Discriminating α-synuclein strains in Parkinson’s disease and multiple system atrophy
作者:Mohammad Shahnawaz、Abhisek Mukherjee、Sandra Pritzkow、Nicolas Mendez、Prakruti Rabadia、Xiangan Liu、Bo Hu、Ann Schmeichel、Wolfgang Singer、Gang Wu、Ah-Lim Tsai、Hamid Shirani、K. Peter R. Nilsson、Phillip A. Low、Claudio Soto
DOI:10.1038/s41586-020-1984-7
日期:2020.2.13
Synucleinopathies are neurodegenerative diseases that are associated with the misfolding and aggregation of α-synuclein, including Parkinsonâs disease, dementia with Lewy bodies and multiple system atrophy1. Clinically, it is challenging to differentiate Parkinsonâs disease and multiple system atrophy, especially at the early stages of disease2. Aggregates of α-synuclein in distinct synucleinopathies have been proposed to represent different conformational strains of α-synuclein that can self-propagate and spread from cell to cell3â6. Protein misfolding cyclic amplification (PMCA) is a technique that has previously been used to detect α-synuclein aggregates in samples of cerebrospinal fluid with high sensitivity and specificity7,8. Here we show that the α-synuclein-PMCA assay can discriminate between samples of cerebrospinal fluid from patients diagnosed with Parkinsonâs disease and samples from patients with multiple system atrophy, with an overall sensitivity of 95.4%. We used a combination of biochemical, biophysical and biological methods to analyse the product of α-synuclein-PMCA, and found that the characteristics of the α-synuclein aggregates in the cerebrospinal fluid could be used to readily distinguish between Parkinsonâs disease and multiple system atrophy. We also found that the properties of aggregates that were amplified from the cerebrospinal fluid were similar to those of aggregates that were amplified from the brain. These findings suggest that α-synuclein aggregates that are associated with Parkinsonâs disease and multiple system atrophy correspond to different conformational strains of α-synuclein, which can be amplified and detected by α-synuclein-PMCA. Our results may help to improve our understanding of the mechanism of α-synuclein misfolding and the structures of the aggregates that are implicated in different synucleinopathies, and may also enable the development of a biochemical assay to discriminate between Parkinsonâs disease and multiple system atrophy. Protein misfolding cyclic amplification (PMCA) technology can discriminate between patients with Parkinsonâs disease and patients with multiple system atrophy on the basis of the characteristics of the α-synuclein aggregates in the cerebrospinal fluid.
突触核蛋白病是与δ-±-突触核蛋白错误折叠和聚集有关的神经退行性疾病,包括帕金森病、路易体痴呆和多系统萎缩1。在临床上,区分帕金森病和多系统萎缩具有挑战性,尤其是在疾病的早期阶段2。有人提出,不同突触核蛋白病中的δ-突触核蛋白聚集体代表了δ-突触核蛋白的不同构象株,它们可以在细胞间自我繁殖和扩散3â6。蛋白质错误折叠循环扩增(PMCA)技术以前曾用于检测脑脊液样本中的δ-突触核蛋白聚集体,具有很高的灵敏度和特异性7,8。在此,我们证明δ-突触核蛋白-PMCA 检测法可区分帕金森病患者脑脊液样本和多系统萎缩患者脑脊液样本,总体灵敏度达 95.4%。我们综合运用生化、生物物理和生物学方法分析了δ-突触核蛋白-PMCA的产物,发现脑脊液中δ-突触核蛋白聚集体的特征可用于区分帕金森病和多系统萎缩。我们还发现,从脑脊液中扩增出的聚集体的特性与从大脑中扩增出的聚集体的特性相似。这些发现表明,与帕金森病和多系统萎缩相关的δ-突触核蛋白聚集体对应于δ-突触核蛋白的不同构象株,而δ-突触核蛋白-PMCA可以扩增和检测这些构象株。我们的研究结果可能有助于加深我们对δ-突触核蛋白错误折叠机制以及与不同突触核蛋白病有关的聚集体结构的理解,还可能有助于开发一种生化检测方法来区分帕金森病和多系统萎缩症。蛋白质错误折叠循环放大(PMCA)技术可以根据脑脊液中δ-突触核蛋白聚集体的特征区分帕金森病患者和多系统萎缩患者。