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From the Department of Pathology and Laboratory Medicine, Indiana University School of Medicine, Indianapolis, Indiana
| Abstract |
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| Introduction |
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Several questions raised by this finding are apparent. Is protein structure or its effect on protein function the immediate cause of neurodegeneration? In this autosomal dominant disease is neuroserpin protein coded by the normal allele involved in the disease process and present in the intraneuronal inclusions in conjunction with the mutant neuroserpin? Are there identifiable changes in the composition of the mutant neuroserpin, eg, glycosylation, that render the protein resistant to normal degradation or to extracellular transport?
To begin to address these questions we have isolated and biochemically characterized a mutant form of neuroserpin from a patient with intraneuronal protein deposits associated with myoclonic epilepsy and dementia that started at age 24 and resulted in death at age 43.
| Materials and Methods |
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The proband was a 43-year-old Caucasian male. His clinical and pathological details have been reported elsewhere.4 In brief, he started to have generalized seizures and thereafter myoclonus at the age of 24 years. His performance at work as an architectural drafter deteriorated and he had difficulties with memory, occasionally being unable to write even his own name. At the age of 27 years, seizures composed of myoclonic, complex partial, and tonic-clonic reappeared. Despite aggressive treatment with several pharmacological agents, his seizures were difficult to control and there were several episodes of status epilepticus. He could not continue to work after age 28. On neurological examination at age 29, he showed slow speech, vertical and horizontal nystagmus, dysarthria, and myoclonus in the extremities. At age 30, he was slow in mental processing and calculation. Symptoms of cognitive abnormality gradually worsened. Although his score on the Mini Mental State Examination at age 34 was 24 of 30 indicating mild cognitive impairment, that score at age 38 dropped to 10 of 30 with advanced dementia. As the disease progressed generalized seizures, myoclonus of the face and extremities, and dementia worsened and were intractable. At the age of 43 years he died from aspiration pneumonia. His mother and his living brother also expressed similar clinical symptoms. This family has lived in Indiana for several generations, and there is no known relation to two previously reported families with mutations in the neuroserpin gene.1-3
At postmortem examination, his brain weighed 980 g and showed
diffuse atrophy that was most evident at the level of the frontal
lobes. On microscopic examination, the most striking histological
finding was the presence of intraneuronal eosinophilic homogenous
bodies in the neuronal perikaryon and the neuropil in most gray matter
areas of the brain and spinal cord (Figure 1A)
. The diameter of these inclusions
ranged from 1.5 to 25 µm. When a major portion of the perikaryon was
occupied by one or more inclusions, the nucleus was eccentric and often
deformed. In addition to being strongly eosinophilic, these bodies were
positive to periodic acid-Schiff (PAS) staining. Neuronal loss was
moderate in the frontal, temporal, parietal, and occipital cortices and
mild in the hippocampus, amygdala, basal ganglia, and thalamus.
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-synuclein, neurofilament proteins, amyloid ß-protein, tubulin,
tau, and ubiquitin. By electron microscopy, the inclusions appeared to
be composed of a fine granular material. These were surrounded by an
irregularly shaped, electron lucent space that was limited by a unit
membrane, that was most likely the rough endoplasmic reticulum. Isolation of Inclusion Bodies
Cortical gray matter, 15 g, was homogenized in 120 ml of 250
mmol/L sucrose and 10 mmol/L ethylenediaminetetraacetic acid, buffered
to pH 7.4 with 10 mmol/L HEPES containing one tablet of protease
inhibitor cocktail (Boehringer Mannheim, Indianapolis, IN). The
homogenate was filtered through gauze and centrifuged at 1,000 x
g for 10 minutes. The supernatant was decanted and the
pellet resuspended in 30 ml of 0.5% N-lauroylsarcosine
(Sigma Chemical Co., St. Louis, MO) in homogenization medium. The
suspension was incubated at 37°C for 30 minutes and then centrifuged
again at 25,000 x g for 60 minutes. The pellet was
resuspended in 30 ml of 1% sarcosyl solution, incubated at 37°C for
30 minutes, and then centrifuged at 25,000 x g for 60
minutes. Verification that the inclusion bodies were not lost was
accomplished by visualization using light microscopy after hematoxylin
and eosin (H&E) staining of an air-dried sample of the pellet on a
glass slide followed by fixing for 1 minute in absolute ethanol before
staining (Figure 1B)
.
