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(American Journal of Pathology. 2000;157:361-368.)
© 2000 American Society for Investigative Pathology


Short Communications

Neurodegeneration with Brain Iron Accumulation, Type 1 Is Characterized by {alpha}-, ß-, and {gamma}-Synuclein Neuropathology

James E. Galvin*{dagger}, Benoit Giasson{dagger}, Howard I. Hurtig{ddagger}, Virginia M.-Y. Lee{dagger} and John Q. Trojanowski{dagger}

From the Department of Neurology,*
Medical College of Pennsylvania Hahnemann University; the Department of Pathology and Laboratory Medicine,{dagger}
the Center for Neurodegenerative Disease Research, and the Department of Neurology,{ddagger}
the University of Pennsylvania, Philadelphia, Pennsylvania

Neurodegeneration with brain iron accumulation, type 1 (NBIA 1), or Hallervorden-Spatz syndrome, is a rare neurodegenerative disorder characterized clinically by Parkinsonism, cognitive impairment, pseudobulbar features, as well as cerebellar ataxia, and neuropathologically by neuronal loss, gliosis, and iron deposition in the globus pallidus, red nucleus, and substantia nigra. The hallmark pathological lesions of NBIA 1 are axonal spheroids, but Lewy body (LB)-like intraneuronal inclusions, glial inclusions, and rare neurofibrillary tangles also occur. Here we show that there is an accumulation of {alpha}-synuclein ({alpha}S) in LB-like inclusions, glial inclusions, and spheroids in the brains of three NBIA 1 patients. Further, ß-synuclein (ßS) and {gamma}-synuclein ({gamma}S) immunoreactivity was detected in spheroids but not in LB-like or glial inclusions. Western blot analysis demonstrated high-molecular weight {alpha}S aggregates in the high-salt-soluble and Triton X-100-insoluble/sodium dodecyl sulfate-soluble fraction of the NBIA 1 brain. Significantly, the levels of {alpha}S were markedly reduced in the Triton X-100-soluble fractions compared to control brain, and unlike other synucleinopathies, insoluble {alpha}S did not accumulate in the formic acid-soluble fraction. These findings expand the concept of neurodegenerative synucleinopathies by implicating {alpha}S, ßS, and {gamma}S in the pathogenesis of NBIA 1.





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