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Genetics of FTD: New Gene, PGRN Variety, and a Bit of FUS
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17 February 2010. The genetics of frontotemporal dementia (FTD) just got more interesting. On February 14, Nature Genetics posted a paper—authored by much of the FTD research community—describing a genomewide association study that identified new SNPs linked to frontotemporal lobal dementia with TDP-43 pathology (FTLD-TDP). The February Archives of Neurology brought multiple snippets of news as well. Researchers from the University of Pennsylvania in Philadelphia and the University of Washington in Seattle spearheaded a broad study of the FTD disease spectrum, and came up with a large list of new mutations in progranulin (PGRN) that may be relevant to disease. In the same journal, researchers from the Mayo Clinic in Rochester, Minnesota, report on yet another PGRN mutation with a varying phenotype, and scientists from the Netherlands contribute to the list of possible variants in the gene FUS. “This is an exhilarating time to be clinicians and scientists in the FTLD field,” wrote Bradley Boeve of the Mayo Clinic in Rochester, in an Archives of Neurology editorial accompanying the disease spectrum paper.
Frontotemporal dementia has multiple causes. Approximately half of familial cases are due to mutations in tau; the other half exhibit TDP-43 proteinopathy, due to mutations in TDP-43 itself or in PGRN. A smaller proportion, caused by none of those proteins, is associated with mutations in FUS.
Introducing TMEM106B (You May Not Have Heard of It...)
The plan to go fishing, GWAS-style, for genetic risk factors for FTLD was hatched by Virginia Lee and John Trojanowski of the University of Pennsylvania in Philadelphia. They recruited joint senior author Hakon Hakonarson at Children’s Hospital in Philadelphia and joint first authors Vivianna Van Deerlin, Maria Martinez-Lage, and Alice Chen-Plotkin at the University of Pennsylvania and Patrick Sleiman at Children’s Hospital. Lee invited scientists in the FTLD field to submit samples in 2007, and—a few thousand e-mails later—researchers from 45 sites in 11 countries had anted up. “I would challenge you to find other fields that play together so well,” Trojanowski said of his 99 coauthors. “I think it is an important paper, despite the fact that much of it is names and addresses of authors,” joked Allen Roses of Duke University in Durham, North Carolina, who was not part of the study group. He expects knowledge of the new locus will come in handy in his own work, helping him to identify and separate people with FTD from other subjects in an Alzheimer disease study.
Researchers’ high hopes for GWASs have not always been borne out (e.g., see ARF related news story on Chiò et al., 2009). “This is the kind of GWAS that one might have been skeptical of at the outset, because the numbers were small,” Trojanowski said. “ The FTLD cohort contained 515 cases. The researchers relied on private funding to start the project. The trick was to carefully select a “squeaky-clean” subject pool, Trojanowski said, limited to only TDP-43-positive cases. The researchers confirmed TDP-43 pathology with autopsy tissue in most cases; a handful were people with PGRN mutations. Controls were 2,509 DNA samples, statistically matched to the cases by ethnic background and other characteristics, Van Deerlin said.
Once the analysis was complete, the authors had identified three SNPs, all in the same region of chromosome 7, associated with FTLD status. Each had a p-value in the -10 to the -11 range—impressive significance, Roses noted. In each case, FTLD was associated with the more common allele; having an FTLD SNP increased odds of disease by approximately 1.6. These SNPs were linked to disease both among cases with PGRN mutations and cases without. Of course, a SNP gives only a nearby address, and does not represent the actual disease-relevant genetic lesion. But in this case, Van Deerlin said, there is only one gene in the area, making that gene, transmembrane protein 106B (TMEM106B), a very likely.
If you have never heard of TMEM106B, you are hardly alone. “Nothing is published, nothing is known, no antibodies, no nothing,” Van Deerlin said. To dig into TMEM106B’s potential mechanism, the group evaluated the gene’s expression in the brains of people who had FTLD-TDP. They used quantitative PCR to assay TMEM106B mRNA levels. Those carrying the risk-associated SNPs had higher levels of TMEM106B mRNA in the cerebral cortex, suggesting the SNPs are linked to higher expression of the gene. TMEM106B expression was 2.5-fold higher in tissues from people with FTLD-TDP, compared to unaffected controls.
There is always the possibility that some other gene, in linkage disequilibrium with the identified SNPs, is the true problem. But the expression data make a “compelling” case,” said Kirk Wilhelmsen of the University of North Carolina in Chapel Hill. “Having sort of a smoking gun, that it changes the expression level of a gene, is relatively satisfying,” he said. This potential mechanism is also encouraging when one considers treatment strategies, he noted; dampening a gene’s overexpression is theoretically easier than repairing a protein that is damaged or missing.
The next step, already underway, according to Trojanowski, is to delve into the normal function of TMEM106B and sequence the gene directly in human samples. Also, like any GWAS, replication is necessary. Roses suggested that one further approach is to perform phylogenetic analysis, as he did in a 2009 study of the Alzheimer disease genetic risk factor ApoE (Roses et al., 2009), to better delineate the specific gene sequence that leads to disease. For doctors and people at risk for FTLD, he noted, “You do not want something that is associated—you want to know what the genetic lesion is.”
A Panoply of PGRN Problems
One frontotemporal dementia is not like another. “FTD has varied clinical phenotypes, and there are several different pathological phenotypes,” Van Deerlin said. She and coauthors at the University of Pennsylvania and the University of Washington in Seattle set out to document the spectrum of PGRN-associated FTLDs with another large-scale study, published in the Archives of Neurology. Joint first authors were Chang-En Yu and Thomas Bird, with Van Deerlin and Gerald Schellenberg, formerly in Washington and now at the University of Pennsylvania, as senior authors.