Chromatography
Isolated inclusions were solubilized in 5 ml of 6 mol/L guanidine HCl, 0.5 mol/L Tris, pH 8.2, containing 50 mg of dithiothreitol with stirring for 2 days, alkylated with 121 mg of iodoacetic acid, and then centrifuged at 25,000 x g for 60 minutes. The supernatant was applied to a Sepharose CL6B column (2.5 x 90 cm). Proteins were eluted with 4 mol/L guanidine HCl, 0.05 mol/L Tris, pH 8.2, and fractions were pooled according to OD280 nm, dialyzed against distilled water, and lyophilized.
Sodium Dodecyl Sulfate-Polyacrylamide Gel Electrophoresis (SDS-PAGE) Analysis
Protein samples were dissolved in 0.125 mol/L Tris-HCl, pH 6.8, buffer containing 4% SDS, 10% glycerol, and 5% 2-mercaptoethanol and boiled for 5 minutes. The samples were applied to a Bio-Rad (Hercules, CA) 4 to 20% gradient Readygel in Tris/glycine/SDS buffer, electrophoresed at 100 volts for 90 minutes, and the gel stained with 0.25% Coomassie brilliant blue solution.
Trypsin Digestion and Peptide Fractionation
Pool III from CL6B chromatography was digested with trypsin (2% by weight, N-tosyl-L-phenylalanine chloro-methyl ketone (TPCK)-treated; Worthington Biochemical Corp., Lakewood, NJ) in 0.1 mol/L ammonium bicarbonate at room temperature overnight and recovered by freezing and lyophilization. The digest was dissolved in 0.5 ml of 25% acetic acid, insoluble material removed by centrifugation, and fractionated on a Beckman Ultra-sphere ODS high-pressure liquid chromatography column (0.46 x 25 cm) (Beckman-Coulter, Inc., Fullerton, CA), equilibrated with 0.1% trifluoro acetic acid (TFA) in water, and eluted with a 0 to 60% acetonitrile gradient. Eluant was monitored by absorbance at 215 nm. Separated peaks were recovered by drying in a Savant Speed Vac Concentrator (Savant Instruments, Farmingdale, NY).
Amino Acid Sequence Analysis
Samples were analyzed by Edman degradation on an Applied Biosystems Model 473A Protein Sequencer using the manufacturers standard cycles (Applied Biosystems, Foster City, CA).
DNA Sequencing
DNA was obtained from the brain of the proband and analyzed by direct sequencing of exons 2 to 9 of neuroserpin.5 The same intronic primers based on the human neuroserpin genomic sequence, reported by Davis and colleagues1 in 1999, were used for amplification and sequencing. Standard amplification reactions were done with 20 ng/µl of genomic DNA. The amplified products were gel-purified and then asymmetrically amplified to generate single-stranded template for sequencing. The reactions were subjected to QIAquick PCR purification spin columns (Qiagen, Valencia, CA) that remove remaining primers and deoxynucleotides.
Standard dideoxynucleotide sequencing was performed using the U.S. Biochemicals Sequenase kit, 35S-dATP (Amersham, Arlington Heights, IL) and modified T7 DNA polymerase (Sequenase Version 2.0, U.S. Biochemicals/Amersham). The reactions were loaded and run on a 6% polyacrylamide/8 mol/L urea sequencing gel. The gel was dried and exposed to X-ray film. Sequences were compared to that of normal controls and to the published neuroserpin coding sequence.
Genomic DNA was isolated from peripheral blood using phenol/chloroform. DNA samples from 100 unrelated patients were used as controls for RFLP analysis.
RFLP Analysis
In the absence of a spontaneous creation of an endonuclease restriction site by the A to C mutation, a PCR-induced mutation restriction analysis (IMRA) was performed.6 A mutation primer (NSz) corresponding to nucleotides 236 to 260 of the neuroserpin cDNA sequence with a G instead of A at the second position from the 3' end (5' ATCATTCCCATTGCAAGAGCAATGC 3') was used to create a restriction site for AviII (TGCGCA) only in the mutant gene PCR products.7 PCR was performed with NSz and NSE2F (5' GGACTCTTCTCTTTGCTG 3') primers in a total volume of 50 µl 10 x PCR buffer (100 mmol/L Tris-HCl, pH 8.3, 500 mmol/L KCl, 12 mmol/L MgCl2), 8 µl of 1.25 mmol/L dNTP, 15 pmol of each primer, 2.5 U Taq polymerase, and 100 ng DNA. Amplification was performed using a Perkin-Elmer Thermal Cycler (Perkin-Elmer, Emeryville, CA) for 30 cycles consisting of denaturation at 95°C for 30 seconds, annealing at 60°C for 1 minute, and extension at 72°C for 30 seconds. After purification of the products by the QIAquick PCR purification kit, 12.5 µl of amplified DNA was added to 1 µl (5 U) of AviII and 1.5 µl of its specific buffer and incubated for 2 hours at 37°C. The samples were electrophoresed through 2% (w/v) Nusieve GTG agarose gel, stained with ethidium bromide, and photographed under UV light.
