利用果蝇模型研究人类Ⅱ型腓骨肌萎缩症的进展

腓骨肌萎缩症(Charcot-Marie-Tooth, CMT)通常是由神经元中某些蛋白质缺陷引起的一种常见家族遗传性外周神经系统疾病,患者表现为远端感觉和运动神经元的缺陷,行动能力不足,严重者可丧失行动能力。根据临床和电生理特征, CMT主要分为原发性脱髓鞘病变CMT1、原发性轴突病变CMT2以及继发性脱髓鞘和轴突病变的DI-CMT。越来越多的研究利用果蝇模型来模拟人类疾病和人类健康相关过程的各个方面。果蝇没有被髓鞘包围的轴突,因此不适合建立脱髓鞘型的CMT模型,而比较适合轴突病变CMT2的研究。该文主要针对CMT2进行分析,总结了人类CMT2涉及的相关致病基因,以及如何利用果蝇模型进行CMT2模型构建和病理分析。这对于CMT2疾病的生物学和医学研究具有重要的意义。     

Periaxin蛋白与腓骨肌萎缩症

Periaxin是施旺氏细胞(Schwann cells)与晶状体纤维细胞中特异表达的支架蛋白之一．在施旺氏细胞包裹轴突形成髓鞘过程中,periaxin蛋白参与髓鞘的延展、修复及再生等．PRX基因的缺失或突变将引起脱髓鞘型腓骨肌萎缩症(CMT)4F亚型的发生．本文就periaxin蛋白分子结构特点、生理学功能、以及其基因突变与脱髓鞘型腓骨肌萎缩症CMT4F亚型的发生等进行综述．     

腓骨肌萎缩症2型(CMT2)小鼠模型的研究进展

腓骨肌萎缩症(Charcot-Marie-Tooth disease, CMT)是人类最常见的遗传性运动和感觉神经疾病之一, 全球群体发病率约为1/2500。CMT主要分为脱髓鞘型(包括CMT1, CMT3, CMT4和CMTX1)和轴索型(CMT2)。迄今为止, 先后已有17个CMT2的致病基因被定位和克隆, 然而对这些基因的致病机制所知甚少。建立CMT2小鼠模型是从动物水平研究突变基因致病机制的有效手段。目前已成功构建了近10种CMT2的转基因小鼠、基因敲除小鼠或基因敲入小鼠模型, 其中尤以带有人源致病基因的转基因小鼠模型为多。文章简要介绍了CMT2小鼠模型构建策略, 着重阐述了CMT2小鼠模型的研究进展, 并对个别小鼠模型进行了剖析。     

腓骨肌萎缩症的分型与分子诊断技术

腓骨肌萎缩症(Charcot-Marie-Tooth disease, CMT)是一种最常见的遗传性周围神经病,虽然常以腓骨肌萎缩和肢端骨骼畸形、运动与感觉障碍等为主要临床表现,但先天致病基因和后天影响因素的不同使该病具有高度的临床和遗传异质性;而对CMT类型的精细分类,更多是依据不同致病基因及其突变。随着近几年二代测序为代表的高通量测序技术的不断发展,已经确定了100多个CMT的致病基因和更多的新突变。本文主要阐述了CMT的遗传分型和临床特征,特别是四种常见CMT亚型的致病基因在神经细胞内参与的信号转导通路、CMT电生理和分子病理特征,以及CMT基因突变检测方法,以期为罕见病CMT的基础研究与临床诊断提供参考。     

脊肌萎缩症的相关致病基因

脊肌萎缩症（SMA）是一种常染色脊肌萎缩症隐性遗传疾病,随着分子生物学的发展,在SMA相关基因的研究方面取得了重大进展,可能与运动神经元存活基因、神经元凋亡抑制蛋白基因和基本转录因子等基因突变有关。     

在两个X连锁显性腓骨肌萎缩症家系中发现同一GJB1基因突变Glu208Lys

在两个X连锁显性腓骨肌萎缩症(Charcot-Marie-Tooth disease, CMT) 家系中进行了GJB1基因的突变分析。提取基因组DNA, PCR(polymerase chain reaction)反应扩增GJB1基因编码序列, 进行单链构象多态性(single strand conformational polymorphism, SSCP)分析, 对有差异SSCP带型的PCR产物进行测序, 结果在两家系中发现同一GJB1基因c.622G→A (Glu208Lys)突变。所发现的突变位点在国内尚未报道。     

脐血干细胞移植治疗中间型脊髓性肌萎缩症1 例并文献复习

目的:探讨脐血干细胞移植治疗中间型脊髓性肌萎缩症的临床治疗可行性及效果。方法:已确诊的中间型脊髓性肌萎缩症患儿,采用脐血干细胞移植治疗,4次为一疗程,移植途径采用静脉输注(1次)加蛛网膜下腔注射(3次)的方法,治疗前和治疗后半年均需完善神经系统体检、实验室检查、FIM评分、肌电图等。结果:移植治疗后患儿神经系统症状明显改善,FIM评分提高,实验室检查肌酶下降,肌电图提示重收缩每10.0ms所检肌运动单位较前增加。随访10月患儿未出现副反应。结论:应用脐血干细胞移植治疗中间型脊髓性肌萎缩症是有效安全的,可以改善患儿神经功能。     