The researchers collected data from eight centers on 434 people with FTD and 111 controls with TDP-43 pathology but no FTD. The FTD cases included many forms of the disease, such as FTLD with ubiquitin-positive inclusions (FTLD-U), FTD with motor neuron disease, corticobasal degeneration, and Pick disease. The controls included subjects with amyotrophic lateral sclerosis (ALS), Alzheimer disease, and parkinsonism, among other conditions. The scientists sequenced the PGRN gene from each sample and used that data and in vitro splicing assays to predict the pathogenic potential of the variants they discovered.
PGRN mutations were limited to cases with symptoms of FTD or corticobasal syndrome and proteinopathy with ubiquitin-tagged deposits. PGRN mutations were not present in other conditions such as AD and ALS. However, some diseases were not fully represented in the sample, noted Marc Cruts of VIB-University of Antwerp, who was not part of the study team. For example, he wrote in an e-mail to ARF, some people with an AD diagnosis have been found to have PGRN mutations (Brouwers et al., 2007). Therefore, Cruts wrote, these diseases cannot be definitively excluded from the PGRN spectrum.
The sequencing revealed 58 PGRN variants, 26 not previously published. The researchers discounted variants in the 3’-UTR and in controls as unlikely to be pathogenic. Twenty-two likely pathogenic mutations caused a premature stop codon in the sequence. Five of them altered splice sites, and likely caused exon skipping, leading to a premature stop codon later on. In vitro splicing assays confirmed this prediction. Sequence analysis indicated that most of these mutations would alter protein function.
Overall, PGRN mutations were found in 6.9 percent of all clinical FTD cases, 16 percent of familial cases, and 21.4 percent of cases with confirmed ubiquitin-tagged inclusions. Many of the mutations cause premature stop codons, and the corresponding mRNA is likely degraded before it can make a protein. Thus, people carrying such a mutation on one chromosome would only make half as much PGRN protein as they should. This haploinsufficiency appears to be the most common cause of PGRN-associated disease, but it is not yet known how reduced PGRN leads to TDP-43 proteinopathy, which is found in all FTD cases with PGRN mutations, or disease symptoms. Perhaps, Van Deerlin and Lee speculated, TMEM106B will turn out to be the “missing link” between PGRN and TDP-43.
“I think we have gone a long distance to nailing down what may be the nearly complete array of mutations,” said Trojanowski, who also participated in this study. They likely did not hit all possible PGRN mutations, though. In fact, in the same issue of the Archives of Neurology, another group at the Mayo Clinic in Rochester, Minnesota, describes yet another PGRN mutation with rather unusual clinical features. This work was led by first author Brendan Kelley, now at the University of Cincinnati in Ohio, and joint senior authors Boeve and Ronald Petersen at the Mayo Clinic.
Kelley and colleagues studied 10 affected members of the same local family with a familial neurodegenerative disorder linked to progranulin. The disorder looked a lot like Alzheimer disease. In fact, some members of the family lived with an AD diagnosis until they died. The first generation was not seen at the Mayo Clinic, but when Petersen and colleagues saw the second generation, AD seemed like the best conclusion. The patients had forgetfulness and mild cognitive impairment. But the diagnosis began to make less sense when members of the third generation started seeing Boeve and other doctors at the Mayo Clinic. “Generation three presented at an earlier age and they had more variable symptoms,” Boeve said. Memory loss, as in AD, was not reliably an early symptom, but nor were the personality changes and executive dysfunction characteristic of FTD. One person had aphasia. Some family members started out with an AD diagnosis that was later changed to FTD. One even had both AD and FTD pathology, although the FTD was considered to be the primary problem.
Five of the second- and third-generation family members underwent MRI, and several were examined at autopsy. The pathology was suspicious; some subjects evinced degeneration and ubiquitin inclusions in the frontotemporal lobe. But there was no genetic explanation until 2006. “Once the progranulin mutation was found, then the light bulb went on,” Boeve said (see ARF related news story on Cruts et al., 2006 and Baker et al., 2006). Of those family members able to offer a DNA sample, all had the same single base pair deletion, causing a frameshift mutation and likely a nonfunctional gene, as in the other PGRN mutations described above.
Ultimately, scientists still do not understand how mutations in the same gene can cause such a panoply of presentations, making it difficult to predict disease course even if genetic information is available. “These two papers are complementary because the point of both is that neuropathology is important,” Bird said. Without pathology data, he said, it is much harder to predict what the genetics of a person with FTD will be. Genetics do not make much difference to treatment options at this point. But understanding the underlying genetic cause makes a big difference to family members concerned about their own level of risk. “One has to consider a PGRN mutation, even in late-onset Alzheimer disease with a strong family history,” Boeve said. “How many late-onset Alzheimer’s families are not having progranulin tested, and would additional insights be provided into pathogenesis?”
And Don’t Forget FUS
FTD and ALS could be viewed as opposite ends of a TDP-43 proteinopathy spectrum, with FTD affecting cortical neurons and ALS affecting motor neurons, and they can co-occur. Recently, FUS was linked to these diseases (see ARF related news story on Kwiatkowski et al., 2009 and Vance et al., 2009; and ARF related news story and Neumann et al., 2009). A group of researchers at the University Medical Center Utrecht in the Netherlands analyzed FUS variants in 52 Dutch people with familial ALS and 970 healthy controls. This report, led by joint first authors Ewout Grown and Michael van Es and senior author Leonard van den Berg, is also printed in February’s Archives of Neurology.
