.R.), Durham, NC; ALS Clinic (R.B.), Duke University, Durham, NC; Departments of Neurology, Pathology and Cell and Molecular Biology (N.S., T.S.), the Les Turner ALS Center, Northwestern University Feinberg School of Medicine; and the Northwestern University Interdepartmental Neuroscience Program (N.S., T.S.), Chicago, IL
| | - Richard Bedlack
- Centre for Neuromuscular and Neurological Disorders (J.P., L.L.F., R.S.A., F.L.M., F.T., A.P., S.K., P.A.A.), University of Western Australia, Crawley; Perron Institute for Neurological and Translational Science (J.P., L.L.F., R.S.A., F.L.M., F.T., A.P., S.K., P.A.A.), Nedlands; Centre for Molecular Medicine and Innovative Therapeutics (L.L.F., A.P., S.K., P.A.A.), Murdoch University; School of Health Sciences (R.S.A.), and Institute for Health Research (R.S.A.), University of Notre Dame Australia, Fremantle; Institute for Immunology and Infectious Diseases (I.J.), Murdoch University, Australia; Department of Neurology (A.M.S., R.B., M.W.L., A.D.R.), Duke University School of Medicine, Durham, NC; Zinfandel Pharmaceuticals, Inc. (A.M.S., D.K.B., A.D.R.), Durham, NC; ALS Clinic (R.B.), Duke University, Durham, NC; Departments of Neurology, Pathology and Cell and Molecular Biology (N.S., T.S.), the Les Turner ALS Center, Northwestern University Feinberg School of Medicine; and the Northwestern University Interdepartmental Neuroscience Program (N.S., T.S.), Chicago, IL
| | - Daniel K Burns
- Centre for Neuromuscular and Neurological Disorders (J.P., L.L.F., R.S.A., F.L.M., F.T., A.P., S.K., P.A.A.), University of Western Australia, Crawley; Perron Institute for Neurological and Translational Science (J.P., L.L.F., R.S.A., F.L.M., F.T., A.P., S.K., P.A.A.), Nedlands; Centre for Molecular Medicine and Innovative Therapeutics (L.L.F., A.P., S.K., P.A.A.), Murdoch University; School of Health Sciences (R.S.A.), and Institute for Health Research (R.S.A.), University of Notre Dame Australia, Fremantle; Institute for Immunology and Infectious Diseases (I.J.), Murdoch University, Australia; Department of Neurology (A.M.S., R.B., M.W.L., A.D.R.), Duke University School of Medicine, Durham, NC; Zinfandel Pharmaceuticals, Inc. (A.M.S., D.K.B., A.D.R.), Durham, NC; ALS Clinic (R.B.), Duke University, Durham, NC; Departments of Neurology, Pathology and Cell and Molecular Biology (N.S., T.S.), the Les Turner ALS Center, Northwestern University Feinberg School of Medicine; and the Northwestern University Interdepartmental Neuroscience Program (N.S., T.S.), Chicago, IL
| | - Michael W Lutz
- Centre for Neuromuscular and Neurological Disorders (J.P., L.L.F., R.S.A., F.L.M., F.T., A.P., S.K., P.A.A.), University of Western Australia, Crawley; Perron Institute for Neurological and Translational Science (J.P., L.L.F., R.S.A., F.L.M., F.T., A.P., S.K., P.A.A.), Nedlands; Centre for Molecular Medicine and Innovative Therapeutics (L.L.F., A.P., S.K., P.A.A.), Murdoch University; School of Health Sciences (R.S.A.), and Institute for Health Research (R.S.A.), University of Notre Dame Australia, Fremantle; Institute for Immunology and Infectious Diseases (I.J.), Murdoch University, Australia; Department of Neurology (A.M.S., R.B., M.W.L., A.D.R.), Duke University School of Medicine, Durham, NC; Zinfandel Pharmaceuticals, Inc. (A.M.S., D.K.B., A.D.R.), Durham, NC; ALS Clinic (R.B.), Duke University, Durham, NC; Departments of Neurology, Pathology and Cell and Molecular Biology (N.S., T.S.), the Les Turner ALS Center, Northwestern University Feinberg School of Medicine; and the Northwestern University Interdepartmental Neuroscience Program (N.S., T.S.), Chicago, IL
| | - Nailah Siddique
- Centre for Neuromuscular and Neurological Disorders (J.P., L.L.F., R.S.A., F.L.M., F.T., A.P., S.K., P.A.A.), University of Western Australia, Crawley; Perron Institute for Neurological and Translational Science (J.P., L.L.F., R.S.A., F.L.M., F.T., A.P., S.K., P.A.A.), Nedlands; Centre for Molecular Medicine and Innovative Therapeutics (L.L.F., A.P., S.K., P.A.A.), Murdoch University; School of Health Sciences (R.S.A.), and Institute for Health Research (R.S.A.), University of Notre Dame Australia, Fremantle; Institute for Immunology and Infectious Diseases (I.J.), Murdoch University, Australia; Department of Neurology (A.M.S., R.B., M.W.L., A.D.R.), Duke University School of Medicine, Durham, NC; Zinfandel Pharmaceuticals, Inc. (A.M.S., D.K.B., A.D.R.), Durham, NC; ALS Clinic (R.B.), Duke University, Durham, NC; Departments of Neurology, Pathology and Cell and Molecular Biology (N.S., T.S.), the Les Turner ALS Center, Northwestern University Feinberg School of Medicine; and the Northwestern University Interdepartmental Neuroscience Program (N.S., T.S.), Chicago, IL
| | - Teepu Siddique
- Centre for Neuromuscular and Neurological Disorders (J.P., L.L.F., R.S.A., F.L.M., F.T., A.P., S.K., P.A.A.), University of Western Australia, Crawley; Perron Institute for Neurological and Translational Science (J.P., L.L.F., R.S.A., F.L.M., F.T., A.P., S.K., P.A.A.), Nedlands; Centre for Molecular Medicine and Innovative Therapeutics (L.L.F., A.P., S.K., P.A.A.), Murdoch University; School of Health Sciences (R.S.A.), and Institute for Health Research (R.S.A.), University of Notre Dame Australia, Fremantle; Institute for Immunology and Infectious Diseases (I.J.), Murdoch University, Australia; Department of Neurology (A.M.S., R.B., M.W.L., A.D.R.), Duke University School of Medicine, Durham, NC; Zinfandel Pharmaceuticals, Inc. (A.M.S., D.K.B., A.D.R.), Durham, NC; ALS Clinic (R.B.), Duke University, Durham, NC; Departments of Neurology, Pathology and Cell and Molecular Biology (N.S., T.S.), the Les Turner ALS Center, Northwestern University Feinberg School of Medicine; and the Northwestern University Interdepartmental Neuroscience Program (N.S., T.S.), Chicago, IL
| | - Allen D Roses
- Centre for Neuromuscular and Neurological Disorders (J.P., L.L.F., R.S.A., F.L.M., F.T., A.P., S.K., P.A.A.), University of Western Australia, Crawley; Perron Institute for Neurological and Translational Science (J.P., L.L.F., R.S.A., F.L.M., F.T., A.P., S.K., P.A.A.), Nedlands; Centre for Molecular Medicine and Innovative Therapeutics (L.L.F., A.P., S.K., P.A.A.), Murdoch University; School of Health Sciences (R.S.A.), and Institute for Health Research (R.S.A.), University of Notre Dame Australia, Fremantle; Institute for Immunology and Infectious Diseases (I.J.), Murdoch University, Australia; Department of Neurology (A.M.S., R.B., M.W.L., A.D.R.), Duke University School of Medicine, Durham, NC; Zinfandel Pharmaceuticals, Inc. (A.M.S., D.K.B., A.D.R.), Durham, NC; ALS Clinic (R.B.), Duke University, Durham, NC; Departments of Neurology, Pathology and Cell and Molecular Biology (N.S., T.S.), the Les Turner ALS Center, Northwestern University Feinberg School of Medicine; and the Northwestern University Interdepartmental Neuroscience Program (N.S., T.S.), Chicago, IL
| | - P Anthony Akkari
- Centre for Neuromuscular and Neurological Disorders (J.P., L.L.F., R.S.A., F.L.M., F.T., A.P., S.K., P.A.A.), University of Western Australia, Crawley; Perron Institute for Neurological and Translational Science (J.P., L.L.F., R.S.A., F.L.M., F.T., A.P., S.K., P.A.A.), Nedlands; Centre for Molecular Medicine and Innovative Therapeutics (L.L.F., A.P., S.K., P.A.A.), Murdoch University; School of Health Sciences (R.S.A.), and Institute for Health Research (R.S.A.), University of Notre Dame Australia, Fremantle; Institute for Immunology and Infectious Diseases (I.J.), Murdoch University, Australia; Department of Neurology (A.M.S., R.B., M.W.L., A.D.R.), Duke University School of Medicine, Durham, NC; Zinfandel Pharmaceuticals, Inc. (A.M.S., D.K.B., A.D.R.), Durham, NC; ALS Clinic (R.B.), Duke University, Durham, NC; Departments of Neurology, Pathology and Cell and Molecular Biology (N.S., T.S.), the Les Turner ALS Center, Northwestern University Feinberg School of Medicine; and the Northwestern University Interdepartmental Neuroscience Program (N.S., T.S.), Chicago, IL
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MacDougall G, Anderton RS, Trimble A, Mastaglia FL, Knuckey NW, Meloni BP. Poly-arginine-18 (R18) Confers Neuroprotection through Glutamate Receptor Modulation, Intracellular Calcium Reduction, and Preservation of Mitochondrial Function. Molecules 2020; 25:E2977. [PMID: 32610439 PMCID: PMC7412265 DOI: 10.3390/molecules25132977] [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: 05/22/2020] [Revised: 06/23/2020] [Accepted: 06/26/2020] [Indexed: 11/16/2022] Open
Abstract
Recent studies have highlighted that a novel class of neuroprotective peptide, known as cationic arginine-rich peptides (CARPs), have intrinsic neuroprotective properties and are particularly effective anti-excitotoxic agents. As such, the present study investigated the mechanisms underlying the anti-excitotoxic properties of CARPs, using poly-arginine-18 (R18; 18-mer of arginine) as a representative peptide. Cortical neuronal cultures subjected to glutamic acid excitotoxicity were used to assess the effects of R18 on ionotropic glutamate receptor (iGluR)-mediated intracellular calcium influx, and its ability to reduce neuronal injury from raised intracellular calcium levels after inhibition of endoplasmic reticulum calcium uptake by thapsigargin. The results indicate that R18 significantly reduces calcium influx by suppressing iGluR overactivation, and results in preservation of mitochondrial membrane potential (ΔΨm) and ATP production, and reduced ROS generation. R18 also protected cortical neurons against thapsigargin-induced neurotoxicity, which indicates that the peptide helps maintain neuronal survival when intracellular calcium levels are elevated. Taken together, these findings provide important insight into the mechanisms of action of R18, supporting its potential application as a neuroprotective therapeutic for acute and chronic neurological disorders.
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Affiliation(s)
- Gabriella MacDougall
- Perron Institute for Neurological and Translational Science, Nedlands, WA 6009, Australia; (R.S.A.); (A.T.); (F.L.M.); (N.W.K.); (B.P.M.)
- Institute for Health Research, School of Heath Sciences and Institute for Health Research, The University Notre Dame, Fremantle, WA 6160, Australia
| | - Ryan S. Anderton
- Perron Institute for Neurological and Translational Science, Nedlands, WA 6009, Australia; (R.S.A.); (A.T.); (F.L.M.); (N.W.K.); (B.P.M.)
- Institute for Health Research, School of Heath Sciences and Institute for Health Research, The University Notre Dame, Fremantle, WA 6160, Australia
- Centre for Neuromuscular and Neurological Disorders, The University of Western Australia, Perth, WA 6009, Australia
| | - Amy Trimble
- Perron Institute for Neurological and Translational Science, Nedlands, WA 6009, Australia; (R.S.A.); (A.T.); (F.L.M.); (N.W.K.); (B.P.M.)
- Institute for Health Research, School of Heath Sciences and Institute for Health Research, The University Notre Dame, Fremantle, WA 6160, Australia
| | - Frank L. Mastaglia
- Perron Institute for Neurological and Translational Science, Nedlands, WA 6009, Australia; (R.S.A.); (A.T.); (F.L.M.); (N.W.K.); (B.P.M.)
- Centre for Neuromuscular and Neurological Disorders, The University of Western Australia, Perth, WA 6009, Australia
| | - Neville W. Knuckey
- Perron Institute for Neurological and Translational Science, Nedlands, WA 6009, Australia; (R.S.A.); (A.T.); (F.L.M.); (N.W.K.); (B.P.M.)
