Congenital myasthenic syndrome caused by low-expressor fast-channel AChR delta subunit mutation
NEUROLOGY
Authors: Shen, XM; Ohno, K; Fukudome, T; Tsujino, A; Brengman, JM; De Vivo, DC; Packer, RJ; Engel, AG
Abstract
Objective: To determine the molecular basis of a disabling congenital myasthenic syndrome (CMS) observed in two related and one unrelated Arab kinship. Background: CMS can arise from defects in presynaptic, synaptic basal lamina-associated, or postsynaptic proteins. Most CMS are postsynaptic, and most reside in the AChR E subunit; only two mutations have been reported in the AChR delta subunit to date. Methods: Cytochemistry, electron microscopy, alpha-bungarotoxin binding studies, microelectrode and patch-clamp recordings, mutation analysis, mutagenesis, and expression studies in human embryonic kidney cells were employed. Results: Endplate studies showed AChR deficiency, fast decaying, low-amplitude endplate currents, and abnormally brief channel opening events. Mutation analysis revealed a novel homozygous missense mutation (deltaP250Q) of the penultimate proline in the first transmembrane domain (TMD1) of the AChR delta subunit. Expression studies indicate that deltaP250Q (1) hinders delta/alpha subunit association during early AChR assembly; (2) hinders opening of the doubly occupied closed receptor (A(2)R); and (3) speeds the dissociation of acetylcholine from A(2)R. Mutagenesis studies indicate that deltaP250L also has fast-channel effects, whereas epsilon P245L and epsilon P245Q, identical mutations of the corresponding proline in the epsilon subunit, have mild slow-channel effects. Conclusions: deltaP250Q represents the third mutation observed in the AChR delta subunit. The severe phenotype caused by deltaP250Q is attributed to endplate AChR deficiency, fast decay of the synaptic response, and lack of compensatory factors. That the penultimate prolines in TMD1 of the delta and epsilon subunits exert a reciprocal regulatory effect on the length of the channel opening bursts reveals an unexpected functional asymmetry between the two subunits.
Collagen XIII secures pre-and postsynaptic integrity of the neuromuscular synapse
HUMAN MOLECULAR GENETICS
Authors: Haronen, Heli; Zainul, Zarin; Tu, Hongmin; Naumenko, Nikolay; Sormunen, Raija; Miinalainen, Ilkka; Shakirzyanova, Anastasia; Oikarainen, Tuomo; Abdullin, Azat; Martin, Paula; Santoleri, Sabrina; Koistinaho, Jari; Silman, Israel; Giniatullin, Rashid; Fox, Michael A.; Heikkinen, Anne; Pihlajaniemi, Taina
Abstract
Both transmembrane and extracellular cues, one of which is collagen XIII, regulate the formation and function of the neuromuscular synapse, and their absence results in myasthenia. We show that the phenotypical changes in collagen XIII knock-out mice are milder than symptoms in human patients, but the Col13a1(-/-)mice recapitulate major muscle findings of congenital myasthenic syndrome type 19 and serve as a disease model. In the lack of collagen XIII neuromuscular synapses do not reach full size, alignment, complexity and function resulting in reduced muscle strength. Collagen XIII is particularly important for the preterminal integrity, and when absent, destabilization of the motor nerves results in muscle regeneration and in atrophy especially in the case of slow muscle fibers. Collagen XIII was found to affect synaptic integrity through binding the ColQ tail of acetylcholine esterase. Although collagen XIII is a muscle-bound transmembrane molecule, it also undergoes ectodomain shedding to become a synaptic basal lamina component. We investigated the two forms' roles by novel wCol13a1(tm/tm) mice in which ectodomain shedding is impaired. While postsynaptic maturation, terminal branching and neuro-transmission was exaggerated in the Col13a1(tm/tm) mice, the transmembrane form's presence sufficed to prevent defects in transsynaptic adhesion, Schwann cell invagination/retraction, vesicle accumulation and acetylcholine receptor clustering and acetylcholinesterase dispersion seen in the Col13a1(-/-)mice, pointing to the transmembrane form as the major conductor