Abstract

Spinal Muscular Atrophy (SMA) is a hereditary childhood disease that causes paralysis by progressive degeneration of skeletal muscles and spinal motor neurons. SMA is associated with reduced levels of full-length Survival of Motor Neuron (SMN) protein, due to mutations in the Survival of Motor Neuron 1 gene. The mechanisms by which lack of SMN causes SMA pathology are not known, making it very difficult to develop effective therapies. We investigated whether DNA damage is a perinatal pathological event in SMA, and whether DNA damage and cell death first occur in skeletal muscle or spinal cord of SMA mice. We used a mouse model of severe SMA to ascertain the extent of cell death and DNA damage throughout the body of prenatal and newborn mice. SMA mice at birth (postnatal day 0) exhibited internucleosomal fragmentation in genomic DNA from hindlimb skeletal muscle, but not in genomic DNA from spinal cord. SMA mice at postnatal day 5, compared with littermate controls, exhibited increased apoptotic cell death profiles in skeletal muscle, by hematoxylin and eosin, terminal deoxynucleotidyl transferase dUTP nick end labeling, and electron microscopy. SMA mice had no increased cell death, no loss of choline acetyl transferase (ChAT)-positive motor neurons, and no overt pathology in the ventral horn of the spinal cord. At embryonic days 13 and 15.5, SMA mice did not exhibit statistically significant increases in cell death profiles in spinal cord or skeletal muscle. Motor neuron numbers in the ventral horn, as identified by ChAT immunoreactivity, were comparable in SMA mice and control littermates at embryonic day 15.5 and postnatal day 5. These observations demonstrate that in SMA, disease in skeletal muscle emerges before pathology in spinal cord, including loss of motor neurons. Overall, this work identifies DNA damage and cell death in skeletal muscle as therapeutic targets for SMA.

Highlights

  • Spinal Muscular Atrophy (SMA) is a genetic disorder characterized by progressive symmetrical limb and trunk paralysis, muscle atrophy, and motor neuron (MN) degeneration

  • SMA mice were smaller than littermate controls, all muscle groups, spinal cord, and organ systems appeared to be anatomically normal (Figure 1A and 1B, data not shown)

  • We have identified an early vulnerability of skeletal muscle that distinguishes it from spinal cord in SMA mice

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Summary

Introduction

Spinal Muscular Atrophy (SMA) is a genetic disorder characterized by progressive symmetrical limb and trunk paralysis, muscle atrophy, and motor neuron (MN) degeneration. It is caused by mutations in the Survival of Motor Neuron (SMN1) gene and is the second most common genetic cause of childhood mortality [1]. Type 0 SMA is the most severe, with prenatal onset characterized by reduced fetal movements, and joint contractures and muscle atrophy at birth [2]. Type III SMA patients experience onset of symptoms after 18 months of age, and are able to walk but have muscle weakness and decreased endurance [3,5,6,7,8,9]. There are no therapies for SMA patients, because little is known about the function of SMN and the pathobiology of the disease, except that it affects MNs

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