- Centre for Neuromuscular and Neurological Disorders, The University of Western Australia, Perth, WA 6009, Australia
- Department of Neurosurgery, Sir Charles Gairdner Hospital, QEII Medical Centre, Nedlands, WA 6008, Australia
| | - Bruno P. Meloni
- Perron Institute for Neurological and Translational Science, Nedlands, WA 6009, Australia; (R.S.A.); (A.T.); (F.L.M.); (N.W.K.); (B.P.M.)
- Centre for Neuromuscular and Neurological Disorders, The University of Western Australia, Perth, WA 6009, Australia
- Department of Neurosurgery, Sir Charles Gairdner Hospital, QEII Medical Centre, Nedlands, WA 6008, Australia
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24
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Abstract
INTRODUCTION Dyspnea is a complex and debilitating non-motor symptom experienced by a significant proportion of PD patients which results in limitations to physical ability and a reduction in quality of life. AREAS COVERED The authors highlight the underlying pathophysiological mechanisms that can contribute to dyspnea in PD patients, and provide the clinician with a practical working algorithm for the management of such patients. The authors further highlight important clinical red flags that should be heeded in dyspneic PD patients and discuss therapeutic strategies for managing dyspnea. EXPERT OPINION Although awareness of dyspnea in PD is increasing, further studies of its prevalence and natural history at different stages of the disease are needed. In particular, it is important to determine whether dyspnea could be an early or prodromal disease manifestation. Although peripheral mechanisms are likely to play a major role in the pathophysiology of dyspnea, the possibility that central changes in brainstem ventilatory control may also play a part warrants further investigation.
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Affiliation(s)
- Srimathy Vijayan
- The Perron Institute for Neurological and Translational sciences, QEII Medical Centre , Nedlands, Perth, Australia.,Faculty of Health and Medical Sciences, University of Western Australia , Nedlands, Perth, Australia
| | - Bhajan Singh
- Department of Pulmonary Physiology & Sleep Medicine, Sir Charles Gairdner Hospital , Nedlands, Perth, Australia.,School of Human Sciences, University of Western Australia , Crawley, Perth, Australia.,West Australian Sleep Disorders Research Institute, Sir Charles Gairdner Hospital, Nedlands , Perth, Australia
| | - Soumya Ghosh
- The Perron Institute for Neurological and Translational sciences, QEII Medical Centre , Nedlands, Perth, Australia
| | - Rick Stell
- The Perron Institute for Neurological and Translational sciences, QEII Medical Centre , Nedlands, Perth, Australia
| | - Frank L Mastaglia
- The Perron Institute for Neurological and Translational sciences, QEII Medical Centre , Nedlands, Perth, Australia
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25
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Meloni BP, Chen Y, Harrison KA, Nashed JY, Blacker DJ, South SM, Anderton RS, Mastaglia FL, Winterborn A, Knuckey NW, Cook DJ. Poly-Arginine Peptide-18 (R18) Reduces Brain Injury and Improves Functional Outcomes in a Nonhuman Primate Stroke Model. Neurotherapeutics 2020; 17:627-634. [PMID: 31833045 PMCID: PMC7283416 DOI: 10.1007/s13311-019-00809-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [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] [Indexed: 12/18/2022] Open
Abstract
Poly-arginine peptide-18 (R18) is neuroprotective in different rodent middle cerebral artery occlusion (MCAO) stroke models. In this study, we examined whether R18 treatment could reduce ischemic brain injury and improve functional outcome in a nonhuman primate (NHP) stroke model. A stroke was induced in male cynomolgus macaques by MCAO distal to the orbitofrontal branch of the MCA through a right pterional craniotomy, using a 5-mm titanium aneurysm clip for 90 min. R18 (1000 nmol/kg) or saline vehicle was administered intravenously 60 min after the onset of MCAO. Magnetic resonance imaging (MRI; perfusion-weighted imaging, diffusion-weighted imaging, or T2-weighted imaging) of the brain was performed 15 min, 24 h, and 28 days post-MCAO, and neurological outcome was assessed using the NHP stroke scale (NHPSS). Experimental endpoint was 28 days post-MCAO, treatments were randomized, and all procedures were performed blinded to treatment status. R18 treatment reduced infarct lesion volume by up to 65.2% and 69.7% at 24 h and 28 days poststroke, respectively. Based on NHPSS scores, R18-treated animals displayed reduced functional deficits. This study confirms the effectiveness of R18 in reducing the severity of ischemic brain injury and improving functional outcomes after stroke in a NHP model, and provides further support for its clinical development as a stroke neuroprotective therapeutic.
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Affiliation(s)
- Bruno P Meloni
- Perron Institute for Neurological and Translational Science, Nedlands, Western Australia, 6009, Australia
- Department of Neurosurgery, QEII Medical Centre, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia
- Centre for Neuromuscular and Neurological Disorders, The University of Western Australia, Perth, Western Australia, Australia
| | - Yining Chen
- Centre for Neuroscience Studies, Queen's University, Kingston, Ontario, Canada
| | - Kathleen A Harrison
- Centre for Neuroscience Studies, Queen's University, Kingston, Ontario, Canada
| | - Joseph Y Nashed
- Centre for Neuroscience Studies, Queen's University, Kingston, Ontario, Canada
| | - David J Blacker
- Perron Institute for Neurological and Translational Science, Nedlands, Western Australia, 6009, Australia
- Department of Neurosurgery, QEII Medical Centre, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia
- Department of Neurology, QEII Medical Centre, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia
| | - Samantha M South
- Office of Research Enterprise, The University of Western Australia, Perth, Western Australia, Australia
| | - Ryan S Anderton
- Perron Institute for Neurological and Translational Science, Nedlands, Western Australia, 6009, Australia
- Centre for Neuromuscular and Neurological Disorders, The University of Western Australia, Perth, Western Australia, Australia
- School of Heath Sciences, and Institute for Health Research, The University Notre Dame Australia, Fremantle, Australia
| | - Frank L Mastaglia
- Perron Institute for Neurological and Translational Science, Nedlands, Western Australia, 6009, Australia
- Department of Neurosurgery, QEII Medical Centre, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia
| | - Andrew Winterborn
- Centre for Neuroscience Studies, Queen's University, Kingston, Ontario, Canada
| | - Neville W Knuckey
- Perron Institute for Neurological and Translational Science, Nedlands, Western Australia, 6009, Australia
- Department of Neurosurgery, QEII Medical Centre, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia
- Centre for Neuromuscular and Neurological Disorders, The University of Western Australia, Perth, Western Australia, Australia
| | - Douglas J Cook
- Centre for Neuroscience Studies, Queen's University, Kingston, Ontario, Canada.
- Division of Neurosurgery, Department of Surgery, Queen's University Kingston Health Sciences Centre, Kingston, Ontario, Canada.
- Division of Neurosurgery, Department of Surgery, Dalhousie University Halifax, Nova Scotia, Canada.
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26
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Pytte J, Anderton RS, Flynn LL, Theunissen F, Jiang L, Pitout I, James I, Mastaglia FL, Saunders AM, Bedlack R, Siddique T, Siddique N, Akkari PA. Association of a structural variant within the SQSTM1 gene with amyotrophic lateral sclerosis. Neurol Genet 2020; 6:e406. [PMID: 32185242 PMCID: PMC7061286 DOI: 10.1212/nxg.0000000000000406] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/19/2019] [Accepted: 01/23/2020] [Indexed: 11/15/2022]
Abstract
Objective As structural variations may underpin susceptibility to complex neurodegenerative diseases such as amyotrophic lateral sclerosis (ALS), the objective of this study was to investigate a structural variant (SV) within sequestosome 1 (SQSTM1). Methods A candidate insertion/deletion variant within intron 5 of the SQSTM1 gene was identified using a previously established SV evaluation algorithm and chosen according to its subsequent theoretical effect on gene expression. The variant was systematically assessed through PCR, polyacrylamide gel fractionation, Sanger sequencing, and reverse transcriptase PCR. Results A reliable and robust assay confirmed the polymorphic nature of this variant and that the variant may influence SQSTM1 transcript levels. In a North American cohort of patients with familial ALS (fALS) and sporadic ALS (sALS) (n = 403) and age-matched healthy controls (n = 562), we subsequently showed that the SQSTM1 variant is associated with fALS (p = 0.0036), particularly in familial superoxide dismutase 1 mutation positive patients (p = 0.0005), but not with patients with sALS (p = 0.97). Conclusions This disease association highlights the importance and implications of further investigation into SVs that may provide new targets for cohort stratification and therapeutic development.
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Affiliation(s)
- Julia Pytte
- University of Western Australia (J.P., R.S.A., L.L.F., F.T., L.J., F.L.M., P.A.A.), Centre for Neuromuscular and Neurological Disorders, Crawley; Perron Institute for Neurological and Translational Science (J.P., R.S.A., L.L.F., F.T., L.J., I.P., F.L.M., P.A.A.), Nedlands; University of Notre Dame Australia (R.S.A.), School of Health Sciences; University of Notre Dame Australia (R.S.A.), Institute for Health Research, Fremantle; Murdoch University (L.L.F., I.P., P.A.A.), Centre for Molecular Medicine and Innovative Therapeutics; Murdoch University, Institute for Immunology and Infectious Diseases (I.J.), Western Australia, Australia; Department of Neurology (R.B.), Duke University School of Medicine, Durham, NC; Zinfandel Pharmaceuticals (A.M.S.), Inc.; Duke University (R.B.), ALS Clinic, Durham, NC; and Departments of Neurology, Pathology and Cell and Molecular Biology (T.S., N.S.), Northwestern University Feinberg School of Medicine, the Les Turner ALS Center and the Northwestern University Interdepartmental Neuroscience Program, Chicago, IL
| | - Ryan S Anderton
- University of Western Australia (J.P., R.S.A., L.L.F., F.T., L.J., F.L.M., P.A.A.), Centre for Neuromuscular and Neurological Disorders, Crawley; Perron Institute for Neurological and Translational Science (J.P., R.S.A., L.L.F., F.T., L.J., I.P., F.L.M., P.A.A.), Nedlands; University of Notre Dame Australia (R.S.A.), School of Health Sciences; University of Notre Dame Australia (R.S.A.), Institute for Health Research, Fremantle; Murdoch University (L.L.F., I.P., P.A.A.), Centre for Molecular Medicine and Innovative Therapeutics; Murdoch University, Institute for Immunology and Infectious Diseases (I.J.), Western Australia, Australia; Department of Neurology (R.B.), Duke University School of Medicine, Durham, NC; Zinfandel Pharmaceuticals (A.M.S.), Inc.; Duke University (R.B.), ALS Clinic, Durham, NC; and Departments of Neurology, Pathology and Cell and Molecular Biology (T.S., N.S.), Northwestern University Feinberg School of Medicine, the Les Turner ALS Center and the Northwestern University Interdepartmental Neuroscience Program, Chicago, IL
| | - Loren L Flynn
- University of Western Australia (J.P., R.S.A., L.L.F., F.T., L.J., F.L.M., P.A.A.), Centre for Neuromuscular and Neurological Disorders, Crawley; Perron Institute for Neurological and Translational Science (J.P., R.S.A., L.L.F., F.T., L.J., I.P., F.L.M., P.A.A.), Nedlands; University of Notre Dame Australia (R.S.A.), School of Health Sciences; University of Notre Dame Australia (R.S.A.), Institute for Health Research, Fremantle; Murdoch University (L.L.F., I.P., P.A.A.), Centre for Molecular Medicine and Innovative Therapeutics; Murdoch University, Institute for Immunology and Infectious Diseases (I.J.), Western Australia, Australia; Department of Neurology (R.B.), Duke University School of Medicine, Durham, NC; Zinfandel Pharmaceuticals (A.M.S.), Inc.; Duke University (R.B.), ALS Clinic, Durham, NC; and Departments of Neurology, Pathology and Cell and Molecular Biology (T.S., N.S.), Northwestern University Feinberg School of Medicine, the Les Turner ALS Center and the Northwestern University Interdepartmental Neuroscience Program, Chicago, IL
| | - Frances Theunissen
