疾病频谱包括伴发性衰弱和脑病不由发烧引发的脑病
Chetan Immanneni1, Daniel Calame1, Song Jiao1
1From the Sam Houston State University College of Osteopathic Medicine (C.I.), Conroe, TX; Molecular Neurophysiology Unit (C.I., S.J., M.H.), National Institute of Neurological Diseases and Stroke, National Institutes of Health, Bethesda, MD; Section of Pediatric Neurology and Developmental Neuroscience (D.C.), Department of Pediatrics; Department of Molecular and Human Genetics (D.C., L.T.E.), Baylor College of Medicine; Texas Children's Hospital (D.C.), Houston, TX; National Human Genome Research Institute (S.T.Y.), National Institutes of Health, Bethesda, MD; and Section of Pediatric Neurology (S.T.Y.), Department of Pediatrics, University of Chicago, IL.
ATP1A3中的致病变体会导致神经系统疾病. 一种新型变异,p.V130del,导致功能丧失和没有发烧的复发性脑病,扩大已知的疾病谱.
科学领域:
- 神经遗传学 神经遗传学
- 分子神经学分子神经学
- 离子运输生理学 离子运输生理学
背景情况:
- 在ATP1A3中异构的致病变体主要导致神经系统疾病,包括情节性运动缺陷.
- 一个明显的表现是反复发烧触发的脑病变,与特定的ATP1A3变体 (例如,p.R756) 相关,影响温度敏感性.
- 这项研究研究了一种与类似的表型相关的新型ATP1A3变体,但缺乏发烧触发物,并表现出蛋白质功能丧失.
研究的目的:
- 描述一个患有 de novo ATP1A3 变异的患者的临床表型,p.V130del.
- 通过体外功能测定来确认p.V130del变种的致病性.
- 描述p.V130del对Na+/K+-ATPase活性,离子运输和细胞表面定位的功能影响.
主要方法:
- 一个7岁男孩的表型特征,患有复发性脑病变和动脉缩.
- 通过三元外基因组测序识别出新的异构性ATP1A3变体 (NM_152296.5:c.388_390delGTG; p.(V130del))
- 试验室功能分析包括细胞生存补充试验 (HEK293细胞),用于离子运输和Na+结合的双电极电压电生理学 (Xenopus卵细胞),以及表面生物化试验.
主要成果:
- 试验对象出现了反复出现的虚弱,脑病和缺氧,而不是由发烧引发的,随后的发育适应性.
- p.V130del变种在细胞存活试验中显示出ATP1A3功能完全丧失,并且在卵细胞中消除了离子运输活性.
- 功能测试显示了细胞外Na+结合的明显异常,并证实了细胞膜中的酶存在,尽管功能丧失了.
结论:
- p.V130del变异代表了ATP1A3相关疾病的新病因,扩大了临床谱,包括非发烧引发的复发性脑病变.
- 离子运输功能的完全丧失,即使保留了细胞表面局部化,也可能是ATP1A3相关疾病中相对轻微的表型的基础.
- 这一发现凸显了ATP1A3功能在神经元健康中的关键作用以及其致病变体的多样化临床表现.
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