肌萎缩侧索硬化患者SOD1基因突变检测及突变与临床表型的关系

应用PCR技术结合DNA直接测序方法对8例临床确诊为家族性肌萎缩侧索硬化(Familiar amyotrophic lateral sclerosis,FALS)家系的先证者进行铜锌超氧化物歧化酶基因(SOD1)的突变筛查,在3例先证者中检出2种SOD1基因突变,其中,2例携带了位于4号外显子的错义突变Cys111Tyr(c.332G>A),另1例携带了位于5号外显子的错义突变Gly147Asp(c.440G>A),这2种突变在中国ALS患者中属首次报道。该结果扩大了中国FALS患者的SOD1基因突变谱,对研究中国FALS患者SOD1基因突变特点和分布规律有一定帮助。分析携带这2个突变患者的临床特点,提示Cys111Tyr突变导致的临床表型相对温和,而Gly147Asp突变可导致病情进展较快。该结果有待在更多的病例中进行证实。     

清栓酶治疗肌萎缩侧索硬化症4例

清栓酶治疗肌萎缩侧索硬化症４例韩贞普何振朝贵州省凯里市４１８医院５５６０００我院内科用清栓酶治疗肌萎缩侧索硬化症４例,收到较满意的效果,现总结如下：１临床资料１．１一般资料：男性３例,女性１例,年龄４１岁～５７岁。病程１年～５年,４例均有典型临床表现...     

3 例以延髓麻痹为首发表现的肌萎缩侧索硬化的病例报告

目的:探讨以延髓麻痹为首发症状的肌萎缩侧索硬化的临床特点。方法:报告3例以构音障碍等延髓麻痹症状起病的肌萎缩侧索硬化少见病例,结合文献复习,分析其临床特点。结果:在ALS患者中,以延髓麻痹为首发症状发生率相对较低,多见于老年人,最易表现为构音障碍,患者的生存期缩短,预后不良。结论:对于以延髓麻痹表现起病的ALS患者,要引起重视,及时针对延髓麻痹对症治疗,改善患者生活质量。     

肌萎缩侧索硬化脊髓器官型培养模型的建立

利用谷氨酸转运体抑制剂苏—羟天冬氨酸(THA)制备选择性运动神经元凋亡的肌萎缩侧索硬化(ALs)脊髓器官型培养模型。取出生后8天乳鼠腰段脊髓组织切成脊髓薄片,在培养液中分别加入不同浓度THA,用SMI—32免疫组化染色对脊髓腹角α运动神经元进行鉴定,calretinin免疫组化染色对背角中间神经元进行鉴定,测定培养液中谷氨酸(Glu)、乳酸脱氢酶(LDH)的含量,并与对照组比较。结果显示对照组α运动神经元数目恒定;THA引起培养液中剂量依赖性Glu、LDH含量增高和SMI—32阳性的α运动神经元数目减少,脊髓背角的中间神经元损伤相对较轻;100μmol／L THA组在体外培养4周后,细胞外Glu含量增高,SMI—32阳性的α运动神经元数目较对照组明显减少,背角的中间神经元数目无显著变化,可以制成ALS脊髓器官型培养模型。     

肌萎缩性侧索硬化症动物模型的应用进展

肌萎缩性侧索硬化症（ALS）是运动神经元选择性死亡而导致运动功能障碍的神经性疾病,是成年人运动神经元病中最常见的疾病。已有很多学说讨论其发病机制,并且建立了ALS动物模型。随着现代生物学的发展和不同学科间的相互渗入,各种治疗策略在ALS模型实验中得到实践并有望用于临床。简要综述了ALS治疗方法在转基因动物模型中的研究进展。     

