Department of Microbiology and Immunology, University of Maryland School of Medicine, Baltimore, Maryland, USA.
Department of Pharmaceutical Sciences, University of Maryland School of Pharmacy, Baltimore, Maryland, USA.
Stem Cells Transl Med. 2021 Jul;10(7):1081-1094. doi: 10.1002/sctm.20-0386. Epub 2021 Mar 3.
Gaucher disease (GD) is a lysosomal storage disorder caused by mutations in GBA1, the gene that encodes lysosomal β-glucocerebrosidase (GCase). Mild mutations in GBA1 cause type 1 non-neuronopathic GD, whereas severe mutations cause types 2 and 3 neuronopathic GD (nGD). GCase deficiency results in the accumulation of glucosylceramide (GlcCer) and glucosylsphingosine (GlcSph). GlcSph is formed by deacylation of GlcCer by the lysosomal enzyme acid ceramidase. Brains from patients with nGD have high levels of GlcSph, a lipid believed to play an important role in nGD, but the mechanisms involved remain unclear. To identify these mechanisms, we used human induced pluripotent stem cell-derived neurons from nGD patients. We found that elevated levels of GlcSph activate mammalian target of rapamycin (mTOR) complex 1 (mTORC1), interfering with lysosomal biogenesis and autophagy, which were restored by incubation of nGD neurons with mTOR inhibitors. We also found that inhibition of acid ceramidase prevented both, mTOR hyperactivity and lysosomal dysfunction, suggesting that these alterations were caused by GlcSph accumulation in the mutant neurons. To directly determine whether GlcSph can cause mTOR hyperactivation, we incubated wild-type neurons with exogenous GlcSph. Remarkably, GlcSph treatment recapitulated the mTOR hyperactivation and lysosomal abnormalities in mutant neurons, which were prevented by coincubation of GlcSph with mTOR inhibitors. We conclude that elevated GlcSph activates an mTORC1-dependent pathogenic mechanism that is responsible for the lysosomal abnormalities of nGD neurons. We also identify acid ceramidase as essential to the pathogenesis of nGD, providing a new therapeutic target for treating GBA1-associated neurodegeneration.
戈谢病(Gaucher disease,GD)是一种溶酶体贮积病,由编码溶酶体β-葡萄糖脑苷脂酶(β-glucocerebrosidase,GCase)的 GBA1 基因突变引起。GBA1 中的轻度突变导致 1 型非神经病变型 GD,而严重突变导致 2 型和 3 型神经病变型 GD(neuronopathic GD,nGD)。GCase 缺乏导致葡萄糖脑苷脂(glucosylceramide,GlcCer)和葡萄糖神经酰胺(glucosylsphingosine,GlcSph)的积累。GlcSph 是由溶酶体酶酸性神经酰胺酶通过酰基水解作用从 GlcCer 中形成的。nGD 患者的大脑中 GlcSph 水平较高,这种脂质被认为在 nGD 中发挥重要作用,但涉及的机制尚不清楚。为了确定这些机制,我们使用来自 nGD 患者的人诱导多能干细胞衍生神经元进行研究。我们发现,升高的 GlcSph 水平激活了哺乳动物雷帕霉素靶蛋白(mammalian target of rapamycin,mTOR)复合物 1(mTORC1),干扰了溶酶体生物发生和自噬,而用 mTOR 抑制剂孵育 nGD 神经元则可以恢复这些过程。我们还发现,抑制酸性神经酰胺酶可防止 mTOR 过度激活和溶酶体功能障碍,这表明这些改变是由突变神经元中 GlcSph 的积累引起的。为了直接确定 GlcSph 是否可以导致 mTOR 过度激活,我们用外源性 GlcSph 孵育野生型神经元。值得注意的是,GlcSph 处理可重现突变神经元中的 mTOR 过度激活和溶酶体异常,而用 mTOR 抑制剂共孵育则可防止这种情况发生。我们得出结论,升高的 GlcSph 激活了一种依赖 mTORC1 的致病机制,该机制负责 nGD 神经元的溶酶体异常。我们还确定酸性神经酰胺酶对 nGD 的发病机制至关重要,为治疗 GBA1 相关神经退行性变提供了新的治疗靶点。
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