| Results |
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Neuroserpin inclusions were isolated from frozen cerebral cortex
by homogenization in a buffered sucrose solution and centrifugation.
The pellet was then treated with detergent to release the inclusions
that were isolated by high-speed centrifugation (Figure 1)
. The
inclusions were solubilized in 6 mol/L guanidine HCl in the presence of
dithiothreitol and proteins fractionated on a Sepharose CL6B column
(2.5 x 90 cm) (Figure 2)
. Only one
major retarded peak (pool III) was found. SDS-PAGE of the solubilized
inclusion preparation before fractionation revealed a major protein
band migrating at a molecular mass of
50 kd. This band was present
in pool III of the fractionated proteins (Figure 3)
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Amino terminal sequence analysis of pool III gave a major sequence
starting with position 20 of human neuroserpin (Figure 4)
. The first two residues could not be
unambiguously identified because of high background in the first few
cycles.
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70% of the mutant
neuroserpin in the inclusion bodies starts with residue 20 and 30%
with residue 19. No tryptic peptides were found that started with
residue 17 or 18. Several carboxyl terminal tryptic peptides starting
with residue 394 and ending with residues 405, 407, 409, and 410 were
found indicating that some C-terminal proteolysis of neuroserpin had
occurred. Three potential Asn glycosylation sites at residues 157, 321,
and 401 were predicted from the neuroserpin cDNA
sequence.7,8
No amino acid was found at these positions in
the tryptic peptides containing these three residues suggesting that
all three Asn are glycosylated. Also, peptides containing Asp instead
of Asn at residues 83, 95, 116, and 328, and Glu instead of Gln at
residue 260 were found indicating that some deamidation of Asn and Gln
had occurred. Only Asp was found at residues 83 and 116, whereas
residue 95 contained 87% Asp and 13% Asn, and residue 328 contained
70% Asn and 30% Asp. In addition to residues 92 to 100 peptides with
Asp or Asn at residue 95, a peptide yielding only residues 92 to 94 was
found (yield
20% that of residue 92 to 100 peptides). Also, an
N-terminal residue 20 to 34 peptide was found in a yield
10% that
of the residue 20 to 36 peptide. The fact that only four of 24 Asn and
one of 16 Gln in neuroserpin have undergone deamidation may indicate
these positions are in a tertiary structure especially susceptible to
deamidation. A common nonenzymatic mechanism of Asn deamidation is via
a cyclic imide formation that then hydrolyzes to Asp or
iso-Asp.9
The finding of tryptic peptides, that on Edman
sequence analysis stopped at the residue before Asn35 and Asn95 (Figure 4)
Several major nontrypsin-like cleavages in neuroserpin were found in
the tryptic digest of pool III (Figure 4)
. The most prominent involved
cleavages between adjacent Met residues and on the carboxyl side of
Met. Complete cleavage of the Met216-Met217 and Met253-Met254 peptide
bonds and
50% cleavage of the Met127-Met128 bond were found.
Significant cleavage of the Met254-Leu255 and Met 357-Ile 358 peptide
bonds were also observed, as well as cleavage after Asn at residues
149, 182, and 281. Proteolysis after Met is rare by trypsin, but can
occur with chymotrypsin. TPCK-treated trypsin was used to minimize
chymotryptic-like proteolysis. It is unlikely that these cleavages were
because of contaminating chymotrypsin in the trypsin preparation
because no usual chymotryptic-specific proteolysis after aromatic
residues (>40 in neuroserpin) was observed in the high-pressure liquid
chromatography separated digest. Possibly, the minor residue 20 to 34
sequence peptide could have resulted from a chymotrypsin-like cleavage
of Tyr34-Asn35, or it could be because of cyclization of Asn and
termination of Edman degradation as mentioned above. The data would
suggest that the rare Met-Met sequence and Met peptide bonds in
neuroserpin are unusually susceptible to trypsin cleavage.