- University of Western Australia (J.P., R.S.A., L.L.F., F.T., L.J., F.L.M., P.A.A.), Centre for Neuromuscular and Neurological Disorders, Crawley; Perron Institute for Neurological and Translational Science (J.P., R.S.A., L.L.F., F.T., L.J., I.P., F.L.M., P.A.A.), Nedlands; University of Notre Dame Australia (R.S.A.), School of Health Sciences; University of Notre Dame Australia (R.S.A.), Institute for Health Research, Fremantle; Murdoch University (L.L.F., I.P., P.A.A.), Centre for Molecular Medicine and Innovative Therapeutics; Murdoch University, Institute for Immunology and Infectious Diseases (I.J.), Western Australia, Australia; Department of Neurology (R.B.), Duke University School of Medicine, Durham, NC; Zinfandel Pharmaceuticals (A.M.S.), Inc.; Duke University (R.B.), ALS Clinic, Durham, NC; and Departments of Neurology, Pathology and Cell and Molecular Biology (T.S., N.S.), Northwestern University Feinberg School of Medicine, the Les Turner ALS Center and the Northwestern University Interdepartmental Neuroscience Program, Chicago, IL
| | - Leanne Jiang
- University of Western Australia (J.P., R.S.A., L.L.F., F.T., L.J., F.L.M., P.A.A.), Centre for Neuromuscular and Neurological Disorders, Crawley; Perron Institute for Neurological and Translational Science (J.P., R.S.A., L.L.F., F.T., L.J., I.P., F.L.M., P.A.A.), Nedlands; University of Notre Dame Australia (R.S.A.), School of Health Sciences; University of Notre Dame Australia (R.S.A.), Institute for Health Research, Fremantle; Murdoch University (L.L.F., I.P., P.A.A.), Centre for Molecular Medicine and Innovative Therapeutics; Murdoch University, Institute for Immunology and Infectious Diseases (I.J.), Western Australia, Australia; Department of Neurology (R.B.), Duke University School of Medicine, Durham, NC; Zinfandel Pharmaceuticals (A.M.S.), Inc.; Duke University (R.B.), ALS Clinic, Durham, NC; and Departments of Neurology, Pathology and Cell and Molecular Biology (T.S., N.S.), Northwestern University Feinberg School of Medicine, the Les Turner ALS Center and the Northwestern University Interdepartmental Neuroscience Program, Chicago, IL
| | - Ianthe Pitout
- University of Western Australia (J.P., R.S.A., L.L.F., F.T., L.J., F.L.M., P.A.A.), Centre for Neuromuscular and Neurological Disorders, Crawley; Perron Institute for Neurological and Translational Science (J.P., R.S.A., L.L.F., F.T., L.J., I.P., F.L.M., P.A.A.), Nedlands; University of Notre Dame Australia (R.S.A.), School of Health Sciences; University of Notre Dame Australia (R.S.A.), Institute for Health Research, Fremantle; Murdoch University (L.L.F., I.P., P.A.A.), Centre for Molecular Medicine and Innovative Therapeutics; Murdoch University, Institute for Immunology and Infectious Diseases (I.J.), Western Australia, Australia; Department of Neurology (R.B.), Duke University School of Medicine, Durham, NC; Zinfandel Pharmaceuticals (A.M.S.), Inc.; Duke University (R.B.), ALS Clinic, Durham, NC; and Departments of Neurology, Pathology and Cell and Molecular Biology (T.S., N.S.), Northwestern University Feinberg School of Medicine, the Les Turner ALS Center and the Northwestern University Interdepartmental Neuroscience Program, Chicago, IL
| | - Ian James
- University of Western Australia (J.P., R.S.A., L.L.F., F.T., L.J., F.L.M., P.A.A.), Centre for Neuromuscular and Neurological Disorders, Crawley; Perron Institute for Neurological and Translational Science (J.P., R.S.A., L.L.F., F.T., L.J., I.P., F.L.M., P.A.A.), Nedlands; University of Notre Dame Australia (R.S.A.), School of Health Sciences; University of Notre Dame Australia (R.S.A.), Institute for Health Research, Fremantle; Murdoch University (L.L.F., I.P., P.A.A.), Centre for Molecular Medicine and Innovative Therapeutics; Murdoch University, Institute for Immunology and Infectious Diseases (I.J.), Western Australia, Australia; Department of Neurology (R.B.), Duke University School of Medicine, Durham, NC; Zinfandel Pharmaceuticals (A.M.S.), Inc.; Duke University (R.B.), ALS Clinic, Durham, NC; and Departments of Neurology, Pathology and Cell and Molecular Biology (T.S., N.S.), Northwestern University Feinberg School of Medicine, the Les Turner ALS Center and the Northwestern University Interdepartmental Neuroscience Program, Chicago, IL
| | - Frank L Mastaglia
- University of Western Australia (J.P., R.S.A., L.L.F., F.T., L.J., F.L.M., P.A.A.), Centre for Neuromuscular and Neurological Disorders, Crawley; Perron Institute for Neurological and Translational Science (J.P., R.S.A., L.L.F., F.T., L.J., I.P., F.L.M., P.A.A.), Nedlands; University of Notre Dame Australia (R.S.A.), School of Health Sciences; University of Notre Dame Australia (R.S.A.), Institute for Health Research, Fremantle; Murdoch University (L.L.F., I.P., P.A.A.), Centre for Molecular Medicine and Innovative Therapeutics; Murdoch University, Institute for Immunology and Infectious Diseases (I.J.), Western Australia, Australia; Department of Neurology (R.B.), Duke University School of Medicine, Durham, NC; Zinfandel Pharmaceuticals (A.M.S.), Inc.; Duke University (R.B.), ALS Clinic, Durham, NC; and Departments of Neurology, Pathology and Cell and Molecular Biology (T.S., N.S.), Northwestern University Feinberg School of Medicine, the Les Turner ALS Center and the Northwestern University Interdepartmental Neuroscience Program, Chicago, IL
| | - Ann M Saunders
- University of Western Australia (J.P., R.S.A., L.L.F., F.T., L.J., F.L.M., P.A.A.), Centre for Neuromuscular and Neurological Disorders, Crawley; Perron Institute for Neurological and Translational Science (J.P., R.S.A., L.L.F., F.T., L.J., I.P., F.L.M., P.A.A.), Nedlands; University of Notre Dame Australia (R.S.A.), School of Health Sciences; University of Notre Dame Australia (R.S.A.), Institute for Health Research, Fremantle; Murdoch University (L.L.F., I.P., P.A.A.), Centre for Molecular Medicine and Innovative Therapeutics; Murdoch University, Institute for Immunology and Infectious Diseases (I.J.), Western Australia, Australia; Department of Neurology (R.B.), Duke University School of Medicine, Durham, NC; Zinfandel Pharmaceuticals (A.M.S.), Inc.; Duke University (R.B.), ALS Clinic, Durham, NC; and Departments of Neurology, Pathology and Cell and Molecular Biology (T.S., N.S.), Northwestern University Feinberg School of Medicine, the Les Turner ALS Center and the Northwestern University Interdepartmental Neuroscience Program, Chicago, IL
| | - Richard Bedlack
- University of Western Australia (J.P., R.S.A., L.L.F., F.T., L.J., F.L.M., P.A.A.), Centre for Neuromuscular and Neurological Disorders, Crawley; Perron Institute for Neurological and Translational Science (J.P., R.S.A., L.L.F., F.T., L.J., I.P., F.L.M., P.A.A.), Nedlands; University of Notre Dame Australia (R.S.A.), School of Health Sciences; University of Notre Dame Australia (R.S.A.), Institute for Health Research, Fremantle; Murdoch University (L.L.F., I.P., P.A.A.), Centre for Molecular Medicine and Innovative Therapeutics; Murdoch University, Institute for Immunology and Infectious Diseases (I.J.), Western Australia, Australia; Department of Neurology (R.B.), Duke University School of Medicine, Durham, NC; Zinfandel Pharmaceuticals (A.M.S.), Inc.; Duke University (R.B.), ALS Clinic, Durham, NC; and Departments of Neurology, Pathology and Cell and Molecular Biology (T.S., N.S.), Northwestern University Feinberg School of Medicine, the Les Turner ALS Center and the Northwestern University Interdepartmental Neuroscience Program, Chicago, IL
| | - Teepu Siddique
- University of Western Australia (J.P., R.S.A., L.L.F., F.T., L.J., F.L.M., P.A.A.), Centre for Neuromuscular and Neurological Disorders, Crawley; Perron Institute for Neurological and Translational Science (J.P., R.S.A., L.L.F., F.T., L.J., I.P., F.L.M., P.A.A.), Nedlands; University of Notre Dame Australia (R.S.A.), School of Health Sciences; University of Notre Dame Australia (R.S.A.), Institute for Health Research, Fremantle; Murdoch University (L.L.F., I.P., P.A.A.), Centre for Molecular Medicine and Innovative Therapeutics; Murdoch University, Institute for Immunology and Infectious Diseases (I.J.), Western Australia, Australia; Department of Neurology (R.B.), Duke University School of Medicine, Durham, NC; Zinfandel Pharmaceuticals (A.M.S.), Inc.; Duke University (R.B.), ALS Clinic, Durham, NC; and Departments of Neurology, Pathology and Cell and Molecular Biology (T.S., N.S.), Northwestern University Feinberg School of Medicine, the Les Turner ALS Center and the Northwestern University Interdepartmental Neuroscience Program, Chicago, IL
| | - Nailah Siddique
- University of Western Australia (J.P., R.S.A., L.L.F., F.T., L.J., F.L.M., P.A.A.), Centre for Neuromuscular and Neurological Disorders, Crawley; Perron Institute for Neurological and Translational Science (J.P., R.S.A., L.L.F., F.T., L.J., I.P., F.L.M., P.A.A.), Nedlands; University of Notre Dame Australia (R.S.A.), School of Health Sciences; University of Notre Dame Australia (R.S.A.), Institute for Health Research, Fremantle; Murdoch University (L.L.F., I.P., P.A.A.), Centre for Molecular Medicine and Innovative Therapeutics; Murdoch University, Institute for Immunology and Infectious Diseases (I.J.), Western Australia, Australia; Department of Neurology (R.B.), Duke University School of Medicine, Durham, NC; Zinfandel Pharmaceuticals (A.M.S.), Inc.; Duke University (R.B.), ALS Clinic, Durham, NC; and Departments of Neurology, Pathology and Cell and Molecular Biology (T.S., N.S.), Northwestern University Feinberg School of Medicine, the Les Turner ALS Center and the Northwestern University Interdepartmental Neuroscience Program, Chicago, IL
| | - P Anthony Akkari
- University of Western Australia (J.P., R.S.A., L.L.F., F.T., L.J., F.L.M., P.A.A.), Centre for Neuromuscular and Neurological Disorders, Crawley; Perron Institute for Neurological and Translational Science (J.P., R.S.A., L.L.F., F.T., L.J., I.P., F.L.M., P.A.A.), Nedlands; University of Notre Dame Australia (R.S.A.), School of Health Sciences; University of Notre Dame Australia (R.S.A.), Institute for Health Research, Fremantle; Murdoch University (L.L.F., I.P., P.A.A.), Centre for Molecular Medicine and Innovative Therapeutics; Murdoch University, Institute for Immunology and Infectious Diseases (I.J.), Western Australia, Australia; Department of Neurology (R.B.), Duke University School of Medicine, Durham, NC; Zinfandel Pharmaceuticals (A.M.S.), Inc.; Duke University (R.B.), ALS Clinic, Durham, NC; and Departments of Neurology, Pathology and Cell and Molecular Biology (T.S., N.S.), Northwestern University Feinberg School of Medicine, the Les Turner ALS Center and the Northwestern University Interdepartmental Neuroscience Program, Chicago, IL
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27
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Meloni BP, Mastaglia FL, Knuckey NW. Cationic Arginine-Rich Peptides (CARPs): A Novel Class of Neuroprotective Agents With a Multimodal Mechanism of Action. Front Neurol 2020; 11:108. [PMID: 32158425 PMCID: PMC7052017 DOI: 10.3389/fneur.2020.00108] [Citation(s) in RCA: 46] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2019] [Accepted: 01/30/2020] [Indexed: 12/17/2022] Open
Abstract
There are virtually no clinically available neuroprotective drugs for the treatment of acute and chronic neurological disorders, hence there is an urgent need for the development of new neuroprotective molecules. Cationic arginine-rich peptides (CARPs) are an expanding and relatively novel class of compounds, which possess intrinsic neuroprotective properties. Intriguingly, CARPs possess a combination of biological properties unprecedented for a neuroprotective agent including the ability to traverse cell membranes and enter the CNS, antagonize calcium influx, target mitochondria, stabilize proteins, inhibit proteolytic enzymes, induce pro-survival signaling, scavenge toxic molecules, and reduce oxidative stress as well as, having a range of anti-inflammatory, analgesic, anti-microbial, and anti-cancer actions. CARPs have also been used as carrier molecules for the delivery of other putative neuroprotective agents across the blood-brain barrier and blood-spinal cord barrier. However, there is increasing evidence that the neuroprotective efficacy of many, if not all these other agents delivered using a cationic arginine-rich cell-penetrating peptide (CCPPs) carrier (e.g., TAT) may actually be mediated largely by the properties of the carrier molecule, with overall efficacy further enhanced according to the amino acid composition of the cargo peptide, in particular its arginine content. Therefore, in reviewing the neuroprotective mechanisms of action of CARPs we also consider studies using CCPPs fused to a putative neuroprotective peptide. We review the history of CARPs in neuroprotection and discuss in detail the intrinsic biological properties that may contribute to their cytoprotective effects and their usefulness as a broad-acting class of neuroprotective drugs.
