Abstract

ObjectivesTbx1 mutant mice are a widely used model of 22q11.2 deletion syndrome (22q11.2DS) because they manifest a broad spectrum of physical and behavioral abnormalities that is similar to that found in 22q11.2DS patients. In Tbx1 mutants, brain abnormalities include changes in cortical cytoarchitecture, hypothesized to be caused by the precocious differentiation of cortical progenitors. The objectives of this research are to identify drugs that have efficacy against the brain phenotype, and through a phenotypic rescue approach, gain insights into the pathogenetic mechanisms underlying Tbx1 haploinsufficiency.Experimental ApproachDisease model: Tbx1 heterozygous and homozygous embryos. We tested the ability of two FDA-approved drugs, the LSD1 inhibitor Tranylcypromine and Vitamin B12, to rescue the Tbx1 mutant cortical phenotype. Both drugs have proven efficacy against the cardiovascular phenotype, albeit at a much reduced level compared to the rescue achieved in the brain.MethodsIn situ hybridization and immunostaining of histological brain sections using a subset of molecular markers that label specific cortical regions or cell types. Appropriate quantification and statistical analysis of gene and protein expression were applied to identify cortical abnormalities and to determine the level of phenotypic rescue achieved.ResultsCortical abnormalities observed in Tbx1 mutant embryos were fully rescued by both drugs. Intriguingly, rescue was obtained with both drugs in Tbx1 homozygous mutants, indicating that they function through mechanisms that do not depend upon Tbx1 function. This was particularly surprising for Vitamin B12, which was identified through its ability to increase Tbx1 gene expression.ConclusionTo our knowledge, this is only the second example of drugs to be identified that ameliorate phenotypes caused by the mutation of a single gene from the 22q11.2 homologous region of the mouse genome. This one drug-one gene approach might be important because there is evidence that the brain phenotype in 22q11.2DS patients is multigenic in origin, unlike the physical phenotypes, which are overwhelmingly attributable to Tbx1 haploinsufficiency. Therefore, effective treatments will likely involve the use of multiple drugs that are targeted to the function of specific genes within the deleted region.

Highlights

  • Brain-related phenotypes, including intellectual disability and psychiatric disorders, are a major concern for the clinical management and quality of life of patients affected by 22q11.2 deletion syndrome (22q11.2DS)

  • The authors of this study reported the partial rescue of cardiovascular phenotypes in mid- and pre-term Tbx1 mutant embryos when treated with high doses of B12

  • In order to obtain a broader picture of the efficacy of B12 treatment, we looked for rescue of the cell proliferation/cell cycle anomalies, which are part of the cortical phenotype observed in Tbx1 mutants (Flore et al, 2017)

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Summary

Introduction

Brain-related phenotypes, including intellectual disability and psychiatric disorders, are a major concern for the clinical management and quality of life of patients affected by 22q11.2 deletion syndrome (22q11.2DS). An additional peculiarity of Tbx function in the embryonic mouse brain is that it is mesoderm-dependent, mediated by an extracellular signal. This is the case for several other phenotypes associated with the haploinsufficiency or loss of this gene (Zhang et al, 2005; Fagman et al, 2007; Xu et al, 2007; Braunstein et al, 2009; Calmont et al, 2009; Lania et al, 2009). The mouse models have been used for testing experimental strategies for rescuing the cardiovascular phenotype, opening the way to targeted pre-clinical studies.

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