A repeat expansion in the gene encoding junctophilin-3 is associated with Huntington disease-like 2.

We recently described a disorder termed Huntington disease-like 2 (HDL2) that completely segregates with an unidentified CAG/CTG expansion in a large pedigree (W). We now report the cloning of this expansion and its localization to a variably spliced exon of JPH3 (encoding junctophilin-3), a gene involved in the formation of junctional membrane structures.

Presentation of a T cell receptor antagonist peptide by immunoglobulins ablates activation of T cells by a synthetic peptide or proteins requiring endocytic processing.

T cell receptor (TCR) antagonism is being considered for inactivation of aggressive T cells and reversal of T cell-mediated autoimmune diseases. TCR antagonist peptides silence aggressive T cells and reverse experimental allergic encephalomyelitis induced with free peptides. However, it is not clear whether free antagonist peptides could reverse natural disease where the antigen is presumably available for endocytic processing and peptides gain access to newly synthesized class II MHC molecules. Using an efficient endocytic presentation system, we demonstrate that a proteolipid protein (PLP) TCR antagonist peptide (PLP-LR) presented on an Ig molecule (Ig-PLP-LR) abrogates the activation of T cells stimulated with free encephalitogenic PLP peptide (PLP1), native PLP, or an Ig containing PLP1 peptide (Ig-PLP1). Free PLP-LR abolishes T cell activation when the stimulator is free PLP1 peptide, but has no measurable effect when the stimulator is the native PLP or Ig-PLP1. In vivo, Ig-PLP1 induces a T cell response to PLP1 peptide. However, when coadministered with Ig-PLP-LR, the response to PLP1 peptide is markedly reduced whereas the response to PLP-LR is normal. Free PLP-LR coadministered with Ig-PLP1 has no effect on the T cell response to PLP1. These findings indicate that endocytic presentation of an antagonist peptide by Ig outcompete both external and endocytic agonist peptides whereas free antagonist hinders external but not endocytic agonist peptide. Direct contact with antagonist ligand and/or trans-regulation by PLP-LR-specific T cells may be the operative mechanism for Ig-PLP-LR-mediated downregulation of PLP1-specific T cells in vivo. Efficient endocytic presentation of antagonist peptides, which is the fundamental event for either mechanism, may be critical for reversal of spontaneous T cell-mediated autoimmune diseases where incessant endocytic antigen processing could be responsible for T cell aggressivity.

Immunochemical characterization of antibodies to the myelin proteolipid protein (PLP).

The immunochemical specificity of antibodies raised against the bovine myelin proteolipid protein (PLP) and a series of PLP synthetic peptides was examined by enzyme-linked immunosorbent assay (ELISA) and immunoblot analyses. Polyclonal rabbit anti-bovine PLP antibodies were cross-reactive with PLP isolated from rat, monkey, and human CNS white matter, as well as with PLP incorporated into rat myelin vesicles. Immunochemical analyses of 11 anti-peptide antisera revealed a more restrictive cross-reactivity pattern with only five of the 11 antisera, against peptides encompassing residues 48-59, 97-105, 183-193, 192-200 and 264-276, cross-reacting with bovine PLP by ELISA. Immunoblot analyses with the anti-peptide antisera demonstrated a similar recognition with four of the 11 antisera against peptides 48-59, 97-105, 192-200 and 264-276 recognizing the myelin PLP. These data suggest that, despite its strong phylogenetic conservation, multiple antigenic sites exist within the PLP molecule, and some of these determinants can be mimicked by synthetic peptides. However, the restrictive cross-reactivities of the anti-peptide antisera suggest that humoral recognition of the myelin PLP is conformationally dependent. The availability of anti-peptide antibodies of predetermined specificity, capable of recognizing the intact protein, should permit detailed examination of PLP topography in various experimental systems.

Monoclonal and polyclonal antibodies to myelin basic protein determinants.

A detailed immunochemical examination of monoclonal and polyclonal antibody responses to myelin basic protein (MBP) and its peptides has revealed the existence of as many as 27 antigenic determinants, many of them conformational. Topological mapping of the potential antigenic determinants onto a model of MBP secondary structure places these determinants within 11 separate regions of the molecule, including those portions that have been found to be encephalitogenic. MBP and its peptides, therefore, fall under the umbrella of the Multideterminant-Regulatory Model of Benjamin et al. (1984). However, in the case of MBP, multideterminant immunogenicity appears to represent mainly an escape from tight regulation through the avenue of conformational change.