The researchers identified three mutations, including a novel one, in FUS. However, some control cases also had FUS variants. “Caution is warranted when interpreting results in a clinical setting,” the authors write. Doctors and genetic counselors should be aware, they write, that not all FUS variants cause disease and that some have incomplete penetrance.—Amber Dance.
References:
Van Deerlin VM, Sleiman PM, Martinez-Lage M, Chen-Plotkin A, Wang LS, Graff-Radford NR, Dickson DW, Rademakers R, Boeve BF, Grossman M, Arnold SE, Mann DM, Pickering-Brown SM, Seelaar H, Heutink P, van Swieten JC, Murrell JR, Ghetti B, Spina S, Grafman J, Hodges J, Spillantini MG, Gilman S, Lieberman AP, Kaye JA, Woltjer RL, Bigio EH, Mesulam M, Al-Sarraj S, Troakes C, Rosenberg RN, White CL 3rd, Ferrer I, Lladó A, Neumann M, Kretzschmar HA, Hulette CM, Welsh-Bohmer KA, Miller BL, Alzualde A, de Munain AL, McKee AC, Gearing M, Levey AI, Lah JJ, Hardy J, Rohrer JD, Lashley T, Mackenzie IR, Feldman HH, Hamilton RL, Dekosky ST, van der Zee J, Kumar-Singh S, Van Broeckhoven C, Mayeux R, Vonsattel JP, Troncoso JC, Kril JJ, Kwok JB, Halliday GM, Bird TD, Ince PG, Shaw PJ, Cairns NJ, Morris JC, McLean CA, Decarli C, Ellis WG, Freeman SH, Frosch MP, Growdon JH, Perl DP, Sano M, Bennett DA, Schneider JA, Beach TG, Reiman EM, Woodruff BK, Cummings J, Vinters HV, Miller CA, Chui HC, Alafuzoff I, Hartikainen P, Seilhean D, Galasko D, Masliah E, Cotman CW, Tuñón MT, Martínez MC, Munoz DG, Carroll SL, Marson D, Riederer PF, Bogdanovic N, Schellenberg GD, Hakonarson H, Trojanowski JQ, Lee VM. Common variants at 7p21 are associated with frontotemporal lobar degeneration with TDP-43 inclusions. Nat Genet. 2010. Epub ahead of print 14 Feb. Abstract
Yu CE, Bird TD, Bekris LM, Montine TJ, Leverenz JB, Steinbart E, Galloway NM, Feldman H, Woltjer R, Miller CA, Wood EM, Grossman M, McCluskey L, Clark CM, Neumann M, Danek A, Gelasko DR, Arnold SE, Chen-Plotkin A, Karydas A, Miller BL, Trojanowski JQ, Lee VM, Schellenberg GD, Van Deerlin VM. The spectrum of mutations in progranulin: a collaborative study screeing 545 cases of neurodegeneration. Arch Neurol. 2010 Feb;67(2):161-70. Abstract
Boeve BF. Progress on progranulin. Arch Neurol. 2010 Feb;67(2):145-7. Abstract
Kelley BJ, Haldar W, Boeve BF, Baker M, Shiung M, Knopman DS, Rademakers R, Hutton M, Adamson J, Kuntz KM, Dickson DW, Parisi JE, Smith GE, Petersen RC. Alzheimer disease-like phenotype associated with the c.154delA mutation in progranulin. Arch Neurol. 2010 Feb;67(2):171-7. Abstract
Groen EJ, van Es MA, van Vught PW, Spliet WG, van Engelen-Lee J, de Visser M, Wokke JH, Schelhaas JH, Ophoff RA, Fumoto K, Pasterkamp RJ, Dooijes D, Cuppen E, Veldink JH, van den Berg LH. FUS mutations in familial amyotrophic lateral sclerosis in the Netherlands. Arch Neurol. 2010 Feb;67(2):224-30. Abstract
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Comments on Related News |
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Related News: Birds of a Feather…Mutations in Tau Gene Neighbor Progranulin Cause FTD
Comment by: John Hardy, ARF Advisor
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Submitted 17 July 2006
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Posted 17 July 2006
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The identification of progranulin mutations by Baker and colleagues is a major advance in our understanding of frontal temporal dementia (FTD). The work by both Baker and Cruts and their colleagues shows that loss of progranulin function is a major cause of FTD, at least in some populations. These findings are remarkable for several reasons: first, this is the first simple loss-of-function autosomal dominant disease; second, it suggests that the genetic linkage of two FTD loci with similar clinical features, but different pathologies, close to the same locus was just a confusing coincidence. Third, it will undoubtedly spawn a huge amount of effort to define the limits of the phenotype and to elucidate its precise function in the CNS. It will also be interesting to see whether other diseases with ubiquitin inclusions will share related pathogenic mechanisms. View all comments by John Hardy
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Related News: Birds of a Feather…Mutations in Tau Gene Neighbor Progranulin Cause FTD
Comment by: Virginia Lee, ARF Advisor, John Trojanowski, ARF Advisor
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Submitted 17 July 2006
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Posted 17 July 2006
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These studies are spectacular advances in FTD research that open up new avenues for understanding mechanisms of FTLD-U. Notably, since progranulin proteins, or derivatives thereof, were not found in the ubiquitin inclusions of these FTLD-U disorders, it will be important to identify the ubiquitinated disease protein(s) that form these hallmark lesions of FTLD-U.