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Affiliation(s)
- Bruno P Meloni
- Department of Neurosurgery, QEII Medical Centre, Sir Charles Gairdner Hospital, Nedlands, WA, Australia.,Perron Institute for Neurological and Translational Science, Nedlands, WA, Australia.,Centre for Neuromuscular and Neurological Disorders, The University of Western Australia, Nedlands, WA, Australia
| | - Frank L Mastaglia
- Perron Institute for Neurological and Translational Science, Nedlands, WA, Australia.,Centre for Neuromuscular and Neurological Disorders, The University of Western Australia, Nedlands, WA, Australia
| | - Neville W Knuckey
- Department of Neurosurgery, QEII Medical Centre, Sir Charles Gairdner Hospital, Nedlands, WA, Australia.,Perron Institute for Neurological and Translational Science, Nedlands, WA, Australia.,Centre for Neuromuscular and Neurological Disorders, The University of Western Australia, Nedlands, WA, Australia
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28
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Vijayan S, Singh B, Ghosh S, Stell R, Mastaglia FL. Brainstem Ventilatory Dysfunction: A Plausible Mechanism for Dyspnea in Parkinson's Disease? Mov Disord 2020; 35:379-388. [DOI: 10.1002/mds.27932] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2019] [Revised: 11/06/2019] [Accepted: 11/07/2019] [Indexed: 12/11/2022] Open
Affiliation(s)
- Srimathy Vijayan
- Perron Institute for Neurological and Translational Sciences Nedlands Perth, Western Australia Australia
| | - Bhajan Singh
- West Australian Sleep Disorders Research Institute, Sir Charles Gairdner Hospital Nedlands Perth, Western Australia Australia
- School of Human Sciences, University of Western Australia Crawley Western Australia Australia
| | - Soumya Ghosh
- Perron Institute for Neurological and Translational Sciences Nedlands Perth, Western Australia Australia
| | - Rick Stell
- Perron Institute for Neurological and Translational Sciences Nedlands Perth, Western Australia Australia
| | - Frank L Mastaglia
- Perron Institute for Neurological and Translational Sciences Nedlands Perth, Western Australia Australia
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29
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Chen W, Zhang Y, Ni Y, Cai S, Zheng X, Mastaglia FL, Wu J. Late-onset riboflavin-responsive multiple acyl-CoA dehydrogenase deficiency (MADD): case reports and epidemiology of ETFDH gene mutations. BMC Neurol 2019; 19:330. [PMID: 31852447 PMCID: PMC6921586 DOI: 10.1186/s12883-019-1562-5] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2019] [Accepted: 12/08/2019] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Multiple acyl-CoA dehydrogenase deficiency (MADD) is a riboflavin-responsive lipid-storage myopathy caused by mutations in the EFTA, EFTB or ETFDH genes. We report a Chinese family of Southern Min origin with two affected siblings with late-onset riboflavin-responsive MADD due to a homozygous c.250G > A EFTDH mutation and review the genetic epidemiology of the c.250G > A mutation. CASE PRESENTATION Both siblings presented with exercise-induced myalgia, progressive proximal muscle weakness and high levels of serum muscle enzymes and were initially diagnosed as polymyositis after a muscle biopsy. A repeat biopsy in one sibling subsequently showed features of lipid storage myopathy and genetic analysis identified a homozygous mutation (c.250G > A) in the ETFDH gene in both siblings and carriage of the same mutation by both parents. Glucocorticoid therapy led to improvement in muscle enzyme levels, but little change in muscle symptoms, and only after treatment with riboflavin was there marked improvement in exercise tolerance and muscle strength. The frequency and geographic distribution of the c.250G > A mutation were determined from a literature search for all previously reported cases of MADD with documented mutations. Our study found the c.250G > A mutation is the most common EFTDH mutation in riboflavin-responsive MADD (RR-MADD) and is most prevalent in China and South-East Asia where its epidemiology correlates with the distribution and migration patterns of the southern Min population in Southern China and neighbouring countries. CONCLUSIONS Mutations in ETFDH should be screened for in individuals with lipid-storage myopathy to identify patients who are responsive to riboflavin. The c.250G > A mutation should be suspected particularly in individuals of southern Min Chinese background.
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Affiliation(s)
- Wei Chen
- Department of Neurology, The Second Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong, China
| | - Youqiao Zhang
- Department of Neurology, The Second Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong, China
| | - Yifeng Ni
- Department of Neurology, The Second Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong, China
| | - Shaoyu Cai
- Department of Neurology, The Second Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong, China
| | - Xin Zheng
- Department of Neurology, The Second Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong, China
| | - Frank L Mastaglia
- Perron Institute for Neurological and Translational Science, QE II Medical Centre, 8 Verdun Street, Nedlands, Western Australia, Australia
| | - Jingshan Wu
- Department of Neurology, The Second Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong, China.
- Faculty of Health and Medical Sciences, The University of Western Australia, (M503), 35 Stirling Highway, Perth, Western Australia, 6009, Australia.
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30
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Gorecki AM, Preskey L, Bakeberg MC, Kenna JE, Gildenhuys C, MacDougall G, Dunlop SA, Mastaglia FL, Akkari PA, Koengten F, Anderton RS. Altered Gut Microbiome in Parkinson's Disease and the Influence of Lipopolysaccharide in a Human α-Synuclein Over-Expressing Mouse Model. Front Neurosci 2019; 13:839. [PMID: 31440136 PMCID: PMC6693556 DOI: 10.3389/fnins.2019.00839] [Citation(s) in RCA: 107] [Impact Index Per Article: 21.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2019] [Accepted: 07/26/2019] [Indexed: 12/31/2022] Open
Abstract
The interaction between the gut microbiota and alpha-synuclein (αSyn) aggregation in Parkinson’s disease (PD) is receiving increasing attention. The objective of this study was to investigate gut microbiota, and effects of an inflammatory lipopolysaccharide (LPS) trigger in a human αSyn over-expressing mouse model of PD (Thy1-αSyn). Stool samples from patients with confirmed PD and Thy1-αSyn mice were analyzed using 16S ribosomal RNA sequencing. Compared to healthy controls, the relative abundance of mucin-degrading Verrucomicrobiae and LPS-producing Gammaproteobacteria were greater in PD patients. In mice, the abundance of Gammaproteobacteria was negligible in both Thy1-αSyn and wild-type (WT) animals, while Verrucomicrobiae were reduced in Thy1-αSyn mice. The effect of LPS on intestinal barrier function was investigated in vitro using intestinal epithelial (IEC-6) cells, and in vivo via administration of LPS in drinking water to Thy1-αSyn mice. Acute exposure to LPS in vitro resulted in a reduction and altered distribution of the tight junction markers ZO-1 and e-Cadherin around the cell membrane in IEC-6 cells, as shown by immunohistochemistry. LPS administration in Thy1-αSyn mice resulted in the emergence of early motor manifestations at 10 weeks, compared to untreated mice who were still asymptomatic at this age. This study reaffirms that an altered microbiome exists in patients with PD, and supports the notion of a proinflammatory gut microbiome environment as a trigger for PD pathogenesis.
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Affiliation(s)
- Anastazja M Gorecki
- Perron Institute for Neurological and Translational Science, Nedlands, WA, Australia.,Centre for Neuromuscular & Neurological Disorders, The University of Western Australia, Crawley, WA, Australia
| | - Leah Preskey
- Ozgene Pty Ltd., Bentley, WA, Australia.,School of Medicine, The University of Notre Dame Australia, Fremantle, WA, Australia
| | - Megan C Bakeberg
- Perron Institute for Neurological and Translational Science, Nedlands, WA, Australia.,Centre for Neuromuscular & Neurological Disorders, The University of Western Australia, Crawley, WA, Australia
| | - Jade E Kenna
- Perron Institute for Neurological and Translational Science, Nedlands, WA, Australia.,Centre for Neuromuscular & Neurological Disorders, The University of Western Australia, Crawley, WA, Australia
| | - Christi Gildenhuys
- Perron Institute for Neurological and Translational Science, Nedlands, WA, Australia.,Institute for Health Research and School of Health Sciences, The University of Notre Dame Australia, Fremantle, WA, Australia
| | - Gabriella MacDougall
- Perron Institute for Neurological and Translational Science, Nedlands, WA, Australia.,Institute for Health Research and School of Health Sciences, The University of Notre Dame Australia, Fremantle, WA, Australia
| | - Sarah A Dunlop
- Perron Institute for Neurological and Translational Science, Nedlands, WA, Australia.,School of Biological Sciences, The University of Western Australia, Nedlands, WA, Australia
| | - Frank L Mastaglia
- Perron Institute for Neurological and Translational Science, Nedlands, WA, Australia.,Centre for Neuromuscular & Neurological Disorders, The University of Western Australia, Crawley, WA, Australia
| | - P Anthony Akkari
- Perron Institute for Neurological and Translational Science, Nedlands, WA, Australia.,Centre for Neuromuscular & Neurological Disorders, The University of Western Australia, Crawley, WA, Australia.,The Centre for Molecular Medicine and Innovative Therapeutics, Murdoch University, Murdoch, WA, Australia
| | - Frank Koengten
- Ozgene Pty Ltd., Bentley, WA, Australia.,School of Medicine, The University of Notre Dame Australia, Fremantle, WA, Australia
| | - Ryan S Anderton
- Perron Institute for Neurological and Translational Science, Nedlands, WA, Australia.,Centre for Neuromuscular & Neurological Disorders, The University of Western Australia, Crawley, WA, Australia.,Institute for Health Research and School of Health Sciences, The University of Notre Dame Australia, Fremantle, WA, Australia
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31
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MacDougall G, Anderton RS, Mastaglia FL, Knuckey NW, Meloni BP. Proteomic analysis of cortical neuronal cultures treated with poly-arginine peptide-18 (R18) and exposed to glutamic acid excitotoxicity. Mol Brain 2019; 12:66. [PMID: 31315638 PMCID: PMC6637488 DOI: 10.1186/s13041-019-0486-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2019] [Accepted: 07/01/2019] [Indexed: 01/30/2023] Open
Abstract
Abstract Poly-arginine peptide-18 (R18) has recently emerged as a highly effective neuroprotective agent in experimental stroke models, and is particularly efficacious in protecting cortical neurons against glutamic acid excitotoxicity. While we have previously demonstrated that R18 can reduce excitotoxicity-induced neuronal calcium influx, other molecular events associated with R18 neuroprotection are yet to investigated. Therefore, in this study we were particularly interested in protein expression changes in R18 treated neurons subjected to excitotoxicity. Proteomic analysis was used to compare protein expression patterns in primary cortical neuronal cultures subjected to: (i) R18-treatment alone (R18); (ii) glutamic acid excitotoxic injury (Glut); (iii) R18-treatment and glutamic acid injury (R18 + Glut); (iv) no treatment (Cont). Whole cell lysates were harvested 24 h post-injury and subjected to quantitative proteomic analysis (iTRAQ), coupled with liquid chromatography-tandem mass spectrometry (LC-MS/MS) and subsequent bioinformatic analysis of differentially expressed proteins (DEPs). Relative to control cultures, R18, Glut, and R18 + Glut treatment resulted in the detection of 5, 95 and 14 DEPs respectively. Compared to Glut alone, R18 + Glut revealed 98 DEPs, including 73 proteins whose expression was also altered by treatment with Glut and/or R18 alone, as well as 25 other uniquely regulated proteins. R18 treatment reversed the up- or down-regulation of all 73 Glut-associated DEPs, which included proteins involved in mitochondrial integrity, ATP generation, mRNA processing and protein translation. Analysis of protein-protein interactions of the 73 DEPs showed they were primarily associated with mitochondrial respiration, proteasome activity and protein synthesis, transmembrane trafficking, axonal growth and neuronal differentiation, and carbohydrate metabolism. Identified protein pathways associated with proteostasis and energy metabolism, and with pathways involved in neurodegeneration. Collectively, the findings indicate that R18 neuroprotection following excitotoxicity is associated with preservation of neuronal protein profiles, and differential protein expression that assists in maintaining mitochondrial function and energy production, protein homeostasis, and membrane trafficking. Graphical abstract ![]()
Electronic supplementary material The online version of this article (10.1186/s13041-019-0486-8) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Gabriella MacDougall
- Perron Institute for Neurological and Translational Sciences, QEII Medical Centre, Ground Floor, RR Block, 8 Verdun St, Nedlands, Western Australia, 6009, Australia. .,School of Heath Sciences and Institute for Health Research, The University Notre Dame, Fremantle, Western Australia, Australia.
