Biochimica et Biophysica Acta (BBA) - Molecular Basis of Disease

Friedreich ataxia (FRDA) is a neurodegenerative disorder characterized by neuromuscular and neurological manifestations. It is caused by mutations in gene FXN, which results in loss of the mitochondrial protein frataxin. Endoplasmic Reticulum-mitochondria associated membranes (MAMs) are inter-organelle structures involved in the regulation of essential cellular processes, including lipid metabolism and calcium signaling. In the present study, we have analyzed in both, unicellular and multicellular models of FRDA, an analysis of calcium management and of integrity of MAMs. We observed that function of MAMs is compromised in our cellular model of FRDA, which was improved upon treatment with antioxidants. In agreement, promoting mitochondrial calcium uptake was sufficient to restore several defects caused by frataxin deficiency in Drosophila Melanogaster. Remarkably, our findings describe for the first time frataxin as a member of the protein network of MAMs, where interacts with two of the main proteins implicated in endoplasmic reticulum-mitochondria communication. These results suggest a new role of frataxin, indicate that FRDA goes beyond mitochondrial defects and highlight MAMs as novel therapeutic candidates to improve patients conditions.

The accumulation of the age pigment lipofuscin within the retinal pigment epithelium (RPE) is one the most remarkable changes observed in association with age-related macular degeneration (AMD) and Stargardt disease. Both aging and pathological processes lead to the accumulation of melanolipofuscin (MLF) granules, which have been reported to reflect the onset of AMD more accurately than lipofuscin. The underlying mechanism by which MLF forms is still not understood. We investigate the potential role that melanin plays in the degradation of lipofuscin and MLF in pigmented Abca4-/- mice following treatment with several NO generating drugs. Abca4-/- mice are generally used as models for lipofuscin-related eye diseases. We also induced melanogenesis in albino Abca4-/- mice via the over-expression of tyrosinase, the key enzyme involved in melanogenesis. We compared the ultrastructure of lipofuscinogensis in the RPE of pigmented and albino Abca4-/- mice. Fluorescence microscopy was employed for the quantification of lipofuscin. We found high amounts of unique thin (3-4 nm) lamellar membranes (TLMs) that were left over from the degradation of photoreceptor disc membranes by high-resolution electron microscopy. Accumulated TLMs were significantly more frequent in the RPE cells of the albinos than the pigmented mice, indicating that melanin plays a role in removing TLMs. The intravitreal injection of several NO generating drugs was found to reduce the amount of autofluorescent lipofuscin in the cytoplasm of RPE cells, particularly the MLF granules of pigmented Abca4-/- mice. No effect was observed in terms of lipofuscin removal in NO-exposed albino Abca4-/- mice. However, transfection with tyrosinase led to a reduction in the lipofuscin levels of artificially pigmented RPE cells in albino Abca4-/- mice following the formation of melanin. The results show for the first time that melanin plays an important, if not a key, role in the degradation of lipofuscin in RPE cells.

Ciliopathies are a class of multi-systemic genetic diseases characterized by ciliary dysfunction. Here, we report a novel ANKS3 variant in patients with a renal ciliopathy known as nephronophthisis (NPH) associated with hepatic defects. ANKS3 is an ankyrin and sterile alpha motif domain-containing protein that interacts with many NPH proteins as well as with BICC1, an RNA-binding protein involved in renal cystic diseases. The pathogenic effect of the ANKS3 mutation was validated in the zebrafish mutant and knock-in rat model, the latter showing urine concentration defect and tubular dilatations similar to NPH patients. In addition, cilia morphology and function as well as epithelialization of kidney tubular cells was affected by loss or mutation of ANKS3. Finally, our results evidenced that these classically renal ciliopathy-associated phenotypes were linked to the negative regulation of BICC1 by ANKS3 which binds to transcripts of the major NPH gene NPHP1 and mediates their decay through the AGO2-RISC complex and recruitment into P-bodies. Altogether, our findings suggest that the ANKS3/BICC1 complex is a key post-transcriptional regulator of NPHP1 transcript stability, providing another level of regulation of cilium biogenesis and kidney homeostasis, as well as an unusual mechanism leading to NPH-related ciliopathies.