View all comments by Virginia Lee View all comments by John Trojanowski
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Related News: Birds of a Feather…Mutations in Tau Gene Neighbor Progranulin Cause FTD
Comment by: Andrew Kertesz
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Submitted 18 July 2006
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Posted 18 July 2006
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Both of these papers represent a significant discovery of a novel
mutation on progranulin, a protein with no known CNS function. It is a
known growth factor in vasculo and tumorigenesis, and it may turn out
to have nerve growth factor properties as well; therefore, it is
reasonable to postulate that a molecular deficit caused by its
mutation could produce neurodegenerative disease such as frontotemporal dementia (FTD). We published the first chromosome 17-linked ubiquitin-positive family from Ontario in 2000 and the first intranuclear ubiquitin-positive inclusions in this and other families (1,2), but these genetic teams deserve credit for finding the mutation.
What is extraordinary is that progranulin is very close to the tau
gene on chromosome 17, the known culprit in the mutated form in FTD
linked to 17. How the two different genes interact, if at all, to
cause a very similar illness is yet to be determined. The relationship
of progranulin mechanisms to chromosome 9-linked cases and the valosin mutation with FTD and myopathy also deserves attention.
References: 1. Kertesz A, Kawarai T, Rogaeva E, St George-Hyslop P, Poorkaj P, Bird TD, Munoz DG. Familial frontotemporal dementia with ubiquitin-positive, tau-negative inclusions. Neurology. 2000 Feb 22;54(4):818-27. Abstract
2. Woulfe J, Kertesz A, Munoz DG. Frontotemporal dementia with ubiquitinated cytoplasmic and intranuclear inclusions. Acta Neuropathol
2001;102:94-102. Abstract
View all comments by Andrew Kertesz
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Related News: New Ubiquitinated Inclusion Body Protein Identified
Comment by: Julene K. Johnson
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Submitted 12 October 2006
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Posted 12 October 2006
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From a clinical perspective, the identification of TDP-43 protein represents a major breakthrough in our understanding of both frontotemporal lobar degeneration (FTLD) and amyotrophic lateral sclerosis (ALS). The TDP-43 is the mystery protein that is associated with the ubiquitin-positive inclusions that are commonly found in many patients with FTLD and in most, if not all, patients with ALS.
This finding is particularly important because several recent papers suggest that patients who have FTLD with ubiquitin inclusions at autopsy (FTLD-U) account for approximately 50 percent of all autopsy-confirmed FTLD cases (1-3). The remaining majority of FTLD cases are associated with the tau protein, but other neuropathological diagnoses exist. The finding that possibly one-half of all FTLD patients may have ubiquitin-positive neuropathology means that any breakthroughs in the biology of this protein could potentially translate into helping a large proportion of FTLD patients.
In addition, the finding that the TDP-43 protein is also found in patients with ALS further supports...
Read more
From a clinical perspective, the identification of TDP-43 protein represents a major breakthrough in our understanding of both frontotemporal lobar degeneration (FTLD) and amyotrophic lateral sclerosis (ALS). The TDP-43 is the mystery protein that is associated with the ubiquitin-positive inclusions that are commonly found in many patients with FTLD and in most, if not all, patients with ALS.
This finding is particularly important because several recent papers suggest that patients who have FTLD with ubiquitin inclusions at autopsy (FTLD-U) account for approximately 50 percent of all autopsy-confirmed FTLD cases (1-3). The remaining majority of FTLD cases are associated with the tau protein, but other neuropathological diagnoses exist. The finding that possibly one-half of all FTLD patients may have ubiquitin-positive neuropathology means that any breakthroughs in the biology of this protein could potentially translate into helping a large proportion of FTLD patients.
In addition, the finding that the TDP-43 protein is also found in patients with ALS further supports the overlap between FTLD and ALS. Future research on the TDP-43 protein will likely also benefit ALS patients and help us understand how these two very different clinical phenotypes are related.
References: 1. Lipton AM, White CL 3rd, Begio EH. Frontotemporal lobar degeneration with motor neuron disease-type inclusions predominates in 76 cases of frontotemporal degeneration. Acta Neuropathol (Berl). 2004 Nov;108(5):379-85. Abstract
2. Johnson JK, Diehl J, Mendez MF, Neuhaus J, Shapira JS, Forman M, Chute DS, Roberson ED, Pace-Savitsky C, Neumann M, Chow TW, Rosen HJ, Forstl H, Kurz A, Miller BL.. Frontotemporal lobar degeneration: demographic characteristics of 353 patients. Archives of Neurology. 2005;62:925-930. Abstract
3. Forman MS, Farmer J, Johnson JK, Clark CM, Arnold SE, Coslett HB, Chatterjee A, Hurtig HI, Karlawish JH, Rosen HJ, Van Deerlin V, Lee V M-Y, Miller BL, Trojanowski JQ, & Grossman M. (2006). Frontotemporal dementia: Clinicopathological correlations. Annals of Neurology. 2006;59:952-962. Abstract
View all comments by Julene K. Johnson
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Related News: New Ubiquitinated Inclusion Body Protein Identified
Comment by: David M.A. Mann
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Submitted 12 October 2006
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Posted 12 October 2006
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In this paper, Drs. Lee and Trojanowski and colleagues have at long last identified the mystery protein hiding within the ubiquitinated inclusions that characterize certain histological forms of frontotemporal lobar degeneration (FTLD), termed FTLD-U. This task has challenged neuroscientists for well over a decade, with all prior attempts at identification using immunohistochemical or biochemical methods proving fruitless. The culprit protein is a TAR DNA-binding protein, known as TDP-43. This protein is present within all the ubiquitinated structures in FTLD-U, viz., the neuronal cytoplasmic inclusions, the neuronal intranuclear inclusions, and the neuritic changes, though whether this is the sole component of these structures (other than ubiquitin) remains uncertain. Some previous studies reported the presence of p62 protein within neuronal cytoplasmic inclusions, but such findings have been inconsistent. Moreover, Lee and Trojanowski have shown that the ubiquitinated neuronal cytoplasmic inclusions seen within spinal and cranial nerve nuclear motor neurons in motor neuron...