不同行为学测试方法在家族性肌萎缩侧索硬化小鼠模型的比较

目的比较目前常用的5种行为学检测方法在家族性肌萎缩侧索硬化鼠模型研究中的作用。方法分为模型组(SOD1-G93A转基因鼠)和阴性对照组(同窝阴性对照)。使用5种行为学评价方法(一般状况评分、体重测定、转棒试验、抓力测定和步长分析)评价其行为学变化。结果 (1)一般状况评分:在第89天,模型组的一般状况评分开始下降。在第101天时,与对照组相比开始有统计学差异(P=0.000)。(2)体重测定:15周(第105天)时,模型组的体重开始下降,且与阴性对照组相比(P=0.026),开始有统计学差异。(3)转棒试验:11周(第77天)时,模型组的转棒时间开始下降。第13周(第91天)时,与阴性对照组相比开始有统计学差异(P=0.047)。(4)抓力测定:10周(第70天)时,模型组的后肢抓力开始下降。第13周(第91天)时,与阴性对照组相比开始有统计学差异(P=0.000)。(5)步长分析:第14周(第98天)后模型组的步长开始变短。15周(第105天)时与阴性对照组相比开始有统计学意义(P=0.000)。结论抓力测定优于其他行为学检测方法。     

肌萎缩侧索硬化患者血清鸢尾素、热休克蛋白70检测及其临床意义

摘要 目的：探讨肌萎缩侧索硬化（ALS）患者血清鸢尾素（Irisin）、热休克蛋白70（HSP70）水平及其临床意义。方法：选取2017年1月-2020年12月中国人民解放军联勤保障部队第904医院神经内科收治的ALS患者62例,根据E1 Escorial诊断标准分为ALS早期组（n=30）和ALS晚期组（n=32）,另选取同期在我院体检的健康志愿者58例为对照组,比较三组血清Irisin、HSP70水平,分析ALS患者血清Irisin、HSP70水平与氧化应激指标、改良后肌萎缩侧索硬化功能（ALSFRS-R）评分、爱丁堡认知行为量表（ECAS）评分和肌电图参数的相关性,采用受试者工作特征（ROC）曲线分析血清Irisin、HSP70对ALS的诊断效能。结果：与对照组比较,ALS早期组、ALS晚期组患者血清Irisin、HSP70、谷胱甘肽过氧化酶（GPX）、超氧化物歧化酶（SOD）水平明显降低,且ALS晚期组低于ALS早期组（P<0.05）。与对照组比较,ALS早期组、ALS晚期组患者血清8-羟基脱氧鸟苷酸(8-OHDG)、丙二醛（MDA）水平明显升高,且ALS晚期组高于ALS早期组（P<0.05）;ALS晚期组ECAS评分、ALSFRS-R评分低于ALS早期组（P<0.05）;与ALS早期组比较,ALS晚期组正中神经、尺神经、腓总神经以及胫神经的复合肌肉动作电位（CMAP）水平明显降低（P<0.05）;Pearson 检验结果显示,血清Irisin、HSP70水平与血清8-OHDG、MDA呈负相关（P<0.05）,与血清GPX、SOD水平、ECAS评分、ALSFRS-R评分以及正中神经CMAP、尺神经CMAP、腓总神经CMAP、胫神经CMAP呈正相关（P<0.05）;ROC曲线分析显示,Irisin、HSP70联合应用时曲线下面积（AUC）（0.95CI）为0.850（0.722～0.976）,诊断效能较高。结论：ALS患者血清Irisin、HSP70水平与患者体内氧化应激的过度激活、认知功能及神经功能的损害相关,血清Irisin、HSP70有可能成为ALS诊断和病情评估的生物标记物之一。     

