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Browsing by Subject "Gain of function"
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Item The role of PTEN in human cancer(2015) Gendron, Jaimie Michelle; Mayo, Lindsey D.; Goebl, Mark G.; Harrington, Maureen A.; Naidu, SamisubbuPhosphatase and tensin homolog, PTEN, is a key tumor suppressor. Mutation of PTEN is associated with both sporadic cancers and a cluster of familial cancer predisposition syndromes called PTEN hamaratoma syndromes. These germline mutations span the length of the PTEN gene with a mutational hot spot localized in exon 5. This exon encodes the catalytic domain of PTEN, which is critical for its tumor suppressor activity. PTEN function is most commonly attributed to lipid phosphatase activity on Phosphatidylinositol (3,4,5)-trisphosphate (PIP3) that leads to inhibition of a cascade with downstream pro-survival effectors including Akt, but PTEN also has phosphatase activity on a small number of proteins. Recently, a mutation, G129E, has been described as a gain of function (GOF) mutation in PTEN knockin mice. This mutant only retains protein phosphatase activity while it completely lacks lipid phosphatase activity. Collectively (in the mouse and in vitro studies), there is no clear mechanism to explain the GOF nature of this mutant. Understanding how mutants of PTEN function in the cells to provide a growth advantage will provide insight into what pathway to therapeutically target. Our central hypothesis is that mutations of PTEN promote tumorigenesis through gain of function activities that result in cell cycle progression. We will determine the signaling pathways that are affected by the gain of function mutant PTEN G129E to better understand the mechanism by which mutants of PTEN confer a growth advantage.Item The gain of function SCN1A disorder spectrum: novel epilepsy phenotypes and therapeutic implications(Oxford University Press, 2022) Brunklaus, Andreas; Brünger, Tobias; Feng, Tony; Fons, Carmen; Lehikoinen, Anni; Panagiotakaki, Eleni; Vintan, Mihaela-Adela; Symonds, Joseph; Andrew, James; Arzimanoglou, Alexis; Delima, Sarah; Gallois, Julie; Hanrahan, Donncha; Lesca, Gaetan; MacLeod, Stewart; Marjanovic, Dragan; McTague, Amy; Nuñez-Enamorado, Noemi; Perez-Palma, Eduardo; Perry, M. Scott; Pysden, Karen; Russ-Hall, Sophie J.; Scheffer, Ingrid E.; Sully, Krystal; Syrbe, Steffen; Vaher, Ulvi; Velayutham, Murugan; Vogt, Julie; Weiss, Shelly; Wirrell, Elaine; Zuberi, Sameer M.; Lal, Dennis; Møller, Rikke S.; Mantegazza, Massimo; Cestèle, Sandrine; Neurology, School of MedicineBrain voltage-gated sodium channel NaV1.1 (SCN1A) loss-of-function variants cause the severe epilepsy Dravet syndrome, as well as milder phenotypes associated with genetic epilepsy with febrile seizures plus. Gain of function SCN1A variants are associated with familial hemiplegic migraine type 3. Novel SCN1A-related phenotypes have been described including early infantile developmental and epileptic encephalopathy with movement disorder, and more recently neonatal presentations with arthrogryposis. Here we describe the clinical, genetic and functional evaluation of affected individuals. Thirty-five patients were ascertained via an international collaborative network using a structured clinical questionnaire and from the literature. We performed whole-cell voltage-clamp electrophysiological recordings comparing sodium channels containing wild-type versus variant NaV1.1 subunits. Findings were related to Dravet syndrome and familial hemiplegic migraine type 3 variants. We identified three distinct clinical presentations differing by age at onset and presence of arthrogryposis and/or movement disorder. The most severely affected infants (n = 13) presented with congenital arthrogryposis, neonatal onset epilepsy in the first 3 days of life, tonic seizures and apnoeas, accompanied by a significant movement disorder and profound intellectual disability. Twenty-one patients presented later, between 2 weeks and 3 months of age, with a severe early infantile developmental and epileptic encephalopathy and a movement disorder. One patient presented after 3 months with developmental and epileptic encephalopathy only. Associated SCN1A variants cluster in regions of channel inactivation associated with gain of function, different to Dravet syndrome variants (odds ratio = 17.8; confidence interval = 5.4-69.3; P = 1.3 × 10-7). Functional studies of both epilepsy and familial hemiplegic migraine type 3 variants reveal alterations of gating properties in keeping with neuronal hyperexcitability. While epilepsy variants result in a moderate increase in action current amplitude consistent with mild gain of function, familial hemiplegic migraine type 3 variants induce a larger effect on gating properties, in particular the increase of persistent current, resulting in a large increase of action current amplitude, consistent with stronger gain of function. Clinically, 13 out of 16 (81%) gain of function variants were associated with a reduction in seizures in response to sodium channel blocker treatment (carbamazepine, oxcarbazepine, phenytoin, lamotrigine or lacosamide) without evidence of symptom exacerbation. Our study expands the spectrum of gain of function SCN1A-related epilepsy phenotypes, defines key clinical features, provides novel insights into the underlying disease mechanisms between SCN1A-related epilepsy and familial hemiplegic migraine type 3, and identifies sodium channel blockers as potentially efficacious therapies. Gain of function disease should be considered in early onset epilepsies with a pathogenic SCN1A variant and non-Dravet syndrome phenotype.