Read more
In this paper, Drs. Lee and Trojanowski and colleagues have at long last identified the mystery protein hiding within the ubiquitinated inclusions that characterize certain histological forms of frontotemporal lobar degeneration (FTLD), termed FTLD-U. This task has challenged neuroscientists for well over a decade, with all prior attempts at identification using immunohistochemical or biochemical methods proving fruitless. The culprit protein is a TAR DNA-binding protein, known as TDP-43. This protein is present within all the ubiquitinated structures in FTLD-U, viz., the neuronal cytoplasmic inclusions, the neuronal intranuclear inclusions, and the neuritic changes, though whether this is the sole component of these structures (other than ubiquitin) remains uncertain. Some previous studies reported the presence of p62 protein within neuronal cytoplasmic inclusions, but such findings have been inconsistent. Moreover, Lee and Trojanowski have shown that the ubiquitinated neuronal cytoplasmic inclusions seen within spinal and cranial nerve nuclear motor neurons in motor neuron disease (amyotrophic lateral sclerosis) also contain TDP-43.
This is an immensely important study with huge implications for neurobiology.
Firstly, it pinpoints a key biochemical constituent in the pathogenesis of FTLD-U and motor neuron disease (MND), and one which previous work would never have regarded as a likely candidate protein.
Secondly, although an association between FTLD and MND had long been known on account of some cases showing defined clinical features of both disorders, sharing pathological features of both disorders, and families being known where some members had FTLD, others MND, and others the combined disorder, it was never clear whether this association was coincidental or causal. Now we can see causality, and the implication that FTLD and MND are part and parcel of the same disease spectrum will have major ramifications for understanding pathogenesis, and eventual treatment.
Thirdly, the finding of TDP-43 pathological changes in FTLD patients with mutations in the newly identified progranulin (PGRN) gene, who typically show FTLD-U pathological changes, firmly brings together a causal relationship in these two fundamental proteins in driving the pathogenesis of the disorder, and opens up untapped vistas of neurobiological research.
Therefore, in rapid time, two major (protein) pieces in the jigsaw puzzle of FTLD have been identified. The challenge now will be to fit the pieces around these and eventually identify the linking processes that bring these together into the fuller picture. Nonetheless, it is clear that even within FTLD-U there are different histological and clinical phenotypes, and it will be necessary to dissect out biochemical or other factors that might determine where the TDP-43 pathological changes take place in the brain to produce the clinical phenotype. That is, why is it that in some patients the most common clinical manifestation of FTLD-U, frontotemporal dementia, is present in association with bilateral involvement of the frontal and temporal lobes, yet in others only the temporal lobes are affected—producing semantic dementia—and in others the left hemisphere is preferentially affected to give progressive non-fluent aphasia. Also, what determines whether TDP-43 changes will be in the brainstem and spinal cord to give MND, or in the cerebral cortex to give FTLD? Lastly, in all this flurry of excitement, it should not be forgotten that tauopathy is still a major cause of FTLD, and it is not immediately apparent how pathological changes in the expression or function of tau might link in with progranulin and TDP-43. Clearly, changes in all three molecules can produce the same disorder of FTLD either separately or collectively: it is not possible to unequivocally discriminate FTD patients with MAPT mutations from those with PGRN mutations, or others without mutations in either. Interrelationships within this Bermuda triangle of tau, progranulin, and TDP-43 will need to be addressed.
The identification of TDP-43 as a (major/sole) component of the ubiquitinated protein of FTLD and MND, in conjunction with the identification of mutations in PGRN, have opened up huge new fields within the neurobiology of neurodegenerative disease with tentacles that may stretch far wider than these two disorders themselves. Whether there is a role for either or both of these proteins in other disorders like Alzheimer disease and Parkinson disease remains to be seen. The gauntlet has been cast down—it is up to the neuroscience community to pick this up and address these issues. What is certain is that there will be a major change in the focus of neurobiological research as groups worldwide seek to investigate the implications of changes in proteins such as progranulin and TDP-43 in terms of health and disease. We can look forward within the near future to major advances in our understanding of how the brain works in respect of these molecules and why neurodegenerative disease occurs when they fail to function properly. Maybe even a treatment for neurodegenerative disease may come a little closer.
View all comments by David M.A. Mann
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Related News: New Ubiquitinated Inclusion Body Protein Identified
Comment by: Tetsuaki Arai
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Submitted 14 October 2006
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Posted 18 October 2006
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I recommend the Primary Papers
Neumann, Sampathu, Kwong, and colleagues have resolved a long-standing issue in the research field of frontotemporal lobar degeneration (FTLD) and amyotrophic lateral sclerosis (ALS). These authors have identified TDP-43 as a major component of ubiquitin-positive inclusions that characterize these disorders. They first extracted a fraction from the patients' brains using monoclonal antibodies and then analyzed it by mass spectrometry. Their findings have greatly facilitated the understanding of the molecular pathogenesis of FTLD and ALS.
Independently, we have also found TDP-43 as a component of the inclusions in FTLD [1]. Following electrophoresis of the sarkosyl-insoluble brain extracts from FTLD, Alzheimer disease (AD) and dementia with Lewy bodies (DLB), we have done exhaustive analyses by mass spectrometry. Following identification of each molecule that is more abundant in FTLD than AD/DLB, we have studied FTLD brain samples immunochemically and immunohistochemically. The antibodies to TDP-43 have immuno-stained neuronal inclusions and dystrophic neurites in the...