稳定表达hSOD1^G93A基因的肌萎缩侧索硬化体外细胞培养模型的建立与鉴定

目的建立并鉴定稳定表达G93A型突变人超氧化物歧化酶（hSOD1^G93A）基因的肌萎缩侧索硬化体外细胞培养模型。方法利用活化的树突状聚合物将空质粒、hSOD1^WT、hSOD1^G93A基因转染入VSC4.1细胞内,G418抗性筛选,从而建立稳定的肌萎缩侧索硬化体外细胞模型。用免疫荧光技术检测VSC4.1细胞系运动神经元标志物。蛋白印迹实验鉴定hSOD1^WT蛋白、hSOD1^G93A蛋白的表达。MTT法检测细胞模型生长曲线。结果VSC4.1细胞分化前表达ClassⅢβ-Tubulin、MNR2,分化后表达ClassⅢβ-Tubulin、MNR2、NF200、MAP2等运动神经元标志物。VSC4.1-hSOD1^WT、VSC4.1-hSOD1^G93A细胞均过表达人来源的SOD1,而VSC4.1-mock则不表达。与VSC4.1-mock、VSC4.1-hSOD1^WT相比,VSC4.1-hSOD1^G93A生长缓慢,在48、72 h细胞活力均低于VSC4.1-mock（P=0.031,P=0.000）、VSC4.1-hSOD1^WT（P=0.001,P=0.000）,其余时间点无明显差异（P〉0.05）。结论成功建立稳定表达hSOD1^WT、hSOD1^G93A基因的VSC4.1细胞系,为进一步研究肌萎缩侧索硬化的发病与治疗奠定了良好的基础。     

肌萎缩侧索硬化患者血清SOD、GSH-Px、MIP-1α、VEGF水平与肌电图特征及病程的关系研究

摘要 目的：研究肌萎缩侧索硬化（ALS）患者血清超氧化物歧化酶（SOD）、谷胱甘肽过氧化物酶（GSH-Px）、巨噬细胞炎性蛋白-1α（MIP-1α）、血管内皮生长因子（VEGF）水平与肌电图特征及病程的关系。方法：将从2018年12月起直至2020年12月,我院收治的ALS患者86例纳入研究,记作病变组。另取同期90例于我院进行体检的健康人员作为对照组。检测并比较两组血清SOD、GSH-Px、MIP-1α、VEGF水平及肌电图特征。将所有病变组患者根据病程的差异分为病程较长组42例以及病程较短组44例,比较两组血清SOD、GSH-Px、MIP-1α、VEGF水平以及肌萎缩侧索硬化症功能评分量表（ALSFRS-r）评分。采用Pearson相关性分析ALS患者血清SOD、GSH-Px、MIP-1α、VEGF水平与肌电图特征及病程的关系。结果：病变组血清SOD、GSH-Px水平均低于对照组,而MIP-1α、VEGF水平均高于对照组（均P＜0.05）。病变组各项肌电图参数水平均低于对照组（均P＜0.05）。病程较长组血清SOD、GSH-Px水平以及ALSFRS-r评分均低于病程较短组,而MIP-1α、VEGF水平均高于病程较短组（均P＜0.05）。经Pearson相关性分析可得：ALS患者血清SOD、GSH-Px水平与肌电图各神经符合肌肉动作电位（CMAP）、ALSFRS-r评分均呈正相关,与病程呈负相关（均P＜0.05）;MIP-1α、VEGF水平则与肌电图各神经CMAP、ALSFRS-r评分均呈负相关,与病程呈正相关（均P＜0.05）。结论：ALS患者血清SOD、GSH-Px水平较低,MIP-1α、VEGF水平较高,且和肌电图特征以及病程密切相关,值得临床关注。     

肌萎缩性侧索硬化症相关的Cu,Zn-SOD

超氧化物歧化酶（superoxide dismutase,SOD）被称为生物体内自由基的清洁剂,其主要形式Cu,Zn-SOD称SOD1. SOD1突变体可引起致死性运动神经元疾病肌萎缩性侧索硬化症(ALS).但是,SOD1的毒性机理尚未完全清楚.本文概述了SOD1、Cu分子伴侣（copper chaperone for SOD1,CCS）的分子结构和CCS活化SOD1的机理,重点分析了突变体SOD1构象变化的原因及其在ALS中的可能致病机制的最新研究进展.     

Chitotriosidase - a putative biomarker for sporadic amyotrophic lateral sclerosis

Background

Potential biomarkers to aid diagnosis and therapy need to be identified for Amyotrophic Lateral Sclerosis, a progressive motor neuronal degenerative disorder. The present study was designed to identify the factor(s) which are differentially expressed in the cerebrospinal fluid (CSF) of patients with sporadic amyotrophic lateral sclerosis (SALS; ALS-CSF), and could be associated with the pathogenesis of this disease.

