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Nikitina M.A.

Siberian State Medical University

Bragina E.Yu.

Research Institute of Medical Genetics of the Tomsk NRMC

Nazarenko M.S.

Siberian State Medical University;
Research Institute of Medical Genetics of the Tomsk NRMC

Alifirova V.M.

Siberian State Medical University

The role of alleles with an intermediate number of trinucleotide repeats in Parkinson’s disease and other neurodegenerative disorders

Authors:

Nikitina M.A., Bragina E.Yu., Nazarenko M.S., Alifirova V.M.

More about the authors

Read: 3325 times


To cite this article:

Nikitina MA, Bragina EYu, Nazarenko MS, Alifirova VM. The role of alleles with an intermediate number of trinucleotide repeats in Parkinson’s disease and other neurodegenerative disorders. S.S. Korsakov Journal of Neurology and Psychiatry. 2022;122(7):42‑50. (In Russ.)
https://doi.org/10.17116/jnevro202212207142

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References:

  1. Hannan AJ. Tandem Repeats and Repeatomes: Delving Deeper into the «Dark Matter» of Genomes. EBioMedicine. 2018;31:3-4.  https://doi.org/10.1016/j.ebiom.2018.04.004
  2. Hannan AJ. Tandem repeat polymorphisms: Mediators of genetic plasticity, modulators of biological diversity and dynamic sources of disease susceptibility. Adv Exp Med Biol. 2012;769:1-9. 
  3. Rodriguez CM, Todd PK. New pathologic mechanisms in nucleotide repeat expansion disorders. Neurobiol Dis. 2019;130:104515. https://doi.org/10.1016/j.nbd.2019.104515
  4. Paulson H. Repeat expansion diseases. Handb Clin Neurol. 2018;147:105-123.  https://doi.org/10.1016/B978-0-444-63233-3.00009-9
  5. Gardiner SL, Boogaard MW, Trompet S, et al. Prevalence of Carriers of Intermediate and Pathological Polyglutamine Disease-Associated Alleles Among Large Population-Based Cohorts. JAMA Neurol. 2019;76(6):650-656.  https://doi.org/10.1001/jamaneurol.2019.0423
  6. Bates GP, Dorsey R, Gusella JF, et al. Huntington disease. Nat Rev Dis Primers. 2015;1:15005. https://doi.org/10.1038/nrdp.2015.5
  7. Killoran A, Biglan KM, Jankovic J, et al. Characterization of the Huntington intermediate CAG repeat expansion phenotype in PHAROS. Neurology. 2013;80(22):2022-2027. https://doi.org/10.1212/WNL.0b013e318294b304
  8. Hogarth P. Huntington disease: How many repeats does it take? Neurology. 2013;80(22):e241-243.  https://doi.org/10.1212/WNL.0b013e3182984b31
  9. Menéndez-González M, Clarimón J, Rosas-Allende I, et al. HTT gene intermediate alleles in neurodegeneration: evidence for association with Alzheimer’s disease. Neurobiol Aging. 2019;76:215.e9-215.e14.  https://doi.org/10.1016/j.neurobiolaging.2018.11.014
  10. Rosas I, Martínez C, Clarimón J, et al. Role for ATXN1, ATXN2, and HTT intermediate repeats in frontotemporal dementia and Alzheimer’s disease. Neurobiol Aging. 2020;87:139.e1-139.e7.  https://doi.org/10.1016/j.neurobiolaging.2019.10.017
  11. Bessi V, Mazzeo S, Bagnoli S, et al. The Effect of CAG Repeats within the Non-Pathological Range in the HTT Gene on Cognitive Functions in Patients with Subjective Cognitive Decline and Mild Cognitive Impairment. Diagnostics (Basel). 2021;11(6):1051. https://doi.org/10.3390/diagnostics11061051
