Adult-onset neuronal ceroid lipofuscinoses (ANCL, Kufs disease) are rare hereditary neuropsychiatric disorders characterized by intralysosomal accumulation of ceroid in tissues. The ceroid accumulation primarily affects the brain, leading to neuronal loss and progressive neurodegeneration. Although several causative genes have been identified (DNAJC5, CLN6, CTSF, GRN, CLN1, CLN5, ATP13A2), the genetic underpinnings of ANCL in some families remain unknown. Here we report one family with autosomal dominant (AD) Kufs disease caused by a 30 bp in-frame duplication in DNAJC5, encoding the cysteine-string protein alpha (CSPα). This variant leads to a duplication of the central core motif of the cysteine-string domain of CSPα and affects palmitoylation-dependent CSPα sorting in cultured neuronal cells similarly to two previously described CSPα variants, p.(Leu115Arg) and p.(Leu116del). Interestingly, the duplication was not detected initially by standard Sanger sequencing due to a preferential PCR amplification of the shorter wild-type allele and allelic dropout of the mutated DNAJC5 allele. It was also missed by subsequent whole-exome sequencing (WES). Its identification was facilitated by reanalysis of original WES data and modification of the PCR and Sanger sequencing protocols. Independently occurring variants in the genomic sequence of DNAJC5 encoding the cysteine-string domain of CSPα suggest that this region may be more prone to DNA replication errors and that insertions or duplications within this domain should be considered in unsolved ANCL cases.
- MeSH
- buněčné linie MeSH
- dospělí MeSH
- duplikace genu * MeSH
- falešně negativní reakce MeSH
- genetické testování normy MeSH
- lidé středního věku MeSH
- lidé MeSH
- membránové proteiny genetika metabolismus MeSH
- myši MeSH
- neuronální ceroidlipofuscinózy genetika patologie MeSH
- neurony metabolismus MeSH
- posttranslační úpravy proteinů MeSH
- proteiny tepelného šoku HSP40 genetika metabolismus MeSH
- sekvenování celého genomu normy MeSH
- transport proteinů MeSH
- zvířata MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- myši MeSH
- ženské pohlaví MeSH
- zvířata MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
Neuronálne ceroidné lipofuscinózy predstavujú skupinu geneticky podmienených neurodegeneratívnych ochorení s klinickými prejavmi prevažne v detskom veku. Jedná sa o lyzozomálne ochorenia sprevádzané intracelulárnou akumuláciou autofluorescentného materiálu charakteru lipofuscínu. Medzi najčastejšie klinické prejavy týchto ochorení patria poruchy vývoja, psychomotorický regres, epileptické záchvaty a poruchy zraku. Popisujeme prípad posmrtne diagnostikovej lipofuscinózy u 9,5-ročného chlapca s postihnutím srdca. Ochorenie sa okrem neurologických prejavov v zmysle parciálnej epilepsie a psychomotorického regresu prejavovalo sínusovou bradykardiou. Makroskopicky sme na rozdiel od častejšie udávanej hypertrofie srdca zistili výraznú atrofiu. Histologickým vyšetrením srdca bola diagnostikovaná nielen lipofuscinóza buniek prevodového systému a kardiomyocytov, ale aj bazofilná degenerácia kardiomyocytov.
Neuronal ceroid lipofuscinoses (NCLs) are a group of inherited neurodegenerative disorders with clinical presentation predominantly in the childhood. The NCLs represent lysosomal storage disorders characterized by the accumulation of autofluorescent lipopigment storage material. The most common clinical features include development failure, psychomotor regression, seizures, and progressive loss of vision. We present a case of neuronal ceroid lipofuscinosis with cardiac involvement diagnosed post-mortem in a 9,5-year-old boy, whose clinical symptomatology comprised partial epilepsy, psychomotor decline and sinus bradycardia. In contrast to ventricular hypertrophy, being more frequently associated with NCLs, we discovered cardiac atrophy. Histologic examination of the heart revealed not only the lipofuscinosis affecting cardiac conducting cells and cardiomyocytes, but also basophilic degeneration of myocardium.