Read more
Neumann, Sampathu, Kwong, and colleagues have resolved a long-standing issue in the research field of frontotemporal lobar degeneration (FTLD) and amyotrophic lateral sclerosis (ALS). These authors have identified TDP-43 as a major component of ubiquitin-positive inclusions that characterize these disorders. They first extracted a fraction from the patients' brains using monoclonal antibodies and then analyzed it by mass spectrometry. Their findings have greatly facilitated the understanding of the molecular pathogenesis of FTLD and ALS.
Independently, we have also found TDP-43 as a component of the inclusions in FTLD [1]. Following electrophoresis of the sarkosyl-insoluble brain extracts from FTLD, Alzheimer disease (AD) and dementia with Lewy bodies (DLB), we have done exhaustive analyses by mass spectrometry. Following identification of each molecule that is more abundant in FTLD than AD/DLB, we have studied FTLD brain samples immunochemically and immunohistochemically. The antibodies to TDP-43 have immuno-stained neuronal inclusions and dystrophic neurites in the hippocampus and the temporal cortex in FTLD, and skein-like inclusions in the spinal cord in FTLD and ALS. Immunoblotting of the sarkosyl-insoluble fraction has shown abnormal changes in TDP-43 including hyperphosphorylation, fragment formation, and smear-like staining, all of which are similar to abnormal tau in AD and suggest a central role for the formation of abnormal aggregates. These findings are comparable with those by Lee's group. This is not surprising, since both groups have employed principally the same polyclonal antibody which is the only commercially available rabbit polyclonal.
In addition, however, we have found TDP-43-positive glial inclusions in the spinal cord in FTLD and ALS. These inclusions were also positive for tau. The distribution of glial inclusions was consistent with the degenerating areas, suggesting that glial abnormalities are involved in the pathological processes of ALS and FTLD. A difference between our results and theirs is the TDP-43-positive staining of some, but not all, tau-positive structures including Pick bodies and neurofibrillary tangles. The significance of these findings remains to be established, since immunoblot analysis did not show any abnormality in TDP-43 in Pick disease and Alzheimer disease. Our paper will appear shortly in Biochem Biophys Res Commun [1].
In the case of tau and α-synuclein, detection of abnormally modified molecules has revealed far more extensive pathology than that seen by ubiquitin immunohistochemistry. While lesions immunohistochemically labeled for TDP-43 are a little more numerous than those labeled for ubiquitin, the difference is far less than that we have experienced for tau and α-synuclein immunohistochemistry. This may be a point that remains to be cleared up. Another issue that is open for further investigations is to prove, by protein chemistry, the ubiquitination of TDP-43.
In any event, it has to be emphasized that two different approaches have come to the same conclusion, establishing with certainty that TDP-43 is the major component of the inclusions in FTLD and ALS. This further strengthens the hypothesis that these disorders are part of a clinicopathological spectrum that shares similar pathogenesis, and suggests the possibility that TDP-43 may be a common therapeutic target for these disorders. It is now necessary to investigate the relationship of TDP-43 to other molecules that have been reported to be associated with familial FTD, FTD with motor neuron disease, or ALS. Such molecules include progranulin, charged multivesicular body protein 2B (CHMP2B), valosin-containing protein, dynactin, and an unidentified protein in familial disease linked to chromosome 9.
References: 1. T. Arai, M. Hasegawa, H. Akiyama, K. Ikeda, T. Nonaka, H. Mori, D. Mann, K. Tsuchiya, M. Yoshida, Y. Hashizume, T. Oda, TDP-43 is a component of ubiquitin-positive tau-negative inclusions in frontotemporal lobar degeneration and amyotrophic lateral sclerosis, Biochem Biophys Res Commun, in press
View all comments by Tetsuaki Arai
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Related News: DC: More MicroRNA Implicated in Dementia
Comment by: Sebastien S. Hebert
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Submitted 1 December 2008
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Posted 1 December 2008
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The manuscript by Rademakers and colleagues provides evidence that increased binding of miR-659 to the 3’UTR of the GRN gene could underlie an important risk for TDP-43-positive frontotemporal dementia (FTLD-U). These data bring strong clinical support for the role of microRNAs in neurodegenerative disorders in humans. These results are consistent with a loss of function of the GRN gene in the disease, further linking gene dosage effects in neurodegenerative disorders (as seen, e.g., with APP in Alzheimer disease and SNCA in Parkinson disease).
I think Amber Dance did a fantastic job reviewing the highlights of this paper. I would like to discuss additional issues with regard to certain technical and mechanistic aspects of these findings, which could be taken into account when interpreting the data.
First, miR-659, located on chromosome 22 in humans, seems to be relatively very weakly expressed in adult brain (with cycle threshold [Ct] values of approximately 32 as measured by qRT-PCR). Therefore, whether endogenous miR-659 levels are sufficient to regulate GRN levels...
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The manuscript by Rademakers and colleagues provides evidence that increased binding of miR-659 to the 3’UTR of the GRN gene could underlie an important risk for TDP-43-positive frontotemporal dementia (FTLD-U). These data bring strong clinical support for the role of microRNAs in neurodegenerative disorders in humans. These results are consistent with a loss of function of the GRN gene in the disease, further linking gene dosage effects in neurodegenerative disorders (as seen, e.g., with APP in Alzheimer disease and SNCA in Parkinson disease).
