Department of Human Genetics, University of Michigan, Ann Arbor, MI, USA.
Neuroscience Graduate Program, University of Michigan, Ann Arbor, MI, USA.
Epilepsia. 2020 Dec;61(12):2847-2856. doi: 10.1111/epi.16741. Epub 2020 Nov 2.
SCN8A encephalopathy is a developmental epileptic encephalopathy typically caused by de novo gain-of-function mutations in Na 1.6. Severely affected individuals exhibit refractory seizures, developmental delay, cognitive disabilities, movement disorders, and elevated risk of sudden death. Patients with the identical SCN8A variant can differ in clinical course, suggesting a role for modifier genes in determining disease severity. The identification of genetic modifiers contributes to understanding disease pathogenesis and suggesting therapeutic interventions.
We generated F1 and F2 crosses between inbred mouse strains and mice carrying the human pathogenic variants SCN8A-R1872W and SCN8A-N1768D. Quantitative trait locus (QTL) analysis of seizure-related phenotypes was used for chromosomal mapping of modifier loci.
In an F2 cross between strain SJL/J and C57BL/6J mice carrying the patient mutation R1872W, we identified a major QTL on chromosome 5 containing the Gabra2 gene. Strain C57BL/6J carries a splice site mutation that reduces expression of Gabra2, encoding the α2 subunit of the aminobutyric acid type A receptor. The protective wild-type allele of Gabra2 from strain SJL/J delays the age at seizure onset and extends life span of the Scn8a mutant mice. Additional Scn8a modifiers were observed in the F2 cross and in an F1 cross with strain C3HeB/FeJ.
These studies demonstrate that the SJL/J strain carries multiple modifiers with protective effects against seizures induced by gain-of-function mutations in Scn8a. Homozygosity for the hypomorphic variant of Gabra2 in strain C57BL/6J is associated with early seizure onset and short life span. GABRA2 is a potential therapeutic target for SCN8A encephalopathy.
SCN8A 脑病是一种发育性癫痫性脑病,通常由 Na 1.6 的新获得性功能突变引起。受严重影响的个体表现出难治性癫痫发作、发育迟缓、认知障碍、运动障碍和猝死风险增加。具有相同 SCN8A 变体的患者在临床病程上可能存在差异,这表明修饰基因在决定疾病严重程度方面发挥作用。遗传修饰物的鉴定有助于了解疾病的发病机制,并提出治疗干预措施。
我们在近交系小鼠品系之间以及携带致病性 SCN8A-R1872W 和 SCN8A-N1768D 变体的小鼠之间产生了 F1 和 F2 杂交。对与癫痫相关表型的定量性状基因座(QTL)分析用于修饰基因座的染色体定位。
在携带患者突变 R1872W 的 SJL/J 品系和 C57BL/6J 品系之间的 F2 杂交中,我们在包含 Gabra2 基因的 5 号染色体上鉴定出一个主要的 QTL。C57BL/6J 品系携带一个剪接位点突变,降低了 Gabra2 的表达,Gabra2 编码 GABA 型 A 受体的 α2 亚基。来自 SJL/J 品系的 Gabra2 的保护性野生型等位基因延迟了 Scn8a 突变小鼠的癫痫发作年龄,并延长了它们的寿命。在 F2 杂交和与 C3HeB/FeJ 品系的 F1 杂交中观察到其他 Scn8a 修饰物。
这些研究表明,SJL/J 品系携带多种修饰物,对 Scn8a 中的获得性功能突变引起的癫痫发作具有保护作用。C57BL/6J 品系中 Gabra2 的低功能变体的纯合性与癫痫发作的早期发作和寿命缩短有关。GABRA2 是 SCN8A 脑病的潜在治疗靶点。