Choline transporter mutations in severe congenital myasthenic syndrome disrupt transporter localization

Haicui Wang, Claire G. Salter, Osama Refai, Holly Hardy, Katy E.S. Barwick, Ugur Akpulat, Malin Kvarnung, Barry A. Chioza, Gaurav Harlalka, Fulya Taylan, Thomas Sejersen, Jane Wright, Holly H Zimmerman, Mert Karakaya, Burkhardt Stüve, Joachim Weis, Ulrike Schara, Mark A. Russell, Omar A. Abdul-Rahman, John Chilton & 4 others Randy D. Blakely, Emma L. Baple, Sebahattin Cirak, Andrew H. Crosby

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

The presynaptic, high-affinity choline transporter is a critical determinant of signalling by the neurotransmitter acetylcholine at both central and peripheral cholinergic synapses, including the neuromuscular junction. Here we describe an autosomal recessive presynaptic congenital myasthenic syndrome presenting with a broad clinical phenotype due to homozygous choline transporter missense mutations. The clinical phenotype ranges from the classical presentation of a congenital myasthenic syndrome in one patient (p.Pro210Leu), to severe neurodevelopmental delay with brain atrophy (p.Ser94Arg) and extend the clinical outcomes to a more severe spectrum with infantile lethality (p.Val112Glu). Cells transfected with mutant transporter construct revealed a virtually complete loss of transport activity that was paralleled by a reduction in transporter cell surface expression. Consistent with these findings, studies to determine the impact of gene mutations on the trafficking of the Caenorhabditis elegans choline transporter orthologue revealed deficits in transporter export to axons and nerve terminals. These findings contrast with our previous findings in autosomal dominant distal hereditary motor neuropathy of a dominant-negative frameshift mutation at the C-terminus of choline transporter that was associated with significantly reduced, but not completely abrogated choline transporter function. Together our findings define divergent neuropathological outcomes arising from different classes of choline transporter mutation with distinct disease processes and modes of inheritance. These findings underscore the essential role played by the choline transporter in sustaining acetylcholine neurotransmission at both central and neuromuscular synapses, with important implications for treatment and drug selection.

Original languageEnglish (US)
Pages (from-to)2838-2850
Number of pages13
JournalBrain
Volume140
Issue number11
DOIs
StatePublished - Nov 1 2017
Externally publishedYes

Fingerprint

Congenital Myasthenic Syndromes
Mutation
Synapses
Acetylcholine
Phenotype
Frameshift Mutation
Neuromuscular Junction
Caenorhabditis elegans
Presynaptic Terminals
Missense Mutation
choline transporter
Synaptic Transmission
Cholinergic Agents
Atrophy
Neurotransmitter Agents
Brain

Keywords

  • choline uptake
  • CHT
  • CHT trafficking
  • congenital myasthenic syndrome
  • SLC5A7

ASJC Scopus subject areas

  • Clinical Neurology

Cite this

Wang, H., Salter, C. G., Refai, O., Hardy, H., Barwick, K. E. S., Akpulat, U., ... Crosby, A. H. (2017). Choline transporter mutations in severe congenital myasthenic syndrome disrupt transporter localization. Brain, 140(11), 2838-2850. https://doi.org/10.1093/brain/awx249

Choline transporter mutations in severe congenital myasthenic syndrome disrupt transporter localization. / Wang, Haicui; Salter, Claire G.; Refai, Osama; Hardy, Holly; Barwick, Katy E.S.; Akpulat, Ugur; Kvarnung, Malin; Chioza, Barry A.; Harlalka, Gaurav; Taylan, Fulya; Sejersen, Thomas; Wright, Jane; Zimmerman, Holly H; Karakaya, Mert; Stüve, Burkhardt; Weis, Joachim; Schara, Ulrike; Russell, Mark A.; Abdul-Rahman, Omar A.; Chilton, John; Blakely, Randy D.; Baple, Emma L.; Cirak, Sebahattin; Crosby, Andrew H.

In: Brain, Vol. 140, No. 11, 01.11.2017, p. 2838-2850.

Research output: Contribution to journalArticle

Wang, H, Salter, CG, Refai, O, Hardy, H, Barwick, KES, Akpulat, U, Kvarnung, M, Chioza, BA, Harlalka, G, Taylan, F, Sejersen, T, Wright, J, Zimmerman, HH, Karakaya, M, Stüve, B, Weis, J, Schara, U, Russell, MA, Abdul-Rahman, OA, Chilton, J, Blakely, RD, Baple, EL, Cirak, S & Crosby, AH 2017, 'Choline transporter mutations in severe congenital myasthenic syndrome disrupt transporter localization', Brain, vol. 140, no. 11, pp. 2838-2850. https://doi.org/10.1093/brain/awx249
Wang H, Salter CG, Refai O, Hardy H, Barwick KES, Akpulat U et al. Choline transporter mutations in severe congenital myasthenic syndrome disrupt transporter localization. Brain. 2017 Nov 1;140(11):2838-2850. https://doi.org/10.1093/brain/awx249
Wang, Haicui ; Salter, Claire G. ; Refai, Osama ; Hardy, Holly ; Barwick, Katy E.S. ; Akpulat, Ugur ; Kvarnung, Malin ; Chioza, Barry A. ; Harlalka, Gaurav ; Taylan, Fulya ; Sejersen, Thomas ; Wright, Jane ; Zimmerman, Holly H ; Karakaya, Mert ; Stüve, Burkhardt ; Weis, Joachim ; Schara, Ulrike ; Russell, Mark A. ; Abdul-Rahman, Omar A. ; Chilton, John ; Blakely, Randy D. ; Baple, Emma L. ; Cirak, Sebahattin ; Crosby, Andrew H. / Choline transporter mutations in severe congenital myasthenic syndrome disrupt transporter localization. In: Brain. 2017 ; Vol. 140, No. 11. pp. 2838-2850.
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AU - Akpulat, Ugur

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AU - Taylan, Fulya

AU - Sejersen, Thomas

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AU - Zimmerman, Holly H

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AU - Stüve, Burkhardt

AU - Weis, Joachim

AU - Schara, Ulrike

AU - Russell, Mark A.

AU - Abdul-Rahman, Omar A.

AU - Chilton, John

AU - Blakely, Randy D.

AU - Baple, Emma L.

AU - Cirak, Sebahattin

AU - Crosby, Andrew H.

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