Polyclonal antibodies to the encephalitogenic neighborhoods of myelin basic protein: singular affinity populations neutralized by specific synthetic peptide probes.

Specific ligand neutralization was used to probe the extent to which singular antibody affinity populations signified specific determinants in the neighborhood myelin basic protein (MBP) encephalitogens. The probes were individual members of a panel of synthetic peptide analogs subsuming encephalitogenic regions. Comparative Scatchard analyses of neutralized and unneutralized antisera helped to identify the particular peptide determinants involved in the original polyclonal antibody responses to the multiple antigenic determinants of encephalitogenic peptides. The range of affinities for an antibody population against a singular MBP peptide determinant was found to be relatively restricted while the range of affinities overall for all populations within a given antipeptide antiserum was found to be relatively wide and invariably discontinuous. Consequently, the individual discontinuous affinity populations could readily be dissected by application of the Rosenthal method of Scatchard curve analysis. It was found that the singular high affinity antibody population (5.6 x 10(7) M-1) of a Lewis rat antiserum to rat encephalitogenic GSLPQKAQRPQDENG (S49) was against a determinant near the N-terminal non-encephalitogenic end of the peptide. Only the low affinity antibody populations were found that had reactivity for determinants within the encephalitogenic region itself. The singular high affinity antibody population (5.97 x 10(7) M-1) of a rabbit antiserum to rabbit encephalitogenic TTHYGSLPQKAQGHRPQDEG (S82) was against a determinant centered about the tyrosyl residue, within the encephalitogenic region for the rabbit, but was completely cross-reactive with a specific circulating endogenous inhibitor. The results obtained with the rat and rabbit EAE sera were consistent with a previously advanced hypothesis that antibodies to determinants within encephalitogenic neighborhoods would effectively block the onset of EAE if high enough in affinity and not neutralized by an endogenous inhibitor.

Heteroclitic antibodies in Fischer 344 rats to a synthetic encephalitogenic myelin basic protein peptide.

Fischer 344 rats, immunized with the synthetic encephalitogenic myelin basic protein peptide YS49 (YGSLPQKAQRPQDENG), produced heteroclitic antibodies that reacted much more extensively and with a much higher affinity with the cross-reacting encephalitogenic guinea pig sequence S49S (GSLPQKSQRSQDENG) than they did with the immunogenic YS49. On the other hand, antisera against S49S reacted in a normal manner with homologous S49S and cross-reacted only poorly with YS49. The phenomenon of heteroclisis in Fischer 344 rats correlated with the greater encephalitogenic potency of the cross-reacting entity. Kibler et al. (J. Exp. Med., 146 (1977) 1323-1331), by comparing the encephalitogenic guinea pig sequence to a less potent analog, had also previously observed what now would be termed a heteroclitic phenomenon at the T cell level in Lewis rats. In their hands, however, as well as in ours Lewis rat antisera against the encephalitogenic peptide region were much too complex to be analyzed with respect to heteroclisis. It was shown in the present experiments that by utilizing the Fischer 344 system one may also readily obtain heteroclisis at the B cell level against encephalitogenic peptides. Neither YS49 nor S49S as immunogen produced detectable antibody in Brown Norway (BN) rats with exception of two immunized with YS49. In those two cases heteroclitic antibodies were obtained that had a very low significant (greater than 3 SD above baseline) antigen binding capacity for S49S and no detectable reactivity for the homologous YS49 ligand.

Acute optic neuritis associated with immunization with the CNS myelin proteolipid protein.