Tryptic peptides from human
- and ß-tubulin, ß- and
-actin,
2', 3'-cyclic nucleotide-3'-phosphodiesterase, and creatine kinase B
chain were also present in the tryptic digest of pool III in
10% of
the molar amounts of neuroserpin. All are similar in molecular mass
(
40 kd to 50 kd) to neuroserpin and would elute from a molecular
sieve column close to neuroserpin. It is highly unlikely that these
proteins are part of the inclusion bodies, but rather contaminants from
the cytosol incompletely removed during isolation of the inclusion
bodies.
DNA Sequence
DNA sequence of neuroserpin exons 3 to 9 of the proband were as published for the normal human cDNA.7 Sequence of exon 2 revealed both adenine and cytosine at the first position of codon 52 of neuroserpin. This sequence indicates heterozygosity for both the normal serine (AGT) and variant arginine (CGT) at this position in the expressed protein.
RFLP analysis of the 167-bp PCR product from NSE2F and
NSz primers revealed that the propositus and his
affected sibling both had the AviII recognition site
associated with the adenine to cytosine mutation (Figure 5)
. Electrophoresis of the digested PCR
product gave a digestion band of 142 bp in addition to the normal
167-bp band indicating heterozygosity for the mutation. Nonaffected
individuals (100 unrelated patients) did not show any digestion of PCR
product.
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| Discussion |
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The PAS-positive reaction of the proband neuronal inclusions
distinguishes them from Pick bodies, Lewy bodies, and Hirano bodies
that are all PAS-negative (Table 1)
. The
morphological features and the PAS-positivity of the intraneuronal
inclusions of the proband are analogous to other types of PAS-positive
inclusions, including corpora amylacea, Lafora bodies, Bielschowsky
bodies, the inclusions of type IV glycogenosis, and the polyglucosan
bodies of adult polyglucosan body disease.14-20
However,
the proband neuronal inclusions differ from these PAS-positive
inclusions in structure and composition (Table 1)
. On electron
microscopic examination, the proband inclusions showed primarily
granular material with a limiting membrane, whereas the other
PAS-positive inclusions are composed of fine filaments without a
limiting membrane. Moreover, the proband inclusions were composed of a
variant neuroserpin as indicated by protein sequencing in this study,
and there was no evidence of polyglucosan deposition as seen in other
inclusions mentioned above.
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30% at Ala19. Analysis of the human
neuroserpin N-terminal sequence by von Heijnes probability matrix
indicates that whereas the Gly18-Ala19 peptide bond has less
probability than the Ala16-Thr17 and Ala19-Thr20 peptide bonds as
signal peptidase cleavage sites, it does have greater probability than
other peptide bonds in the region.22
This is supported by
the finding that a PCR product encoding for residues 1 to 410 of human
neuroserpin inserted into a baculovirus expression vector and expressed
in Sf9 insect cells yielded a purified recombinant neuroserpin protein
that had equal amounts beginning with Ala19 and Thr20.23
These results show that the signal peptidase in this system cleaves the
expressed normal neuroserpin after Gly18 and Ala19, similar to the
results in our characterization of the Ser52-Arg mutant neuroserpin. One distinguishing characteristic of the neuroserpin inclusions is that they contain carbohydrate as indicated by their positive staining with PAS reagent.4 Human, mouse, and rat neuroserpins have three potential carbohydrate attachment sites at Asn residues 157, 321, and 401.7,12,13 Chicken neuroserpin has only two sites, as Asp is at position 321 instead of Asn.11 All species have carbohydrate attached at least to one site because the size of the protein on SDS-PAGE analysis is greater than its molecular weight calculated from its amino acid sequence.2,11-13 Sequence analysis of the Ser52-Arg mutant neuroserpin is consistent with glycosylation of all three Asns. The tertiary structure model, based on the primary structure, positions each of these Asn residues on the surface of the molecule and, therefore, indicates that a carbohydrate moiety can be readily accommodated at all three sites.24
The neuroserpin inclusion bodies in the brain bear similarity to
inclusion bodies in the liver composed of
1-antitrypsin, another member of the serpin
superfamily. Although >70
1-antitrypsin
variants are known, only three are associated with liver
abnormalities.25
Like the neuroserpin mutants (Ser49Pro
and Ser52Arg), two
1-antitrypsins, Malton
(
Phe51) and Siiyama (Ser53Phe) have mutations in the shutter region
of the molecule.26,27
The third,
1-antitrypsin Z (Glu342Lys), involves loss of
a salt bridge.28-30
Although inclusion bodies from
homozygous variant
1-antitrypsin patients have
been characterized, we are not aware of any studies on inclusion bodies
from heterozygous patients investigating if only the variant protein is
present as we found with the neuroserpin inclusion bodies. Variant
1-antitrypsin isolated from plasma and liver
inclusion bodies has altered carbohydrate compared to the normal
protein with no sialic acid and high mannose
content.31-34
The incomplete carbohydrate maturation
results in its accumulation in the liver endoplasmic reticulum and
reduced secretion into the blood stream. Although mutant neuroserpin is
glycosylated, its carbohydrate structure is unknown. Elucidation and
comparison of the carbohydrate structures on mutant and normal
neuroserpin should provide insight on the role of glycosylation in
neuroserpin inclusion body formation.
