Sase Sunetra, Takanohashi Asako, Vanderver Adeline, Almad Akshata
Division of Neurology, Children's Hospital of Philadelphia, Philadelphia, PA.
Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA.
Brain Pathol. 2018 May;28(3):399-407. doi: 10.1111/bpa.12600.
Aicardi-Goutières syndrome (AGS) is an early-onset, autoimmune and genetically heterogeneous disorder with severe neurologic injury. Molecular studies have established that autosomal recessive mutations in one of the following genes are causative: TREX1, RNASEH2A, RNASEH2B, RNASEH2C, SAMHD1, ADAR1 and IFIH1/MDA5. The phenotypic presentation and pathophysiology of AGS is associated with over-production of the cytokine Interferon-alpha (IFN-α) and its downstream signaling, characterized as type I interferonopathy. Astrocytes are one of the major source of IFN in the central nervous system (CNS) and it is proposed that they could be key players in AGS pathology. Astrocytes are the most ubiquitous glial cell in the CNS and perform a number of crucial and complex functions ranging from formation of blood-brain barrier, maintaining ionic homeostasis, metabolic support to synapse formation and elimination in healthy CNS. Involvement of astrocytic dysfunction in neurological diseases-Alexander's disease, Epilepsy, Alzheimer's and amyotrophic lateral sclerosis (ALS)-has been well-established. It is now known that compromised astrocytic function can contribute to CNS abnormalities and severe neurodegeneration, nevertheless, its contribution in AGS is unclear. The current review discusses known molecular and cellular pathways for AGS mutations and how it stimulates IFN-α signaling. We shed light on how astrocytes might be key players in the phenotypic presentations of AGS and emphasize the cell-autonomous and non-cell-autonomous role of astrocytes. Understanding the contribution of astrocytes will help reveal mechanisms underlying interferonopathy and develop targeted astrocyte specific therapeutic treatments in AGS.
艾卡迪-古铁雷斯综合征(AGS)是一种早发性、自身免疫性且具有遗传异质性的疾病,伴有严重的神经损伤。分子研究已证实,以下基因之一的常染色体隐性突变具有致病性:TREX1、RNASEH2A、RNASEH2B、RNASEH2C、SAMHD1、ADAR1和IFI1H1/MDA5。AGS的表型表现和病理生理学与细胞因子α干扰素(IFN-α)及其下游信号的过度产生有关,其特征为I型干扰素病。星形胶质细胞是中枢神经系统(CNS)中IFN的主要来源之一,有人提出它们可能是AGS病理学的关键因素。星形胶质细胞是中枢神经系统中最普遍存在的神经胶质细胞,在健康的中枢神经系统中发挥着许多关键而复杂的功能,从血脑屏障的形成、离子稳态的维持、代谢支持到突触的形成和消除。星形胶质细胞功能障碍与神经疾病——亚历山大病、癫痫、阿尔茨海默病和肌萎缩侧索硬化症(ALS)——的关联已得到充分证实。现在已知星形胶质细胞功能受损会导致中枢神经系统异常和严重的神经退行性变,然而,其在AGS中的作用尚不清楚。本综述讨论了已知的AGS突变分子和细胞途径以及它如何刺激IFN-α信号传导。我们阐明了星形胶质细胞如何可能是AGS表型表现的关键因素,并强调了星形胶质细胞的细胞自主和非细胞自主作用。了解星形胶质细胞的作用将有助于揭示干扰素病的潜在机制,并开发针对AGS的星形胶质细胞特异性靶向治疗方法。