Alpha-synuclein seeding shows a wide heterogeneity in multiple system atrophy.


Journal

Translational neurodegeneration
ISSN: 2047-9158
Titre abrégé: Transl Neurodegener
Pays: England
ID NLM: 101591861

Informations de publication

Date de publication:
07 02 2022
Historique:
received: 29 09 2021
accepted: 19 01 2022
entrez: 7 2 2022
pubmed: 8 2 2022
medline: 5 4 2022
Statut: epublish

Résumé

Multiple system atrophy (MSA) is a neurodegenerative condition characterized by variable combinations of parkinsonism, autonomic failure, cerebellar ataxia and pyramidal features. Although the distribution of synucleinopathy correlates with the predominant clinical features, the burden of pathology does not fully explain observed differences in clinical presentation and rate of disease progression. We hypothesized that the clinical heterogeneity in MSA is a consequence of variability in the seeding activity of α-synuclein both between different patients and between different brain regions. The reliable detection of α-synuclein seeding activity derived from MSA using cell-free amplification assays remains challenging. Therefore, we conducted a systematic evaluation of 168 different reaction buffers, using an array of pH and salts, seeded with fully characterized brain homogenates from one MSA and one PD patient. We then validated the two conditions that conferred the optimal ability to discriminate between PD- and MSA-derived samples in a larger cohort of 40 neuropathologically confirmed cases, including 15 MSA. Finally, in a subset of brains, we conducted the first multi-region analysis of seeding behaviour in MSA. Using our novel buffer conditions, we show that the physicochemical factors that govern the in vitro amplification of α-synuclein can be tailored to generate strain-specific reaction buffers that can be used to reliably study the seeding capacity from MSA-derived α-synuclein. Using this novel approach, we were able to sub-categorize the 15 MSA brains into 3 groups: high, intermediate and low seeders. To further demonstrate heterogeneity in α-synuclein seeding in MSA, we conducted a comprehensive multi-regional evaluation of α-synuclein seeding in 13 different regions from 2 high seeders, 2 intermediate seeders and 2 low seeders. We have identified unexpected differences in seed-competent α-synuclein across a cohort of neuropathologically comparable MSA brains. Furthermore, our work has revealed a substantial heterogeneity in seeding activity, driven by the PBS-soluble α-synuclein, between different brain regions of a given individual that goes beyond immunohistochemical observations. Our observations pave the way for future subclassification of MSA, which exceeds conventional clinical and neuropathological phenotyping and considers the structural and biochemical heterogeneity of α-synuclein present. Finally, our methods provide an experimental framework for the development of vitally needed, rapid and sensitive diagnostic assays for MSA.

Sections du résumé

BACKGROUND
Multiple system atrophy (MSA) is a neurodegenerative condition characterized by variable combinations of parkinsonism, autonomic failure, cerebellar ataxia and pyramidal features. Although the distribution of synucleinopathy correlates with the predominant clinical features, the burden of pathology does not fully explain observed differences in clinical presentation and rate of disease progression. We hypothesized that the clinical heterogeneity in MSA is a consequence of variability in the seeding activity of α-synuclein both between different patients and between different brain regions.
METHODS
The reliable detection of α-synuclein seeding activity derived from MSA using cell-free amplification assays remains challenging. Therefore, we conducted a systematic evaluation of 168 different reaction buffers, using an array of pH and salts, seeded with fully characterized brain homogenates from one MSA and one PD patient. We then validated the two conditions that conferred the optimal ability to discriminate between PD- and MSA-derived samples in a larger cohort of 40 neuropathologically confirmed cases, including 15 MSA. Finally, in a subset of brains, we conducted the first multi-region analysis of seeding behaviour in MSA.
RESULTS
Using our novel buffer conditions, we show that the physicochemical factors that govern the in vitro amplification of α-synuclein can be tailored to generate strain-specific reaction buffers that can be used to reliably study the seeding capacity from MSA-derived α-synuclein. Using this novel approach, we were able to sub-categorize the 15 MSA brains into 3 groups: high, intermediate and low seeders. To further demonstrate heterogeneity in α-synuclein seeding in MSA, we conducted a comprehensive multi-regional evaluation of α-synuclein seeding in 13 different regions from 2 high seeders, 2 intermediate seeders and 2 low seeders.
CONCLUSIONS
We have identified unexpected differences in seed-competent α-synuclein across a cohort of neuropathologically comparable MSA brains. Furthermore, our work has revealed a substantial heterogeneity in seeding activity, driven by the PBS-soluble α-synuclein, between different brain regions of a given individual that goes beyond immunohistochemical observations. Our observations pave the way for future subclassification of MSA, which exceeds conventional clinical and neuropathological phenotyping and considers the structural and biochemical heterogeneity of α-synuclein present. Finally, our methods provide an experimental framework for the development of vitally needed, rapid and sensitive diagnostic assays for MSA.

