Clinical and Pathological Characteristics of Patients with Leucine-Rich Repeat Kinase-2 Mutations

Department of Pharmacology, University of Pennsylvania, Philadelphia, Pennsylvania 19104-6084, USA.
Movement Disorders (Impact Factor: 5.63). 12/2008; 24(1):32-9. DOI: 10.1002/mds.22096
Source: PubMed

ABSTRACT Mutations in LRRK2 are the single most common known cause of Parkinson's disease (PD). Two new PD patients with LRRK2 mutation were identified from a cohort with extensive postmortem assessment. One of these patients harbors the R793M mutation and presented with the typical clinical and pathological features of PD. A novel L1165P mutation was identified in a second patient. This patient had the classical and pathological features of PD, but additionally developed severe neuropsychological symptoms and dementia associated with abundant neurofibrillary tangles in the hippocampal formation; features consistent with a secondary diagnosis of tangle-predominant dementia. alpha-Synuclein-containing pathological inclusions in these patients also were highly phosphorylated at Ser-129, similar to other patients with idiopathic PD. These two PD patients also were characterized by the presence of occasional cytoplasmic TDP-43 inclusions in the temporal cortex, a finding that was not observed in three other patients with the G2019S mutation in LRRK2. These findings extend the clinical and pathological features that may be associated with LRRK2 mutations.

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    ABSTRACT: Introduction¿-Synuclein (¿-syn) is a key protein in Parkinson¿s disease (PD), and one of its phosphorylated forms, pS129, is higher in PD patients than healthy controls. However, few studies have examined its levels in longitudinally collected cerebrospinal fluid (CSF) or in preclinical cases. In this study, CSF and clinical data were contributed by >300 subjects from three cohorts (the longitudinal DATATOP cohort, a large cross-sectional cohort, and a cohort of LRRK2 mutation carriers).ResultsConsistent with our previous observation that CSF pS129 positively correlated with Unified Parkinson¿s Disease Rating Scale (UPDRS) scores, CSF pS129 in the DATATOP cohort increased over approximately two years of disease progression (mean change 5.60 pg/ml, p¿=¿0.050). Intriguingly, in the DATATOP cohort, pS129 negatively correlated with UPDRS scores at the baseline (R¿=¿¿0.244, p¿=¿0.017), but not final point, suggesting that this association may depend on disease stage. Reanalysis of our previous cohort with stratification by PD stage, and addition of a cohort of LRRK2 mutation carriers with very early/preclinical PD, supported the idea that the relationship between CSF pS129 and disease severity over a wider range of PD stages might be represented with a U-shaped curve, in which lower pS129 levels correlated with worse clinical condition at early stages, but better condition at later stages.Conclusion The observation of a negative-to-positive transition of correlation of pS129 to disease severity as PD progresses could have profound impact on how pS129 is used as a biomarker clinically as well as in modeling PD experimentally.
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    ABSTRACT: Parkinson’s disease (PD) is a common neurodegenerative disorder whose symptoms are consistent with death of dopaminergic neurons in the substantia nigra of the brain. The pathogenesis of PD involves several factors, such as α-synuclein aggregation, oxidative stress, mitochondrial dysfunction, and activation of apoptosis, but the exact molecular mechanism of neurodegeneration remains obscure. PD is usually sporadic, while rare monogenic forms have been identified and described in the past 15 years. Familial Parkinson’s disease is most commonly associated with mutations of the leucine repeat-rich kinase 2 gene (LRRK2). The mechanism of the disease due to LRRK2 mutations is unknown. The signaling cascades regulated by LRRK2 are difficult to study because the physiological substrates of the enzyme are unidentified. The G2019S substitution has been found to be the most common LRRK2 mutation, facilitating a search for patients with LRRK2-associated PD in various populations. The review considers the effects of LRRK2 mutations on protein and, in particular, α-synuclein aggregation, cytoskeletal dynamics, the inflammatory response, and the induction of apoptosis as revealed in both in vitro experiments and studies in PD patients. Investigation of rare hereditary PD forms with known etiology provides for a better understanding of the mechanism of neurodegeneration in more common sporadic PD forms.
    Molecular Biology 01/2014; 48(1). DOI:10.1134/S0026893314010117 · 0.74 Impact Factor
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    ABSTRACT: Increasing evidence suggests that Parkinson's disease (PD)-linked Leucine-rich repeat kinase 2 (LRRK2) has a role in peripheral and brain-resident immune cells. Furthermore, dysregulation of the anti-inflammatory, neurotrophic protein progranulin (PGRN) has been demonstrated in several chronic neurodegenerative diseases. Here we show that PGRN levels are significantly reduced in conditioned medium of LRRK2(R1441G) mutant mouse fibroblasts, leukocytes, and microglia, whereas levels of proinflammatory factors, like interleukin-1β and keratinocyte-derived chemokine, were significantly increased. Decreased PGRN levels were also detected in supernatants of cultured human fibroblasts isolated from presymptomatic LRRK2(G2019S) mutation carriers, while mitochondrial function was unaffected. Furthermore, medium levels of matrix metalloprotease (MMP) 2 increased, whereas MMP 9 decreased in LRRK2(R1441G) mutant microglia. Increased proteolytic cleavage of the MMP substrates ICAM-5 and α-synuclein in synaptoneurosomes from LRRK2(R1441G) mutant mouse brain indicates increased net synaptic MMP activity. PGRN levels were decreased in the cerebrospinal fluid of presymptomatic LRRK2 mutant mice, whereas PGRN levels were increased in aged symptomatic mutant mice. Notably, PGRN levels were also increased in the cerebrospinal fluid of PD patients carrying LRRK2 mutations, but not in idiopathic PD patients and in healthy control donors. Our data suggest that proinflammatory activity of peripheral and brain-resident immune cells may particularly contribute to the early stages of Parkinson's disease caused by LRRK2 mutations. GLIA 2014
    Glia 07/2014; 62(7). DOI:10.1002/glia.22663 · 5.47 Impact Factor


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