Journal of Pediatric Neurology 2023; 21(05): 371-376
DOI: 10.1055/s-0042-1749669
Case Report

Childhood-Onset Neurodegeneration with Cerebellar Atrophy Syndrome: Severe Neuronal Degeneration and Cardiomyopathy with Loss of Tubulin Deglutamylase Cytosolic Carboxypeptidase 1

Bahadir M. Samur*
1   Department of Pediatrics, Faculty of Medicine, Erciyes University, Kayseri, Turkey
,
Gulhan A. Ercan-Sencicek*
2   Masonic Medical Research Institute, Utica, New York, United States
3   Department of Neurosurgery, Program on Neurogenetics, Yale University School of Medicine, New Haven, Connecticut, United States
,
Hakan Gumus
4   Division of Pediatric Neurology, Department of Pediatrics, Faculty of Medicine, Erciyes University, Kayseri, Turkey
,
Gulsum Gumus
5   Division of Pediatric Radiology, Faculty of Medicine, Department of Pediatrics, Erciyes University, Kayseri, Turkey
,
Ali Baykan
6   Division of Pediatric Cardiology, Faculty of Medicine, Department of Pediatrics, Erciyes University, Kayseri, Turkey
,
Ahmet Okay Caglayan*
3   Department of Neurosurgery, Program on Neurogenetics, Yale University School of Medicine, New Haven, Connecticut, United States
7   Department of Neurosurgery, Yale School of Medicine, Connecticut, United States
8   Department of Medical Genetics, School of Medicine, Dokuz Eylul University, Turkey
,
Huseyin Per*
4   Division of Pediatric Neurology, Department of Pediatrics, Faculty of Medicine, Erciyes University, Kayseri, Turkey
› Author Affiliations

Abstract

The cytoskeleton is a dynamic filamentous network with various cellular and developmental functions. The loss of cytosolic carboxypeptidase 1 (CCP1) causes neuronal death. Childhood-onset neurodegeneration with cerebellar atrophy (CONDCA, OMIM no.: 618276) is an extremely rare disease caused by ATP/GTP binding protein 1 (AGTPBP1) gene-related CCP1 dysfunction of microtubules affecting the cerebellum, spinal motor neurons, and peripheral nerves. Also, possible problems are expected in tissues where the cytoskeleton plays a dynamic role, such as cardiomyocytes. In the present study, we report a novel homozygous missense (NM_015239: c.2447A > C, p. Gln816Pro) variant in the AGTPBP1 gene that c.2447A > C variant has never been reported in a homozygous state in the Genome Aggregation (gnomAD; v2.1.1) database, identified by whole-exome sequencing in a patient with a seizure, dystonia, dilated cardiomyopathy (DCM), and accompanying atrophy of caudate nuclei, putamen, and cerebellum. Unlike other cases in the literature, we expand the phenotype associated with AGTPBP1 variants to include dysmorphic features, idiopathic DCM which could be reversed with supportive treatments, seizure patterns, and radiological findings. These findings expanded the spectrum of the AGTPBP1 gene mutations and associated possible manifestations. Our study may help establish appropriate genetic counseling and prenatal diagnosis for undiagnosed neurodegenerative patients.

Ethical Approval

This study was approved by the Erciyes University, Department of Pediatrics Academic Committee, 2019.


* These authors contributed equally.




