Proceedings of the Texas A&M Medical Student Grand Rounds

The Role of TDP-43 in the Pathogenesis of Amyotrophic Lateral Sclerosis (ALS)

June 1, 2022 Amanda Figueroa

Amanda Figueroa

Introduction. Amyotrophic lateral sclerosis (ALS) is a neurodegenerative disease that leads to progressive loss of function of upper and lower motor neurons in the brain and spinal cord.5 ALS affects approximately 16,000 individuals who typically suffer from muscle weakness and paralysis.6 There is not a full understanding of the cause of ALS, but 30 genes have been associated to this disease. A common cause are the pathological inclusions involving heterozygous missense mutation in TARDBP, the gene encoding TDP-43.5,6,8 Methods. Semi denaturing detergent-agarose electrophoresis was used to detect rTDP-43 complexes and the aggregation over time.4 Isothermal titration calorimetry was used to investigate cooperative binding of TDP-43 to the repeats.7 iPSCs from three ALS patients and Western blot analysis were used to study the aggregation and location of TDP-43.1 Immunohistochemistry was also used to see the phosphorylation and stress granule formation.1,2 Results. The initial TDP-43 oligomer formation and larger aggregate are inhibited by RNA rich in GU repeats because of tight binding affinity.4 RRM1 and RRM2 fragments are specifically significant in binding to 24 GT repeats, which is key to preventing aggregation.3,7 The wild type TDP-43 cell lines having no clear mislocalizion and abnormal phosphorylation suggests that the mutation does not alter where TDP-43 is localized, but the molecular interactions it has.2 CRISPR/Cas9 gene editing of the G287S mutation in mutant cell lines was corrected and found decrease abnormal levels of TDP-43. 2 The soluble levels remain unchanged, but the insoluble accumulation decreased.2 HDAC6 inhibition, using Tubastatin A, restored the mitochondrial movement in mutant TDP-43 motor neurons. 2 Cytoplasmic aggregation of TDP-43 was found to increase FMRP phosphorylation, which affects SG.1 The FMRP granules influence TDP-43 aggregation by recruiting the deacetylase HDAC6. Inhibition of HDAC6 with FMRP granules lead to a significant increase of cytoplasmic TDP-43 aggregates and restoration of HDAC6 did reduce the SG-induced TDP-43 accumulation.1 Conclusion. TDP-43 mutations lead to cytoplasmic, insoluble aggregates that affect cellular function. The mislocalization of this process can be the contributing factor or the recruitment of TDP-43 interacting proteins.2 The mechanism of how TDP-43 can be varied depending on the formation of stress granules. These interactions affect whether HDAC6 inhibition increases or decreases TDP-43 aggregation. However, HDAC6 inhibition is being widely studied in various diseases and shows a promising therapeutic approach.1,4 Another therapeutic approach is the use of small molecules that target the TDP-43 binding with RNA or using CRISPR/Cas9 gene editing to change the TDP-43 mutation.1,5

  1. Chen Y, Cohen TJ. Aggregation of the nucleic acid-binding protein TDP-43 occurs via distinct routes that are coordinated with stress granule formation. J Biol Chem. 2019;294(10):3696-3706. doi:10.1074/jbc.RA118.006351
  2. Fazal R, Boeynaems S, Swijsen A, et al. HDAC6 inhibition restores TDP-43 pathology and axonal transport defects in human motor neurons with TARDBP mutations. EMBO J. 2021;40(7):e106177. doi:10.15252/embj.2020106177
  3. François-Moutal L, Felemban R, Scott DD, et al. Small Molecule Targeting TDP-43’s RNA Recognition Motifs Reduces Locomotor Defects in a DrosophilaModel of Amyotrophic Lateral Sclerosis (ALS). ACS Chem Biol. 2019;14(9):2006-2013. doi:10.1021/acschembio.9b00481
  4. French RL, Grese ZR, Aligireddy H, et al. Detection of TAR DNA-binding protein 43 (TDP-43) oligomers as initial intermediate species during aggregate formation. J Biol Chem. 2019;294(17):6696-6709. doi:10.1074/jbc.RA118.005889
  5. Hulisz D. Amyotrophic lateral sclerosis: disease state overview. Am J Manag Care. 2018;24(15 Suppl):S320-S326.
  6. Masrori P, Van Damme P. Amyotrophic lateral sclerosis: a clinical review. Eur J Neurol. 2020;27(10):1918-1929. doi:10.1111/ene.14393
  7. Rengifo-Gonzalez JC, El Hage K, Clément MJ, et al. The cooperative binding of TDP-43 to GU-rich RNA repeats antagonizes TDP-43 aggregation. Elife. 2021;10:e67605. Published 2021 Sep 7. doi:10.7554/eLife.67605
  8. Vanneste J, Van Den Bosch L. The Role of Nucleocytoplasmic Transport Defects in Amyotrophic Lateral Sclerosis. Int J Mol Sci. 2021;22(22):12175. Published 2021 Nov 10. doi:10.3390/ijms222212175

 

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