Results

Quantitative mass spectrometry of ALS-CSF and control-CSF (from orthopaedic surgical patients undergoing spinal anaesthesia) samples showed upregulation of 31 proteins in the ALS-CSF, amongst which a ten-fold increase in the levels of chitotriosidase-1 (CHIT-1) was seen compared to the controls. A seventeen-fold increase in the CHIT-1 levels was detected by ELISA, while a ten-fold elevated enzyme activity was also observed. Both these results confirmed the finding of LC-MS/MS. CHIT-1 was found to be expressed by the Iba-1 immunopositive microglia.

Conclusion

Elevated CHIT-1 levels in the ALS-CSF suggest a definitive role for the enzyme in the disease pathogenesis. Its synthesis and release from microglia into the CSF may be an aligned event of neurodegeneration. Thus, high levels of CHIT-1 signify enhanced microglial activity which may exacerbate the process of neurodegeneration. In view of the multifold increase observed in ALS-CSF, it can serve as a potential CSF biomarker for the diagnosis of SALS.     

Nogo-A and Nogo-66 receptor in amyotrophic lateral sclerosis

Nogo/reticulon (RTN)-4 has been strongly implicated as a disease marker for the motor neuron disease amyotrophic lateral sclerosis (ALS). Nogo isoforms, including Nogo-A, are ectopically expressed in the skeletal muscle of ALS mouse models and patients and their levels correlate with the disease severity. The notion of a direct involvement of Nogo-A in ALS aetiology is supported by the findings that Nogo-A deletion in mice reduces muscle denervation and prolongs survival, whereas overexpression of Nogo-A destabilizes motor nerve terminals and promotes denervation. Another intriguing, and somewhat paradoxical, recent finding revealed that binding of the Nogo-66 receptor (NgR) by either agonistic or antagonistic Nogo-66-derived peptides protects against p75 neurotrophin receptor (p75(NTR))-dependent motor neuron death. Ligand binding by NgR could result in subsequent engagement of p75(NTR), and this association could preclude pro-apoptotic signalling by the latter. Understanding the intricate interplay among Nogo isoforms, NgR and p75(NTR) in ALS disease progression may provide important, therapeutically exploitable information.     

Proteomic profiling of cerebrospinal fluid identifies biomarkers for amyotrophic lateral sclerosis

Amyotrophic lateral sclerosis (ALS) is characterized by degeneration of motor neurons. We tested the hypothesis that proteomic analysis will identify protein biomarkers that provide insight into disease pathogenesis and are diagnostically useful. To identify ALS specific biomarkers, we compared the proteomic profile of cerebrospinal fluid (CSF) from ALS and control subjects using surface-enhanced laser desorption/ionization-time of flight mass spectrometry (SELDI-TOF-MS). We identified 30 mass ion peaks with statistically significant (p < 0.01) differences between control and ALS subjects. Initial analysis with a rule-learning algorithm yielded biomarker panels with diagnostic predictive value as subsequently assessed using an independent set of coded test subjects. Three biomarkers were identified that are either decreased (transthyretin, cystatin C) or increased (carboxy-terminal fragment of neuroendocrine protein 7B2) in ALS CSF. We validated the SELDI-TOF-MS results for transthyretin and cystatin C by immunoblot and immunohistochemistry using commercially available antibodies. These findings identify a panel of CSF protein biomarkers for ALS.     

