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Impaired Presynaptic High-Affinity Choline Transporter Causes a Congenital Myasthenic Syndrome with Episodic Apnea

Stéphanie Bauché 1 Seana O’regan Yoshiteru Azuma 2 Fanny Laffargue 3 Grace Mcmacken Damien Sternberg 4 Guy Brochier 4 Céline Buon Nassima Bouzidi Ana Topf Emmanuelle Lacène 5 Ganaelle Remerand Anne Beaufrere Céline Pebrel-Richard Julien Thévenon 6 Salima El chehadeh-Djebbar Laure Faivre 7 Yannis Duffourd 7 Federica Ricci Tiziana Mongini Chiara Fiorillo Guja Astrea Carmen Burloiu Niculina Butoianu Carmen Sandu Laure Servais Gisèle Bonne 8 Isabelle Nelson 9 Isabelle Desguerre 10 Marie-Christine Nougues Benoit Bœuf Norma B Romero 5 Jocelyn Laporte 11 Anne Boland 12 Doris Lechner 12 Jean-François Deleuze 12 Bertrand Fontaine 13 Laure Strochlic 14 Hanns Lochmuller 2 Bruno Eymard 1 Michèle Mayer 15 Sophie Nicole 1, * 
Abstract : The neuromuscular junction (NMJ) is one of the best-studied cholinergic synapses. Inherited defects of peripheral neurotransmission result in congenital myasthenic syndromes (CMS5), a clinically and genetically heterogeneous group of rare diseases with fluctuating fatigable muscle weakness as the clinical hallmark. Whole-exome sequencing and Sanger sequencing in six unrelated families identified compound heterozygous and homozygous mutations in SLC5A7 encoding the presynaptic sodium-dependent high-affinity choline transporter 1 (CHT), which is known to be mutated in one dominant form of distal motor neuronopathy (DHMN7A). We identified 11 recessive mutations in SLC5A7 that were associated with a spectrum of severe muscle weakness ranging from a lethal antenatal form of arthrogryposis and severe hypotonia to a neonatal form of CMS with episodic apnea and a favorable prognosis when well managed at the clinical level. As expected given the critical role of CHT for multisystemic cholinergic neurotransmission, autonomic dysfunctions were reported in the antenatal form and cognitive impairment was noticed in half of the persons with the neonatal form. The missense mutations induced a near complete loss of function of CHT activity in cell models. At the human NMJ, a delay in synaptic maturation and an altered maintenance were observed in the antenatal and neonatal forms, respectively. Increased synaptic expression of butyrylcholinesterase was also observed, exposing the dysfunction of cholinergic metabolism when CHT is deficient in vivo. This work broadens the clinical spectrum of human diseases resulting from reduced CHT activity and highlights the complexity of cholinergic metabolism at the synapse.
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Soumis le : mercredi 10 janvier 2018 - 14:33:53
Dernière modification le : lundi 21 novembre 2022 - 17:24:08

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Stéphanie Bauché, Seana O’regan, Yoshiteru Azuma, Fanny Laffargue, Grace Mcmacken, et al.. Impaired Presynaptic High-Affinity Choline Transporter Causes a Congenital Myasthenic Syndrome with Episodic Apnea. American Journal of Human Genetics, 2016, 99 (3), pp.753 - 761. ⟨10.1016/j.ajhg.2016.06.033⟩. ⟨hal-01680226⟩



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