  12. Lee JK, Ding Y, Conrad AL, et al. Sex-specific effects of the Huntington gene on normal neurodevelopment. J Neurosci Res. 2017;95(1-2):398-408.  https://doi.org/10.1002/jnr.23980
  13. Mühlau M, Winkelmann J, Rujescu D, et al. Variation within the Huntington’s disease gene influences normal brain structure. PLoS One. 2012;7(1):e29809. https://doi.org/10.1371/journal.pone.0029809
  14. Bessi V, Mazzeo S, Bagnoli S, et al. The implication of BDNF Val66Met polymorphism in progression from subjective cognitive decline to mild cognitive impairment and Alzheimer’s disease: a 9-year follow-up study. Eur Arch Psychiatry Clin Neurosci. 2020;270(4):471-482.  https://doi.org/10.1007/s00406-019-01069-y
  15. Ong PA, Annisafitrie FR, Purnamasari N, et al. Dementia Prevalence, Comorbidities, and Lifestyle Among Jatinangor Elders. Front Neurol. 2021;12:643480. https://doi.org/10.3389/fneur.2021.643480
  16. Hannan AJ. Tandem repeats mediating genetic plasticity in health and disease. Nat Rev Genet. 2018;19(5):286-298.  https://doi.org/10.1038/nrg.2017.115
  17. Zabnenkova V, Schagina OA, Galeeva NM, et al. HTT Gene Premutation Allele Frequencies in the Russian Federation. Russ J Genet. 2018;54:732-739.  https://doi.org/10.1134/S1022795418060169
  18. Semaka AJ. Genetic counselling implications for intermediate allele predictive test results for Huntington disease (T). University of British Columbia. 2012. https://open.library.ubc.ca/collections/ubctheses/24/items/1.0071843
  19. Alvarez-Mora MI, Madrigal I, Martinez F, et al. Clinical implication of FMR1 intermediate alleles in a Spanish population. Clin Genet. 2018;94(1):153-158.  https://doi.org/10.1111/cge.13257
  20. Paulson HL, Shakkottai VG, Clark HB, Orr HT. Polyglutamine spinocerebellar ataxias — from genes to potential treatments. Nat Rev Neurosci. 2017;18(10):613-626.  https://doi.org/10.1038/nrn.2017.92
  21. Lattante S, Pomponi MG, Conte A, et al. ATXN1 intermediate-length polyglutamine expansions are associated with amyotrophic lateral sclerosis. Neurobiol Aging. 2018;64:157.e1-157.e5.  https://doi.org/10.1016/j.neurobiolaging.2017.11.011
  22. Van Damme P, Veldink JH, van Blitterswijk M, et al. Expanded ATXN2 CAG repeat size in ALS identifies genetic overlap between ALS and SCA2. Neurology. 2011;76(24):2066-2072. https://doi.org/10.1212/WNL.0b013e31821f445b
  23. Lee T, Li YR, Chesi A, et al. Evaluating the prevalence of polyglutamine repeat expansions in amyotrophic lateral sclerosis. Neurology. 2011;76(24):2062-2065. https://doi.org/10.1212/WNL.0b013e31821f4447
  24. Choubtum L, Witoonpanich P, Kulkantrakorn K, et al. Trinucleotide repeat expansion of TATA-binding protein gene associated with Parkinson’s disease: A Thai multicenter study. Parkinsonism Relat Disord. 2016;28:146-149.  https://doi.org/10.1016/j.parkreldis.2016.05.008
  25. Hammer MB, Singleton AB. Common Premutations in the General Population. JAMA Neurol. 2019;76(6):639-640.  https://doi.org/10.1001/jamaneurol.2019.0216
  26. Loesch DZ, Khaniani MS, Slater HR, Rubio JP, Bui QM, Kotschet K, D’Souza W, Venn A, Kalitsis P, Choo AK, Burgess T, Johnson L, Evans A, Horne M. Small CGG repeat expansion alleles of FMR1 gene are associated with parkinsonism. Clin Genet. 2009;76(5):471-476. Epub 2009 Sep 30. PMID: 19796183; PMCID: PMC2888465. https://doi.org/10.1111/j.1399-0004.2009.01275.x
