Homozygous boricua TBCK mutation causes neurodegeneration and aberrant autophagy

Xilma R Ortiz-González1,2,3, Jesus A Tintos-Hernández1,3,4, Kierstin Keller3,4

  • 1Department of Pediatrics, Division of Neurology, The Children's Hospital of Philadelphia, Philadelphia, PA.

Annals of Neurology
|December 29, 2017
PubMed
Abstract

Insights

Mutations in TBCK cause TBCK-encephaloneuronopathy (TBCKE), a neurodegenerative disorder. This study found that activating mTORC1 may improve autophagic-lysosomal dysfunction in TBCKE patients.

Area of Science:

  • Genetics and Neurology
  • Molecular Biology
  • Metabolic Disorders

Background:

  • Autosomal-recessive mutations in TBCK gene are linked to intellectual disability.
  • Loss-of-function TBCK mutations are associated with reduced mechanistic target of rapamycin complex 1 (mTORC1) signaling.
  • mTORC1 signaling regulates autophagy, suggesting a potential link to neurodegeneration in TBCK-associated disorders.

Purpose of the Study:

  • To investigate autophagic-lysosomal dysfunction in TBCK-encephalopathy patients with a neurodegenerative course.
  • To characterize the neurological and systemic phenotype of TBCK-encephaloneuronopathy (TBCKE).
  • To explore the potential therapeutic effect of mTORC1 activation on autophagic dysfunction.

Main Methods:

  • Neurological phenotyping and neurophysiological studies in 8 children with TBCK p.R126X mutations.
  • Quantification of autophagosome content and autophagic markers in patient-derived fibroblasts.
  • Assay of free sialylated oligosaccharide profiles in patient urine and fibroblasts.

Main Results:

  • TBCK-encephaloneuronopathy (TBCKE) presents with congenital hypotonia, progressive motor neuronopathy, leukoencephalopathy, epilepsy, coarse facies, dyslipidemia, and osteoporosis.
  • TBCK-deficient fibroblasts show increased autophagosomes and autophagic flux.
  • Patients' urine and fibroblasts exhibit altered free oligosaccharide profiles, which are improved by leucine (mTORC1 activator).

Conclusions:

  • TBCK-encephaloneuronopathy (TBCKE) is a distinct syndrome characterized by progressive neurological dysfunction.
  • Inappropriate autophagy, independent of cellular stress, may contribute to TBCKE pathogenesis.
  • mTORC1 activation shows potential in ameliorating autophagic-lysosomal dysfunction, and oligosaccharide profiles may serve as biomarkers.

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