I think Amber Dance did a fantastic job reviewing the highlights of this paper. I would like to discuss additional issues with regard to certain technical and mechanistic aspects of these findings, which could be taken into account when interpreting the data.
First, miR-659, located on chromosome 22 in humans, seems to be relatively very weakly expressed in adult brain (with cycle threshold [Ct] values of approximately 32 as measured by qRT-PCR). Therefore, whether endogenous miR-659 levels are sufficient to regulate GRN levels in vivo remains speculative. Mechanistically, one must envisage that regulation of GRN mRNA by miR-659 occurs in a cell-autonomous fashion. One possibility, not shown here, is that miR-659 is expressed in specific cell types, such as the granular cell layer of the cerebellum where GRN protein is decreased (it should be noted that the qRT-PCR for miR-659 was performed on whole tissues). In my opinion, this would strongly strengthen the biological significance of the proposed mode of regulation.
Here, the authors use basic, but widely accepted in vitro systems to validate their hypothesis. First, artificial overexpression of miR-659 (at a concentration of 12 nM) in human M17 neuroblastoma cells leads to decreased expression of endogenous GRN protein levels (note that inverse experiments using antisense oligonucleotides to block endogenous miR-659 was not performed, possibly due to the extremely low levels of this microRNA in these cells). Whether GRN mRNA levels are affected in these conditions is not shown. Then, additional studies were conducted in mouse Neuro2A cells using luciferase-based constructs containing the GRN 3’UTR. In these latter experiments, functional effects on GRN expression are seen with the mutant TT construct at concentrations starting at 5 pM of exogenous miR-659. Again from a mechanistic point of view, it would be interesting to see whether the “increased” binding (i.e., increased sequence complementarity) of miR-659 to the mutant TT allele causes an siRNA effect (thus degradation of mRNA). It should be noted, however, that, in affected patients, GRN mRNA (from total tissue sections) is not affected.
Interestingly, the predicted target site (more particularly the “seed” sequence) for miR-659 in the GRN 3’UTR is only conserved in humans, and is not found in other mammals including mouse and dog (e.g., see www.targetscan.org). Similarly, miR-659 is, at least for now, only found in humans. Interestingly, the GRN 3’UTR is quite short (approximately 300 bp in length). In comparison, the BACE1 and APP 3’UTRs, which equally have functional microRNA target sites, are approximately 4,000 bp and 2,000 bp in length, respectively.
Overall, these findings provide novel and important clues into the development of FTLD-U. In addition, this study contributes to the potential role of microRNA pathways in the development of neurodegenerative disorders in human. I agree that relatively few patients were analyzed here to make definitive conclusions with regard to the biological relevance of these findings.
View all comments by Sebastien S. Hebert
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Related News: New Gene for ALS: RNA Regulation May Be Common Culprit
Comment by: Robert Bowser
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Submitted 27 February 2009
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Posted 27 February 2009
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These papers represent exciting work describing a new genetic mutation associated with familial ALS. The results further highlight the importance for RNA processing in at least familial forms of motor neuron disease. Much work remains to determine the exact mechanisms by which FUS modulates motor neuron survival. It may be related to that of TDP-43. However, the lack of cytoplasmic aggregation of TDP-43, and rare ubiquitin inclusions in the patients with FUS mutations, suggest the mechanisms may be distinct. It is interesting that FUS protein did not accumulate in the cytoplasm of motor neurons in sporadic ALS patients, again suggestive that the pathogenic mechanisms of mutant FUS-induced motor neuron degeneration may be distinct from that in sporadic ALS. View all comments by Robert Bowser
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Related News: New Gene for ALS: RNA Regulation May Be Common Culprit
Comment by: Eric Frank
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Submitted 27 February 2009
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Posted 27 February 2009
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These studies raise interesting questions about whether one problem in ALS and perhaps other neurodegenerative diseases is that RNA trafficking proteins fail to properly deliver RNAs to dendritic spines. The paper by Kwiatkowski et al. reports evidence that wild-type FUS and TDP-43 may be involved in transporting RNA into dendrites, where it mediates local protein synthesis that can be stimulated by neural activity. The clumping of the mutant form described by both new papers could therefore perturb the transport of RNA. Local protein synthesis in dendrites plays a major role in the activity-dependent modulation of synaptic strength. Changes in synaptic activity have been recently reported in the mouse model of SOD1 mutation ( van Zundert et al., 2008), so it will be worthwhile to examine this issue in the FUS mice that will certainly be developed by these investigators.
View all comments by Eric Frank
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Related News: New Gene for ALS: RNA Regulation May Be Common Culprit
Comment by: Jeffrey D. Rothstein
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Submitted 2 March 2009
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Posted 2 March 2009
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This is an extremely exiting story in the understanding of ALS pathogenesis. It actually it dates back to 1998—with the first description of mRNA processing errors in sporadic ALS ( Lin et al., 1998), which, interestingly, was made not in the SOD1 mouse model. At the same time, the spinal muscular atrophy gene was discovered. SMA is not unlike a childhood ALS, though predominately lower motor neurons are affected in that disease. The SMA gene defect is involved in RNA metabolism. So for the next 10 years, the SMA field has investigated the pathobiology of the defective protein. At the time it made the link between sporadic ALS and the SMA story intriguing. But there was no clear genetic link (or cause for the changes in sporadic ALS).
Feed forward to 2008, when Chris Shaw and others found a true genetic defect in RNA metabolism-based protein TDP-43. (Of course more work needs to be done on that.) And now another gene by the Shaw group, and now verified by the group in Boston, does set a string of targets that all focus on RNA...