Optic nerve tissue for SJL/J mice immunized with the central nervous system (CNS) myelin-specific proteolipid protein (PLP) was examined for histopathologic evidence of optic neuritis. Optic nerves isolated 17 d after immunization with PLP revealed an interstitial and submeningeal inflammatory infiltrate consisting of neutrophils and monocytes. In all cases, histologic evidence of optic nerve involvement correlated serologically with the presence of circulating anti-PLP antibodies. Control animals had no histopathologic evidence of disease or anti-PLP antibody. In many respects, the observed histopathologic profile of PLP-induced optic neuritis is similar to that associated with human inflammatory demyelinating diseases such as multiple sclerosis (MS). Because optic neuritis frequently is associated with some of the earliest clinical symptoms of MS, the acute nature of optic nerve involvement in this animal model suggests that immune recognition of the myelin PLP may play a significant role in the pathophysiology of optic nerve damage associated with sensitization to CNS-specific antigens.

Epibodies in autoimmunity: antisera against autoantibodies to the renal glomerular basement membrane react with idiotypes as well as with autoantigens.

The results reported here show that we have experimentally produced xenogeneic anti-idiotypic antibodies to rat autoantibodies specific for the renal GBM and one of its components, laminin. Cross-reactive idiotypes have been detected by anti-idiotypic antibodies (anti-Id) on autoantibodies to the GBM (anti-GBM) from rats of different strains, confirming the results obtained in other autoantibody systems. During the course of studies aimed at determining whether anti-Id were directed to the paratope of anti-GBM antibodies, we have observed the presence of anti-GBM (and anti-laminin) antibodies in rabbit sera with anti-Id. Affinity chromatography experiments suggest that anti-GBM reactions detected with our anti-Id sera may be caused by a heterogeneous combination of anti-Id. Thus, Ab2 alpha (and/or Ab2 gamma, all reacting with Ab1), Ab2 epsilon (epibodies, that bind to both Ab1 and GBM) and Ab3 (similar to Ab1 and therefore, reacting with GBM) may be present in our anti-Id sera. It has been suggested that antibodies displaying epibody properties may be involved in the mutual regulation of autoreactive clones and represent an important component of the autoimmune process.

Expression and distribution of the dentatorubral-pallidoluysian atrophy gene product (atrophin-1/drplap) in neuronal and non-neuronal tissues.

Utilizing an affinity-purified antiserum directed against the carboxyl terminal region of atrophin-1/drplap (residues 1170-1185), we have examined the expression and distribution of the protein in a variety of neuronal and non-neuronal tissues. Immunohistochemical analyses of gelatin-embedded sections of monkey brain demonstrated a wide-spread distribution of the protein throughout the cerebrum and cerebellum. Labeling was primarily cytoplasmic within neuronal cell bodies and dendrites. Prominently staining regions included layers II, III, V, and VI of cerebral cortex, CA1-4 of the hippocampus, caudate nucleus, putamen, globus pallidus, amygdala, thalamus, red nucleus, pons, Purkinje cells, and deep cerebellar nuclei. Immunoblot analysis of extracts of frontal cortex from a wide variety of mammalian species (human, monkey, rabbit, rat, mouse, and bovine) detected a 190 kDa band in each extract. No cross-reactive material of similar molecular weight was detected in an extract of avian (chicken) central nervous system (CNS) tissue. Furthermore, in the rat, expression of the protein was predominantly neuronal in origin as immunoblot analyses of non-neuronal tissue extracts detected little or no 190 kDa protein. Collectively these investigations suggest a ubiquitous expression of atrophin-1/drplap in mammalian CNS tissue and provide initial immunochemical data for the study of the neuroanatomic and perhaps, phylogenetic relationships between mammalian and non-mammalian forms of the protein.

Genetic testing for ataxia in North America.

BACKGROUND: The Ataxia Molecular Diagnostics Testing Group was established to generate quantitative proficiency and outcomes data regarding molecular testing for the autosomal dominant cerebellar ataxias (spinocerebellar ataxia types 1 [SCA-1] through -3, -6, and -7, and dentatorubral-pallidoluysian atrophy) in North America. METHODS AND RESULTS: Twenty-four North American laboratories that offered diagnostic testing for one or more ataxia genes were initially identified through GeneTests (Children's Health Care System, Seattle, WA). Eighteen laboratories agreed to participate in the study, which consisted of completing a technical survey, clinical survey, and molecular proficiency test. One laboratory returned the completed surveys but did not perform the proficiency testing. Ten of 18 laboratories (56%) provided data on test volumes, and these laboratories collectively performed 2,240 tests; approximately 5% of the tests yielded a positive result (i.e., identification of a pathological trinucleotide (CAG) repeat expansion). In proficiency testing, 100% of the laboratories correctly genotyped all samples, and 93% of the laboratories were within 1 SD of the mean for sizing normal alleles (one repeat unit or less). Ninety percent of the laboratories were within 1 SD for sizing expanded alleles. CONCLUSIONS: Proficiency testing showed little difference between laboratories with respect to allele sizing. However, additional phenotype/genotype correlations are necessary to define CAG repeat-length descriptors for SCA-1, SCA-2, and SCA-7 alleles of intermediate size.