Niemann Pick disease type C (NPC) is an autosomal recessive neurodegenerative lysosomal disorder characterized by an accumulation of lipids in different organs. Clinical manifestations can start at any age and include hepatosplenomegaly, intellectual impairment, and cerebellar ataxia. NPC1 is the most common causal gene, with over 460 different mutations with heterogeneous pathological consequences. We generated a zebrafish NPC1 model by CRISPR/Cas9 carrying a homozygous mutation in exon 22, which encodes the end of the cysteine-rich luminal loop of the protein. This is the first zebrafish model with a mutation in this gene region, which is frequently involved in the human disease. We observed a high lethality in npc1 mutants, with all larvae dying before reaching the adult stage. Npc1 mutant larvae were smaller than wild type (wt) and their motor function was impaired. We observed vacuolar aggregations positive to cholesterol and sphingomyelin staining in the liver, intestine, renal tubules and cerebral gray matter of mutant larvae. RNAseq comparison between npc1 mutants and controls showed 249 differentially expressed genes, including genes with functions in neurodevelopment, lipid exchange and metabolism, muscle contraction, cytoskeleton, angiogenesis, and hematopoiesis. Lipidomic analysis revealed significant reduction of cholesteryl esters and increase of sphingomyelin in the mutants. Compared to previously available zebrafish models, our model seems to recapitulate better the early onset forms of the NPC disease. Thus, this new model of NPC will allow future research in the cellular and molecular causes/consequences of the disease and on the search for new treatments.

A homozygous variant in IVNS1ABP was identified in three siblings, displaying progeroid features with severe neuropathy. By generating isogenic induced pluripotent stem cells (iPSCs) from the patients fibroblasts and differentiating the iPSCs into neural progenitor cells (NPCs), we found that mutant IVNS1ABP fibroblasts, iPSCs, and NPCs exhibited disrupted cytokinesis, DNA damage and cellular senescence. Correspondingly, cerebral organoids displayed premature differentiation of NPCs to neurons. Molecular profiling as well as biochemical and cellular analysis revealed altered binding of mutant IVNS1ABP to actin /actin-associated proteins and dysregulated actin dynamics during cytokinesis. Taken together, we propose that mutant IVNS1ABP dysregulates actin polymerization and organization which is at least partly responsible for the cellular senescence phenotypes in this progeroid neuropathy syndrome.

Limb-Girdle Muscular Dystrophy Type-2B/2R is caused by mutations in the dysferlin gene (DYSF). This disease has two known pathogenic missense mutations that occur within dysferlins C2A domain, namely C2AW52R and C2AV67D. Yet, the etiological rationale to explain the disease linkage for these two mutations is still unclear. In this study, we have presented evidence from biophysical, computational, and immunological experiments which suggest that these missense mutations interfere with dysferlins ability to repair cells. The failure of C2AW52R and C2AV67D to initiate membrane repair arises from their propensity to form stable amyloid. The misfolding of the C2A domain caused by either mutation exposes {beta}-strands, which are predicted to nucleate classical amyloid structures. When dysferlin C2A amyloid is formed, it triggers the NLRP3 inflammasome, leading to the secretion of inflammatory cytokines, including IL-1{beta}. The present study suggests that the muscle dysfunction and inflammation evident in Limb-Girdle Muscular Dystrophy types-2B/2R, specifically in cases involving C2AW52R and C2AV67D, as well as other C2 domain mutations with considerable hydrophobic core involvement, may be attributed to this mechanism.

Metabolic dysfunction-associated steatotic liver disease (MASLD) begins with simple steatosis, which can progress to hepatocellular carcinoma (HCC). The pathogenesis of MASLD alters the secretion of hepatokines such as fibrinogen-like 1 (FGL1), a candidate mediator of liver steatosis and hyperglycemia. To investigate the contribution of FGL1 to liver diseases, we compared wild-type mice to mice with hepatocyte-specific deletion of Fgl1 subjected to a steatosis or HCC experimental protocol. We found that mice deficient for Fgl1 in hepatocytes showed higher levels of plasma glucose, pronounced metabolic alterations and liver injury when fed a western diet compared to their wild-type counterparts. However, both genotypes exhibited a similar lipid deposition in the liver. Similarly, wild type and Fgl1-deficient mice displayed comparable liver alterations during HCC progression. We observed that FGL1 expression was repressed during MASLD progression in mice and human concomitantly with the severity of liver injury. Altogether, these findings suggest that FGL1 is not a major contributor to the pathogenesis of MASLD and HCC.