| | - Ryan S Anderton
- Centre for Neuromuscular and Neurological Disorders, The University of Western Australia, Nedlands, Australia.,Perron Institute for Neurological and Translational Sciences, QEII Medical Centre, Ground Floor, RR Block, 8 Verdun St, Nedlands, Western Australia, 6009, Australia.,School of Heath Sciences and Institute for Health Research, The University Notre Dame, Fremantle, Western Australia, Australia
| | - Frank L Mastaglia
- Centre for Neuromuscular and Neurological Disorders, The University of Western Australia, Nedlands, Australia.,Perron Institute for Neurological and Translational Sciences, QEII Medical Centre, Ground Floor, RR Block, 8 Verdun St, Nedlands, Western Australia, 6009, Australia
| | - Neville W Knuckey
- Centre for Neuromuscular and Neurological Disorders, The University of Western Australia, Nedlands, Australia.,Department of Neurosurgery, Sir Charles Gairdner Hospital, QEII Medical Centre, Nedlands, Western Australia, Australia.,Perron Institute for Neurological and Translational Sciences, QEII Medical Centre, Ground Floor, RR Block, 8 Verdun St, Nedlands, Western Australia, 6009, Australia
| | - Bruno P Meloni
- Centre for Neuromuscular and Neurological Disorders, The University of Western Australia, Nedlands, Australia.,Department of Neurosurgery, Sir Charles Gairdner Hospital, QEII Medical Centre, Nedlands, Western Australia, Australia.,Perron Institute for Neurological and Translational Sciences, QEII Medical Centre, Ground Floor, RR Block, 8 Verdun St, Nedlands, Western Australia, 6009, Australia
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32
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Paramalingam S, Counsel P, Mastaglia FL, Keen H, Needham M. Imaging in the diagnosis of idiopathic inflammatory myopathies; indications and utility. Expert Rev Neurother 2019; 19:173-184. [PMID: 30661408 DOI: 10.1080/14737175.2019.1572507] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
INTRODUCTION Idiopathic inflammatory myopathies (IIM) are a heterogeneous group of muscle diseases that carry a significant morbidity and mortality risk. The utilization of imaging in the diagnostic pathway of IIM is therefore important to obtain early diagnosis and even monitor patients over time. Areas covered: Magnetic resonance imaging (MRI) has been the main imaging modality used to detect myositis but limitations include cost and accessibility, leading to delays in time to scan, and patient contraindications. This has led to the exploration of other imaging techniques to diagnose and monitor response to therapy. This article is based primarily on a literature search via PubMed using Boolean terms 'myositis' and the various imaging modalities. Expert opinion: Imaging is sensitive to pathology in IIM and may contribute to the diagnostic process. Learning how specific imaging features can distinguish different forms of IIM may allow more rapid diagnosis of myositis subtype and treatment planning, and to monitor disease activity particularly in patients who respond poorly to treatment. However, more work is needed to investigate the validity and relative utility of these imaging modalities.
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Affiliation(s)
- Shereen Paramalingam
- a Department of Rheumatology , Fiona Stanley Hospital , Murdoch , Australia.,b School of Medicine , Notre Dame University Australia , Fremantle , Australia
| | - Peter Counsel
- c Department of Radiology , Perth Radiology Clinic , Subiaco , Australia.,d Department of Radiology , Perth Children's Hospital , Nedlands , Australia
| | - Frank L Mastaglia
- e School of Medicine , University of Western Australia , Crawley , Australia.,f Department of Neurology , Perron Institute for Neurological and translational science , Nedlands , Australia
| | - Helen Keen
- a Department of Rheumatology , Fiona Stanley Hospital , Murdoch , Australia.,e School of Medicine , University of Western Australia , Crawley , Australia.,g School of Medicine , Murdoch University , Murdoch , Australia
| | - Merrilee Needham
- b School of Medicine , Notre Dame University Australia , Fremantle , Australia.,g School of Medicine , Murdoch University , Murdoch , Australia.,h Department of Neurology , Fiona Stanley Hospital , Murdoch , Australia
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33
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Li D, Mastaglia FL, Fletcher S, Wilton SD. Precision Medicine through Antisense Oligonucleotide-Mediated Exon Skipping. Trends Pharmacol Sci 2018; 39:982-994. [PMID: 30282590 DOI: 10.1016/j.tips.2018.09.001] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2018] [Revised: 08/30/2018] [Accepted: 09/04/2018] [Indexed: 12/11/2022]
Abstract
Clinical implementation of two recently approved antisense RNA therapeutics - Exondys51® to treat Duchenne muscular dystrophy (Duchenne MD) and Spinraza® as a treatment for spinal muscular atrophy (SMA) - highlights the therapeutic potential of antisense oligonucleotides (ASOs). As shown in the Duchenne and Becker cases, the identification and specific removal of 'dispensable' exons by exon-skipping ASOs could potentially bypass lethal mutations in other genes and bring clinical benefits to affected individuals carrying amenable mutations. In this review, we discuss the potential of therapeutic alternative splicing, with a particular focus on targeted exon skipping using Duchenne MD as an example, and speculate on new applications for other inherited rare diseases where redundant or dispensable exons may be amenable to exon-skipping ASO intervention as precision medicine.
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Affiliation(s)
- Dunhui Li
- Centre for Comparative Genomics, Murdoch University, Perth 6050, Australia; Perron Institute for Neurological and Translational Science, University of Western Australia, Perth 6000, Australia
| | - Frank L Mastaglia
- Perron Institute for Neurological and Translational Science, University of Western Australia, Perth 6000, Australia
| | - Sue Fletcher
- Centre for Comparative Genomics, Murdoch University, Perth 6050, Australia; Perron Institute for Neurological and Translational Science, University of Western Australia, Perth 6000, Australia
| | - Steve D Wilton
- Centre for Comparative Genomics, Murdoch University, Perth 6050, Australia; Perron Institute for Neurological and Translational Science, University of Western Australia, Perth 6000, Australia.
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Fabis-Pedrini MJ, Bundell C, Wee CK, Lucas M, McLean-Tooke A, Mastaglia FL, Carroll WM, Kermode AG. Prevalence of anti-aquaporin 4 antibody in a diagnostic cohort of patients being investigated for possible neuromyelitis optica spectrum disorder in Western Australia. J Neuroimmunol 2018; 324:76-80. [PMID: 30248527 DOI: 10.1016/j.jneuroim.2018.09.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [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: 06/28/2018] [Revised: 09/13/2018] [Accepted: 09/13/2018] [Indexed: 01/21/2023]
Abstract
OBJECTIVE To evaluate the prevalence of anti-AQP4 antibody in serum and CSF samples from patients being investigated for possible neuromyelitis optica spectrum disorder (NMOSD) referred to the PathWest State reference laboratory using a sensitive cell-based assay (CBA). BACKGROUND NMOSD is an inflammatory CNS disease distinct from MS, which is relatively rare in Western countries. A proportion of patients with NMOSD have detectable serum IgG antibodies that target the water channel aquaporin-4 (AQP4-IgG), but the frequency varies in different populations studied and according to the assay method employed. METHODS Sera or CSF from a diagnostic cohort of 196 consecutive patients with possible NMOSD which had previously been screened by indirect immunofluorescence (IIF) on primate cerebellum were re-tested for AQP4-IgG reactivity to the M1 and M23 isoforms of AQP4 using a commercial CBA. A control group of 205 patients with definite MS was also included in the study. RESULTS Of the 196 patients, only 5 sera were AQP4-IgG positive, representing 2.6% of patients in the diagnostic cohort. All 5 AQP4-IgG positive patients fulfilled the 2015 revised diagnostic criteria for NMOSD and were females of varied ethnic origins, 4 of whom had longitudinally extensive transverse myelitis. The CBA confirmed AQP4-IgG positivity in the four patients previously reported as positive by IIF, and an additional patient with NMOSD who had previously been diagnosed as MS was also identified. None of the 205 MS sera were AQP4-IgG positive. CONCLUSIONS Our study confirms the utility and greater reliability of the M1/M23 CBA for detecting AQP4-IgG in patients with possible NMOSD, and indicates a prevalence of seropositive NMOSD in the Western Australian population similar to that in other Western populations.
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Affiliation(s)
- Marzena J Fabis-Pedrini
- Centre for Neuromuscular and Neurological Disorders, University of Western Australia, Perron Institute for Neurological & Translational Science, Queen Elizabeth II Medical Centre, Perth, Western Australia, Australia
| | - Christine Bundell
- PathWest Laboratory Medicine, Queen Elizabeth II Medical Centre, Perth, Western Australia, Australia; School of Pathology and Laboratory Medicine, University of Western Australia, Nedlands, Western Australia, Australia
| | - Chee-Keong Wee
- Centre for Neuromuscular and Neurological Disorders, University of Western Australia, Perron Institute for Neurological & Translational Science, Queen Elizabeth II Medical Centre, Perth, Western Australia, Australia
| | - Michaela Lucas
- PathWest Laboratory Medicine, Queen Elizabeth II Medical Centre, Perth, Western Australia, Australia; School of Medicine and Pharmacology, School of Pathology and Laboratory Medicine, UWA, Perth, Western Australia, Australia; Institute for Immunology and Infectious Diseases, Murdoch University, Perth, Western Australia, Australia; Department of Immunology, Sir Charles Gairdner Hospital, Queen Elizabeth II Medical Centre, Perth, Western Australia, Australia
| | - Andrew McLean-Tooke
- PathWest Laboratory Medicine, Queen Elizabeth II Medical Centre, Perth, Western Australia, Australia; Department of Immunology, Sir Charles Gairdner Hospital, Queen Elizabeth II Medical Centre, Perth, Western Australia, Australia
| | - Frank L Mastaglia
- Centre for Neuromuscular and Neurological Disorders, University of Western Australia, Perron Institute for Neurological & Translational Science, Queen Elizabeth II Medical Centre, Perth, Western Australia, Australia
| | - William M Carroll
- Centre for Neuromuscular and Neurological Disorders, University of Western Australia, Perron Institute for Neurological & Translational Science, Queen Elizabeth II Medical Centre, Perth, Western Australia, Australia; Department of Neurology & Clinical Neurophysiology, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia
| | - Allan G Kermode
- Centre for Neuromuscular and Neurological Disorders, University of Western Australia, Perron Institute for Neurological & Translational Science, Queen Elizabeth II Medical Centre, Perth, Western Australia, Australia; Institute for Immunology and Infectious Diseases, Murdoch University, Perth, Western Australia, Australia; Department of Neurology & Clinical Neurophysiology, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia.
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MacDougall G, Anderton RS, Mastaglia FL, Knuckey NW, Meloni BP. Mitochondria and neuroprotection in stroke: Cationic arginine-rich peptides (CARPs) as a novel class of mitochondria-targeted neuroprotective therapeutics. Neurobiol Dis 2018; 121:17-33. [PMID: 30218759 DOI: 10.1016/j.nbd.2018.09.010] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2018] [Revised: 08/26/2018] [Accepted: 09/11/2018] [Indexed: 01/11/2023] Open
Abstract
Stroke is the second leading cause of death globally and represents a major cause of devastating long-term disability. Despite sustained efforts to develop clinically effective neuroprotective therapies, presently there is no clinically available neuroprotective agent for stroke. As a central mediator of neurodamaging events in stroke, mitochondria are recognised as a critical neuroprotective target, and as such, provide a focus for developing mitochondrial-targeted therapeutics. In recent years, cationic arginine-rich peptides (CARPs) have been identified as a novel class of neuroprotective agent with several demonstrated mechanisms of action, including their ability to target mitochondria and exert positive effects on the organelle. This review provides an overview on neuronal mitochondrial dysfunction in ischaemic stroke pathophysiology and highlights the potential beneficial effects of CARPs on mitochondria in the ischaemic brain following stroke.