Mutation detection in an equivocal case of Friedreich's ataxia.

Compound heterozygosity at the Friedreich's ataxia locus accounts for approximately 2% of molecularly confirmed cases. Genotype-phenotype correlation in this subgroup of patients reveals a spectrum of clinical variability. This report describes the clinical and molecular findings in a 6-year-old patient with Friedreich's ataxia who carried a pathologic GAA expansion of approximately 1,000 repeats on one allele and a novel initiation codon point mutation (3G-->A) on the other.

Neurogenetics in developmental and behavioral pediatrics: advances in molecular diagnosis.

The discovery and characterization of thousands of genes involved in human disorders has the potential for great benefit in patient diagnosis and treatment. A combined approach using molecular genetic testing for some disorders as an adjunct to the clinical evaluation of children with developmental or behavioral features is rapidly occupying a more prominent role in the diagnostic evaluation. In some instances, molecular testing might confirm a genetic etiology in a child initially referred with a DSM-IV diagnosis, but molecular testing might be of limited use in other instances. This review presents advances in the diagnosis of inherited disorders affecting the pediatric population, with an emphasis on those with a developmental/behavioral component. We examine several relatively common disorders in detail (and less common disorders in a more cursory fashion) to elucidate the strengths and weaknesses of molecular diagnosis in clinical practice.

The relationship between (CAG)n repeat number and age of onset in a family with dentatorubral-pallidoluysian atrophy (DRPLA): diagnostic implications of confirmatory and predictive testing.

Dentatorubral-pallidoluysian atrophy (DRPLA) is a rare neurodegenerative disorder characterised by variability in both age of onset and clinical features. Despite the recent identification of the CAG expansion mutation in DRPLA, the number of molecularly confirmed cases remains small. Given its rarity and prominent phenotypic heterogeneity, some care needs to be exercised in the interpretation and dissemination of test results derived from direct gene testing for the DRPLA specific expansion mutation.

Meiotic instability associated with the CAGR1 trinucleotide repeat at 13q13.

CAGR1 is a recently characterised polymorphic trinucleotide repeat localised to 13q13, which has been suggested as a possible candidate gene for neurological disorders that manifest genetic anticipation. To provide evidence in support of this hypothesis, a large number of chromosomes (n = 928) from patients with a wide variety of neurological diseases were screened for evidence of repeat expansion and meiotic instability. One person with a CAGR1 repeat number of 50 was identified (normal range 9-29). Subsequent molecular analyses of CAGR1 repeat number in additional family members showed meiotic instability of a (CAG)45 allele through three generations. While CAGR1 repeat number did not correlate with a readily discernible phenotype in this family, the finding of meiotic stability and mendelian inheritance of normal CAG alleles and meiotic instability of larger repeats fulfil several criteria thought essential for pathologically relevant mutations of this type. Thus, these data strengthen the hypothesis for a role of CAGR1 in the development of an as yet molecularly uncharacterised human neurological disease.

Sporadic ALS and chromosome 22: evidence for a possible neurofilament gene defect.

ALS is associated with the P2 blood group phenotype. Molecular evidence now shows the gene encoding this antigen to be on the long arm of human chromosome 22 near the newly discovered gene for heavy neurofilament (NF-H). Since an ALS-type condition can be generated in transgenic mice expressing the human NF-H gene, and since the gene for the CNTF-related cytokine leukemia inhibitory factor (LIF) is located adjacent to this gene, it is hypothesized that a defect on the chromosome 22 band region q12 is involved in the pathogenesis of sporadic ALS.