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This is an extremely exiting story in the understanding of ALS pathogenesis. It actually it dates back to 1998—with the first description of mRNA processing errors in sporadic ALS ( Lin et al., 1998), which, interestingly, was made not in the SOD1 mouse model. At the same time, the spinal muscular atrophy gene was discovered. SMA is not unlike a childhood ALS, though predominately lower motor neurons are affected in that disease. The SMA gene defect is involved in RNA metabolism. So for the next 10 years, the SMA field has investigated the pathobiology of the defective protein. At the time it made the link between sporadic ALS and the SMA story intriguing. But there was no clear genetic link (or cause for the changes in sporadic ALS).
Feed forward to 2008, when Chris Shaw and others found a true genetic defect in RNA metabolism-based protein TDP-43. (Of course more work needs to be done on that.) And now another gene by the Shaw group, and now verified by the group in Boston, does set a string of targets that all focus on RNA metabolism and (lower) motor neurons.
By the way, all these cases appear to predominately involve a lower motor neuron form of ALS. The hint from genetics does suggest more of a loss of function rather than gain, but cell biology will ultimately sort that out. We certainly await the generation of mouse or fly models, which are now well underway for TDP-43. However, this may be a particularly difficult target for specific, non-toxic drug therapy.
View all comments by Jeffrey D. Rothstein
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Related News: New Gene for ALS: RNA Regulation May Be Common Culprit
Comment by: P. Hande Ozdinler
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Submitted 17 March 2009
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Posted 17 March 2009
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These back-to-back papers on the identification of FUS (fused in sarcoma) gene as a new genetic component of ALS open a new era of research and direct our attention to mRNA biology with respect to disease. After the first identification of mRNA processing errors in ALS patients (Lin, Bristol et al., 1998), the discovery of TDP-43 (Neumann, Sampathu et al., 2006) and now the FUS gene clearly indicate the importance of mRNA management in neurodegenerative diseases. Defects in RNA transcription, splicing, and trafficking may be the reason for cell-type-specific degeneration of motor neurons in ALS. Motor neurons both in the cortex and spinal cord are very large excitatory neurons that extend long axons to their targets and require high levels of energy and protein integrity for survival and function. Defects in transcriptional mechanisms may result in splicing defects, which could give rise to formation of non-functional proteins that would deplete the pool of required proteins for cellular function, and these non-functional proteins may form aggregates that are toxic to neurons. In...
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These back-to-back papers on the identification of FUS (fused in sarcoma) gene as a new genetic component of ALS open a new era of research and direct our attention to mRNA biology with respect to disease. After the first identification of mRNA processing errors in ALS patients (Lin, Bristol et al., 1998), the discovery of TDP-43 (Neumann, Sampathu et al., 2006) and now the FUS gene clearly indicate the importance of mRNA management in neurodegenerative diseases. Defects in RNA transcription, splicing, and trafficking may be the reason for cell-type-specific degeneration of motor neurons in ALS. Motor neurons both in the cortex and spinal cord are very large excitatory neurons that extend long axons to their targets and require high levels of energy and protein integrity for survival and function. Defects in transcriptional mechanisms may result in splicing defects, which could give rise to formation of non-functional proteins that would deplete the pool of required proteins for cellular function, and these non-functional proteins may form aggregates that are toxic to neurons. In addition, defects in the trafficking of mRNA may lead to depletion of key proteins that are in high demand locally for motor neuron function. But if FUS has a general function in mRNA transcription, splicing, and trafficking, why do mutations in this gene cause ALS and not other neurodegenerative diseases? What makes motor neurons more vulnerable in the presence of defective FUS? It could be true that in motor neurons FUS controls the transcription of a distinct set of mRNA that is expressed in a cell-type-specific manner in motor neurons, or that FUS controls the production of a key protein that is highly required in motor neurons when compared to other cell-types, and thus motor neurons may become vulnerable first. FUS seems to be the tip of the iceberg. Finding effectors, binding partners including mRNA, may lead to the identification of key components of both familial and sporadic ALS. More work is on the way!
References: Kneussel M. Dynamic regulation of GABA(A) receptors at synaptic sites. Brain Res Brain Res Rev. 2002 Jun ;39(1):74-83. Abstract
Lin CL, Bristol LA, Jin L, Dykes-Hoberg M, Crawford T, Clawson L, Rothstein JD. Aberrant RNA processing in a neurodegenerative disease: the cause for absent EAAT2, a glutamate transporter, in amyotrophic lateral sclerosis. Neuron. 1998 Mar;20(3):589-602. Abstract
Neumann M, Sampathu DM, Kwong LK, Truax AC, Micsenyi MC, Chou TT, Bruce J, Schuck T, Grossman M, Clark CM, McCluskey LF, Miller BL, Masliah E, Mackenzie IR, Feldman H, Feiden W, Kretzschmar HA, Trojanowski JQ, Lee VM. Ubiquitinated TDP-43 in frontotemporal lobar degeneration and amyotrophic lateral sclerosis. Science. 2006 Oct 6;314(5796):130-3. Abstract
Vance C, Rogelj B, Hortobágyi T, De Vos KJ, Nishimura AL, Sreedharan J, Hu X, Smith B, Ruddy D, Wright P, Ganesalingam J, Williams KL, Tripathi V, Al-Saraj S, Al-Chalabi A, Leigh PN, Blair IP, Nicholson G, de Belleroche J, Gallo JM, Miller CC, Shaw CE. Mutations in FUS, an RNA processing protein, cause familial amyotrophic lateral sclerosis type 6. Science. 2009 Feb 27;323(5918):1208-11. Abstract
View all comments by P. Hande Ozdinler
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