  27. Kurz MW, Schlitter AM, Klenk Y, et al. FMR1 alleles in Parkinson’s disease: relation to cognitive decline and hallucinations, a longitudinal study. J Geriatr Psychiatry Neurol. 2007;20(2):89-92.  https://doi.org/10.1177/0891988706297737
  28. Loesch DZ, Tassone F, Mellick GD, Horne M, Rubio JP, Bui MQ, Francis D, Storey E. Evidence for the role of FMR1 gray zone alleles as a risk factor for parkinsonism in females. Mov Disord. 2018;33(7):1178-1181. PMID: 30153395; PMCID: PMC6116531. https://doi.org/10.1002/mds.27420
  29. Hall DA. In the Gray Zone in the Fragile X Gene: What are the Key Unanswered Clinical and Biological Questions? Tremor Other Hyperkinet Mov (N Y). 2014;4:208.  https://doi.org/10.7916/D8NG4NP3
  30. Clark LN, Ye X, Liu X, Louis ED. Genetic analysis of FMR1 repeat expansion in essential tremor. Neurosci Lett. 2015;593:114-117.  https://doi.org/10.1016/j.neulet.2015.03.027
  31. Morrison PJ, Benito-León J. Neurologic features in intermediate allele carriers of Huntington disease. Neurology. 2016;87(6):556-557.  https://doi.org/10.1212/WNL.0000000000002958
  32. van Hagen M, Piebes DGE, de Leeuw WC, et al. The dynamics of early-state transcriptional changes and aggregate formation in a Huntington’s disease cell model. BMC Genomics. 2017;18(1):373.  https://doi.org/10.1186/s12864-017-3745-z
  33. Marques Sousa C, Humbert S. Huntingtin: here, there, everywhere! J Huntingtons Dis. 2013;2(4):395-403.  https://doi.org/10.3233/JHD-130082
  34. Rigamonti D, Bauer JH, De-Fraja C, et al. Wild-type huntingtin protects from apoptosis upstream of caspase-3. J Neurosci. 2000;20(10):3705-3713. https://doi.org/10.1523/JNEUROSCI.20-10-03705.2000
  35. Schaefer MH, Wanker EE, Andrade-Navarro MA. Evolution and function of CAG/polyglutamine repeats in protein-protein interaction networks. Nucleic Acids Res. 2012;40(10):4273-4287. https://doi.org/10.1093/nar/gks011
  36. Sampedro F, Martinez-Horta S, Pérez-Pérez J, et al. Interaction between sex and neurofilament light chain on brain structure and clinical severity in Huntington’s disease. Ann Clin Transl Neurol. 2021;8(12):2309-2313. https://doi.org/10.1002/acn3.51460
  37. Riccardi C, Napolitano F, Montesarchio D, et al. Nanoparticle-Guided Brain Drug Delivery: Expanding the Therapeutic Approach to Neurodegenerative Diseases. Pharmaceutics. 2021;13(11):1897. https://doi.org/10.3390/pharmaceutics13111897
  38. Savitt D, Jankovic J. Clinical phenotype in carriers of intermediate alleles in the huntingtin gene. J Neurol Sci. 2019;402:57-61.  https://doi.org/10.1016/j.jns.2019.05.010
  39. Testa CM, Jankovic J. Huntington disease: A quarter century of progress since the gene discovery. J Neurol Sci. 2019;396:52-68.  https://doi.org/10.1016/j.jns.2018.09.022
  40. Downing NR, Lourens S, De Soriano I, et al.; PREDICT-HD Investigators and Coordinators of the Huntington Study Group. Phenotype Characterization of HD Intermediate Alleles in PREDICT-HD. J Huntingtons Dis. 2016;5(4):357-368.  https://doi.org/10.3233/JHD-160185
