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      Niemann-Pick C Disease Gene Mutations and Age-Related Neurodegenerative Disorders

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          Abstract

          Niemann-Pick type C (NPC) disease is a rare autosomal-recessively inherited lysosomal storage disorder caused by mutations in NPC1 (95%) or NPC2. Given the highly variable phenotype, diagnosis is challenging and particularly late-onset forms with predominantly neuropsychiatric presentations are likely underdiagnosed. Pathophysiologically, genetic alterations compromising the endosomal/lysosomal system are linked with age-related neurodegenerative disorders. We sought to examine a possible association of rare sequence variants in NPC1 and NPC2 with Parkinson's disease (PD), frontotemporal lobar degeneration (FTLD) and progressive supranuclear palsy (PSP), and to genetically determine the proportion of potentially misdiagnosed NPC patients in these neurodegenerative conditions. By means of high-resolution melting, we screened the coding regions of NPC1 and NPC2 for rare genetic variation in a homogenous German sample of patients clinically diagnosed with PD (n = 563), FTLD (n = 133) and PSP (n = 94), and 846 population-based controls. The frequencies of rare sequence variants in NPC1/ 2 did not differ significantly between patients and controls. Disease-associated NPC1/ 2 mutations were found in six PD patients (1.1%) and seven control subjects (0.8%), but not in FTLD or PSP. All rare variation was detected in the heterozygous state and no compound heterozygotes were observed. Our data do not support the hypothesis that rare NPC1/ 2 variants confer susceptibility for PD, FTLD, or PSP in the German population. Misdiagnosed NPC patients were not present in our samples. However, further assessment of NPC disease genes in age-related neurodegeneration is warranted.

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          Most cited references24

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          Accuracy of clinical diagnosis of idiopathic Parkinson's disease: a clinico-pathological study of 100 cases.

          Few detailed clinico-pathological correlations of Parkinson's disease have been published. The pathological findings in 100 patients diagnosed prospectively by a group of consultant neurologists as having idiopathic Parkinson's disease are reported. Seventy six had nigral Lewy bodies, and in all of these Lewy bodies were also found in the cerebral cortex. In 24 cases without Lewy bodies, diagnoses included progressive supranuclear palsy, multiple system atrophy, Alzheimer's disease, Alzheimer-type pathology, and basal ganglia vascular disease. The retrospective application of recommended diagnostic criteria improved the diagnostic accuracy to 82%. These observations call into question current concepts of Parkinson's disease as a single distinct morbid entity.
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            Marked elevation of plasma chitotriosidase activity. A novel hallmark of Gaucher disease.

            Gaucher disease (GD; glucosylceramidosis) is caused by a deficient activity of the enzyme glucocerebrosidase (GC). Clinical manifestations are highly variable and cannot be predicted accurately on the basis of the properties of mutant GC. Analysis of secondary abnormalities, such as elevated plasma levels of some hydrolases, may help to increase insight into the complicated pathophysiology of the disease and could also provide useful disease markers. The recent availability of enzyme supplementation therapy for GD increases the need for markers as early predictors of the efficacy of treatment. We report the finding of a very marked increase in chitotrisidase activity in plasma of 30 of 32 symptomatic type 1 GD patients studied: the median activity being > 600 times the median value in plasma of healthy volunteers. In three GC-deficient individuals without clinical symptoms, only slight increases were noted. Chitotriosidase activity was absent in plasma of three control subjects and two patients. During enzyme supplementation therapy, chitotriosidase activity declined dramatically. We conclude that plasma chitotriosidase levels can serve as a new diagnostic hallmark of GD and should prove to be useful in assessing whether clinical manifestations of GD are present and for monitoring the efficacy of therapeutic intervention.
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              A block of autophagy in lysosomal storage disorders.

              Most lysosomal storage disorders (LSDs) are caused by deficiencies of lysosomal hydrolases. While LSDs were among the first inherited diseases for which the underlying biochemical defects were identified, the mechanisms from enzyme deficiency to cell death are poorly understood. Here we show that lysosomal storage impairs autophagic delivery of bulk cytosolic contents to lysosomes. By studying the mouse models of two LSDs associated with severe neurodegeneration, multiple sulfatase deficiency (MSD) and mucopolysaccharidosis type IIIA (MPSIIIA), we observed an accumulation of autophagosomes resulting from defective autophagosome-lysosome fusion. An impairment of the autophagic pathway was demonstrated by the inefficient degradation of exogenous aggregate-prone proteins (i.e. expanded huntingtin and mutated alpha-synuclein) in cells from LSD mice. This impairment resulted in massive accumulation of polyubiquitinated proteins and of dysfunctional mitochondria which are the putative mediators of cell death. These data identify LSDs as 'autophagy disorders' and suggest the presence of common mechanisms in the pathogenesis of these and other neurodegenerative diseases.
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                Author and article information