- Klíčová slova
- bazofilní degenerace kardiomycytů,
- MeSH
- bradykardie MeSH
- dítě MeSH
- lidé MeSH
- neuronální ceroidlipofuscinózy * patologie MeSH
- pitva MeSH
- Check Tag
- dítě MeSH
- lidé MeSH
- mužské pohlaví MeSH
- Publikační typ
- kazuistiky MeSH
The neuronal ceroid lipofuscinoses (NCLs) are a group of rare genetic diseases characterised clinically by the progressive deterioration of mental, motor and visual functions and histopathologically by the intracellular accumulation of autofluorescent lipopigment - ceroid - in affected tissues. The NCLs are clinically and genetically heterogeneous and more than 14 genetically distinct NCL subtypes have been described to date (CLN1-CLN14) (Haltia and Goebel, 2012 [1]). In this review we will chronologically summarise work which has led over the years to identification of NCL genes, and outline the potential of novel genomic techniques and related bioinformatic approaches for further genetic dissection and diagnosis of NCLs. This article is part of a Special Issue entitled: The Neuronal Ceroid Lipofuscinoses or Batten Disease.
- MeSH
- fenotyp MeSH
- genetická predispozice k nemoci * MeSH
- lidé MeSH
- membránové proteiny genetika MeSH
- mutace genetika MeSH
- neuronální ceroidlipofuscinózy genetika patologie terapie MeSH
- výpočetní biologie * MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- přehledy MeSH
Autosomal-dominant adult-onset neuronal ceroid lipofuscinosis (ANCL) is characterized by accumulation of autofluorescent storage material in neural tissues and neurodegeneration and has an age of onset in the third decade of life or later. The genetic and molecular basis of the disease has remained unknown for many years. We carried out linkage mapping, gene-expression analysis, exome sequencing, and candidate-gene sequencing in affected individuals from 20 families and/or individuals with simplex cases; we identified in five individuals one of two disease-causing mutations, c.346_348delCTC and c.344T>G, in DNAJC5 encoding cysteine-string protein alpha (CSPα). These mutations-causing a deletion, p.Leu116del, and an amino acid exchange, p.Leu115Arg, respectively-are located within the cysteine-string domain of the protein and affect both palmitoylation-dependent sorting and the amount of CSPα in neuronal cells. The resulting depletion of functional CSPα might cause in parallel the presynaptic dysfunction and the progressive neurodegeneration observed in affected individuals and lysosomal accumulation of misfolded and proteolysis-resistant proteins in the form of characteristic ceroid deposits in neurons. Our work represents an important step in the genetic dissection of a genetically heterogeneous group of ANCLs. It also confirms a neuroprotective role for CSPα in humans and demonstrates the need for detailed investigation of CSPα in the neuronal ceroid lipofuscinoses and other neurodegenerative diseases presenting with neuronal protein aggregation.
- MeSH
- dominantní geny genetika MeSH
- dospělí MeSH
- exony genetika MeSH
- genetická vazba MeSH
- genová dávka genetika MeSH
- lidé MeSH
- lipoylace MeSH
- lyzozomy metabolismus ultrastruktura MeSH
- membránové proteiny genetika MeSH
- molekulární sekvence - údaje MeSH
- mozek metabolismus patologie ultrastruktura MeSH
- mutace genetika MeSH
- neuronální ceroidlipofuscinózy epidemiologie genetika patologie MeSH
- neurony metabolismus patologie ultrastruktura MeSH
- proteiny tepelného šoku HSP40 genetika MeSH
- regulace genové exprese MeSH
- rodina MeSH
- rodokmen MeSH
- segregace chromozomů genetika MeSH
- sekvence nukleotidů MeSH
- sekvenční analýza DNA MeSH
- transport proteinů MeSH
- věk při počátku nemoci MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
This is the first neuropathology report of a male patient (born 1960-died 1975) with an extremely rare, atypical variant of CLN2 that has been diagnosed only in five families so far. The clinical history started during his preschool years with relatively mild motor and psychological difficulties, but with normal intellect and vision. Since age six there were progressive cerebellar and extrapyramidal symptomatology, amaurosis, and mental deterioration. Epileptic seizures were absent. The child died aged 15 years in extreme cachexy. Neuropathology revealed neurolysosomal storage of autofluorescent, curvilinear and subunit c of mitochondrial ATP synthase (SCMAS) rich material. The neuronal storage led to laminar neuronal depopulation in the cerebral cortex and to a practically total eradication of the cerebellar cortical neurons. The other areas of the central nervous system including hippocampus, which are usually heavily affected in classical forms of CLN2, displayed either a lesser degree or absence of neuronal storage, or storage without significant neuronal loss. Transformation of the stored material to the spheroid like perikaryal inclusions was rudimentary. The follow-up, after 30 years, showed heterozygous values of TPP1 (tripeptidylpeptidase 1) activity in the white blood cells of both parents and the sister. DNA analysis of CLN2 gene identified a paternal frequent null mutation c.622C > T (p.Arg208 X) in the 6th exon and a maternal novel mutation c.1439 T > G in exon 12 (p.Val480Gly). TPP1 immunohistochemistry using a specific antibody gave negative results in the brain and other organs. Our report supports the notion that the spectrum of CLN2 phenotypes may be surprisingly broad. The study revealed variable sensitivities in neuronal subpopulations to the metabolic defect which may be responsible for the variant's serious course.
