Homozygous mutation in the APOA1BP is associated with a lethal infantile leukoencephalopathy

Ronen Spiegel1,2, Avraham Shaag3, Stavit Shalev4,5

  • 1Pediatric Department B, Emek Medical Center, Afula, Israel. spiegelr@zahav.net.il.

Neurogenetics
|April 29, 2016
PubMed

Insights

A genetic defect in the APOA1BP gene causes febrile-induced neurodegenerative disease in children, leading to severe leukoencephalopathy. This study identifies a novel mutation in the nicotinamide nucleotide repair system.

Area of Science:

  • Genetics
  • Neuroscience
  • Metabolism

Background:

  • Febrile-induced neurodegenerative diseases are often inborn errors of metabolism causing irreversible central nervous system damage.
  • A consanguineous family presented with five siblings exhibiting normal development for 6-12 months, followed by severe leukoencephalopathy after a febrile illness.

Purpose of the Study:

  • To identify the genetic cause of febrile-induced neurodegenerative disease in a consanguineous family.
  • To elucidate the molecular mechanism underlying this newly identified neurological disorder.

Main Methods:

  • Homozygosity mapping was employed to identify regions of shared homozygosity among affected siblings.
  • Whole exome sequencing was performed to pinpoint the causative genetic mutation.
  • Functional analysis of the identified gene and its encoded protein was conducted.

Main Results:

  • A homozygous c.281C>A mutation in the APOA1BP gene was identified, leading to a p.Ala94Asp substitution.
  • The mutation affects epimerase, an enzyme critical for NAD(P)XH dehydration and toxic metabolite clearance.
  • This represents the first reported human defect in the nicotinamide nucleotide repair system.

Conclusions:

  • A novel genetic defect in APOA1BP causes a severe, febrile-induced leukoencephalopathy.
  • Disruption of the nicotinamide nucleotide repair pathway is implicated in neurodegeneration.
  • This finding expands the spectrum of inborn errors of metabolism affecting the central nervous system.

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