脐血干细胞移植治疗中间型脊髓性肌萎缩症1例并文献复习

目的：探讨脐血干细胞移植治疗中间型脊髓性肌萎缩症的临床治疗可行性及效果。方法：已确诊的中间型脊髓性肌萎缩症患儿,采用脐血干细胞移植治疗,4次为一疗程,移植途径采用静脉输注（1次）加蛛网膜下腔注射（3次）的方法,治疗前和治疗后半年均需完善神经系统体检、实验室检查、FIM评分、肌电图等。结果：移植治疗后患儿神经系统症状明显改善,FIM评分提高,实验室检查肌酶下降,肌电图提示重收缩每10.0ms所检肌运动单位较前增加。随访10月患儿未出现副反应。结论：应用脐血干细胞移植治疗中间型脊髓性肌萎缩症是有效安全的,可以改善患儿神经功能。     

进行性脊肌萎缩症会成年后发病吗？

问：我门生育过一个婴儿型脊肌萎缩症的孩子,现已不在了,双方家族几代都没有这种病例。孩子曾在某医院做过基因检查,结果发现SMN基因部分缺失。听说这种病还有成人发病的,请问我们今后是否还有得这种病的可能？再怀孕的话,生出这种患儿的几率是多少？     

Cell expression of GDAP1 in the nervous system and pathogenesis of Charcot-Marie-Tooth type 4A disease

Mutations in the mitochondrial protein GDAP1 are the cause of Charcot-Marie-Tooth type 4A disease (CMT4A), a severe form of peripheral neuropathy associated with either demyelinating, axonal or intermediate phenotypes. GDAP1 is located in the outer mitochondrial membrane and it seems that may be related with the mitochondrial network dynamics. We are interested to define cell expression in the nervous system and the effect of mutations in mitochondrial morphology and pathogenesis of the disease. We investigated GDAP1 expression in the nervous system and dorsal root ganglia (DRG) neuron cultures. GDAP1 is expressed in motor and sensory neurons of the spinal cord and other large neurons such as cerebellar Purkinje neurons, hippocampal pyramidal neurons, mitral neurons of the olfactory bulb and cortical pyramidal neurons. The lack of GDAP1 staining in the white matter and nerve roots suggested that glial cells do not express GDAP1. In DRG cultures satellite cells and Schwann cells were GDAP1-negative. Overexpression of GDAP1-induced fragmentation of mitochondria suggesting a role of GDAP1 in the fission pathway of the mitochondrial dynamics. Missense mutations showed two different patterns: most of them induced mitochondrial fragmentation but the T157P mutation showed an aggregation pattern. Whereas null mutations of GDAP1 should be associated with loss of function of the protein, missense mutations may act through different pathogenic mechanisms including a dominant-negative effect, suggesting that different molecular mechanisms may underlay the pathogenesis of CMT4A.     

Farnesol Ameliorates Demyelinating Phenotype in a Cellular and Animal Model of Charcot-Marie-Tooth Disease Type 1A

Charcot-Marie-Tooth disease (CMT) is a genetically heterogeneous disease affecting the peripheral nervous system that is caused by either the demyelination of Schwann cells or degeneration of the peripheral axon. Currently, there are no treatment options to improve the degeneration of peripheral nerves in CMT patients. In this research, we assessed the potency of farnesol for improving the demyelinating phenotype using an animal model of CMT type 1A. In vitro treatment with farnesol facilitated myelin gene expression and ameliorated the myelination defect caused by PMP22 overexpression, the major causative gene in CMT. In vivo administration of farnesol enhanced the peripheral neuropathic phenotype, as shown by rotarod performance in a mouse model of CMT1A. Electrophysiologically, farnesol-administered CMT1A mice exhibited increased motor nerve conduction velocity and compound muscle action potential compared with control mice. The number and diameter of myelinated axons were also increased by farnesol treatment. The expression level of myelin protein zero (MPZ) was increased, while that of the demyelination marker, neural cell adhesion molecule (NCAM), was reduced by farnesol administration. These data imply that farnesol is efficacious in ameliorating the demyelinating phenotype of CMT, and further elucidation of the underlying mechanisms of farnesol’s effect on myelination might provide a potent therapeutic strategy for the demyelinating type of CMT.     

Alterations of autophagy in the peripheral neuropathy Charcot-Marie-Tooth type 2B

Charcot-Marie-Tooth type 2B (CMT2B) disease is a dominant axonal peripheral neuropathy caused by 5 mutations in the RAB7A gene, a ubiquitously expressed GTPase controlling late endocytic trafficking. In neurons, RAB7A also controls neuronal-specific processes such as NTF (neurotrophin) trafficking and signaling, neurite outgrowth and neuronal migration. Given the involvement of macroautophagy/autophagy in several neurodegenerative diseases and considering that RAB7A is fundamental for autophagosome maturation, we investigated whether CMT2B-causing mutants affect the ability of this gene to regulate autophagy. In HeLa cells, we observed a reduced localization of all CMT2B-causing RAB7A mutants on autophagic compartments. Furthermore, compared to expression of RAB7A^WT, expression of these mutants caused a reduced autophagic flux, similar to what happens in cells expressing the dominant negative RAB7A^T22N mutant. Consistently, both basal and starvation-induced autophagy were strongly inhibited in skin fibroblasts from a CMT2B patient carrying the RAB7A^V162M mutation, suggesting that alteration of the autophagic flux could be responsible for neurodegeneration.     