Humoral immune recognition of proteolipid protein (PLP)-specific encephalitogenic epitopes in the SJL/J mouse.

SJL/J mice were immunized with human PLP as well as encephalitogenic PLP peptides 139-151 and 178-191 and the resulting antibody responses examined for immunochemical specificity employing a panel of 17 synthetic PLP peptide ligands. All animals had demonstrable circulating titers of antibodies early in the humoral immune response to their respective encephalitogens, however, there was no clear qualitative correlation between antibody responses and the induction of EAE. In the majority of PLP immunized animals, determinant-specific antibody populations, including those against encephalitogenic centers, were not detectable in the presence of an anti-PLP antibody response. Antiencephalitogenic peptide antibodies were present in both 139-151 and 178-191 immunized animals regardless of clinical/histologic status. Neither group produced cross-reactive anti-PLP antibodies as detected by ELISA. In animals immunized with peptide 139-151, only anti-139-151 antibody specificities were noted. In contrast, all animals immunized with peptide 178-191 had an antibody population cross-reactive with three other PLP peptides: 97-110, 209-217, and 215-228. As humoral immune responses can be demonstrated against PLP-specific encephalitogenic epitopes, the significance of these B cell responses should be considered in the context of their potential role in the development, modulation, and/or potentiation of EAE.

Immunochemical specificity of antisera raised against the synthetic encephalitogenic peptide SH624, residues 59-74 of the myelin basic protein.

Synthetic peptide SH624 (SHHPARTAHYGSLPQK), residues 59-74 of human myelin basic protein (MBP) was found to be encephalitogenic in the rabbit. Four antisera raised, against the peptide were employed in a liquid-phase equilibrium competitive radioimmunoassay with a series of synthetic peptide analogs of the region to probe the structural requirements of the B-cell determinant subsumed within SH624. The cross-reactivities of the four antisera with intact MBP were also examined. Immunochemical analyses of the four antisera suggested specificities directed against a conformational determinant dependent upon residues from the more phylogenetically conserved carboxyl C-terminal region, residues 65-74 (TAHYGSLPQK) of the synthetic immunogen. Peptide analogs shorter than SH624 from the C-terminal end showed no cross-reactivity with any of the reagent antisera while analogs shorter from the N-terminal end and including the encephalitogenic sequence TTHYGSLPQK, as well as, HYGSLPQK were reactive under equilibrium competitive conditions. SH624-reactive antibodies, cross-reactive with purified heterologous MBPs from 10 different species were also identified in all four reagent antisera. The results of these experiments support previous investigations demonstrating the accessibility of the encephalitogenic 65-74 region in intact MBP. They also underscore the importance of B-cell recognition of organ specific antigenic determinants with respect to MBP immunology and, in particular, the recognition of autoreactive determinants in the neighborhood of encephalitogenic centers.

An immunochemical analysis of a myelin basic protein serum factor: cross reactivity with residues 69-71 of the rabbit encephalitogenic sequence 65-74 of myelin basic protein.

A partially purified myelin basic protein serum factor (MBP-SF), cross-reactive with residues 65-74 (TTHYGSLPQK) of myelin basic protein, has been employed in an immunochemical study to identify the nature of the cross-reacting determinant more precisely. To probe the structural requirements of this determinant, Scatchard inhibition analyses and competitive peptide inhibition radioimmunoassays were employed with a series of peptide analogs of the 65-74 region and with three different reagent antisera: a rabbit anti-rat myelin antiserum (#My05) and two antisera, one rabbit (#162) and one chicken (#66), raised against synthetic peptide S24 (TTHYGSLPQKG). Scatchard inhibition analyses with MBP-SF revealed specific inhibition of binding of 125I-S24 to #162 and #My05, but not to #66. Further delineation of the structural requirements of the cross-reactive determinant, employing a liquid-phase radioimmunoassay, revealed a unique reactivity pattern for the chicken anti-S24 antiserum which, unlike #162 and #My05, did not cross-react under high-affinity conditions with synthetic peptide S20 (GSLPQK, representing the C-terminal half of S24). This, in concert with the Scatchard data, is suggestive of the presence of a cross-reactive determinant centered around residues 69-71 of MBP.