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Affiliation(s)
- Gabriella MacDougall
- Centre for Neuromuscular and Neurological Disorders, The University of Western Australia, Nedlands, Australia; Perron Institute for Neurological and Translational Science, Nedlands, Australia; School of Heath Sciences, and Institute for Health Research, The University Notre Dame Australia, Fremantle, Australia.
| | - Ryan S Anderton
- Centre for Neuromuscular and Neurological Disorders, The University of Western Australia, Nedlands, Australia; Perron Institute for Neurological and Translational Science, Nedlands, Australia; School of Heath Sciences, and Institute for Health Research, The University Notre Dame Australia, Fremantle, Australia
| | - Frank L Mastaglia
- Centre for Neuromuscular and Neurological Disorders, The University of Western Australia, Nedlands, Australia; Perron Institute for Neurological and Translational Science, Nedlands, Australia
| | - Neville W Knuckey
- Centre for Neuromuscular and Neurological Disorders, The University of Western Australia, Nedlands, Australia; Perron Institute for Neurological and Translational Science, Nedlands, Australia; Department of Neurosurgery, Sir Charles Gairdner Hospital, QEII Medical Centre, Nedlands, Western Australia, Australia
| | - Bruno P Meloni
- Centre for Neuromuscular and Neurological Disorders, The University of Western Australia, Nedlands, Australia; Perron Institute for Neurological and Translational Science, Nedlands, Australia; Department of Neurosurgery, Sir Charles Gairdner Hospital, QEII Medical Centre, Nedlands, Western Australia, Australia
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Gutteridge DH, Mastaglia FL. Recognition of giant cell arteritis in patients with polymyalgia rheumatica who have a stroke: a cautionary tale. Intern Med J 2018; 47:1199-1201. [PMID: 28994265 DOI: 10.1111/imj.13567] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2016] [Accepted: 11/19/2016] [Indexed: 11/30/2022]
Abstract
An 82-year-old woman with polymyalgia rheumatica (PMR) on prednisone 7 mg daily was admitted to an acute stroke unit with a right homonymous hemianopia, a left posterior cerebral artery occlusion and occipital lobe infarct. She had raised inflammatory markers, did not have a temporal artery biopsy, and was discharged on the same dose of prednisone. After 21 months, off prednisone, her ophthalmologist, concerned about giant cell arteritis (GCA), restarted prednisone 40 mg daily, with rapid, profound visual improvement. After 3 days her general practitioner, noting normal baseline inflammatory markers, stopped treatment-with rapid visual reversion. It is critical to recognise GCA in patients with PMR admitted to a stroke unit and not to withdraw prematurely corticosteroids once commenced.
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Affiliation(s)
- Donald H Gutteridge
- Department of Endocrinology and Diabetes, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia
| | - Frank L Mastaglia
- West Australian Neuroscience Research Institute, QEII Medical Centre, Perth, Western Australia, Australia.,Institute for Immunology and Infectious Diseases, Murdoch University, Perth, Western Australia, Australia
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Fabis-Pedrini MJ, James I, Seewann A, Yau WY, van de Bovenkamp AA, Sanders FRK, Qiu W, Burton J, Mastaglia FL, Carroll WM, Kermode AG. Natural history of benign multiple sclerosis: Clinical and HLA correlates in a Western Australian cohort. J Neurol Sci 2018; 388:12-18. [PMID: 29627005 DOI: 10.1016/j.jns.2018.02.036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2017] [Revised: 02/20/2018] [Accepted: 02/21/2018] [Indexed: 10/18/2022]
Abstract
BACKGROUND Benign multiple sclerosis (BMS) is a controversial term that has been used for MS patients with minimal disability decades after disease onset. Herein, we evaluated disease status after 20 years in a Western Australian cohort defined as BMS based on an Expanded Disability Status Scale (EDSS) score ≤ 3.0 at 10 years from onset. METHODS MS patients with an EDSS score ≤ 3.0 at 10 years from onset and minimum of 20 years follow up were included in the study. The 20-year EDSS score was considered the primary outcome. Associations with demographic and clinical characteristics and HLA-DRB1 genotype were investigated. RESULTS Among 120 patients with a benign course at 10 years, 78 (65%) remained benign at the 20-year follow up, but patients with an EDSS ≥ 2.5 were more likely to go on to develop more severe disability in the next decade. When considering factors associated with an increase in EDSS score ≤ 1 from 10 to 20 years, indicating limited progression, apart from the EDSS score at 10 years, poly-symptomatic presentation (p = 0.004) and cerebellar/brainstem mono-symptomatic presentation (p = 0.016) were independently associated with more rapid progression compared with other mono-symptomatic presentations. Carriage of the high risk HLA-DRB1*1501 allele was marginally associated with slower progression. CONCLUSIONS In this geographically isolated MS cohort of predominantly Anglo-Celtic origin clinical progression in the benign MS group was similar to that in other published series from Western countries. These results are in keeping with the view that patients labeled as benign MS are part of a heterogeneous continuum of disease progression and do not possess unique clinical characteristics. Possible genetic determinants of a benign course warrant further investigation.
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Affiliation(s)
- Marzena J Fabis-Pedrini
- Centre for Neuromuscular and Neurological Disorders, Perron Institute for Neurological and Translational Science, UWA, Queen Elizabeth II Medical Centre, Perth, Western Australia, Australia
| | - Ian James
- Institute for Immunology and Infectious Diseases, Murdoch University, Perth, Western Australia, Australia
| | - Alexandra Seewann
- Centre for Neuromuscular and Neurological Disorders, Perron Institute for Neurological and Translational Science, UWA, Queen Elizabeth II Medical Centre, Perth, Western Australia, Australia
| | - Wai Y Yau
- Sir Charles Gairdner Hospital, Neurology Department, Queen Elizabeth II Medical Centre, Perth, Western Australia, Australia
| | - Arnold A van de Bovenkamp
- Centre for Neuromuscular and Neurological Disorders, Perron Institute for Neurological and Translational Science, UWA, Queen Elizabeth II Medical Centre, Perth, Western Australia, Australia
| | - Fay R K Sanders
- Centre for Neuromuscular and Neurological Disorders, Perron Institute for Neurological and Translational Science, UWA, Queen Elizabeth II Medical Centre, Perth, Western Australia, Australia
| | - Wei Qiu
- Centre for Neuromuscular and Neurological Disorders, Perron Institute for Neurological and Translational Science, UWA, Queen Elizabeth II Medical Centre, Perth, Western Australia, Australia
| | - Jason Burton
- Centre for Neuromuscular and Neurological Disorders, Perron Institute for Neurological and Translational Science, UWA, Queen Elizabeth II Medical Centre, Perth, Western Australia, Australia; Sir Charles Gairdner Hospital, Neurology Department, Queen Elizabeth II Medical Centre, Perth, Western Australia, Australia
| | - Frank L Mastaglia
- Centre for Neuromuscular and Neurological Disorders, Perron Institute for Neurological and Translational Science, UWA, Queen Elizabeth II Medical Centre, Perth, Western Australia, Australia
| | - William M Carroll
- Centre for Neuromuscular and Neurological Disorders, Perron Institute for Neurological and Translational Science, UWA, Queen Elizabeth II Medical Centre, Perth, Western Australia, Australia; Sir Charles Gairdner Hospital, Neurology Department, Queen Elizabeth II Medical Centre, Perth, Western Australia, Australia
| | - Allan G Kermode
- Centre for Neuromuscular and Neurological Disorders, Perron Institute for Neurological and Translational Science, UWA, Queen Elizabeth II Medical Centre, Perth, Western Australia, Australia; Institute for Immunology and Infectious Diseases, Murdoch University, Perth, Western Australia, Australia; Sir Charles Gairdner Hospital, Neurology Department, Queen Elizabeth II Medical Centre, Perth, Western Australia, Australia.
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Evans T, Jefferson A, Byrnes M, Walters S, Ghosh S, Mastaglia FL, Power B, Anderton RS. Extended "Timed Up and Go" assessment as a clinical indicator of cognitive state in Parkinson's disease. J Neurol Sci 2017; 375:86-91. [PMID: 28320196 DOI: 10.1016/j.jns.2017.01.050] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2016] [Revised: 01/02/2017] [Accepted: 01/16/2017] [Indexed: 10/20/2022]
Abstract
OBJECTIVE To evaluate a modified extended Timed Up and Go (extended-TUG) assessment against a panel of validated clinical assessments, as an indicator of Parkinson's disease (PD) severity and cognitive impairment. METHODS Eighty-seven participants with idiopathic PD were sequentially recruited from a Movement Disorders Clinic. An extended-TUG assessment was employed which required participants to stand from a seated position, walk in a straight line for 7m, turn 180° and then return to the start, in a seated position. The extended-TUG assessment duration was correlated to a panel of clinical assessments, including the Unified Parkinson's Disease Rating Scale (MDS-UPDRS), Quality of Life (PDQ-39), Scales for Outcomes in Parkinson's Disease (SCOPA-Cog), revised Addenbrooke's Cognitive Index (ACE-R) and Barratt's Impulsivity Scale 11 (BIS-11). RESULTS Extended-TUG time was significantly correlated to MDS-UPDRS III score and to SCOPA-Cog, ACE-R (p<0.001) and PDQ-39 scores (p<0.01). Generalized linear models determined the extended-TUG to be a sole variable in predicting ACE-R or SCOPA-Cog scores. Patients in the fastest extended-TUG tertile were predicted to perform 8.3 and 13.4 points better in the SCOPA-Cog and ACE-R assessments, respectively, than the slowest group. Patients who exceeded the dementia cut-off scores with these instruments exhibited significantly longer extended-TUG times. CONCLUSIONS Extended-TUG performance appears to be a useful indicator of cognition as well as motor function and quality of life in PD, and warrants further evaluation as a first line assessment tool to monitor disease severity and response to treatment. Poor extended-TUG performance may identify patients without overt cognitive impairment form whom cognitive assessment is needed.
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Affiliation(s)
- Tess Evans
- School of Medicine, University of Notre Dame Australia, Fremantle, WA, Australia
| | - Alexa Jefferson
- Western Australian Neuroscience Research Institute, A Block, QEII Medical Centre, Nedlands, WA, Australia
| | - Michelle Byrnes
- Western Australian Neuroscience Research Institute, A Block, QEII Medical Centre, Nedlands, WA, Australia; Centre for Neuromuscular and Neurological Disorders, University of Western Australia, Nedlands, WA, Australia
| | - Sue Walters
- Western Australian Neuroscience Research Institute, A Block, QEII Medical Centre, Nedlands, WA, Australia; Centre for Neuromuscular and Neurological Disorders, University of Western Australia, Nedlands, WA, Australia
| | - Soumya Ghosh
- Western Australian Neuroscience Research Institute, A Block, QEII Medical Centre, Nedlands, WA, Australia; Centre for Neuromuscular and Neurological Disorders, University of Western Australia, Nedlands, WA, Australia
| | - Frank L Mastaglia
- Western Australian Neuroscience Research Institute, A Block, QEII Medical Centre, Nedlands, WA, Australia; Centre for Neuromuscular and Neurological Disorders, University of Western Australia, Nedlands, WA, Australia; Institute of Immunology and Infectious Diseases, Murdoch University, Perth, WA, Australia
| | - Brian Power
- School of Medicine, University of Notre Dame Australia, Fremantle, WA, Australia
| | - Ryan S Anderton
- Western Australian Neuroscience Research Institute, A Block, QEII Medical Centre, Nedlands, WA, Australia; Centre for Neuromuscular and Neurological Disorders, University of Western Australia, Nedlands, WA, Australia; School of Health Sciences, University of Notre Dame Australia, Fremantle, WA, Australia.
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Bates KA, Sohrabi HR, Rainey-Smith SR, Weinborn M, Bucks RS, Rodrigues M, Beilby J, Howard M, Taddei K, Martins G, Paton A, Shah T, Dhaliwal SS, Foster JK, Martins IJ, Lautenschlager NT, Mastaglia FL, Gandy SE, Martins RN. Serum high-density lipoprotein is associated with better cognitive function in a cross-sectional study of aging women. Int J Neurosci 2016; 127:243-252. [PMID: 27113638 DOI: 10.1080/00207454.2016.1182527] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Purpose/Aim of the study: Poor cardiovascular health, including obesity and altered lipid profiles at mid-life, are linked to increased risk of Alzheimer's disease (AD). The biological mechanisms linking cardiovascular health and cognitive function are unclear though are likely to be multifactorial. This study examined the association between various lipoproteins and cognitive functioning in ageing women. MATERIALS AND METHODS We investigated the relationship between readily available biomarkers (i.e. serum lipoprotein) and cognitive decline in domains associated with increased risk of AD (e.g. episodic verbal memory performance and subjective memory complaint). We report cross-sectional data investigating the relationship between serum total cholesterol, triglycerides, high-density lipoprotein (HDL-C) and low-density lipoprotein with verbal memory and learning ability in 130 women with and without memory complaints (n = 71 and 59, respectively) drawn from a study investigating cognitively healthy Western Australians (average age 62.5 years old). RESULTS After statistical modelling that controlled for the effects of age, depression and apolipoprotein E genotype, HDL-C was significantly associated with better verbal learning and memory performance, specifically short and long delay-free recalls (F = 3.062; p < .05 and F = 3.2670; p < .05, respectively). CONCLUSION Our cross-sectional findings suggest that the positive effect of HDL-C on verbal memory may be present much earlier than previously reported and provide further support for the role of HDL-C in healthy brain ageing. Further exploration of the protective effect of HDL-C on cognitive function in ageing is warranted through follow-up, longitudinal studies.
