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Ketogenic diet modifies ribosomal protein dysregulation in KMT2D Kabuki syndrome.
Tsang, Erica; Han, Velda X; Flutter, Chloe; Alshammery, Sarah; Keating, Brooke A; Williams, Tracey; Gloss, Brian S; Graham, Mark E; Aryamanesh, Nader; Pang, Ignatius; Wong, Melanie; Winlaw, David; Cardamone, Michael; Mohammad, Shekeeb; Gold, Wendy; Patel, Shrujna; Dale, Russell C.
Affiliation
  • Tsang E; Kids Neuroscience Centre, The Children's Hospital at Westmead, Faculty of Medicine and Health, University of Sydney, NSW, Australia; The Children's Hospital at Westmead Clinical School, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia.
  • Han VX; Kids Neuroscience Centre, The Children's Hospital at Westmead, Faculty of Medicine and Health, University of Sydney, NSW, Australia; Khoo Teck Puat-National University Children's Medical Institute, National University Health System, Singapore, Singapore; Department of Paediatrics, Yong Loo Lin Schoo
  • Flutter C; The Kabuki Syndrome Foundation - Volunteer, Northbrook, IL, USA.
  • Alshammery S; Kids Neuroscience Centre, The Children's Hospital at Westmead, Faculty of Medicine and Health, University of Sydney, NSW, Australia; The Children's Hospital at Westmead Clinical School, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia.
  • Keating BA; Kids Neuroscience Centre, The Children's Hospital at Westmead, Faculty of Medicine and Health, University of Sydney, NSW, Australia.
  • Williams T; Kids Rehab, The Children's Hospital at Westmead, Sydney, NSW, Australia.
  • Gloss BS; Westmead Research Hub, Westmead Institute for Medical Research, Westmead, NSW, Australia.
  • Graham ME; Biomedical Proteomics, Children's Medical Research Institute, The University of Sydney, Australia.
  • Aryamanesh N; Bioinformatics Group, Children's Medical Research Institute, Westmead, Sydney, NSW, Australia; School of Medical Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia.
  • Pang I; Bioinformatics Group, Children's Medical Research Institute, Westmead, Sydney, NSW, Australia.
  • Wong M; The Children's Hospital at Westmead, Westmead, NSW, Australia.
  • Winlaw D; Heart Centre, Ann and Robert H. Lurie Children's Hospital of Chicago and Feinberg School of Medicine, Northwestern University, USA.
  • Cardamone M; Sydney Children's Hospital, Randwick, NSW, Australia; School of Clinical Medicine, University of New South Wales, NSW, Australia.
  • Mohammad S; Kids Neuroscience Centre, The Children's Hospital at Westmead, Faculty of Medicine and Health, University of Sydney, NSW, Australia; The Children's Hospital at Westmead Clinical School, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia.
  • Gold W; School of Medical Sciences, Faculty of Medicine and Health, The University of Sydney, NSW, Australia; Molecular Neurobiology Research Laboratory, Kids Research, The Children's Hospital at Westmead & the Children's Medical Research Institute, NSW, Australia.
  • Patel S; Kids Neuroscience Centre, The Children's Hospital at Westmead, Faculty of Medicine and Health, University of Sydney, NSW, Australia; The Children's Hospital at Westmead Clinical School, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia.
  • Dale RC; Kids Neuroscience Centre, The Children's Hospital at Westmead, Faculty of Medicine and Health, University of Sydney, NSW, Australia; The Children's Hospital at Westmead Clinical School, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia; The Brain and Mind Centre, The Unive
EBioMedicine ; 104: 105156, 2024 Jun.
Article in En | MEDLINE | ID: mdl-38768529
ABSTRACT

BACKGROUND:

Kabuki syndrome (KS) is a genetic disorder caused by DNA mutations in KMT2D, a lysine methyltransferase that methylates histones and other proteins, and therefore modifies chromatin structure and subsequent gene expression. Ketones, derived from the ketogenic diet, are histone deacetylase inhibitors that can 'open' chromatin and encourage gene expression. Preclinical studies have shown that the ketogenic diet rescues hippocampal memory neurogenesis in mice with KS via the epigenetic effects of ketones.

METHODS:

Single-cell RNA sequencing and mass spectrometry-based proteomics were used to explore molecular mechanisms of disease in individuals with KS (n = 4) versus controls (n = 4).

FINDINGS:

Pathway enrichment analysis indicated that loss of function mutations in KMT2D are associated with ribosomal protein dysregulation at an RNA and protein level in individuals with KS (FDR <0.05). Cellular proteomics also identified immune dysregulation and increased abundance of other lysine modification and histone binding proteins, representing a potential compensatory mechanism. A 12-year-old boy with KS, suffering from recurrent episodes of cognitive decline, exhibited improved cognitive function and neuropsychological assessment performance after 12 months on the ketogenic diet, with concomitant improvement in transcriptomic ribosomal protein dysregulation.

INTERPRETATION:

Our data reveals that lysine methyltransferase deficiency is associated with ribosomal protein dysfunction, with secondary immune dysregulation. Diet and the production of bioactive molecules such as ketone bodies serve as a significant environmental factor that can induce epigenetic changes and improve clinical outcomes. Integrating transcriptomic, proteomic, and clinical data can define mechanisms of disease and treatment effects in individuals with neurodevelopmental disorders.

FUNDING:

This study was supported by the Dale NHMRC Investigator Grant (APP1193648) (R.D), Petre Foundation (R.D), and The Sydney Children's Hospital Foundation/Kids Research Early and Mid-Career Researcher Grant (E.T).
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Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Ribosomal Proteins / Vestibular Diseases / Proteomics / DNA-Binding Proteins / Face / Diet, Ketogenic / Hematologic Diseases Limits: Child / Female / Humans / Male Language: En Journal: EBioMedicine Year: 2024 Document type: Article Affiliation country: Australia Country of publication: Netherlands
Fulltext
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Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Ribosomal Proteins / Vestibular Diseases / Proteomics / DNA-Binding Proteins / Face / Diet, Ketogenic / Hematologic Diseases Limits: Child / Female / Humans / Male Language: En Journal: EBioMedicine Year: 2024 Document type: Article Affiliation country: Australia Country of publication: Netherlands