A novel NGF mutation clarifies the molecular mechanism and extends the phenotypic spectrum of the HSAN5 neuropathy
- Ofélia P Carvalho1,
- Gemma K Thornton1,
- Joseph Hertecant2,
- Henry Houlden3,
- Adeline K Nicholas1,
- James J Cox1,
- Mary Rielly3,
- Lihadh Al-Gazali2,
- C Geoffrey Woods1
- 1Department of Medical Genetics, Cambridge Institute for Medical Research, University of Cambridge, Cambridge, UK
- 2Department of Pediatrics, Faculty of Medicine & Health Sciences, United Arab Emirates University, United Arab Emirates
- 3Department of Molecular Neuroscience, Institute of Neurology and the National Hospital for Neurology and Neurosurgery, London, UK
- Correspondence to Dr C Geoffrey Woods, Department of Medical Genetics, Cambridge Institute for Medical Research, University of Cambridge, Cambridge CB2 0XY, UK; and Lihadh Al-Gazali Department of Pediatrics, Faculty of Medicine & Health Sciences, United Arab Emirates University, United Arab Emirates;
- Received 21 May 2010
- Revised 9 July 2010
- Accepted 27 July 2010
- Published Online First 26 October 2010
Background Nerve growth factor β (NGFβ) and tyrosine kinase receptor type A (TRKA) are a well studied neurotrophin/receptor duo involved in neuronal survival and differentiation. The only previously reported hereditary sensory neuropathy caused by an NGF mutation, c.661C>T (HSAN5), and the pathology caused by biallelic mutations in the TRKA gene (NTRK1) (HSAN4), share only some clinical features. A consanguineous Arab family, where five of the six children were completely unable to perceive pain, were mentally retarded, did not sweat, could not discriminate temperature, and had a chronic immunodeficiency, is reported here. The condition is linked to a new homozygous mutation in the NGF gene, c.[680C>A]+[681_682delGG].
Methods Genetic linkage and standard sequencing techniques were used to identify the causative gene. Using wild-type or mutant over-expression constructs transfected into PC12 and COS-7 cells, the cellular and molecular consequences of the mutations were investigated.
Results The mutant gene produced a precursor protein V232fs that was unable to differentiate PC12 cells. V232fs was not secreted from cells as mature NGFβ.
Conclusions Both the clinical and cellular data suggest that the c.[680C>A]+[681_682delGG] NGF mutation is a functional null. The HSAN5 phenotype is extended to encompass HSAN4-like characteristics. It is concluded that the HSAN4 and HSAN5 phenotypes are parts of a phenotypic spectrum caused by changes in the NGF/TRKA signalling pathway.
OPC and GKT contributed equally to this work.
Funding Action Medical Research, UK; Wellcome Trust; Pfizer, Sandwich, UK.
Competing interests None
Patient consent Obtained.
Ethics approval This study was conducted with the approval of the relevant authorities in the United Arab Emirates and the UK (Cambridge Research Ethics Committee 05/Q0108/402).
Provenance and peer review Not commissioned; externally peer reviewed.
This is an open-access article distributed under the terms of the Creative Commons Attribution Non-commercial License, which permits use, distribution, and reproduction in any medium, provided the original work is properly cited, the use is non commercial and is otherwise in compliance with the license. See: http://creativecommons.org/licenses/by-nc/2.0/ and http://creativecommons.org/licenses/by-nc/2.0/legalcode.