1 Centro de Investigaciones Biológicas, Consejo Superior de Investigaciones, Científicas, Ramiro de Maeztu 9, 28040 Madrid, Spain.
Brain. 2014 Mar;137(Pt 3):806-18. doi: 10.1093/brain/awt353. Epub 2014 Jan 14.
Lafora progressive myoclonus epilepsy (Lafora disease) is a fatal autosomal recessive neurodegenerative disorder characterized by the presence of glycogen-like intracellular inclusions called Lafora bodies. The vast majority of patients carry mutations in either the EPM2A or EPM2B genes, encoding laforin, a glucan phosphatase, and malin, an E3 ubiquitin ligase, respectively. Although the precise physiological role of these proteins is not fully understood, work in past years has established a link between glycogen synthesis, Lafora bodies formation and Lafora disease development. To determine the role of the phosphatase activity of laforin in disease development we generated two Epm2a(-/-) mouse lines expressing either wild-type laforin or a mutant (C265S) laforin lacking only the phosphatase activity. Our results demonstrate that expression of either transgene blocks formation of Lafora bodies and restores the impairment in macroautophagy, preventing the development of Lafora bodies in Epm2a(-/-) mice. These data indicate that the critical pathogenic process is the control of abnormal glycogen accumulation through intracellular proteolytic systems by the laforin-malin complex, and not glycogen dephosphorylation by laforin. Understanding which is the essential process leading to Lafora disease pathogenesis represents a critical conceptual advance that should facilitate development of appropriate therapeutics.
拉佛拉病(Lafora 病)是一种进行性肌阵挛性癫痫,为致命的常染色体隐性神经退行性疾病,其特征在于存在糖原样细胞内包涵体,称为拉佛拉体。绝大多数患者分别携带编码加利醛酸酶的 EPM2A 或 EPM2B 基因突变,和编码 E3 泛素连接酶的 malin。尽管这些蛋白质的精确生理功能尚未完全阐明,但过去几年的研究工作已经建立了糖原合成、拉佛拉体形成和拉佛拉病发展之间的联系。为了确定加利醛酸酶活性在疾病发展中的作用,我们生成了两种表达野生型加利醛酸酶或仅缺乏加利醛酸酶活性的突变体(C265S)的 Epm2a(-/-) 小鼠系。我们的结果表明,表达任一种转基因都可以阻止拉佛拉体的形成,并恢复巨自噬的损伤,从而防止 Epm2a(-/-) 小鼠中拉佛拉体的形成。这些数据表明,关键的致病过程是通过加利醛酸酶- malin 复合物控制异常糖原积累的细胞内蛋白水解系统,而不是通过加利醛酸酶进行糖原去磷酸化。了解导致拉佛拉病发病机制的关键过程是一个关键的概念性进展,应该有助于开发适当的治疗方法。