These mutations in
1-antitrypsin and
presumably in neuroserpin result in two effects leading to
intracellular inclusion body formation. First, the mutation alters the
molecules structure sufficiently to impair carbohydrate maturation
that results in reduced secretion and increased intracellular
concentration. Second, the mutation alters the proteins structure or
stability to allow aggregation by the insertion of the reactive loop of
one mutant molecule into the ß-sheet of a second mutant molecule at
the increased intracellular concentration. This aggregation phenomenon
is common in the serpin superfamily as certain mutants of
antithrombin, C1-inhibitor, and
1-antichymotrypsin also form inclusion bodies
and/or multimers.35-37
The fact that individuals heterozygous for variant neuroserpins have normal central nervous system development suggests that function of the mutant protein is intact, the expression of one normal allele during fetal development is sufficient, or that neuroserpin is not essential for brain development. The finding of only mutant neuroserpin in the inclusions indicates that synthesis and processing of normal neuroserpin is unaltered. It has been postulated that neuroserpin is part of the protease and protease inhibitor complex that determines neuronal growth and synaptic plasticity processes that occur extracellularly.12,13 In the case of mutant neuroserpin, the protein accumulates within neurons of the cerebral cortex, brain stem nuclei, and dorsal root ganglia.2,4 The mutant protein is secreted past the ribosomal membrane with cleavage of the signal peptide, it is posttranscriptionally modified by glycosylation, but is not excreted. If the mutant does retain its function of serine protease inhibition, it is not transported to the location where this function is required. Intracellular accumulation of the abnormally aggregating protein is, therefore, the most likely cause of neuronal dysfunction.
| Acknowledgements |
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| Footnotes |
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Supported in part by the Public Health Service (grants AG10133, DK42111, and RR-00750), the Veteran Affairs Medical Research, the Marion E. Jacobson Fund, and the Machado Family Research Fund. M. Yazaki is a postdoctoral fellow from Shinshu University and is supported by Japanese Gift Foundation, Boshi-Aiiku-Kai. M. Takao is a postdoctoral fellow from Keio University and is supported by the Sasakawa Health Science Foundation.
Accepted for publication September 21, 2000.
| References |
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1-Antitrypsin deficiency. The Metabolic and Molecular Bases of Inherited Disease, Connective Tissues, ed 7, vol III, chap 138, part 18. Edited by CR Scriver, AL Beaudet, WS Sly, D Valle. New York, McGraw Hill, 1995, pp 41254158
1-antitrypsin-deficient variant with mutation on a predicted conserved residue of the serpin backbone. J Biol Chem 1991, 266:12627-12632
1-antitrypsin deficiency allele Mmalton. J Biol Chem 1989, 264:13938-13945
Lys in
1-antitrypsin PiZ. FEBS Lett 1976, 65:195-197[Medline]
1-antitrypsin. Nature 1982, 298:329-334[Medline]
-1-antitrypsin deficiency. Nature 1973, 243:410-411[Medline]
1-antitrypsin in the inclusion bodies from the liver in
1-antitrypsin deficiency. N Engl J Med 1975, 293:576-579[Abstract]
1-antitrypsin isolated from human liver. FEBS Lett 1984, 177:179-183[Medline]
Thr) results in nonsubstrate-like behavior and in polymerization of the molecule. J Biol Chem 1993, 268:18088-18094
1-antichymotrypsin deficiency in a heterozygote with liver and lung disease. J Hepatol 1993, 18:313-321[Medline]
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