PUBLICATION

Bi-allelic ACBD6 variants lead to a neurodevelopmental syndrome with progressive and complex movement disorders

Authors

Kaiyrzhanov, R., Rad, A., Lin, S.J., Bertoli-Avella, A., Kallemeijn, W.W., Godwin, A., Zaki, M.S., Huang, K., Lau, T., Petree, C., Efthymiou, S., Ghayoor Karimiani, E., Hempel, M., Normand, E.A., Rudnik-Schöneborn, S., Schatz, U.A., Baggelaar, M.P., Ilyas, M., Sultan, T., Alvi, J.R., Ganieva, M., Fowler, B., Aanicai, R., Akay Tayfun, G., Al Saman, A., Alswaid, A., Amiri, N., Asilova, N., Shotelersuk, V., Yeetong, P., Azam, M., Babaei, M., Bahrami Monajemi, G., Mohammadi, P., Samie, S., Banu, S.H., Basto, J.P., Kortüm, F., Bauer, M., Bauer, P., Beetz, C., Garshasbi, M., Hameed Issa, A., Eyaid, W., Ahmed, H., Hashemi, N., Hassanpour, K., Herman, I., Ibrohimov, S., Abdul-Majeed, B.A., Imdad, M., Isrofilov, M., Kaiyal, Q., Khan, S., Kirmse, B., Koster, J., Lourenço, C.M., Mitani, T., Moldovan, O., Murphy, D., Najafi, M., Pehlivan, D., Rocha, M.E., Salpietro, V., Schmidts, M., Shalata, A., Mahroum, M., Talbeya, J.K., Taylor, R.W., Vazquez, D., Vetro, A., Waterham, H.R., Zaman, M., Schrader, T.A., Chung, W.K., Guerrini, R., Lupski, J.R., Gleeson, J., Suri, M., Jamshidi, Y., Bhatia, K.P., Vona, B., Schrader, M., Severino, M., Guille, M., Tate, E.W., Varshney, G.K., Houlden, H., Maroofian, R.

ID

ZDB-PUB-231112-10

Date

2023

Source

Brain : a journal of neurology 147(4): 1436-1456 (Journal)

Registered Authors

Lin, Sheng-Jia, Varshney, Gaurav

Keywords

ACBD6, N-myristoylation, ataxia, dystonia, neudegeneration, parkinsonism

MeSH Terms

ATP-Binding Cassette Transporters
Adolescent
Adult
Animals
Child
Child, Preschool
Female
Humans
Infant
Intellectual Disability*/genetics
Male
Microcephaly*
Middle Aged
Movement Disorders*/genetics
Nervous System Malformations*/genetics
Neurodevelopmental Disorders*/genetics
Tremor
Young Adult
Zebrafish

PubMed

37951597 Full text @ Brain

Abstract

The acyl-CoA-binding domain-containing protein 6 (ACBD6) is ubiquitously expressed, plays a role in the acylation of lipids and proteins, and regulates the N-myristoylation of proteins via N-myristoyltransferase enzymes (NMTs). However, its precise function in cells is still unclear, as is the consequence of ACBD6 defects on human pathophysiology. Utilizing exome sequencing and extensive international data sharing efforts, we identified 45 affected individuals from 28 unrelated families (consanguinity 93%) with bi-allelic pathogenic, predominantly loss-of-function (18/20) variants in ACBD6. We generated zebrafish and Xenopus tropicalis acbd6 knockouts by CRISPR/Cas9 and characterized the role of ACBD6 on protein N-myristoylation with YnMyr chemical proteomics in the model organisms and human cells, with the latter also being subjected further to ACBD6 peroxisomal localization studies. The affected individuals (23 males and 22 females), with ages ranging from 1 to 50 years old, typically present with a complex and progressive disease involving moderate-to-severe global developmental delay/intellectual disability (100%) with significant expressive language impairment (98%), movement disorders (97%), facial dysmorphism (95%), and mild cerebellar ataxia (85%) associated with gait impairment (94%), limb spasticity/hypertonia (76%), oculomotor (71%) and behavioural abnormalities (65%), overweight (59%), microcephaly (39%) and epilepsy (33%). The most conspicuous and common movement disorder was dystonia (94%), frequently leading to early-onset progressive postural deformities (97%), limb dystonia (55%), and cervical dystonia (31%). A jerky tremor in the upper limbs (63%), a mild head tremor (59%), parkinsonism/hypokinesia developing with advancing age (32%), and simple motor and vocal tics were among other frequent movement disorders. Midline brain malformations including corpus callosum abnormalities (70%), hypoplasia/agenesis of the anterior commissure (66%), short midbrain and small inferior cerebellar vermis (38% each), as well as hypertrophy of the clava (24%) were common neuroimaging findings. acbd6-deficient zebrafish and Xenopus models effectively recapitulated many clinical phenotypes reported in patients including movement disorders, progressive neuromotor impairment, seizures, microcephaly, craniofacial dysmorphism, and midbrain defects accompanied by developmental delay with increased mortality over time. Unlike ACBD5, ACBD6 did not show a peroxisomal localisation and ACBD6-deficiency was not associated with altered peroxisomal parameters in patient fibroblasts. Significant differences in YnMyr-labelling were observed for 68 co- and 18 post-translationally N-myristoylated proteins in patient-derived fibroblasts. N-Myristoylation was similarly affected in acbd6-deficient zebrafish and Xenopus tropicalis models, including Fus, Marcks, and Chchd-related proteins implicated in neurological diseases. The present study provides evidence that bi-allelic pathogenic variants in ACBD6 lead to a distinct neurodevelopmental syndrome accompanied by complex and progressive cognitive and movement disorders.

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Phenotype

Mutations / Transgenics

Human Disease / Model

Sequence Targeting Reagents

Fish

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Mapping

Kaiyrzhanov et al., 2023 ZDB-PUB-231112-10 PMID:37951597

Bi-allelic ACBD6 variants lead to a neurodevelopmental syndrome with progressive and complex movement disorders

Kaiyrzhanov et al., 2023

ZDB-PUB-231112-10
PMID:37951597