Cloning, expression and characterization of the murine orthologue of SBF2, the gene mutated in Charcot-Marie-Tooth disease type 4B2

Autosomal recessive hereditary motor and sensory neuropathy (HMSN) or Charcot-Marie-Tooth disease (CMT) is a clinically and genetically heterogeneous disorder of the peripheral nervous system. The clinical picture includes progressive distal weakness and atrophy, foot deformities, and distal sensory loss. For autosomal recessive CMT type 4B2 one locus was mapped to chromosome 11p15. Recently, mutations in SET binding factor 2 (SBF2), were identified as cause of CMT4B2. SBF2 is a member of the pseudo-phosphatase branch of myotubularins and all disease-associated mutations known to date lead to shortened or truncated proteins, also implicating loss-of-function. Here, we describe the molecular cloning and the expression pattern of Sbf2. The mRNA spans around 8 kb, and the protein shares high amino acid identity compared to the human protein suggesting a conserved function. Sbf2 is encoded by 40 exons on murine chromosome 7. In situ hybridization, Northern blots and RT-analysis revealed a very broad pattern of Sbf2 expression. Overexpressed epitope tagged Sbf2 showed cytoplasmic distribution. Taken together, this study provides information about the mRNA expression and subcellular localization of Sbf2 and as such helps in further understanding its function in development and disease.     

Mouse models of Charcot-Marie-Tooth disease

A common peripheral neuropathy, Charcot-Marie-Tooth disease, progressively develops with distal muscle atrophy. Several genes expressed in Schwann cells and neurons have been identified to be responsible for this hereditary disease, and used in generating transgenic and knockout mice. Such mice are good disease models for cell biological and therapeutic studies.     

Large Conformational Changes of Insertion 3 in Human Glycyl-tRNA Synthetase (hGlyRS) during Catalysis

Glycyl-tRNA synthetase (GlyRS) is the enzyme that covalently links glycine to cognate tRNA for translation. It is of great research interest because of its nonconserved quaternary structures, unique species-specific aminoacylation properties, and noncanonical functions in neurological diseases, but none of these is fully understood. We report two crystal structures of human GlyRS variants, in the free form and in complex with tRNA^Gly respectively, and reveal new aspects of the glycylation mechanism. We discover that insertion 3 differs considerably in conformation in catalysis and that it acts like a “switch” and fully opens to allow tRNA to bind in a cross-subunit fashion. The flexibility of the protein is supported by molecular dynamics simulation, as well as enzymatic activity assays. The biophysical and biochemical studies suggest that human GlyRS may utilize its flexibility for both the traditional function (regulate tRNA binding) and alternative functions (roles in diseases).     

Localization of Charcot-Marie-Tooth disease type 1a (CMT1A) to chromosome 17p11.2.

Charcot-Marie-Tooth (CMT) disease type 1a has been previously localized to chromosome 17 using the markers D17S58 and D17S71. In that report we were unable to provide unequivocal localization of the CMT1A gene on either the proximal p or the q arm. Therefore, data from one additional CMT1A family and typing of other probes spanning the pericentromeric region of chromosome 17 (D17S73, D17S58, D17S122, D17S125, D17S124) were analyzed. Multipoint analysis demonstrates convincing evidence (log likelihood difference greater than 5) that the CMT1A gene lies within 17p11.2 and most likely between the flanking markers D17S122 and D17S124.     

Identification of A Novel SBF2 Frameshift Mutation in Charcot–Marie–Tooth Disease Type 4B2 Using Whole-exome Sequencing

Abstract Charcot-Marie-Tooth disease type 4B2 with early-onset glaucoma （CMT4B2, OMIM 604563） is a genetically-heterogeneous childhood-onset neuromuscular disorder. Here, we report the case of a 15-year-old male adolescent with lower extremity weakness, gait abnormalities, foot deformities and early-onset glaucoma. Since clinical diagnosis alone was insufficient for providing pathogenetic evidence to indicate that the condition belonged to a consanguineous family, we applied whole-exome sequencing to samples from the patient, his parents and his younger brother, assuming that the patient＇s condition is transmitted in an autosomal recessive pattern. A frame-shift mutation, c.4571delG （P.Gly1524Glufs＊42）, was revealed in the CMT4B2-related gene SBF2 （also known as MTMR13, MIM 607697）, and this mutation was found to be homozygous in the proband and heterozygous in his parents and younger brother. Together with the results of clinical diagnosis, this case was diagnosed as CMT4B2. Our finding further demonstrates the use of whole-exome sequencing in the diagnosis and treatment of rare diseases.