Skeletal muscle vulnerability in a child with Pitt-Hopkins syndrome.


Journal

Skeletal muscle
ISSN: 2044-5040
Titre abrégé: Skelet Muscle
Pays: England
ID NLM: 101561193

Informations de publication

Date de publication:
18 Jul 2024
Historique:
received: 14 12 2023
accepted: 29 06 2024
medline: 19 7 2024
pubmed: 19 7 2024
entrez: 18 7 2024
Statut: epublish

Résumé

TCF4 acts as a transcription factor that binds to the immunoglobulin enhancer Mu-E5/KE5 motif. Dominant variants in TCF4 are associated with the manifestation of Pitt-Hopkins syndrome, a rare disease characterized by severe mental retardation, certain features of facial dysmorphism and, in many cases, with abnormalities in respiratory rhythm (episodes of paroxysmal tachypnea and hyperventilation, followed by apnea and cyanosis). Frequently, patients also develop epilepsy, microcephaly, and postnatal short stature. Although TCF4 is expressed in skeletal muscle and TCF4 seems to play a role in myogenesis as demonstrated in mice, potential myopathological findings taking place upon the presence of dominant TCF4 variants are thus far not described in human skeletal muscle. To address the pathological effect of a novel deletion affecting exons 15 and 16 of TCF4 on skeletal muscle, histological and immunofluorescence studies were carried out on a quadriceps biopsy in addition to targeted transcript studies and global proteomic profiling. We report on muscle biopsy findings from a Pitt-Hopkins patient with a novel heterozygous deletion spanning exon 15 and 16 presenting with neuromuscular symptoms. Microscopic characterization of the muscle biopsy revealed moderate fiber type I predominance, imbalance in the proportion of fibroblasts co-expressing Vimentin and CD90, and indicate activation of the complement cascade in TCF4-mutant muscle. Protein dysregulations were unraveled by proteomic profiling. Transcript studies confirmed a mitochondrial vulnerability in muscle and confirmed reduced TCF4 expression. Our combined findings, for the first time, unveil myopathological changes as phenotypical association of Pitt-Hopkins syndrome and thus expand the current clinical knowledge of the disease as well as support data obtained on skeletal muscle of a mouse model.

Sections du résumé

BACKGROUND BACKGROUND
TCF4 acts as a transcription factor that binds to the immunoglobulin enhancer Mu-E5/KE5 motif. Dominant variants in TCF4 are associated with the manifestation of Pitt-Hopkins syndrome, a rare disease characterized by severe mental retardation, certain features of facial dysmorphism and, in many cases, with abnormalities in respiratory rhythm (episodes of paroxysmal tachypnea and hyperventilation, followed by apnea and cyanosis). Frequently, patients also develop epilepsy, microcephaly, and postnatal short stature. Although TCF4 is expressed in skeletal muscle and TCF4 seems to play a role in myogenesis as demonstrated in mice, potential myopathological findings taking place upon the presence of dominant TCF4 variants are thus far not described in human skeletal muscle.
METHOD METHODS
To address the pathological effect of a novel deletion affecting exons 15 and 16 of TCF4 on skeletal muscle, histological and immunofluorescence studies were carried out on a quadriceps biopsy in addition to targeted transcript studies and global proteomic profiling.
RESULTS RESULTS
We report on muscle biopsy findings from a Pitt-Hopkins patient with a novel heterozygous deletion spanning exon 15 and 16 presenting with neuromuscular symptoms. Microscopic characterization of the muscle biopsy revealed moderate fiber type I predominance, imbalance in the proportion of fibroblasts co-expressing Vimentin and CD90, and indicate activation of the complement cascade in TCF4-mutant muscle. Protein dysregulations were unraveled by proteomic profiling. Transcript studies confirmed a mitochondrial vulnerability in muscle and confirmed reduced TCF4 expression.
CONCLUSION CONCLUSIONS
Our combined findings, for the first time, unveil myopathological changes as phenotypical association of Pitt-Hopkins syndrome and thus expand the current clinical knowledge of the disease as well as support data obtained on skeletal muscle of a mouse model.

Identifiants

pubmed: 39026379
doi: 10.1186/s13395-024-00348-0
pii: 10.1186/s13395-024-00348-0
doi:

Substances chimiques

Transcription Factor 4 0
TCF4 protein, human 0

Types de publication

Journal Article Case Reports

Langues

eng

Sous-ensembles de citation

IM

Pagination

15

Informations de copyright

© 2024. The Author(s).

Références

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Auteurs

Celine Chiu (C)

Centre for Neuromuscular Disorders, Department of Pediatric Neurology, Centre for Translational Neuro- and Behavioral Sciences, University Hospital Essen, 45147, Essen, Germany.

Alma Küchler (A)

Center for Rare Diseases Essen, Institute for Human Genetics, University Hospital Essen, University Duisburg-Essen, 45147, Essen, Germany.

Christel Depienne (C)

Center for Rare Diseases Essen, Institute for Human Genetics, University Hospital Essen, University Duisburg-Essen, 45147, Essen, Germany.

Corinna Preuße (C)

Department of Neuropathology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität Zu Berlin, Charitéplatz 1, 10117, Berlin, Germany.
Department of Neuropediatrics, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität Zu Berlin, Berlin Institute of Health (BIH), Augustenburger Platz 1, 13353, Berlin, Germany.

Adela Della Marina (AD)

Centre for Neuromuscular Disorders, Department of Pediatric Neurology, Centre for Translational Neuro- and Behavioral Sciences, University Hospital Essen, 45147, Essen, Germany.

Andre Reis (A)

Institute for Human Genetics, University Hospital Erlangen, Friedrich-Alexander-University, 91054, Erlangen, Germany.

Frank J Kaiser (FJ)

Center for Rare Diseases Essen, Institute for Human Genetics, University Hospital Essen, University Duisburg-Essen, 45147, Essen, Germany.

Kay Nolte (K)

Department of Neuropathology, University Hospital Aachen, RWTH Aachen University, 52074, Aachen, Germany.

Andreas Hentschel (A)

Leibniz-Institute for Analytical Science -ISAS- E.V, 44127, Dortmund, Germany.

Ulrike Schara-Schmidt (U)

Centre for Neuromuscular Disorders, Department of Pediatric Neurology, Centre for Translational Neuro- and Behavioral Sciences, University Hospital Essen, 45147, Essen, Germany.

Heike Kölbel (H)

Centre for Neuromuscular Disorders, Department of Pediatric Neurology, Centre for Translational Neuro- and Behavioral Sciences, University Hospital Essen, 45147, Essen, Germany.

Andreas Roos (A)

Centre for Neuromuscular Disorders, Department of Pediatric Neurology, Centre for Translational Neuro- and Behavioral Sciences, University Hospital Essen, 45147, Essen, Germany. andreas.roos@uk-essen.de.
Children's Hospital of Eastern Ontario Research Institute, Ottawa, ON, K1H 5B2, Canada. andreas.roos@uk-essen.de.
Department of Neurology, Medical Faculty and University Hospital Düsseldorf, Heinrich Heine University, 40225, Düsseldorf, Germany. andreas.roos@uk-essen.de.

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