HCN1 mutation spectrum: from neonatal epileptic encephalopathy to benign generalized epilepsy and beyond

. 2018 Nov 01 ; 141 (11) : 3160-3178.

Jazyk angličtina Země Anglie, Velká Británie Médium print

Typ dokumentu časopisecké články, práce podpořená grantem

Perzistentní odkaz   https://www.medvik.cz/link/pmid30351409

Hyperpolarization-activated cyclic nucleotide-gated (HCN) channels control neuronal excitability and their dysfunction has been linked to epileptogenesis but few individuals with neurological disorders related to variants altering HCN channels have been reported so far. In 2014, we described five individuals with epileptic encephalopathy due to de novo HCN1 variants. To delineate HCN1-related disorders and investigate genotype-phenotype correlations further, we assembled a cohort of 33 unpublished patients with novel pathogenic or likely pathogenic variants: 19 probands carrying 14 different de novo mutations and four families with dominantly inherited variants segregating with epilepsy in 14 individuals, but not penetrant in six additional individuals. Sporadic patients had epilepsy with median onset at age 7 months and in 36% the first seizure occurred during a febrile illness. Overall, considering familial and sporadic patients, the predominant phenotypes were mild, including genetic generalized epilepsies and genetic epilepsy with febrile seizures plus (GEFS+) spectrum. About 20% manifested neonatal/infantile onset otherwise unclassified epileptic encephalopathy. The study also included eight patients with variants of unknown significance: one adopted patient had two HCN1 variants, four probands had intellectual disability without seizures, and three individuals had missense variants inherited from an asymptomatic parent. Of the 18 novel pathogenic missense variants identified, 12 were associated with severe phenotypes and clustered within or close to transmembrane domains, while variants segregating with milder phenotypes were located outside transmembrane domains, in the intracellular N- and C-terminal parts of the channel. Five recurrent variants were associated with similar phenotypes. Using whole-cell patch-clamp, we showed that the impact of 12 selected variants ranged from complete loss-of-function to significant shifts in activation kinetics and/or voltage dependence. Functional analysis of three different substitutions altering Gly391 revealed that these variants had different consequences on channel biophysical properties. The Gly391Asp variant, associated with the most severe, neonatal phenotype, also had the most severe impact on channel function. Molecular dynamics simulation on channel structure showed that homotetramers were not conducting ions because the permeation path was blocked by cation(s) strongly complexed to the Asp residue, whereas heterotetramers showed an instantaneous current component possibly linked to deformation of the channel pore. In conclusion, our results considerably expand the clinical spectrum related to HCN1 variants to include common generalized epilepsy phenotypes and further illustrate how HCN1 has a pivotal function in brain development and control of neuronal excitability.

AP HP Groupe Hospitalier Pitié Salpêtrière Département de Génétique Paris France

Azienda Unità Sanitaria Locale IRCCS di Reggio Emilia Reggio Emilia Italy

Child Neuropsychiatry Unit Department of Medical and Surgical Neurosciences and Rehabilitation IRCCS Istituto Giannina Gaslini Genova Italy

Computational Biology and Simulation Group Department of Biology Technische Universität Darmstadt Darmstadt Germany

Département de Génétique Médicale Maladies Rares et Médecine Personnalisée Hôpital Arnaud de Villeneuve Montpellier France

Department of Biosciences The PaceLab Università degli Studi di Milano Milan Italy

Department of Biosciences University of Milan Milan Italy

Department of Child Neurology Charles University 2nd Faculty of Medicine and University Hospital Motol Prague Czech Republic

Department of Clinical Diagnostics Ambry Genetics Aliso Viejo CA USA

Department of Clinical Genomics and Neurology Mayo Clinic Phoenix AZ USA

Department of Genetics Hôpital Erasme ULB Center of Human Genetics Université Libre de Bruxelles Brussels Belgium

Department of Genetics Hôpital Universitaire des Enfants Reine Fabiola ULB Center of Human Genetics Université Libre de Bruxelles Brussels Belgium

Department of Genetics University Medical Center Utrecht Utrecht The Netherlands

Department of Medical Genetics and Alberta Children's Hospital Research Institute Cumming School of Medicine University of Calgary Calgary Alberta Canada

Department of Neurology Academic Center for Epileptology Kempenhaeghe Maastricht University Medical Center Heeze The Netherlands

Department of Neurology San Gerardo Hospital University Milano Bicocca Monza Italy

Department of Neuroscience Columbia University New York NY USA

Department of Neurosciences University of Virginia Charlottesville VA USA

Department of Pediatric Neurology Hôpital Universitaire des Enfants Reine Fabiola Université Libre de Bruxelles ULB Brussels Belgium

Division of Genetics Department of Pediatrics Oishei Children's Hospital Jacobs School of Medicine and Biomedical Sciences University of Buffalo State University of New York Buffalo NY USA

Division of Neurology Children's Hospital of Philadelphia Philadelphia PA USA

EuroEPINOMICS RES Consortium

FHU TRANSLAD Université de Bourgogne CHU Dijon and INSERM UMR 1231 GAD team Genetics of Developmental Anomalies Université de Bourgogne Franche Comté Dijon France

Fondazione IRCCS Istituto Neurologico Carlo Besta Milan Italy

Génétique Biologique Histologie CHRU de Besançon Besançon France

IGBMC CNRS UMR 7104 INSERM U964 Université de Strasbourg Illkirch France

Inserm U 1127 CNRS UMR 7225 Sorbonne Universités UPMC Univ Paris 06 UMR S 1127 Institut du Cerveau et de la Moelle épinière ICM Paris France

Institute of Human Genetics University Hospital Essen University Duisburg Essen Essen Germany

Institute of Human Genetics University of Leipzig Hospitals and Clinics Leipzig Germany

Interuniversity Institute of Bioinformatics in Brussels Université Libre de Bruxelles Brussels Belgium

Laboratoire de Génétique Moléculaire et Génomique CHU de Rennes Rennes France

Laboratoires de génétique Institut de génétique médicale d'Alsace Hôpitaux Universitaires de Strasbourg Strasbourg France

Laboratory of Neurogenetics and Neuroscience Institute G Gaslini Genova Italy

Membrane Biophysics Deparment of Biology Technische Universität Darmstadt Darmstadt Germany

Mendelics Genomic Analysis Sao Paulo SP Brazil

Neuropediatric Department Centro Hospitalar do Porto Porto Portugal

Pediatric Neurology and Muscular Diseases Unit Department of Neurosciences Rehabilitation Ophthalmology Genetics Maternal and Child Health University of Genoa 'G Gaslini' Institute Genova Italy

Pediatric Neurology Neurogenetics and Neurobiology Unit and Laboratories Neuroscience Department A Meyer Children's Hospital University of Florence Viale Pieraccini 24 Florence Italy

School of Medicine and Surgery University Milano Bicocca Monza Italy

Service de Génétique Clinique Centre Référence Déficiences Intellectuelles de causes rares CHU Rennes Rennes France

Service de génétique médicale Pôle de biologie CHU de Toulouse Hôpital Purpan Toulouse France

Wessex Clinical Genetics Service Princess Anne Hospital Southampton UK

Women's and Children's Hospital Adelaide Australia

Citace poskytuje Crossref.org

Najít záznam

Citační ukazatele

Nahrávání dat ...

Možnosti archivace

Nahrávání dat ...