Mutant SOD1 inhibits ER‐Golgi transport in amyotrophic lateral sclerosis

Cu/Zn‐superoxide dismutase is misfolded in familial and sporadic amyotrophic lateral sclerosis, but it is not clear how this triggers endoplasmic reticulum (ER) stress or other pathogenic processes. Here, we demonstrate that mutant SOD1 (mSOD1) is predominantly found in the cytoplasm in neuronal cells. Furthermore, we show that mSOD1 inhibits secretory protein transport from the ER to Golgi apparatus. ER‐Golgi transport is linked to ER stress, Golgi fragmentation and axonal transport and we also show that inhibition of ER‐Golgi trafficking preceded ER stress, Golgi fragmentation, protein aggregation and apoptosis in cells expressing mSOD1. Restoration of ER‐Golgi transport by over‐expression of coatomer coat protein II subunit Sar1 protected against inclusion formation and apoptosis, thus linking dysfunction in ER‐Golgi transport to cellular pathology. These findings thus link several cellular events in amyotrophic lateral sclerosis into a single mechanism occurring early in mSOD1 expressing cells.

     

MicroRNAs as regulators of cell death mechanisms in amyotrophic lateral sclerosis

Amyotrophic lateral sclerosis (ALS) is a progressive neurodegenerative disorder affecting upper and lower motor neurons (MNs), resulting in paralysis and precocious death from respiratory failure. Although the causes of ALS are incompletely understood, the role of alterations in RNA metabolism seems central. MicroRNAs (miRNAs) are noncoding RNAs implicated in the regulation of gene expression of many relevant physiological processes, including cell death. The recent model of programmed cell death (PCD) encompasses different mechanisms, from apoptosis to regulated necrosis (RN), in particular necroptosis. Both apoptosis and necroptosis play a significant role in the progressive death of MNs in ALS. In this review, we present key research related to miRNAs that modulate apoptosis and RN pathways in ALS. We also discuss whether these miRNAs represent potential targets for therapeutic development in patients.     

Trace elements, age, and sex in amyotrophic lateral sclerosis disease

The statistical tests analysis of variance, analysis of covariance, correlation coefficient, Kolmogorov-Smirnov test,t-test, and Tukey test were applied to copper, magnesium, managenese, and zinc content in serum (S) and in cerebrospinal fluid (CSF) of controls and of a sporadic form of Amyotrophic Lateral Sclerosis (ALS) disease. This is carried out in order to evaluate statistically the possible relationships among the trace elements when ALS patients and controls are considered as independent groups, within sex groups and within age decades of both patients and control classes. A statistically significant difference between older controls (age >40) and ALS patients (age>40) for copper in CSF, copper in S, manganese in S, and zinc in CSF was found. Statistically significant correlation coefficients within the different classes formed for this study were observed. Within this pool, a correlation of patient group can differ statistically from the corresponding one of controls and vice versa. Thus, this correlation could be characteristic of the group from which is extracted, e.g., the correlation between copper in S and zinc in S, which is characteristic of ALS patients when considered as an independent group as well as members of the male patient class.     

Protein kinase and protein phosphatase expression in amyotrophic lateral sclerosis spinal cord