Retinitis Pigmentosa (RP) is a group of inherited retinal diseases that initially affects rod photoreceptors and causes progressive vision loss and blindness. Mutations in rhodopsin (RHO) can cause both autosomal recessive (ar) and dominant (ad) forms of RP, yet, the underlying degenerative mechanisms remain largely unknown, rendering the disease untreatable. Here, we focus on an in-frame, 3-base pair deletion, eliminating the isoleucine residue at codon 255 (i.e., RHO{Delta}I255) and resulting in adRP. We generated a novel knock-in mouse homologous to the human RHO{Delta}I255 mutation. This new mouse model displays a severe disruption of photoreceptor structure and function, as is seen in human patients. Our results indicate that this form of RP is a systems disease of the neuroretina that also impacts neuronal connectivity of bipolar- and horizontal cells, initiates neuroinflammation, and reduces the structural and functional integrity of the retina. Typical for adRP, Rho{Delta}I255 mice exhibit primary rod photoreceptor loss, followed by secondary cone degeneration, rhodopsin protein (RHO) mislocalization, progressive shortening of outer segments (OS), and disorganized OS structures. Subsequently, increasing gliosis, morphologic abnormalities of the inner retina, and impaired cone-driven visual function developed. In adRP, a single mutated allele is sufficient to cause the disease, as confirmed here in Rho{Delta}I255/+ heterozygous animals, where most photoreceptors were lost within two months after birth. Compared to this, homozygous Rho{Delta}I255/{Delta}I255 mutants exhibit an accelerated onset and even faster progression of retinal degeneration. The degeneration of Rho{Delta}I255-mutant photoreceptors was linked to the activation of both caspase- and calpain-type proteases, as well as poly(ADP-ribose) polymerase (PARP), indicating a parallel execution of both apoptotic and non-apoptotic processes. In conclusion, our data indicate that this form of RP affects the neuroretina beyond photoreceptor cell loss sharing features typical for other degenerative central nervous systems diseases, an insight, which may bear critical impact to understand and eventually develop treatment for these currently untreatable forms of blindness. Author summaryDominant mutations in the human rhodopsin gene are among the most common causes for the blinding disease retinitis pigmentosa (RP). To date, the underlying pathophysiological mechanisms are still largely unknown and dominant RP remains untreatable. Here, we introduce a new knock-in mouse model carrying the dominant human Rho{Delta}I255 mutation. As in humans, the Rho{Delta}I255 mouse suffers from a rapid degeneration of rod photoreceptors followed by subsequent cell death of cone photoreceptors and complete loss of visual function. The new mouse model displays sign of neuroinflammation and the concomitant activation of both apoptotic and non-apoptotic cell death mechanisms. These results will likely stimulate further studies into the degenerative processes governing dominant RP and may facilitate future therapy development for inherited retinal diseases that are still untreatable to this day.

Mutations of ubiquitous PRPF splicing factors represent the second cause of retina-specific autosomic dominant retinitis pigmentosa. Prpf31 downregulation decreases phagocytosis of mouse and human retinal pigment epithelial (RPE) cells, thus suggesting similar pathogenesis between species. With time, the mouse RPE ultrastructure shows signs of cellular stress such as cytoplasmic vacuoles. To decipher the primary cellular origin of Prpf31-related deleterious processes we first confirmed the gradual accumulation of protein and lipid oxidations. We then showed deregulation in the expression levels of oxidative and endoplasmic reticulum stress markers as well as of mitochondrial respiratory chain constituants, first and foremost in the RPE from 3 months onward. For the first time we analyzed the energetic metabolism of freshly dissected RPE/choroid, retina and peritoneal macrophages, and showed that mitochondrial respiration and global energy production were decreased solely in Prpf31+/- RPE cells. Therefore, our results indicate that metabolic impairments and associated stress might contribute to pathogenesis first in Prpf31+/- RPE cells before affecting the retina.

Pathogenic variants in the X-linked gene NDP (Norrie disease protein) have been associated with a variety of non-syndromic and syndromic human retinal diseases, including Norrie disease and familial exudative vitroretinopathy. The gene codes for Norrin, a secreted angiogenic molecule which binds to FZD4 and its co-receptors LRP5/6 and TSPAN12 and activates Wnt-signaling. Additionally, it also potentiates Wnt-signaling by binding to the LGR4 receptor. Norrin was also found to exert a neuroprotective function in the retina, specifically for retinal ganglion cells. Furthermore, it was suggested to be involved in neurodevelopmental processes such as early neuro-ectodermal specification and differentiation, as well as maintenance of cochlear hair cells. To better understand the putative role of Norrin in neuronal cells of the retina we generated NDP mutant and eGFP-expressing NDP reporter human induced pluripotent stem cells, which were differentiated to retinal organoids. Bulk RNA sequencing and fixed single-cell RNA sequencing revealed alterations in gene expression as well as cellular composition, with increased proportions of retinal progenitors as well as Muller glia cells in NDPKO retinal organoids. Differential expression of genes related to glutamate signaling, Wnt and MAPK signaling, as well as neurogenesis was detected. Furthermore, genes associated with functions in the extracellular matrix were also differentially expressed. The considerable decrease in retinal neurons found in our NDPKO organoids suggest that Norrin is also important for retinal neurogenesis, which may precede the vascular manifestations in NDP-associated diseases.

