Cerebral arterial stenoses and stroke: novel features of Aicardi-Goutières syndrome caused by the Arg164X mutation in SAMHD1 are associated with altered cytokine expression
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Cerebral arterial stenoses and stroke: novel features of Aicardi-Goutières syndrome caused by the Arg164X mutation in SAMHD1 are associated with altered cytokine expression. / Thiele, Holger; du Moulin, Marcel; Barczyk, Katarzyna; George, Christel; Schwindt, Wolfram; Nürnberg, Gudrun; Frosch, Michael; Kurlemann, Gerhard; Roth, Johannes; Nürnberg, Peter; Rutsch, Frank.
In: HUM MUTAT, Vol. 31, No. 11, 11.2010, p. E1836-50.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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T1 - Cerebral arterial stenoses and stroke: novel features of Aicardi-Goutières syndrome caused by the Arg164X mutation in SAMHD1 are associated with altered cytokine expression
AU - Thiele, Holger
AU - du Moulin, Marcel
AU - Barczyk, Katarzyna
AU - George, Christel
AU - Schwindt, Wolfram
AU - Nürnberg, Gudrun
AU - Frosch, Michael
AU - Kurlemann, Gerhard
AU - Roth, Johannes
AU - Nürnberg, Peter
AU - Rutsch, Frank
N1 - ©2010 Wiley-Liss, Inc.
PY - 2010/11
Y1 - 2010/11
N2 - Aicardi-Goutières syndrome (AGS) is a rare inborn multisystemic disease, resembling intrauterine viral infection and resulting in psychomotor retardation, spasticity and chilblain-likeskin lesions. Diagnostic criteria include intracerebral calcifications and elevated interferon-alpha and pterin levels in cerebrospinal fluid (CSF). We report on four adult siblings with unknown neurodegenerative disease presenting with cerebrovascular stenoses, stroke and glaucoma in childhood, two of whom died at the age of 40 and 29 years. Genome-wide homozygosity mapping identified 170 candidate genes embedded in a common haplotype of 8Mb on chromosome 20q11-13. Next generation sequencing of the entire region identified the c.490C>T (p.Arg164X) mutationin SAMHD1, a gene most recently described in AGS, on both alleles in all affected siblings.Clinical diagnosis of AGS was then confirmed by demonstrating intracerebral calcifications on cranial computed tomography in all siblings and elevated pterin levels in CSF in three of them. Inpatient fibroblasts, lack of SAMHD1 protein expression was associated with increased basal expression of IL8, while stimulated expression of IFNB1 was reduced. We conclude that cerebrovascular stenoses and stroke associated with the Arg164X mutation in SAMHD1 extend the phenotypic spectrum of AGS. The observed vascular changes most likely reflect a vasculitis caused by dysregulated inflammatory stress response.
AB - Aicardi-Goutières syndrome (AGS) is a rare inborn multisystemic disease, resembling intrauterine viral infection and resulting in psychomotor retardation, spasticity and chilblain-likeskin lesions. Diagnostic criteria include intracerebral calcifications and elevated interferon-alpha and pterin levels in cerebrospinal fluid (CSF). We report on four adult siblings with unknown neurodegenerative disease presenting with cerebrovascular stenoses, stroke and glaucoma in childhood, two of whom died at the age of 40 and 29 years. Genome-wide homozygosity mapping identified 170 candidate genes embedded in a common haplotype of 8Mb on chromosome 20q11-13. Next generation sequencing of the entire region identified the c.490C>T (p.Arg164X) mutationin SAMHD1, a gene most recently described in AGS, on both alleles in all affected siblings.Clinical diagnosis of AGS was then confirmed by demonstrating intracerebral calcifications on cranial computed tomography in all siblings and elevated pterin levels in CSF in three of them. Inpatient fibroblasts, lack of SAMHD1 protein expression was associated with increased basal expression of IL8, while stimulated expression of IFNB1 was reduced. We conclude that cerebrovascular stenoses and stroke associated with the Arg164X mutation in SAMHD1 extend the phenotypic spectrum of AGS. The observed vascular changes most likely reflect a vasculitis caused by dysregulated inflammatory stress response.
KW - Adult
KW - Autoimmune Diseases of the Nervous System
KW - Base Sequence
KW - Cerebral Arterial Diseases
KW - Codon, Nonsense
KW - Consanguinity
KW - Constriction, Pathologic
KW - Cytokines
KW - DNA Mutational Analysis
KW - DNA Primers
KW - Female
KW - Gene Expression
KW - Haplotypes
KW - Homozygote
KW - Humans
KW - Male
KW - Monomeric GTP-Binding Proteins
KW - Nervous System Malformations
KW - Pedigree
KW - Siblings
KW - Stroke
KW - Young Adult
KW - Case Reports
KW - Journal Article
KW - Research Support, Non-U.S. Gov't
U2 - 10.1002/humu.21357
DO - 10.1002/humu.21357
M3 - SCORING: Journal article
C2 - 20842748
VL - 31
SP - E1836-50
JO - HUM MUTAT
JF - HUM MUTAT
SN - 1059-7794
IS - 11
ER -