The Kinetworks trade mark multi-immunoblotting technique was used to evaluate the expressions of 78 protein kinases, 24 protein phosphatases and phosphorylation states of 31 phosphoproteins in thoracic spinal cord tissue from control subjects and patients having the sporadic form of amyotrophic lateral sclerosis (ALS). In both the cytosolic (C) and particulate (P) fractions of spinal cord from ALS patients as compared with controls, there were increased levels of calcium/calmodulin-dependent protein kinase kinase (CaMKK; C = 120% increase/P = 580% increase;% change, compared with control), extracellular regulated kinase 2 (ERK2; C = 120% increase/P = 170% increase), G protein-coupled receptor kinase 2 (GRK2; C = 140% increase/P = 140% increase), phospho-Y279/216 glycogen synthase kinase 3 alpha/beta (GSK3alpha/beta; C = 90% increase/P = 220% increase), protein kinase B alpha (PKBalpha; C = 360% increase/P = 200% increase), phospho-T638 PKCalpha/beta (C = 630% increase/P = 170% increase), cGMP-dependent protein kinase (PKG; C = 100% increase/P = 75% increase), phospho-T451 dsRNA-dependent protein kinase (PKR; C = 2600% increase/P = 3330% increase), ribosomal S6 kinase 1 (RSK1; C = 750% increase/P = 630% increase), phospho-T389 p70 S6 kinase (S6K; C = 1000% increase/P = 460% increase), and protein-tyrosine phosphatase 1 delta (PTP1delta; C = 43% increase/P = 70% increase). Cytosolic increases in phospho-alpha-S724/gamma-S662 adducin (C = 15650% increase), PKCalpha (C = 100% increase) and PKCzeta (C = 190% increase) were found in ALS patients as compared with controls, while particulate increases in cAMP-dependent protein kinase (PKA; 43% increase), protein kinase C beta (PKCbeta; 330% increase), and stress-activated protein kinase beta (SAPKbeta; 34% increase) were also observed. Cyclin-dependent kinase-associated phosphatase (KAP) was apparently translocated, as it was reduced (31% decrease) in cytosolic fractions but elevated (100% increase) in particulate fractions of ALS spinal cord tissue. Our observations indicate that ALS is associated with the elevated expression and/or activation of many protein kinases, including PKCalpha, PKCbeta, PKCzeta and GSK3alpha/beta, which may augment neural death in ALS, and CaMKK, PKBalpha, Rsk1, S6K, and SAPK, which may be a response to neuronal injury that potentially can mitigate cell death.     

Harnessing cellular aging in human stem cell models of amyotrophic lateral sclerosis

Amyotrophic lateral sclerosis (ALS) is a relentlessly progressive neurodegenerative condition that is invariably fatal, usually within 3 to 5 years of diagnosis. The etiology of ALS remains unresolved and no effective treatments exist. There is therefore a desperate and unmet need for discovery of disease mechanisms to guide novel therapeutic strategies. The single major risk factor for ALS is aging, yet the molecular consequences of cell type‐specific aging remain understudied in this context. Induced pluripotent stem cells (iPSCs) have transformed the standard approach of examining human disease, generating unlimited numbers of disease‐relevant cells from patients, enabling analysis of disease mechanisms and drug screening. However, reprogramming patient cells to iPSCs reverses key hallmarks of cellular age. Therefore, although iPSC models recapitulate some disease hallmarks, a crucial challenge is to address the disparity between the advanced age of onset of neurodegenerative diseases and the fetal‐equivalent maturational state of iPSC‐derivatives. Increasing recognition of cell type‐specific aging paradigms underscores the importance of heterogeneity in ultimately tipping the balance from a state of compensated dysfunction (clinically pre‐symptomatic) to decompensation and progression (irreversible loss of neurological functions). In order to realize the true promise of iPSC technology in ALS, efforts need to prioritize faithfully recapitulating the clinical pathophysiological state, with proportionate emphasis on capturing the molecular sequelae of both cellular age and non‐cell‐autonomous disease mechanisms within this context.     

Misfolded superoxide dismutase-1 in CSF from amyotrophic lateral sclerosis patients

Several of the superoxide dismutase-1 (SOD1) mutations linked to amyotrophic lateral sclerosis (ALS) lead to synthesis of structurally defective molecules, suggesting that any cytotoxic conformational species common for all mutations should be misfolded. SOD1 can be secreted and evidence from ALS model systems suggests that extracellular SOD1 may be involved in cytotoxicity. Three ELISAs specifically reacting with different sequence segments in misfolded SOD1 species were used for analysis of CSF from 38 neurological controls and from 96 ALS patients, 57 of whom were sporadic cases and 39 familial, including 22 patients carrying SOD1 mutations. Misfolded SOD1 was found in all samples. There were, however, no significant differences between patients with and without mutations, and between all the ALS patients and the controls. The estimated concentration of misfolded SOD1 in the interstitium of the CNS is a 1000 times lower than that required for appreciable cytotoxicity in model systems. The results argue against a direct cytotoxic role of extracellular misfolded SOD1 in ALS. Misfolded SOD1 in CSF cannot be used as a biomarker of ALS in patients with and without mutations in the enzyme.