- MeSH
- aminopeptidasy MeSH
- buněčná inkluze metabolismus patologie MeSH
- dítě MeSH
- endopeptidasy genetika MeSH
- financování organizované MeSH
- lidé MeSH
- mitochondriální protonové ATPasy metabolismus MeSH
- mladiství MeSH
- mozek patologie MeSH
- neuronální ceroidlipofuscinózy genetika patofyziologie patologie MeSH
- neurony patologie MeSH
- předškolní dítě MeSH
- progrese nemoci MeSH
- serinové endopeptidasy MeSH
- věk při počátku nemoci MeSH
- Check Tag
- dítě MeSH
- lidé MeSH
- mladiství MeSH
- mužské pohlaví MeSH
- předškolní dítě MeSH
- Publikační typ
- kazuistiky MeSH
- MeSH
- dítě MeSH
- dospělí MeSH
- kojenec MeSH
- lidé středního věku MeSH
- lidé MeSH
- lyzozomální nemoci z ukládání enzymologie patologie MeSH
- mitochondrie enzymologie patologie MeSH
- mladiství MeSH
- následné studie MeSH
- neuronální ceroidlipofuscinózy enzymologie patologie MeSH
- neurony chemie patologie MeSH
- předškolní dítě MeSH
- senioři MeSH
- western blotting MeSH
- Check Tag
- dítě MeSH
- dospělí MeSH
- kojenec MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladiství MeSH
- předškolní dítě MeSH
- senioři MeSH
Clinicopathological studies of a series of nine children with a new subform of Jansky-Bielschowsky disease or late infantile neuronal ceroid lipofuscinosis (LINCL) is presented. The onset of this subform is between 2.5-3.5 years of age with initial neurological symptoms of abnormal motor skills caused by cerebellar and extrapyramidal signs. Soon after dementia, myoclonic seizures are followed. Visual impairment is more clearly seen after the age of 5 or 6 years. The ultrastructural studies of the skin and/or buffy coat showed abundant lysosomal storage of curvilinear profiles, rarely intermixed with fingerprint profiles. The MRI of the head performed in seven cases, showed initially enlargement of the ventricles that is secondary to basal ganglia atrophy and presence of cerebellar and cerebral atrophy. In 4 of 7 cases (Cases 1, 5, 6, 8) abnormalities in the deep white matter showing increased signals of T2-weighted imaging in the periventricular areas of the fronto-parietal region, internal capsule, tracks of the brainstem, and white matter of cerebellum were seen. These abnormalities were also observed by post-mortem neuropathological studies in three cases (nos. 7-9). The MRI in Cases 7 and 9 was not performed. The electrophysiological abnormalities (EEG, ERG, VER) are similar as described in the classical LINCL. Neuropathological studies done in 3 of 9 cases showed generalized brain atrophy and unique type of neuronal cytoplasmic inclusion body in the basal ganglia, brainstem, dentate nuclei, and rarely, cerebral cortex. These large, round neuronal cytoplasmic inclusions were pink in hematoxylin (HE), violet in cresyl violet, and dark blue with Kluver-Barrera method.(ABSTRACT TRUNCATED AT 250 WORDS)
- MeSH
- bazální ganglia patofyziologie MeSH
- degenerace nervu MeSH
- demence etiologie patofyziologie MeSH
- dítě MeSH
- elektroencefalografie MeSH
- fibroblasty ultrastruktura MeSH
- lidé MeSH
- magnetická rezonanční tomografie MeSH
- mozeček patologie MeSH
- nemoci bazálních ganglií diagnóza patologie MeSH
- nemoci mozečku diagnóza patologie MeSH
- neuronální ceroidlipofuscinózy diagnóza klasifikace patologie MeSH
- pohybové poruchy diagnóza patologie MeSH
- předškolní dítě MeSH
- Check Tag
- dítě MeSH
- lidé MeSH
- mužské pohlaví MeSH
- předškolní dítě MeSH
- ženské pohlaví MeSH
- Publikační typ
- kazuistiky MeSH
- Research Support, U.S. Gov't, P.H.S. MeSH