Abstract

The NIH Undiagnosed Diseases Program admitted a male patient with unclassifiable late-onset ataxia-like symptoms. Exome sequencing revealed a heterozygous de novo mutation converting glycine 316 to serine in ATP1A3, which might cause disease. ATP1A3 encodes the Na+/K+ ATPase pump α3-subunit. Using CRISPR/Cas9-mediated homologous recombination for genome editing, we modelled this putative disease-causing allele in Caenorhabditis elegans, recreating the patient amino acid change in eat-6, the orthologue of ATP1A3. The impact of the mutation on eat-6 function at the neuromuscular junction was examined using two behavioural assays: rate of pharyngeal pumping and sensitivity to aldicarb, a drug that causes paralysis over time via the inhibition of acetylcholinesterase. The patient allele decreased pumping rates and caused hypersensitivity to aldicarb. Animals heterozygous for the allele exhibited similar defects, whereas loss of function mutations in eat-6 were recessive. These results indicate that the mutation is dominant and impairs the neuromuscular function. Thus, we conclude that the de novo G316S mutation in ATP1A3 likely causes or contributes to patient symptoms. More broadly, we conclude that, for conserved genes, it is possible to rapidly and easily model human diseases in C. elegans using CRIPSR/Cas9 genome editing.

Highlights

  • The Undiagnosed Diseases Program of the National Institutes of Health (NIH) aims to identify the cause of patient symptoms that are not explained by a known syndrome[1]

  • To determine impact of G316S mutation on ATP1A3 in vivo, we studied the effect of the mutation on the protein function in C. elegans

  • Since glycine codons contain GGs, the G304 codon was used as the protospacer adjacent motif (PAM) site

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Summary

Introduction

The Undiagnosed Diseases Program of the National Institutes of Health (NIH) aims to identify the cause of patient symptoms that are not explained by a known syndrome ( called rare diseases)[1]. Under this program, exome sequencing was undertaken for a patient suffering from numerous neurological symptoms including ataxia. Exome sequencing was undertaken for a patient suffering from numerous neurological symptoms including ataxia This revealed a de novo G316S mutation in the fourth transmembrane domain of the ATP1A3 protein. The G316S mutation was shown to reduce pump activity when ATP1A3 was overexpressed in vitro[2]. Na+/K+ ATPases use energy from hydrolysis of ATP to synchronously pump

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