한빛사논문
Zheng Yie Yap1,36, Stephanie Efthymiou2,36, Simone Seiffert3,36, Karen Vargas Parra1, Sukyeong Lee4, Alessia Nasca5, Reza Maroofian2, Isabelle Schrauwen6, Manuela Pendziwiat7, Sunhee Jung8, Elizabeth Bhoj9,10, Pasquale Striano11,12, Kshitij Mankad13, Barbara Vona14, Sanmati Cuddapah9,10, Anja Wagner15, Javeria Raza Alvi16, Elham Davoudi-Dehaghani17, Mohammad-Sadegh Fallah18, Srinitya Gannavarapu19, Costanza Lamperti5, Andrea Legati5, Bibi Nazia Murtaza20, Muhammad Shahid Nadeem21, Mujaddad Ur Rehman22, Kolsoum Saeidi23, Vincenzo Salpietro11,12, Sarah von Spiczak7,24, Abigail Sandoval1, Sirous Zeinali17, Massimo Zeviani25, Adi Reich26, SYNaPS Study Group2, University of Washington Center for Mendelian Genomics27, Cholsoon Jang8, Ingo Helbig7,28,29,30,31, Tahsin Stefan Barakat32, Daniele Ghezzi5,33, Suzanne M. Leal6,34, Yvonne Weber3,35, Henry Houlden2, Wan Hee Yoon1,*
1Aging and Metabolism Research Program, Oklahoma Medical Research Foundation, Oklahoma City, OK 73104, USA
2Department of Neuromuscular Disorders, UCL Queen Square Institute of Neurology, London WC1N 3BG, UK
3Department of Neurology and Epileptology, Hertie-Institute for Clinical Brain Research, University of Tübingen, Tübingen 72076, Germany
4Verna and Marrs McLean Department of Biochemistry and Molecular Biology, Baylor College of Medicine, Houston, TX 77030, USA
5Unit of Medical Genetics and Neurogenetics, Fondazione IRCCS Istituto Neurologico “Carlo Besta,” via Temolo 4, 20126 Milan, Italy
6Center for Statistical Genetics, Gertrude H. Sergievsky Center, and the Department of Neurology, Columbia University Medical Center, New York, NY 10032, USA
7Institute of Clinical Molecular Biology, Christian-Albrechts-University of Kiel, Kiel 24105, Germany
8Department of Biological Chemistry, University of California, Irvine, Irvine, CA 92697, USA
9Division of Human Genetics, Children’s Hospital of Philadelphia, Philadelphia, PA 19104, USA
10Department of Pediatrics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA 19104, USA
11Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, 16124 Genoa, Italy
12Pediatric Neurology and Muscular Diseases Unit, IRCCS, Istituto “Giannina Gaslini,” Genoa 16123, Italy
13Neuroradiology Unit, Great Ormond Street Hospital for Children, London WC1N3JH, UK
14Department of Otolaryngology-Head and Neck Surgery, Tübingen Hearing Research Center, Eberhard Karls University, 72076 Tübingen, Germany
15Department of Clinical Genetics, Erasmus University Medical Center, Erasmus MC Cancer Institute, 3000 Rotterdam, the Netherlands
16Department of Pediatric Neurology, Institute of Child Health, Children Hospital Lahore, Lahore 54600, Pakistan
17Department of Molecular Medicine, Biotechnology Research Center, Pasteur Institute of Iran, Tehran 1316943551, Iran
18Department of Medical Genetics, Kawsar Human Genetics Research Center, Tehran 15956-45513, Iran
19Department of Pathology and Laboratory Medicine, Western University, London, ON N6A 5C1, Canada
20Department of Zoology, Abbottabad University of Science and Technology, Abbottabad 22500, Pakistan
21Department of Biochemistry, King Abdulaziz University, Jeddah 21589, Saudi Arabia
22Department of Microbiology, Abbottabad University of Science and Technology, Abbottabad 22500, Pakistan
23Neuroscience Research Center, Institute of Neuropharmacology, Kerman University of Medical Sciences, Kerman 7616914115, Iran
24DRK-Northern German Epilepsy Centre for Children and Adolescents, 24223 Schwentinental-Raisdorf, Germany
25Department of Neurosciences, University of Padova, via Giustiniani 2, Padova 35128, Italy
26GeneDx, Gaithersburg, MD 20877, USA
27University of Washington, Seattle, WA 98195, USA
28Division of Neurology, Children’s Hospital of Philadelphia, Philadelphia, PA 19104, USA
29The Epilepsy NeuroGenetics Initiative, Children’s Hospital of Philadelphia, Philadelphia, PA 19104, USA
30Department of Biomedical and Health Informatics, Children’s Hospital of Philadelphia, Philadelphia, PA 19104, USA
31Department of Neurology, University of Pennsylvania, Perelman School of Medicine, Philadelphia, PA 19104, USA
32Department of Clinical Genetics, Erasmus University Medical Center, 3015 Rotterdam, the Netherlands
33Department of Pathophysiology and Transplantation, University of Milan, 20122 Milan, Italy
34Taub Institute for Alzheimer Disease and the Aging Brain, Columbia University Medical Center, New York, NY 10032, USA
35Department of Epileptology and Neurology, University of Aachen, Aachen 52074, Germany
36These authors contributed equally
*Corresponding author
Abstract
The 2-oxoglutarate dehydrogenase-like (OGDHL) protein is a rate-limiting enzyme in the Krebs cycle that plays a pivotal role in mitochondrial metabolism. OGDHL expression is restricted mainly to the brain in humans. Here, we report nine individuals from eight unrelated families carrying bi-allelic variants in OGDHL with a range of neurological and neurodevelopmental phenotypes including epilepsy, hearing loss, visual impairment, gait ataxia, microcephaly, and hypoplastic corpus callosum. The variants include three homozygous missense variants (p.Pro852Ala, p.Arg244Trp, and p.Arg299Gly), three compound heterozygous single-nucleotide variants (p.Arg673Gln/p.Val488Val, p.Phe734Ser/p.Ala327Val, and p.Trp220Cys/p.Asp491Val), one homozygous frameshift variant (p.Cys553Leufs∗16), and one homozygous stop-gain variant (p.Arg440Ter). To support the pathogenicity of the variants, we developed a novel CRISPR-Cas9-mediated tissue-specific knockout with cDNA rescue system for dOgdh, the Drosophila ortholog of human OGDHL. Pan-neuronal knockout of dOgdh led to developmental lethality as well as defects in Krebs cycle metabolism, which was fully rescued by expression of wild-type dOgdh. Studies using the Drosophila system indicate that p.Arg673Gln, p.Phe734Ser, and p.Arg299Gly are severe loss-of-function alleles, leading to developmental lethality, whereas p.Pro852Ala, p.Ala327Val, p.Trp220Cys, p.Asp491Val, and p.Arg244Trp are hypomorphic alleles, causing behavioral defects. Transcript analysis from fibroblasts obtained from the individual carrying the synonymous variant (c.1464T>C [p.Val488Val]) in family 2 showed that the synonymous variant affects splicing of exon 11 in OGDHL. Human neuronal cells with OGDHL knockout exhibited defects in mitochondrial respiration, indicating the essential role of OGDHL in mitochondrial metabolism in humans. Together, our data establish that the bi-allelic variants in OGDHL are pathogenic, leading to a Mendelian neurodevelopmental disease in humans.
Keywords : OGDHL, mitochondria, α-ketoglutarate, bi-allelic, developmental and epileptic encephalopathy, DEE, exome sequencing, Drosophila, CRISPR-Cas9 gene editing, neurodevelopmental disease
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