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Affiliation(s)
- Kristyn A Bates
- a School of Medical and Health Sciences , Edith Cowan University , Joondalup , Australia.,b The McCusker Alzheimer's Research Foundation , Nedlands , Australia.,c M650 School of Psychiatry and Clinical Neurosciences , The University of Western Australia , Crawley , Australia
| | - Hamid R Sohrabi
- a School of Medical and Health Sciences , Edith Cowan University , Joondalup , Australia.,b The McCusker Alzheimer's Research Foundation , Nedlands , Australia.,c M650 School of Psychiatry and Clinical Neurosciences , The University of Western Australia , Crawley , Australia.,d Cooperative Research Centre for Mental Health , Carlton , Australia
| | - Stephanie R Rainey-Smith
- a School of Medical and Health Sciences , Edith Cowan University , Joondalup , Australia.,b The McCusker Alzheimer's Research Foundation , Nedlands , Australia
| | - Michael Weinborn
- a School of Medical and Health Sciences , Edith Cowan University , Joondalup , Australia.,b The McCusker Alzheimer's Research Foundation , Nedlands , Australia.,e M347 School of Psychology, The University of Western Australia , Crawley , Australia
| | - Romola S Bucks
- e M347 School of Psychology, The University of Western Australia , Crawley , Australia
| | - Mark Rodrigues
- a School of Medical and Health Sciences , Edith Cowan University , Joondalup , Australia.,b The McCusker Alzheimer's Research Foundation , Nedlands , Australia
| | - John Beilby
- f M576 School of Pathology and Laboratory Medicine , The University of Western Australia , Crawley , Australia.,g PathWest Laboratory Medicine of WA , Nedlands , Australia
| | - Matthew Howard
- a School of Medical and Health Sciences , Edith Cowan University , Joondalup , Australia
| | - Kevin Taddei
- a School of Medical and Health Sciences , Edith Cowan University , Joondalup , Australia.,b The McCusker Alzheimer's Research Foundation , Nedlands , Australia
| | - Georgia Martins
- a School of Medical and Health Sciences , Edith Cowan University , Joondalup , Australia.,b The McCusker Alzheimer's Research Foundation , Nedlands , Australia
| | - Athena Paton
- a School of Medical and Health Sciences , Edith Cowan University , Joondalup , Australia
| | - Tejal Shah
- b The McCusker Alzheimer's Research Foundation , Nedlands , Australia
| | | | - Jonathan K Foster
- i School of Psychology and Speech Pathology , Curtin University of Technology , Perth , Australia
| | - Ian J Martins
- a School of Medical and Health Sciences , Edith Cowan University , Joondalup , Australia.,b The McCusker Alzheimer's Research Foundation , Nedlands , Australia
| | - Nicola T Lautenschlager
- c M650 School of Psychiatry and Clinical Neurosciences , The University of Western Australia , Crawley , Australia.,j Academic Unit for Psychiatry of Old Age, St Vincent's Health, Department of Psychiatry , University of Melbourne , Kew , Australia.,k M577 WA Centre for Health and Aging , The University of Western Australia , Crawley , Australia
| | - Frank L Mastaglia
- l Institute for Immunology and Infectious Diseases , Murdoch University , Murdoch , Australia
| | - Samuel E Gandy
- m Departments of Neurology and Psychiatry and the Alzheimer's Disease Research Center , Icahn School of Medicine at Mount Sinai , New York , NY , United States
| | - Ralph N Martins
- a School of Medical and Health Sciences , Edith Cowan University , Joondalup , Australia.,b The McCusker Alzheimer's Research Foundation , Nedlands , Australia.,c M650 School of Psychiatry and Clinical Neurosciences , The University of Western Australia , Crawley , Australia
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Abstract
Spinal muscular atrophy (SMA) is a debilitating and incurable childhood onset disease characterized by the degeneration of motor neurons in the spinal cord resulting in muscular atrophy and paralysis. Over the past 20 years, there has been significant progress in understanding the molecular basis of the disease, allowing researchers to identify the main causative gene and successfully model SMA in various animals. Despite an improved understanding of the disease, there is still no effective treatment for SMA patients. Here, we discuss the current knowledge surrounding the pathogenesis of SMA, and outline recent advances toward the development of a successful therapy for this devastating disease.
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Affiliation(s)
- Ryan S Anderton
- School of Health Sciences, University of Notre Dame Australia, 33 Phillimore Street, Fremantle, Western Australia 6959, Australia
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Abstract
Until recently, the treatment of immune-mediated inflammatory myopathies has largely been empirical with glucocorticoids, steroid-sparing immunosuppressive drugs, and intravenous immunoglobulin. However, a proportion of patients are only partially responsive to these therapies, and there has been a need to consider alternative treatment approaches. In particular, patients with inclusion body myositis are resistant to conventional immunotherapies or show only a transient response, and remain a major challenge. With increasing recognition of the different subtypes of immune-mediated inflammatory myopathies, and improved understanding of their pathogenesis, more targeted treatments are now being trialled. The overall approach to treatment, and novel therapies targeting B cells, T cells, and specific cytokines are discussed in this review.
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Affiliation(s)
- Merrilee Needham
- Institute for Immunology and Infectious Diseases, Murdoch University, Murdoch, 6150, WA, Australia.
- Fiona Stanley Hospital, Murdoch, 6150, WA, Australia.
- West Australian Neuroscience Research Institute, Queen Elizabeth II Medical Centre, Nedlands, 6009, WA, Australia.
| | - Frank L Mastaglia
- Institute for Immunology and Infectious Diseases, Murdoch University, Murdoch, 6150, WA, Australia
- West Australian Neuroscience Research Institute, Queen Elizabeth II Medical Centre, Nedlands, 6009, WA, Australia
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Needham M, Mastaglia FL. Sporadic inclusion body myositis: A review of recent clinical advances and current approaches to diagnosis and treatment. Clin Neurophysiol 2015; 127:1764-73. [PMID: 26778717 DOI: 10.1016/j.clinph.2015.12.011] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.1] [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: 10/12/2015] [Revised: 12/08/2015] [Accepted: 12/13/2015] [Indexed: 01/01/2023]
Abstract
Sporadic inclusion body myositis is the most frequent acquired myopathy of middle and later life and is distinguished from other inflammatory myopathies by its selective pattern of muscle involvement and slowly progressive course, and by the combination of inflammatory and degenerative muscle pathology and multi-protein deposits in muscle tissue. This review summarises the findings of recent studies that provide a more complete picture of the clinical phenotype and natural history of the disease and its global prevalence and genetic predisposition. Current diagnostic criteria, including the role of electrophysiological and muscle imaging studies and the recently identified anti-5'-nucleotidase (anti-cN1A) antibody in diagnosis are also discussed as well as current trends in the treatment of the disease.
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Affiliation(s)
- Merrilee Needham
- Institute for Immunology and Infectious Diseases, Murdoch University, Western Australia, Australia; Fiona Stanley Hospital, Murdoch, Western Australia, Australia; Notre Dame University, Fremantle, Western Australia, Australia.
| | - Frank L Mastaglia
- Institute for Immunology and Infectious Diseases, Murdoch University, Western Australia, Australia
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Silbert BI, Heaton AE, Cash RFH, James I, Dunne JW, Lawn ND, Silbert PL, Mastaglia FL, Thickbroom GW. Evidence for an excitatory GABAA response in human motor cortex in idiopathic generalised epilepsy. Seizure 2015; 26:36-42. [PMID: 25799900 DOI: 10.1016/j.seizure.2015.01.014] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2014] [Revised: 12/28/2014] [Accepted: 01/23/2015] [Indexed: 12/24/2022] Open
Abstract
PURPOSE Impaired GABAergic inhibition has been implicated in the pathophysiology of epilepsy. The possibility of a paradoxical excitatory effect of GABA in epilepsy has been suggested, but has not been investigated in vivo. We investigated pre- and post-synaptic GABAergic mechanisms in patients with idiopathic generalised epilepsy (IGE). METHOD In 10 patients and 12 control subjects we explored short- and long-interval intracortical inhibition (SICI, LICI; post-synaptic GABAA and GABAB-mediated respectively) and long-interval intracortical facilitation (LICF; pre-synaptic disinhibition) using transcranial magnetic stimulation. RESULTS While post-synaptic GABAB-mediated inhibition was unchanged in IGE (p=0.09), LICF was reduced compared to controls (controls: 141±17% of baseline; untreated patients: 107±12%, p=0.2; treated patients: 79±10%, p=0.003). GABAA-mediated inhibition was reduced in untreated patients (response amplitude 56±4% of baseline vs. 26±6% in controls, p=0.004) and normalised with treatment (37±12%, p=0.5 vs. controls). When measured during LICI, GABAA-mediated inhibition became excitatory in untreated IGE (response amplitude 120±10% of baseline, p=0.017), but not in treated patients. CONCLUSION Pre- and post-synaptic GABA-mediated inhibitory mechanisms are altered in IGE. The findings lend in vivo support to evidence from experimental models and in vitro studies of human epileptic brain tissue that GABA may have a paradoxical excitatory role in ictogenesis.
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Affiliation(s)
- Benjamin I Silbert
- Western Australian Neuroscience Research Institute, University of Western Australia, 4th Floor, A Block, QEII Medical Centre, Verdun Street, Nedlands, Perth, Western Australia 6009, Australia
| | - Alexandra E Heaton
- Western Australian Neuroscience Research Institute, University of Western Australia, 4th Floor, A Block, QEII Medical Centre, Verdun Street, Nedlands, Perth, Western Australia 6009, Australia
| | - Robin F H Cash
- Western Australian Neuroscience Research Institute, University of Western Australia, 4th Floor, A Block, QEII Medical Centre, Verdun Street, Nedlands, Perth, Western Australia 6009, Australia; Division of Brain, Imaging and Behaviour - Systems Neuroscience, Toronto Western Research Institute, University Health Network, 339 Bathurst Street, MP14-324, Toronto, Ontario M5T 2S8, Canada
| | - Ian James
- Centre for Clinical Immunology and Biomedical Statistics, Institute for Immunology and Infectious Diseases, Murdoch University, Building 390, Discovery Way, Murdoch, Perth, Western Australia 6150, Australia
| | - John W Dunne
- Department of Neurology, Royal Perth Hospital, Level 8, A Block, GPO Box X2213, Perth, Western Australia 6001, Australia
| | - Nicholas D Lawn
- Department of Neurology, Royal Perth Hospital, Level 8, A Block, GPO Box X2213, Perth, Western Australia 6001, Australia
| | - Peter L Silbert
- Department of Neurology, Royal Perth Hospital, Level 8, A Block, GPO Box X2213, Perth, Western Australia 6001, Australia
| | - Frank L Mastaglia
- Western Australian Neuroscience Research Institute, University of Western Australia, 4th Floor, A Block, QEII Medical Centre, Verdun Street, Nedlands, Perth, Western Australia 6009, Australia
| | - Gary W Thickbroom
- Western Australian Neuroscience Research Institute, University of Western Australia, 4th Floor, A Block, QEII Medical Centre, Verdun Street, Nedlands, Perth, Western Australia 6009, Australia.
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Moran EM, Mastaglia FL. Cytokines in immune-mediated inflammatory myopathies: cellular sources, multiple actions and therapeutic implications. Clin Exp Immunol 2015; 178:405-15. [PMID: 25171057 DOI: 10.1111/cei.12445] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/26/2014] [Indexed: 12/14/2022] Open
Abstract
The idiopathic inflammatory myopathies are a heterogeneous group of disorders characterised by diffuse muscle weakness and inflammation. A common immunopathogenic mechanism is the cytokine-driven infiltration of immune cells into the muscle tissue. Recent studies have further dissected the inflammatory cell types and associated cytokines involved in the immune-mediated myopathies and other chronic inflammatory and autoimmune disorders. In this review we outline the current knowledge of cytokine expression profiles and cellular sources in the major forms of inflammatory myopathy and detail the known mechanistic functions of these cytokines in the context of inflammatory myositis. Furthermore, we discuss how the application of this knowledge may lead to new therapeutic strategies for the treatment of the inflammatory myopathies, in particular for cases resistant to conventional forms of therapy.