  41. Huntington Study Group PHAROS Investigators, Biglan KM, Shoulson I, Kieburtz K, et al. Clinical-Genetic Associations in the Prospective Huntington at Risk Observational Study (PHAROS): Implications for Clinical Trials. JAMA Neurol. 2016;73(1):102-10.. PMID: 26569098. https://doi.org/10.1001/jamaneurol.2015.2736
  42. Ha AD, Beck CA, Jankovic J. Intermediate CAG Repeats in Huntington’s Disease: Analysis of COHORT. Tremor Other Hyperkinet Mov (N Y). 2012;2:tre-02-64-287-4.  https://doi.org/10.7916/D8FF3R2P
  43. Leija-Salazar M, Piette C, Proukakis C. Review: Somatic mutations in neurodegeneration. Neuropathol Appl Neurobiol. 2018;44(3):267-285.  https://doi.org/10.1111/nan.12465
  44. Falush D, Almqvist EW, Brinkmann RR, et al. Measurement of mutational flow implies both a high new-mutation rate for Huntington disease and substantial underascertainment of late-onset cases. Am J Hum Genet. 2001;68(2):373-385.  https://doi.org/10.1086/318193
  45. Kay C, Collins JA, Wright GEB, et al. The molecular epidemiology of Huntington disease is related to intermediate allele frequency and haplotype in the general population. Am J Med Genet B Neuropsychiatr Genet. 2018;177(3):346-357.  https://doi.org/10.1002/ajmg.b.32618
  46. Semaka A, Balneaves LG, Hayden MR. «Grasping the grey»: patient understanding and interpretation of an intermediate allele predictive test result for Huntington disease. J Genet Couns. 2013;22(2):200-217.  https://doi.org/10.1007/s10897-012-9533-7
  47. Hendricks AE, Latourelle JC, Lunetta KL, et al. Estimating the probability of de novo HD cases from transmissions of expanded penetrant CAG alleles in the Huntington disease gene from male carriers of high normal alleles (27-35 CAG). Am J Med Genet A. 2009;149A(7):1375-1381. https://doi.org/10.1002/ajmg.a.32901
  48. Semaka A, Kay C, Doty C, et al. CAG size-specific risk estimates for intermediate allele repeat instability in Huntington disease. J Med Genet. 2013;50(10):696-703.  https://doi.org/10.1136/jmedgenet-2013-101796
  49. Telenius H, Kremer B, Goldberg YP, et al. Somatic and gonadal mosaicism of the Huntington disease gene CAG repeat in brain and sperm. Nat Genet. 1994;6(4):409-414.  https://doi.org/10.1038/ng0494-409
  50. Semaka A, Kay C, Belfroid RD, et al. A new mutation for Huntington disease following maternal transmission of an intermediate allele. Eur J Med Genet. 2015;58(1):28-30.  https://doi.org/10.1016/j.ejmg.2014.11.005
  51. MacLeod R, Tibben A, Frontali M, et al. Editorial Committee and Working Group ‘Genetic Testing Counselling’ of the European Huntington Disease Network. Recommendations for the predictive genetic test in Huntington’s disease. Clin Genet. 2013;83(3):221-231.  https://doi.org/10.1111/j.1399-0004.2012.01900.x
  52. Semaka A, Hayden MR. Evidence-based genetic counselling implications for Huntington disease intermediate allele predictive test results. Clin Genet. 2014;85(4):303-311.  https://doi.org/10.1111/cge.12324
  53. Squitieri F, Jankovic J. Huntington’s disease: how intermediate are intermediate repeat lengths? Mov Disord. 2012;27(14):1714-1717. https://doi.org/10.1002/mds.25172
