Abstract

A large GGGGCC hexanucleotide repeat expansion in the first intron or promoter region of the C9orf72 gene is the most common genetic cause of familial and sporadic Amyotrophic lateral sclerosis (ALS), a devastating degenerative disease of motor neurons, and of Frontotemporal Dementia (FTD), the second most common form of presenile dementia after Alzheimer’s disease. C9orf72-associated ALS/FTD is a multifaceted disease both in terms of its clinical presentation and the misregulated cellular pathways contributing to disease progression. Among the numerous pathways misregulated in C9orf72-associated ALS/FTD, altered RNA processing has consistently appeared at the forefront of C9orf72 research. This includes bidirectional transcription of the repeat sequence, accumulation of repeat RNA into nuclear foci sequestering specific RNA-binding proteins (RBPs) and translation of RNA repeats into dipeptide repeat proteins (DPRs) by repeat-associated non-AUG (RAN)-initiated translation. Over the past few years the true extent of RNA misprocessing in C9orf72-associated ALS/FTD has begun to emerge and disruptions have been identified in almost all aspects of the life of an RNA molecule, including release from RNA polymerase II, translation in the cytoplasm and degradation. Furthermore, several alterations have been identified in the processing of the C9orf72 RNA itself, in terms of its transcription, splicing and localization. This review article aims to consolidate our current knowledge on the consequence of the C9orf72 repeat expansion on RNA processing and draws attention to the mechanisms by which several aspects of C9orf72 molecular pathology converge to perturb every stage of RNA metabolism.

Highlights

  • Amyotrophic lateral sclerosis (ALS) is a fatal progressive neuromuscular disease resulting from the degeneration of motor neurons in the brain and spinal cord for which no effective treatments are currently available

  • It is becoming clear that impaired RNA processing is a central feature of c9ALS/Frontotemporal Dementia (FTD) pathogenesis which is mediated via several interconnected mechanisms, including sequestration of RNA-binding proteins (RBPs), repeat-associated non-AUG (RAN) translation and TDP-43 mislocalization

  • It is likely that these mechanisms all contribute to RNA processing abnormalities to different extents, generating numerous small defects at the level of RNA metabolism

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Summary

Introduction

Amyotrophic lateral sclerosis (ALS) is a fatal progressive neuromuscular disease resulting from the degeneration of motor neurons in the brain and spinal cord for which no effective treatments are currently available. C9orf repeat expansion as a common genetic cause of ALS of FTD further. A report described an individual with an intermediate repeat length (30 units) exhibiting some C9orf72-associated pathological phenotypes in the absence of clinical manifestations (Gami et al, 2015) suggesting that 30 repeats may lie on the border between initial cellular abnormalities and full-blown disease. Expansions of less than 30 repeats are not typically associated with disease; a minority of ALS cases with 20–22 repeats have been described (Byrne et al, 2014) Such intermediate repeat sizes significantly increase the risk of developing ALS (Chen et al, 2016) and are associated with decreased C9orf promoter activity (Gijselinck et al, 2016)

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