Triñanes-Ramos Javier, Bugiani Marianna, van Rooijen-van Leeuwen Gemma, Chevalier Juliette A, Siu Yuan Jiew, van Utenhove Elise L H, Hoogterp Leoni, Witkamp Diede, Oudejans Ellen, Lodder Bastiaan, Kole Maarten, Saher Gesine, Nave Klaus-Armin, Abbink Truus E M, van der Knaap Marjo S
Department of Child Neurology, Amsterdam Leukodystrophy Center, Emma Children's Hospital, Amsterdam University Medical Centers, Amsterdam, 1105 AZ, The Netherlands.
Department of Pathology, Amsterdam University Medical Centers, Amsterdam, 1105 AZ, The Netherlands.
Brain. 2025 May 6. doi: 10.1093/brain/awaf171.
Vanishing white matter (VWM) is a leukodystrophy caused by mutations in any of the genes encoding the subunits of the eukaryotic translation initiation factor 2B (eIF2B), a central factor in mRNA translation initiation and regulator of the translation rate during the integrated stress response (ISR). Clinically, VWM is characterized by chronic motor and cognitive decline and premature death. Neuropathology shows selective white matter involvement with dysmorphic, immature astrocytes and defective reactive astrogliosis, while oligodendrocytes show increased expression of immaturity and proliferation markers and neurons look normal. The expression of the ATF4-transcriptome is increased in the white matter. These characteristics have been successfully replicated in eIF2B mutant mouse models. Until now, the relative contribution of each cell type to the development of VWM has remained unclear. Understanding the vulnerability of specific cell types for VWM is critical for understanding disease mechanisms and developing effective therapies. We generated astrocyte-, oligodendrocyte-, and neuron-specific Eif2b5 conditional mouse lines to determine the role of each mutant cell type in the onset and development of the disease. We evaluated motor performance, white matter pathology and the expression of myelin-related proteins. We analyzed astrocytes and oligodendrocytes density, maturity, morphology, proliferation, and apoptosis. We investigated the expression of the ISR-/ATF4-related genes and proteins, as well as their localization within the glial cells. At age 9 months, we found that astrocyte-specific Eif2b5 conditional mice showed very mild ataxia, extensive intramyelinic vacuolization, normal density and maturity of oligodendrocytes, and high expression of ATF4-related genes. Oligodendrocyte-specific Eif2b5 conditional mice developed gait ataxia that matched the phenotype of the whole-body Eif2b5 mutant line. Myelin looked normal, but numerous axons were unmyelinated; astrocytes were reactive, and oligodendrocytes were immature and in cell cycle. The enhanced ATF4-transcriptome was minor compared to the astrocyte-specific lines. The neuron-specific Eif2b5 conditional line exhibited a very mild phenotype and none of the major characteristic of VWM. Our findings highlight a complex effect of Eif2b5 mutations in different brain cell types leading to the clinical and neuropathological characteristics of VWM. Oligodendrocytes are the major contributors to the development of ataxia, but astrocyte-specific Eif2b5 conditional mice display several histological and molecular key features of VWM. In conclusion, the view of a single cell population being responsible for the onset and development of VWM needs to be replaced by the concept of VWM as a disease involving diverse cell types.
消失性白质病(VWM)是一种白质营养不良症,由真核生物翻译起始因子2B(eIF2B)亚基编码基因的任何突变引起,eIF2B是mRNA翻译起始的核心因子,也是整合应激反应(ISR)期间翻译速率的调节因子。临床上,VWM的特征是慢性运动和认知功能衰退以及过早死亡。神经病理学显示白质选择性受累,伴有畸形、未成熟的星形胶质细胞和有缺陷的反应性星形胶质细胞增生,而少突胶质细胞显示未成熟和增殖标志物的表达增加,神经元看起来正常。白质中ATF4转录组的表达增加。这些特征已在eIF2B突变小鼠模型中成功复制。到目前为止,每种细胞类型对VWM发展的相对贡献仍不清楚。了解特定细胞类型对VWM的易感性对于理解疾病机制和开发有效疗法至关重要。我们生成了星形胶质细胞、少突胶质细胞和神经元特异性的Eif2b5条件性小鼠品系,以确定每种突变细胞类型在疾病发生和发展中的作用。我们评估了运动性能、白质病理学以及髓鞘相关蛋白的表达。我们分析了星形胶质细胞和少突胶质细胞的密度、成熟度、形态、增殖和凋亡。我们研究了ISR-/ATF4相关基因和蛋白的表达,以及它们在神经胶质细胞内的定位。在9个月大时,我们发现星形胶质细胞特异性Eif2b5条件性小鼠表现出非常轻微的共济失调、广泛的髓鞘内空泡化、少突胶质细胞密度和成熟度正常,以及ATF4相关基因的高表达。少突胶质细胞特异性Eif2b5条件性小鼠出现步态共济失调,与全身Eif2b5突变品系的表型相符。髓鞘看起来正常,但许多轴突未被髓鞘化;星形胶质细胞有反应,少突胶质细胞未成熟且处于细胞周期。与星形胶质细胞特异性品系相比,增强的ATF4转录组较小。神经元特异性Eif2b5条件性品系表现出非常轻微的表型且没有VWM的主要特征。我们的研究结果突出了Eif2b5突变在不同脑细胞类型中的复杂作用,导致了VWM的临床和神经病理学特征。少突胶质细胞是共济失调发展的主要促成因素,但星形胶质细胞特异性Eif2b5条件性小鼠表现出VWM的几个组织学和分子关键特征。总之,认为单一细胞群体负责VWM发生和发展的观点需要被VWM是一种涉及多种细胞类型的疾病这一概念所取代。