  54. Bean L, Bayrak-Toydemir P; ACMG Laboratory Quality Assurance Committee. Addendum: American College of Medical Genetics and Genomics Standards and Guidelines for Clinical Genetics Laboratories, 2014 edition: technical standards and guidelines for Huntington disease. Genet Med. 2021;23(12):2461. https://doi.org/10.1038/s41436-020-0893-3
  55. Illarioshkin SN, Klyushnikov SA, Seliverstov YuA. Huntington’s disease. M.: Limited Liability Company «Publishing Enterprise «Atmosfera»; 2018. (In Russ.). https://doi.org/10.12731/978-5-902123-69-9
  56. Jankovic J, Ashizawa T. Tourettism associated with Huntington’s disease. Mov Disord. 1995;10(1):103-105.  https://doi.org/10.1002/mds.870100116
  57. Ng ASL, Tan E. Intermediate C9orf72 alleles in neurological disorders: does size really matter? Journal of Medical Genetics. 2017;54:591-597. 
  58. Migliore S, Jankovic J, Squitieri F. Genetic Counseling in Huntington’s Disease: Potential New Challenges on Horizon? Front Neurol. 2019;10:453.  https://doi.org/10.3389/fneur.2019.00453
  59. McKhann GM, Knopman DS, Chertkow H, et al. The diagnosis of dementia due to Alzheimer’s disease: recommendations from the National Institute on Aging-Alzheimer’s Association workgroups on diagnostic guidelines for Alzheimer’s disease. Alzheimers Dement. 2011;7(3):263-269.  https://doi.org/10.1016/j.jalz.2011.03.005
  60. Postuma RB, Berg D, Stern M, et al. MDS clinical diagnostic criteria for Parkinson’s disease. Mov Disord. 2015;30(12):1591-1601. https://doi.org/10.1002/mds.26424
  61. Semaka A, Warby S, Leavitt BR, Hayden MR. Re: Autopsy-proven Huntington’s disease with 29 trinucleotide repeats. Mov Disord. 2008;23(12):1794-1795; author reply 1793. https://doi.org/10.1002/mds.21820
  62. Davis MY, Keene CD, Jayadev S, Bird T. The co-occurrence of Alzheimer’s disease and Huntington’s disease: a neuropathological study of 15 elderly Huntington’s disease subjects. J Huntingtons Dis. 2014;3(2):209-217.  https://doi.org/10.3233/JHD-140111
  63. Bürger K, Mergner R, Arbusow V, et al. Chorea Huntington mit später Manifestation als Differenzialdiagnose der Alzheimer-Krankheit. Nervenarzt. 2002;73(9):870-873. German. https://doi.org/10.1007/s00115-002-1361-9
  64. Mulroy E, Latorre A, Menozzi E, et al. Huntington disease like 2 (HDL-2) with parkinsonism and abnormal DAT-SPECT — A novel observation. Parkinsonism Relat Disord. 2020;71:46-48.  https://doi.org/10.1016/j.parkreldis.2020.01.008
  65. Sun YM, Zhang YB, Wu ZY. Huntington’s Disease: Relationship Between Phenotype and Genotype. Mol Neurobiol. 2017;54(1):342-348.  https://doi.org/10.1007/s12035-015-9662-8
  66. Lee JK, Conrad A, Epping E, et al. Effect of Trinucleotide Repeats in the Huntington’s Gene on Intelligence. EBioMedicine. 2018;31:47-53.  https://doi.org/10.1016/j.ebiom.2018.03.031
  67. Gardiner SL, van Belzen MJ, Boogaard MW, et al. Huntingtin gene repeat size variations affect risk of lifetime depression. Transl Psychiatry. 2017;7(12):1277. PMID: 29225330; PMCID: PMC5802693. https://doi.org/10.1038/s41398-017-0042-1
  68. Gardiner SL, van Belzen MJ, Boogaard MW, et al. Large normal-range TBP and ATXN7 CAG repeat lengths are associated with increased lifetime risk of depression. Transl Psychiatry. 2017;7(6):e1143. Published 2017 Jun 6.  https://doi.org/10.1038/tp.2017.116