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Affiliation(s)
- E M Moran
- Institute for Immunology and Infectious Diseases (IIID), Murdoch University, Murdoch, WA, Australia
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Mastaglia FL, Needham M. Inclusion body myositis: a review of clinical and genetic aspects, diagnostic criteria and therapeutic approaches. J Clin Neurosci 2014; 22:6-13. [PMID: 25510538 DOI: 10.1016/j.jocn.2014.09.012] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [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: 08/17/2014] [Accepted: 09/14/2014] [Indexed: 10/24/2022]
Abstract
Inclusion body myositis is the most common myopathy in patients over the age of 40 years encountered in neurological practice. Although it is usually sporadic, there is increasing awareness of the influence of genetic factors on disease susceptibility and clinical phenotype. The diagnosis is based on recognition of the distinctive pattern of muscle involvement and temporal profile of the disease, and the combination of inflammatory and myodegenerative changes and protein deposits in the muscle biopsy. The diagnostic importance of immunohistochemical staining for major histocompatibility complex I and II antigens, for the p62 protein, and of the recently identified anti-cN1A autoantibody in the serum, are discussed. The condition is generally poorly responsive to conventional immune therapies but there have been relatively few randomised controlled trials and most of these have been under-powered and of short duration. There is an urgent need for further well-designed multicentre trials of existing and novel therapies that may alter the natural history of the disease.
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Affiliation(s)
- Frank L Mastaglia
- Institute of Immunology and Infectious Diseases, Murdoch University, Murdoch, WA, Australia; Western Australian Neuroscience Research Institute, Queen Elizabeth II Medical Centre, Verdun Street, Nedlands, WA 6009, Australia.
| | - Merrilee Needham
- Institute of Immunology and Infectious Diseases, Murdoch University, Murdoch, WA, Australia; Western Australian Neuroscience Research Institute, Queen Elizabeth II Medical Centre, Verdun Street, Nedlands, WA 6009, Australia
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Rodríguez Cruz PM, Needham M, Hollingsworth P, Mastaglia FL, Hillman DR. Sleep disordered breathing and subclinical impairment of respiratory function are common in sporadic inclusion body myositis. Neuromuscul Disord 2014; 24:1036-41. [DOI: 10.1016/j.nmd.2014.08.003] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2014] [Revised: 07/15/2014] [Accepted: 08/10/2014] [Indexed: 10/24/2022]
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Rodríguez Cruz PM, Luo YB, Miller J, Junckerstorff RC, Mastaglia FL, Fabian V. An analysis of the sensitivity and specificity of MHC-I and MHC-II immunohistochemical staining in muscle biopsies for the diagnosis of inflammatory myopathies. Neuromuscul Disord 2014; 24:1025-35. [PMID: 25153265 DOI: 10.1016/j.nmd.2014.06.436] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2014] [Revised: 06/17/2014] [Accepted: 06/20/2014] [Indexed: 01/09/2023]
Abstract
Although there have been several previous reports of immunohistochemical staining for MHC antigens in muscle biopsies, there appears to be a lack of consensus about its routine use in the diagnostic evaluation of biopsies from patients with suspected inflammatory myopathy. Positive MHC-I staining is nonspecific but is widely used as a marker for inflammatory myopathy, whilst the role of MHC-II staining is not clearly defined. We investigated the sensitivity and specificity of MHC-I and MHC-II immunostaining for the diagnosis of inflammatory myopathy in a large group of biopsies from a single reference laboratory. Positive staining for MHC-I was found to have a high sensitivity in biopsies from patients with inflammatory myopathy but a very low specificity, as it was also common in other non-inflammatory myopathies and neurogenic disorders. On the other hand, MHC-II positivity had a much higher specificity in all major subgroups of inflammatory myopathy, especially inclusion body myositis. The findings indicate that the combination of MHC-I and MHC-II staining results in a higher degree of specificity for the diagnosis of inflammatory myopathy and that in biopsies with inflammation, positive MHC-II staining strongly supports the diagnosis of an immune-mediated myopathy. We recommend that immunohistochemical staining for both MHC-I and MHC-II should be included routinely in the diagnostic evaluation of muscle biopsies from patients with suspected inflammatory myopathy. However, as the sensitivity and interpretation of MHC staining may depend on the technique used, further studies are needed to compare procedures in different centres and develop standardised protocols.
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Affiliation(s)
- Pedro M Rodríguez Cruz
- Centre for Neuromuscular and Neurological Disorders, Western Australian Neuroscience Research Institute, Perth, Australia; Department of Neurology, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Yue-Bei Luo
- Centre for Neuromuscular and Neurological Disorders, Western Australian Neuroscience Research Institute, Perth, Australia; Department of Neurology, Xiangya Hospital, Central South University, Changsha, China
| | - James Miller
- Department of Neurology, Royal Victoria Infirmary, Newcastle-upon-Tyne, United Kingdom
| | - Reimar C Junckerstorff
- Section of Neuropathology, Department of Anatomical Pathology, PathWest Laboratory Medicine WA, Royal Perth Hospital, Perth, Western Australia, Australia; School of Pathology and Laboratory Medicine, University of Western Australia, Nedlands, Western Australia, Australia
| | - Frank L Mastaglia
- Centre for Neuromuscular and Neurological Disorders, Western Australian Neuroscience Research Institute, Perth, Australia; Institute for Immunology & Infectious Diseases, Murdoch University, Perth, Australia.
| | - Victoria Fabian
- Section of Neuropathology, Department of Anatomical Pathology, PathWest Laboratory Medicine WA, Royal Perth Hospital, Perth, Western Australia, Australia; School of Pathology and Laboratory Medicine, University of Western Australia, Nedlands, Western Australia, Australia
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48
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Moran EM, Mastaglia FL. The role of interleukin-17 in immune-mediated inflammatory myopathies and possible therapeutic implications. Neuromuscul Disord 2014; 24:943-52. [PMID: 25052503 DOI: 10.1016/j.nmd.2014.06.432] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [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: 03/11/2014] [Revised: 06/03/2014] [Accepted: 06/09/2014] [Indexed: 12/26/2022]
Abstract
The idiopathic inflammatory myopathies are a heterogeneous group of autoimmune muscle disorders with distinct clinical and pathological features and underlying immunopathogenic mechanisms. Traditionally, CD4(+) Th1 cells or CD8(+) cytotoxic effector T cells and type I/II interferons have been primarily implicated in the pathogenesis of the inflammatory myopathies. The presence of IL-17A producing cells in the inflamed muscle tissue of myositis patients and the results of in vitro studies suggest that IL-17A and the Th17 pathway may also have a key role in these diseases. The contribution of IL-17A to other chronic inflammatory and autoimmune diseases has been well established and clinical trials of IL-17A inhibitors are now at an advanced stage. However the precise role of IL-17A in the various forms of myositis and the potential for therapeutic targeting is currently unknown and warrants further investigation.
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Affiliation(s)
- Ellen M Moran
- Institute for Immunology & Infectious Diseases (IIID), Murdoch University, Murdoch, WA, Australia.
| | - Frank L Mastaglia
- Institute for Immunology & Infectious Diseases (IIID), Murdoch University, Murdoch, WA, Australia; Western Australian Neuroscience Research Institute, Centre for Neuromuscular & Neurological Disorders, University of Western Australia, Australia
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Luo YB, Mitrpant C, Adams AM, Johnsen RD, Fletcher S, Mastaglia FL, Wilton SD. Antisense oligonucleotide induction of progerin in human myogenic cells. PLoS One 2014; 9:e98306. [PMID: 24892300 PMCID: PMC4044034 DOI: 10.1371/journal.pone.0098306] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2014] [Accepted: 04/30/2014] [Indexed: 01/16/2023] Open
Abstract
We sought to use splice-switching antisense oligonucleotides to produce a model of accelerated ageing by enhancing expression of progerin, translated from a mis-spliced lamin A gene (LMNA) transcript in human myogenic cells. The progerin transcript (LMNA Δ150) lacks the last 150 bases of exon 11, and is translated into a truncated protein associated with the severe premature ageing disease, Hutchinson-Gilford progeria syndrome (HGPS). HGPS arises from de novo mutations that activate a cryptic splice site in exon 11 of LMNA and result in progerin accumulation in tissues of mesodermal origin. Progerin has also been proposed to play a role in the 'natural' ageing process in tissues. We sought to test this hypothesis by producing a model of accelerated muscle ageing in human myogenic cells. A panel of splice-switching antisense oligonucleotides were designed to anneal across exon 11 of the LMNA pre-mRNA, and these compounds were transfected into primary human myogenic cells. RT-PCR showed that the majority of oligonucleotides were able to modify LMNA transcript processing. Oligonucleotides that annealed within the 150 base region of exon 11 that is missing in the progerin transcript, as well as those that targeted the normal exon 11 donor site induced the LMNA Δ150 transcript, but most oligonucleotides also generated variable levels of LMNA transcript missing the entire exon 11. Upon evaluation of different oligomer chemistries, the morpholino phosphorodiamidate oligonucleotides were found to be more efficient than the equivalent sequences prepared as oligonucleotides with 2'-O-methyl modified bases on a phosphorothioate backbone. The morpholino oligonucleotides induced nuclear localised progerin, demonstrated by immunostaining, and morphological nuclear changes typical of HGPS cells. We show that it is possible to induce progerin expression in myogenic cells using splice-switching oligonucleotides to redirect splicing of LMNA. This may offer a model to investigate the role of progerin in premature muscle ageing.
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Affiliation(s)
- Yue-Bei Luo
- Centre for Neuromuscular and Neurological Disorders, Australian Neuro-Muscular Research Institute, University of Western Australia, Perth, Australia
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, China
| | - Chalermchai Mitrpant
- Centre for Neuromuscular and Neurological Disorders, Australian Neuro-Muscular Research Institute, University of Western Australia, Perth, Australia
- Department of Biochemistry, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Abbie M. Adams
- Centre for Neuromuscular and Neurological Disorders, Australian Neuro-Muscular Research Institute, University of Western Australia, Perth, Australia
- Centre for Comparative Genomics, Murdoch University, Perth, Australia
| | - Russell D. Johnsen
- Centre for Neuromuscular and Neurological Disorders, Australian Neuro-Muscular Research Institute, University of Western Australia, Perth, Australia
- Centre for Comparative Genomics, Murdoch University, Perth, Australia
| | - Sue Fletcher
- Centre for Neuromuscular and Neurological Disorders, Australian Neuro-Muscular Research Institute, University of Western Australia, Perth, Australia
- Centre for Comparative Genomics, Murdoch University, Perth, Australia
| | - Frank L. Mastaglia
- Centre for Neuromuscular and Neurological Disorders, Australian Neuro-Muscular Research Institute, University of Western Australia, Perth, Australia
- Institute for Immunology & Infectious Diseases, Murdoch University, Perth, Australia
| | - Steve D. Wilton
- Centre for Neuromuscular and Neurological Disorders, Australian Neuro-Muscular Research Institute, University of Western Australia, Perth, Australia
- Centre for Comparative Genomics, Murdoch University, Perth, Australia
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Abstract
The LMNA gene gives rise to at least three isoforms (lamin A, C, lamin AΔ10) as a result of normal alternative splicing, regulated by cis- and trans-acting regulatory factors, as well as the 5' and 3' untranslated regions of the gene. The two main isoforms, lamin A and C, are constitutive components of the fibrous nuclear lamina and have diverse physiological roles, ranging from mechanical nuclear membrane maintenance to gene regulation. The clinical spectrum of diseases (called 'laminopathies') caused by LMNA mutations is broad, including at least eight well-characterised phenotypes, some of which are confined to the skeletal muscles or skin, while others are multisystemic. This review discusses the different alternatively spliced isoforms of LMNA and the regulation of LMNA splicing, as well as the subgroup of mutations that affect splicing of LMNA pre-mRNA, and also seeks to bridge the mis-splicing of LMNA at transcript level and the resulting clinical phenotypes. Finally, we discuss the manipulation of LMNA splicing by splice-switching antisense oligonucleotides and its therapeutic potential for the treatment of some laminopathies.
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Affiliation(s)
- Yue-Bei Luo
- Centre for Neuromuscular and Neurological Disorders, Australian Neuro-Muscular Research Institute, University of Western Australia, Perth, Australia
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