                Contributors
                Role: Editor
                Journal
                PLoS One
                PLoS ONE
                plos
                plosone
                PLoS ONE
                Public Library of Science (San Francisco, USA )
                1932-6203
                2013
                30 December 2013
                : 8
                : 12
                : e82879
                Affiliations
                [1 ]Neurologische Klinik und Poliklinik, Klinikum rechts der Isar, Technische Universität München, Munich, Germany
                [2 ]Institut für Humangenetik, Helmholtz Zentrum München, Munich, Germany
                [3 ]Institute of Epidemiology II, Helmholtz Zentrum München, Munich, Germany
                [4 ]Institute of Genetic Epidemiology, Helmholtz Zentrum München, Munich, Germany
                [5 ]Institut für Humangenetik, Technische Universität München, Munich, Germany
                [6 ]Neurologische Klinik und Poliklinik, Klinikum der Universität München, Ludwig-Maximilians-Universität München, Munich, Germany
                [7 ]Paracelsus-Elena-Klinik, Kassel, Germany
                [8 ]Department of Psychiatry and Psychotherapy, Technische Universität München, Munich, Germany
                [9 ]Neuroepidemiology and Ageing Research Unit, School of Public Health, Faculty of Medicine, The Imperial College of Science, Technology and Medicine, London, United Kingdom
                [10 ]West London Cognitive Disorders Treatment and Research Unit, West London Mental Health Trust, London, United Kingdom
                [11 ]Klinik für Psychiatrie und Psychotherapie, Universität Regensburg, Regensburg, Germany
                [12 ]Neurochirurgische Klinik, Georg-August-Universität, Göttingen, Germany
                [13 ]Klinik für Kinder- und Jugendmedizin, Universitätsklinikum Münster, Münster, Germany
                [14 ]Laboratoire Gillet-Mérieux, CBPE, Hospices Civils de Lyon, Lyon, France
                [15 ]UF de Neurogénétique Moléculaire, CBPE, Hospices Civils de Lyon, Lyon, France
                [16 ]Munich Cluster for Systems Neurology, SyNergy, Munich, Germany
                [17 ]Department of Neurology and Neurological Sciences and Center for Sleep Sciences and Medicine, Stanford University School of Medicine, Palo Alto, California, United States of America
                Centre Hospitalier Universitaire Vaudois (CHUV), Switzerland
                Author notes

                Competing Interests: MZ has received travel expenses form Actelion Pharmaceuticals Ltd. FC has received funding for travel from Medtronic. AJ has received funding for travel from Allergan and Ipsen Pharmaceuticals. BM received travel compensation from Novartis and Boehringer-Ingelheim, lecturing fees from Orion and Glaxo-Smith-Kline, grant support from GE Healthcare, Boehringer-Ingelheim, Desitin, TEVA-Pharma, and serves as a consultant to Bayer-Schering Pharma and the Michael J. Fox Foundation for Parkinson's Disease Research. MV has received travel expenses, carried out paid and unpaid consultancy work, and presentation honoraria from Actelion Pharmaceuticals Ltd., and has received travel expenses, presentation honoraria, and been invited to meetings funded and organized by Genzyme Corporation and Shire HGT. PLa has received presentation honoraria from Actelion Pharmaceuticals France. HK has received travel expenses, carried out paid consultancy work, and received presentation honoraria from Actelion Pharmaceuticals Ltd. CT serves on scientific advisory boards for Boehringer Ingelheim and UCB, has received speaker honoraria from Boehringer Ingelheim, UCB, and Mundipharma as well as travel compensation from UCB, Boehringer-Ingelheim, and Mundipharma. TMei was supported by the German Network for Mitochondrial Disorders (mitoNET 01GM0867), the European Commission Seventh Framework Program (N. 261123), Genetic European Variation in Disease Consortium, and German Ministry for Education and Research (01GR0804-4). BH serves on a scientific advisory board for Merz Pharmaceuticals; has received funding for travel from Biogen Idec, Ipsen, and Merz Pharmaceuticals; has received speaker honoraria from Allergan and Ipsen, and receives research support from Ipsen and the DFG. SL received grants from UCB Pharma, TEVA, Boehringer, Grünenthal, Orion. JW serves on a scientific advisory board for UCB; has received speaker honoraria from UCB and Boehringer Ingelheim; has filed a patent re: Winkelmann et al. Nat Genet 2007; and receives research support from the German RLS foundation, the Deutsche Forschungsgemeinschaft (DFG) and the Fritz Thyssen Foundation. This does not alter the authors' adherence to all the PLOS ONE policies on sharing data and materials.

                Conceived and designed the experiments: MZ GN ECS BH SL JW. Performed the experiments: MZ GN ECS. Analyzed the data: MZ GN ECS BH SL JW. Contributed reagents/materials/analysis tools: MZ GN FC AJ ECS BM P. Lichtner AP CG T. Marquardt MV P. Latour HK CT JDS RP KO T. Meitinger BH SL JW. Wrote the paper: MZ GN JW.

                Article
                PONE-D-13-43122
                10.1371/journal.pone.0082879
                3875432
                24386122
                0cb9f352-6e95-4bf8-b2a1-5f89553b859f
                Copyright @ 2013

                This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

                History
                : 21 October 2013
                : 28 October 2013
                Page count
                Pages: 8
                Funding
                Recruitment and analysis of 94 patients with progressive supranuclear palsy was funded by Actelion Pharmaceuticals Ltd ( www.actelion.com). The remaining study as well as the recruitment of patients with Parkinson's disease and frontotemporal lobar degeneration was funded by in-house institutional funding from Technische Universität München and Helmholtz Zentrum München, Munich, Germany. Controls belong to the KORA research platform (KORA, Cooperative Research in the Region of Augsburg), which was initiated and financed by the Helmholtz Zentrum München – German Research Center for Environmental Health, which is funded by the German Federal Ministry of Education and Research and by the State of Bavaria. Furthermore, KORA research was supported within the Munich Center of Health Sciences (MC Health), Ludwig-Maximilians-Universität, as part of LMUinnovativ. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
                Categories
                Research Article
                Biology
                Genetics
                Human Genetics
                Autosomal Recessive
                Niemann-Pick disease
                Population Biology
                Epidemiology
                Genetic Epidemiology
                Medicine
                Clinical Genetics
                Autosomal Recessive
                Niemann-Pick disease
                Epidemiology
                Genetic Epidemiology
                Metabolic Disorders
                Niemann-Pick disease
                Neurology
                Neurodegenerative Diseases
                Parkinson Disease

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                Uncategorized

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