  69. Bogdanov RR, Borisova SYu, Kotov SV, Zavarzina OO. The personality profile of patients with early manifestations of Parkinson’s disease. Almanac of Clinical Medicine. 2016;44(3):329-335. (In Russ.). https://doi.org/10.18786/2072-0505-2016-44-3-329-335
  70. Dewan R, Chia R, Ding J, et al.; American Genome Center (TAGC); FALS Sequencing Consortium; Genomics England Research Consortium; International ALS/FTD Genomics Consortium (iAFGC); International FTD Genetics Consortium (IFGC); International LBD Genomics Consortium (iLBDGC); NYGC ALS Consortium; PROSPECT Consortium, Rowe JB, Benussi L, Binetti G, et al. Pathogenic Huntingtin Repeat Expansions in Patients with Frontotemporal Dementia and Amyotrophic Lateral Sclerosis. Neuron. 2021;109(3):448-460.e4.  https://doi.org/10.1016/j.neuron.2020.11.005
  71. Squitieri F, Esmaeilzadeh M, Ciarmiello A, Jankovic J. Caudate glucose hypometabolism in a subject carrying an unstable allele of intermediate CAG(33) repeat length in the Huntington’s disease gene. Mov Disord. 2011;26(5):925-927.  https://doi.org/10.1002/mds.23623
  72. Groen JL, de Bie RM, Foncke EM, et al. Late-onset Huntington disease with intermediate CAG repeats: true or false? J Neurol Neurosurg Psychiatry. 2010;81(2):228-230.  https://doi.org/10.1136/jnnp.2008.170902
  73. Nikitina MA, Bragina EYu, Nazarenko MS, et al. Atypical course of Parkinson’s disease with clinical manifestations of Huntington’s disease in a patient with an allele of 27 CAG repeats in the HTT gene. Bulletin of Siberian Medicine. 2020;19(4):235-240. (In Russ.). https://doi.org/10.20538/1682-0363-2020-4-235-240
  74. Cubo E, Ramos-Arroyo MA, Martinez-Horta S, et al.; European HD Network. Clinical manifestations of intermediate allele carriers in Huntington disease. Neurology. 2016;87(6):571-578.  https://doi.org/10.1212/WNL.0000000000002944
  75. Ha AD, Jankovic J. Exploring the correlates of intermediate CAG repeats in Huntington disease. Postgrad Med. 2011;123(5):116-121.  https://doi.org/10.3810/pgm.2011.09.2466
  76. Sequeiros J, Ramos EM, Cerqueira J, et al. Large normal and reduced penetrance alleles in Huntington disease: instability in families and frequency at the laboratory, at the clinic and in the population. Clin Genet. 2010;78(4):381-387.  https://doi.org/10.1111/j.1399-0004.2010.01388.x
  77. Stoker TB, Holden ST, Barker RA. Late-onset Huntington’s disease associated with CAG repeat lengths of 30 and 31. J Neurol. 2021;268(10):3916-3919. https://doi.org/10.1007/s00415-021-10633-3
  78. Jevtic SD, Provias JP. Case report and literature review of Huntington disease with intermediate CAG expansion. BMJ Neurol Open. 2020;2(1):e000027. https://doi.org/10.1136/bmjno-2019-000027
  79. Chintalaphani SR, Pineda SS, Deveson IW, Kumar KR. An update on the neurological short tandem repeat expansion disorders and the emergence of long-read sequencing diagnostics. Acta Neuropathologica Communications. 2021;9(1):45-49  https://doi.org/10.1186/s40478-021-01201-x
  80. Ng ASL, Tan E. Intermediate C9orf72 alleles in neurological disorders: does size really matter? Journal of Medical Genetics. 2017;54:591-597. 

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