Wolman disease (WD) is a severe lysosomal storage disorder characterized by fatal lipid accumulation caused by the deficiency of a lipid metabolic enzyme, Lysosomal Acid Lipase (LAL), involved in the lysosomal hydrolysis of cholesterols and triglycerides. Due to the imbalance of lipids homeostasis, WD patients suffer from severe hepatosplenomegaly, hepatic failure and adrenal calcification resulting in a premature infant death within the first year of age. In this work, we explored multiple imaging analyses to fully characterize the phenotype of LAL deficient cells. In particular, we stained WD patients fibroblasts for intracellular lipid droplets (LD) and lysosomes and we analysed staining intensity and granularity as well as an increased number of LD and lysosomes using fluorescence wide field microscopy, confocal microscopy, conventional and image flow cytometry. Noteworthy, we showed that lipid homeostasis was restored upon delivery of a functional LAL transgene. Finally, since fibroblasts cannot be used as routine clinical test as they are difficult to collect from WD patients, we confirmed our observations in LAL deficient human blood cell lines and in peripheral blood mononuclear cells (PBMC) from LAL deficient (LAL-D) mouse model, as a proxy for easily accessible WD PBMC. Overall, we expect that this novel imaging analysis pipeline will help to diagnose WD, follow its progression and evaluate the success of enzyme replacement therapy or gene correction strategies for WD as well as other lysosomal storage disorders.

In 2012 Liu et al. reported that miR-34 is an age-related miRNA regulating age-associated events and long-term brain integrity in Drosophila. They demonstrated that modulating miR-34 and its downstream target Eip74EF showed beneficial effects on age-related diseases using a Drosophila model of SCA3trQ78. These results imply that miR-34 could be a general genetic modifier and therapeutic candidate for age-related diseases. Therefore, we examined the effect of miR-34 and Eip74EF on another age-related Drosophila disease model. Using a Drosophila model expressing mutant Drosophila VCP that causes amyotrophic lateral sclerosis (ALS) and frontotemporal dementia (FTD), or multisystem proteinopathy (MSP), we demonstrated that abnormal eye phenotypes generated by Drosophila VCP R152H were rescued when expressed with Eip74EF siRNA. Contrary to our expectation, miR-34 overexpression resulted in lethality when expressed with mutant VCP. Our data indicate that the other downstream targets of miR-34 might more significantly interact with mutant VCP, causing lethality. Identifying transcriptional targets of Eip74EF might provide valuable insights into diseases caused by mutations in VCP such as ALS, FTD, and MSP.

Peroxisomal Biogenesis Disorders (PBDs) are a class of inherited metabolic disorders with profound neurological and other phenotypes. The most severe PBDs are caused by mutations in peroxin genes, which result in nonfunctional peroxisomes typically through impaired protein import. In order to better understand the molecular causes of Zellweger Spectrum Disease (ZSD) -the most severe PBDs -, we investigated the fate of peroxisomal mRNAs and proteins in ZSD model systems. We found that loss of peroxisomal import has no effect on peroxin mRNA expression or translational efficiency. Instead, peroxin proteins--still produced at high levels-- aberrantly accumulate on the mitochondrial membrane, impairing respiration and ATP generation. Finally, we rescued mitochondrial function in fibroblasts derived from human patients with ZSD by overexpressing ATAD1, an AAA-ATPase that functions in mitochondrial quality control. These findings might provide a new focus of PBD therapies in supporting quality control pathways that protect mitochondrial function.

