Institute for Medical Science of Aging, Aichi Medical University, Aichi, Japan.
Department of Neurology, Graduate School of Nagoya University, Aichi, Japan.
Brain. 2022 Aug 27;145(8):2769-2784. doi: 10.1093/brain/awac091.
TDP-43 is mislocalized from the nucleus and aggregates within the cytoplasm of affected neurons in cases of amyotrophic lateral sclerosis. TDP-43 pathology has also been found in brain tissues under non-amyotrophic lateral sclerosis conditions, suggesting mechanistic links between TDP-43-related amyotrophic lateral sclerosis and various neurological disorders. This study aimed to assess TDP-43 pathology in the spinal cord motor neurons of tauopathies. We examined 106 spinal cords from consecutively autopsied cases with progressive supranuclear palsy (n = 26), corticobasal degeneration (n = 12), globular glial tauopathy (n = 5), Alzheimer's disease (n = 21) or Pick's disease (n = 6) and neurologically healthy controls (n = 36). Ten of the progressive supranuclear palsy cases (38%) and seven of the corticobasal degeneration cases (58%) showed mislocalization and cytoplasmic aggregation of TDP-43 in spinal cord motor neurons, which was prominent in the cervical cord. TDP-43 aggregates were found to be skein-like, round-shaped, granular or dot-like and contained insoluble C-terminal fragments showing blotting pattern of amyotrophic lateral sclerosis or frontotemporal lobar degeneration. The lower motor neurons also showed cystatin-C aggregates, although Bunina bodies were absent in haematoxylin-eosin staining. The spinal cord TDP-43 pathology was often associated with TDP-43 pathology of the primary motor cortex. Positive correlations were shown between the severities of TDP-43 and four-repeat (4R)-tau aggregates in the cervical cord. TDP-43 and 4R-tau aggregates burdens positively correlated with microglial burden in anterior horn. TDP-43 pathology of spinal cord motor neuron did not develop in an age-dependent manner and was not found in the Alzheimer's disease, Pick's disease, globular glial tauopathy and control groups. Next, we assessed SFPQ expression in spinal cord motor neurons; SFPQ is a recently identified regulator of amyotrophic lateral sclerosis/frontotemporal lobar degeneration pathogenesis, and it is also reported that interaction between SFPQ and FUS regulates splicing of MAPT exon 10. Immunofluorescent and proximity-ligation assays revealed altered SFPQ/FUS-interactions in the neuronal nuclei of progressive supranuclear palsy, corticobasal degeneration and amyotrophic lateral sclerosis-TDP cases but not in Alzheimer's disease, Pick's disease and globular glial tauopathy cases. Moreover, SFPQ expression was depleted in neurons containing TDP-43 or 4R-tau aggregates of progressive supranuclear palsy and corticobasal degeneration cases. Our results indicate that progressive supranuclear palsy and corticobasal degeneration may have properties of systematic motor neuron TDP-43 proteinopathy, suggesting mechanistic links with amyotrophic lateral sclerosis-TDP. SFPQ dysfunction, arising from altered interaction with FUS, may be a candidate of the common pathway.
TDP-43 在肌萎缩侧索硬化症患者的受影响神经元的细胞质中从细胞核错误定位并聚集。TDP-43 病理学在非肌萎缩侧索硬化症条件下的脑组织中也有发现,这表明 TDP-43 相关肌萎缩侧索硬化症与各种神经疾病之间存在机制联系。本研究旨在评估神经退行性tau 病患者脊髓运动神经元中的 TDP-43 病理学。我们检查了 106 例连续尸检的病例的脊髓,包括进行性核上性麻痹(n=26)、皮质基底节变性(n=12)、球状神经胶质 tau 病(n=5)、阿尔茨海默病(n=21)或皮克病(n=6)和神经健康对照组(n=36)。10 例进行性核上性麻痹病例(38%)和 7 例皮质基底节变性病例(58%)的脊髓运动神经元中出现 TDP-43 的错误定位和细胞质聚集,在颈髓中尤为明显。TDP-43 聚集物呈线丝状、圆形、颗粒状或点状,包含不溶性 C 端片段,显示肌萎缩侧索硬化症或额颞叶变性的印迹模式。下运动神经元也显示胱抑素-C 聚集物,但苏木精-伊红染色中未见 Bunina 体。脊髓 TDP-43 病理学常与原发性运动皮层的 TDP-43 病理学相关。颈髓中 TDP-43 和四重复(4R)-tau 聚集物的严重程度呈正相关。TDP-43 和 4R-tau 聚集物与前角的小胶质细胞负担呈正相关。脊髓运动神经元的 TDP-43 病理学不会以年龄依赖的方式发展,也不会在阿尔茨海默病、皮克病、球状神经胶质 tau 病和对照组中发现。接下来,我们评估了脊髓运动神经元中的 SFPQ 表达;SFPQ 是肌萎缩侧索硬化症/额颞叶变性发病机制的最近确定的调节剂,据报道,SFPQ 和 FUS 之间的相互作用调节 MAPT 外显子 10 的剪接。免疫荧光和接近连接测定显示,在进行性核上性麻痹、皮质基底节变性和肌萎缩侧索硬化症-TDP 病例的神经元核中存在改变的 SFPQ/FUS 相互作用,但在阿尔茨海默病、皮克病和球状神经胶质 tau 病病例中则没有。此外,SFPQ 在进行性核上性麻痹和皮质基底节变性病例的含有 TDP-43 或 4R-tau 聚集物的神经元中表达减少。我们的结果表明,进行性核上性麻痹和皮质基底节变性可能具有系统性运动神经元 TDP-43 蛋白病的特性,这表明与肌萎缩侧索硬化症-TDP 存在机制联系。由于与 FUS 的相互作用改变而导致的 SFPQ 功能障碍可能是共同途径的候选者。
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