Sangam: A Confluence of Knowledge Streams

Two newly defined inherited disorders due to cholinergic transporter dysfunction with distinct clinical outcomes, disease mechanisms and modes of inheritance.

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dc.contributor Crosby, Andrew Harry
dc.contributor Harries, Lorna
dc.creator Barwick, Katy Elizabeth Sara
dc.date 2016-09-12T09:58:34Z
dc.date 2016-04-18
dc.date.accessioned 2023-02-23T09:57:54Z
dc.date.available 2023-02-23T09:57:54Z
dc.identifier Defective presynaptic choline transport underlies hereditary motor neuropathy. (2012) Barwick K.E.S., Wright J., Al-Turki S., McEntagart M.M., Sreekantan-Nair A., Chioza B., Al-Memar A., Modarres H., Reilly M.M., Dick K.J., Ruggiero A.M., Balekly R.D., Hurles M.E., Crosby A.H. The American Journal of Human Genetics. 91(6): 1103-1107
dc.identifier Distal spinal muscular atrophy with vocal paresis: from the Welsh choir to genes. (2013) Ingram G., Barwick K.E.S., McEntagart M.M., Crosby A.H., Hartley L., Llewlyn G., Morris H. Journal of Neurology, neurosurgery, and psychiatry. 84(11): 0
dc.identifier Distal hereditary motor neuropathy with vocal cord paresis: from difficulty in choral singing to a molecular genetic diagnosis. (2016) Ingram G., Barwick K.E.S., Hartley L., McEntagart M.M., Crosby A.H., Llewelyn G., Morris H.R. Practical Neurology., 0: 1-5
dc.identifier http://hdl.handle.net/10871/23407
dc.identifier.uri http://localhost:8080/xmlui/handle/CUHPOERS/256556
dc.description Neurodegenerative diseases are becoming increasingly prevalent due to the ageing population, and are among the major contributors to disability and disease worldwide. The identification of the gene defects responsible for many of these conditions has played a major role in our understanding of the pathogenic processes involved, and provided opportunity to develop targeted treatment strategies. Cholinergic neurotransmission supports a wide range of physiological and behavioural processes and its dysfunction of cholinergic signalling has been associated with a number of disorders, including myasthenias, cardiovascular disease(1), attention-deficit hyperactivity disorder (ADHD) (2), Alzheimer’s disease (ADi), schizophrenia, addiction(3), and depression(4). SLC5A7 encodes the Na+/Cl- dependent, high-affinity choline transporter (CHT) which represents the rate limiting step in acetylcholine (Ach) synthesis and is critical for normal cholinergic signalling. The work in this thesis details two new inherited disorders, caused by distinct pathogenic disease mechanisms, associated with novel SLC5A7 mutations. Chapter three documents the discovery of two autosomal-dominantly acting SLC5A7/CHT mutations associated with adult onset motor neurone disorders. Initially we identified a frameshift mutation that results in premature truncation of the transporter protein in a large Welsh kindred affected with distal hereditary motor neuropathy type VII (dHMN-VII), in which neurodegeneration and muscle paresis is largely restricted to the distal limb muscles and vocal cords. The mutation responsible results in the dominant-negative interference of the mutant molecule with function of the wild type choline transporter, resulting in significantly reduced (although not completely abolished) transporter activity. This finding is further evidenced by the discovery of a second dHMN family associated with a distinct frameshift SLC5A7 mutation indicative of a similar dominant-negative disease mechanism. Together these findings corroborate a dominant-negative disease mechanism arising from C-terminal truncating SLC5A7 mutations associated with dHMN, and provide further insight into the role of aberrant choline transporter function in neurological disease. Chapter four describes N-terminal missense mutations located in the transmembrane spanning region of SLC5A7/CHT, associated with a severe infantile neuromuscular disorder characterised by predominantly central hypotonia and developmental delay. The phenotypic effects of these mutations are likely to result from the near abolition of CHT-mediated choline transport in homozygous individuals, and are in keeping with those observed in CHT knock-out mouse models(5). The development of a mouse model of the human motor neurone disease arising from SLC5A7 frameshift mutations should allow for further investigation of the mechanism by which truncated CHT leads to the dHMN phenotype. Chapter 5 details treatment hypotheses for dHMN, as well as the generation of a patient-specific knock-in mouse model carrying an Slc5a7 mutation orthologous to that identified in dHMN-VII families in chapter 3, and results from preliminary neurological phenotyping of the mouse model. This model will be crucially important for the exploration of treatment options in dHMN-VII motor neurone disease as a prelude to clinical trials in humans.
dc.description Neurosciences Research Foundation
dc.description John McDowall Bursary (for MND research)
dc.language en
dc.publisher University of Exeter
dc.publisher Medical Sciences
dc.rights I wish to place an extended embargo on my thesis and withhold consent for my thesis to be publicly available on ORE or to the British Library until 15/04/2017
dc.rights 2017-04-15
dc.rights We are preparing two publications for submission in which data included in my thesis will be published (unprotected intellectual property).
dc.subject High affinity choline transporter
dc.subject CHT
dc.subject Distal hereditary motor neuropathy type 7
dc.subject dHMN-VII
dc.subject Distal hereditary motor neuropathy type 5
dc.subject dHMN-V
dc.subject Hypotonia
dc.subject Mouse model
dc.subject Charcot-Marie-Tooth disease
dc.subject SLC5A7
dc.title Two newly defined inherited disorders due to cholinergic transporter dysfunction with distinct clinical outcomes, disease mechanisms and modes of inheritance.
dc.type Thesis or dissertation
dc.type PhD in Medical Studies
dc.type Doctoral
dc.type PhD


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