Publication History

Received: 31 January 2022

Accepted: 15 April 2022

Article published online:
16 August 2022

© 2022. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 
  • References

  • 1 Mishra-Gorur K, Çağlayan AO, Schaffer AE. et al. Mutations in KATNB1 cause complex cerebral malformations by disrupting asymmetrically dividing neural progenitors. Neuron 2015; 85 (01) 228
  • 2 Richards S, Aziz N, Bale S. et al. ACMG Laboratory Quality Assurance Committee. Standards and guidelines for the interpretation of sequence variants: a joint consensus recommendation of the American College of Medical Genetics and Genomics and the Association for Molecular Pathology. Genet Med 2015; 17 (05) 405-424
  • 3 Tanco S, Tort O, Demol H. et al. C-terminomics screen for natural substrates of cytosolic carboxypeptidase 1 reveals processing of acidic protein C termini. Mol Cell Proteomics 2015; 14 (01) 177-190
  • 4 Magiera MM, Singh P, Gadadhar S, Janke C. Tubulin posttranslational modifications and emerging links to human disease. Cell 2018; 173 (06) 1323-1327
  • 5 Liu G, Dwyer T. Microtubule dynamics in axon guidance. Neurosci Bull 2014; 30 (04) 569-583
  • 6 Shashi V, Magiera MM, Klein D. et al; Undiagnosed Diseases Network. Loss of tubulin deglutamylase CCP1 causes infantile-onset neurodegeneration. EMBO J 2018; 37 (23) e100540
  • 7 Rogowski K, van Dijk J, Magiera MM. et al. A family of protein-deglutamylating enzymes associated with neurodegeneration. Cell 2010; 143 (04) 564-578
  • 8 Baltanás FC, Berciano MT, Santos E, Lafarga M. The childhood-onset neurodegeneration with cerebellar atrophy (CONDCA) disease caused by AGTPBP1 gene mutations: the Purkinje cell degeneration mouse as an animal model for the study of this human disease. Biomedicines 2021; 9 (09) 1157
  • 9 Zhao X, Onteru SK, Dittmer KE. et al. A missense mutation in AGTPBP1 was identified in sheep with a lower motor neuron disease. Heredity 2012; 109 (03) 156-162
  • 10 Karakaya M, Paketci C, Altmueller J. et al. Biallelic variant in AGTPBP1 causes infantile lower motor neuron degeneration and cerebellar atrophy. Am J Med Genet A 2019; 179 (08) 1580-1584
  • 11 Halvardson J, Zhao JJ, Zaghlool A. et al. Mutations in HECW2 are associated with intellectual disability and epilepsy. J Med Genet 2016; 53 (10) 697-704
  • 12 Orenstein N, Weiss K, Oprescu SN. et al. Bi-allelic IARS mutations in a child with intra-uterine growth retardation, neonatal cholestasis, and mild developmental delay. Clin Genet 2017; 91 (06) 913-917
  • 13 Shao J, Fu Z, Ji Y. et al. Leucine zipper-EF-hand containing transmembrane protein 1 (LETM1) forms a Ca2+/H+ antiporter. Sci Rep 2016; 6 (01) 34174
  • 14 Akhmanova A, Hoogenraad CC. More is not always better: hyperglutamylation leads to neurodegeneration. EMBO J 2018; 37 (23) e101023
  • 15 Magiera MM, Bodakuntla S, Žiak J. et al. Excessive tubulin polyglutamylation causes neurodegeneration and perturbs neuronal transport. EMBO J 2018; 37 (23) e100440
  • 16 Türay S, Eröz R, Başak AN. A novel pathogenic variant in the 3ʹ end of the AGTPBP1 gene gives rise to neurodegeneration without cerebellar atrophy: an expansion of the disease phenotype?. Neurogenetics 2021; 22 (02) 127-132
  • 17 Gilmore-Hall S, Kuo J, Ward JM. et al. CCP1 promotes mitochondrial fusion and motility to prevent Purkinje cell neuron loss in pcd mice. J Cell Biol 2019; 218 (01) 206-219
  • 18 Sheffer R, Gur M, Brooks R. et al. Biallelic variants in AGTPBP1, involved in tubulin deglutamylation, are associated with cerebellar degeneration and motor neuropathy. Eur J Hum Genet 2019; 27 (09) 1419-1426
  • 19 Janmey PA, Miller RT. Mechanisms of mechanical signaling in development and disease. J Cell Sci 2011; 124 (Pt 1): 9-18
  • 20 Lyon AR, MacLeod KT, Zhang Y. et al. Loss of T-tubules and other changes to surface topography in ventricular myocytes from failing human and rat heart. Proc Natl Acad Sci U S A 2009; 106 (16) 6854-6859
  • 21 Kuznetsov AV, Javadov S, Guzun R, Grimm M, Saks V. Cytoskeleton and regulation of mitochondrial function: the role of beta-tubulin II. Front Physiol 2013; 4: 82
  • 22 Watson PA, Hannan R, Carl LL, Giger KE. Contractile activity and passive stretch regulate tubulin mRNA and protein content in cardiac myocytes. Am J Physiol 1996; 271 (2, pt. 1): C684-C689
  • 23 Yutao X, Geru W, Xiaojun B, Tao G, Aiqun M. Mechanical stretch-induced hypertrophy of neonatal rat ventricular myocytes is mediated by β(1)-integrin-microtubule signaling pathways. Eur J Heart Fail 2006; 8 (01) 16-22