Identifiants

pubmed: 35125105
doi: 10.1186/s40035-022-00283-4
pii: 10.1186/s40035-022-00283-4
pmc: PMC8819887
doi:

Substances chimiques

alpha-Synuclein 0

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

7

Informations de copyright

© 2022. The Author(s).

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Auteurs

Ivan Martinez-Valbuena (I)

Tanz Centre for Research in Neurodegenerative Diseases, University of Toronto, Toronto, ON, Canada.

Naomi P Visanji (NP)

Edmond J. Safra Program in PD and the Morton and Gloria Shulman Movement Disorders Clinic, Toronto Western Hospital, Toronto, ON, Canada.
Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON, Canada.
Krembil Brain Institute, University Health Network, Toronto, ON, Canada.

Ain Kim (A)

Tanz Centre for Research in Neurodegenerative Diseases, University of Toronto, Toronto, ON, Canada.

Heather H C Lau (HHC)

Tanz Centre for Research in Neurodegenerative Diseases, University of Toronto, Toronto, ON, Canada.
Department of Biochemistry, University of Toronto, Toronto, ON, Canada.

Raphaella W L So (RWL)

Tanz Centre for Research in Neurodegenerative Diseases, University of Toronto, Toronto, ON, Canada.
Department of Biochemistry, University of Toronto, Toronto, ON, Canada.

Sohaila Alshimemeri (S)

Edmond J. Safra Program in PD and the Morton and Gloria Shulman Movement Disorders Clinic, Toronto Western Hospital, Toronto, ON, Canada.
Division of Neurology, Department of Medicine, King Saud University, Riyadh, Saudi Arabia.

Andrew Gao (A)

Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON, Canada.
Laboratory Medicine Program, University Health Network, Toronto, ON, Canada.

Michael A Seidman (MA)

Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON, Canada.
Laboratory Medicine Program, University Health Network, Toronto, ON, Canada.

Maria R Luquin (MR)

Department of Neurology, Clinica Universidad de Navarra, Pamplona, Navarra, Spain.

Joel C Watts (JC)

Tanz Centre for Research in Neurodegenerative Diseases, University of Toronto, Toronto, ON, Canada.
Department of Biochemistry, University of Toronto, Toronto, ON, Canada.

Anthony E Lang (AE)

Tanz Centre for Research in Neurodegenerative Diseases, University of Toronto, Toronto, ON, Canada.
Edmond J. Safra Program in PD and the Morton and Gloria Shulman Movement Disorders Clinic, Toronto Western Hospital, Toronto, ON, Canada.
Krembil Brain Institute, University Health Network, Toronto, ON, Canada.

Gabor G Kovacs (GG)

Tanz Centre for Research in Neurodegenerative Diseases, University of Toronto, Toronto, ON, Canada. gabor.kovacs@uhnresearch.ca.
Edmond J. Safra Program in PD and the Morton and Gloria Shulman Movement Disorders Clinic, Toronto Western Hospital, Toronto, ON, Canada. gabor.kovacs@uhnresearch.ca.
Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON, Canada. gabor.kovacs@uhnresearch.ca.
Krembil Brain Institute, University Health Network, Toronto, ON, Canada. gabor.kovacs@uhnresearch.ca.
Laboratory Medicine Program, University Health Network, Toronto, ON, Canada. gabor.kovacs@uhnresearch.ca.

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