Progressive neurodegeneration and cognitive disability are prominent symptoms of MPS VII, a lysosomal storage disorder caused by {beta}-glucuronidase enzyme deficiency. Yet, the mechanism of neurodegeneration in MPS VII remains elusive thereby limiting the scope of targeted intervention. To address this, we recently developed a {beta}-glucuronidase-deficient (CG2135-/-) Drosophila model of MPS VII. The CG2135-/- flies exhibited signs of neuromuscular degeneration, including loss of dopaminergic neurons, and accumulated engorged lysosomes, ubiquitinated proteins and mitochondria in their brains. These observations, coupled with our current finding that the CG2135-/- flies were highly susceptible to starvation, prompted us to investigate potential defects in the autophagy-lysosomal clearance machinery in the brain. We found that both autophagy induction and lysosome-mediated autophagosomal turnover were impaired in the CG2135-/- fly brain. This was evidenced by lower Atg8a-II levels, reduced Atg1 and Ref(2)P expression along with accumulation of lipofuscin-like inclusions and multilamellar bodies. Interestingly, mitophagy was also found to be defective in their brain, causing buildup of enlarged mitochondria with distorted cristae and reduced membrane potential. This, in turn, affected mitochondrial function as reflected by drastically reduced brain ATP levels. Energy depletion triggered apoptosis in neuronal as well as non-neuronal cells of the CG2135-/- fly brain, where we also detected apoptotic dopaminergic neurons. Resveratrol treatment, previously found to protect against loss of dopaminergic neurons in the CG2135-/- flies, has now been shown act by correcting the mitophagy defect and preventing ATP depletion. Collectively, our study establishes a causal link between mitophagy defect, mitochondrial malfunction, and apoptotic neurodegeneration in MPS VII.

Glaucoma is an optic neuropathy often referred to as "the silent thief of sight", due to its late diagnosis, which is generally made when degeneration of the optic nerve and retinal ganglion cells is already well under way. It is thus of utmost importance to have a better understanding of the disease, and to investigate more deeply the early causes of glaucoma. The transcriptional coactivator YAP recently emerged as an important regulator of eye homeostasis and is drawing attention in the glaucoma research field. Here we show that Yap conditional knockout mice (Yap cKO), in which the deletion of Yap is induced in both Muller glia (i.e. the only retinal YAP-expressing cells) and the non-pigmented epithelial cells of the ciliary body, exhibit breakdown of the aqueous-blood barrier accompanied by progressive collapse of the ciliary body as we observed in human uveitic patients. In addition, aged Yap cKO mice harbor glaucoma features, including alteration of glutamate recycling, deregulation of key homeostatic Muller-derived proteins, retinal vascular defects, optic nerve degeneration, and retinal ganglion cell death. Together, our findings reveal the essential role of YAP in preserving the ciliary body and the retinal ganglion cells, thereby preventing the onset of glaucoma features.

Dominant variants in WFS1, a gene coding for the mitochondria-associated endoplasmic reticulum (ER) membrane (MAM) resident protein Wolframin, have been associated with Wolfram-like syndrome (WLS). In vitro and in vivo, WFS1 loss results in reduced ER to mitochondria calcium (Ca2+) transfer, mitochondrial dysfunction, and enhanced autophagy and mitophagy. However, in WLS pathological context, whether the mutant protein triggers the same cellular processes is unknown. Here, we show that, in human fibroblasts and murine neuronal cultures, WLS protein WFS1E864K leads to decreases in mitochondria bioenergetics and Ca2+ uptake, deregulation of the mitochondrial quality system mechanisms, and alteration of the autophagic flux. Moreover, in the Wfs1E864K mouse, these alterations are concomitant with a decrease of MAM number. These findings reveal pathophysiological similarities between WS and WLS, highlighting the importance of WFS1 for MAMs integrity and functionality. It may open new treatment perspectives, until now non-existent, for patients with WLS.

Metabolic associated fatty liver disease (MAFLD) consists of lipid accumulation in the liver. Lipotoxicity, supported by aberrant amino acid metabolism, induces TLR9 upregulation, and activation, driving inflammation. Relatively, erythrocyte TLR9 activation leads to membrane rearrangement, surface CD47 loss, and pro-inflammatory erythrophagocytosis. Erythrocyte surface protein loss is accompanied by chemokine release. In addition, CD47 binds circulating TSP-1, a molecule controlling arginine and glutamine metabolism, along with metabolic inflammation. Based on these, we speculated that in MAFLD, lipotoxicity would drive erythrocyte TLR9 upregulation and activation, leading to immunometabolic remodeling. Twenty-four patients (15 men and 9 women) with MAFLD and 9 healthy controls (4 men and 5 women) were enrolled. Erythrocytes were isolated from EDTA-containing blood. Protein levels were measured in erythrocyte lysates (triton X-100 0.01% v/v) or plasma with enzyme-linked immunosorbent assays, whereas lipids and enzyme activities were measured in erythrocyte hemoglobin-free membranes by a semi-quantitative thin layer chromatography and assay kits, respectively. The levels of TLR9 were increased (p=0.002) and positively correlated with sphingosine levels, albeit not statistically significantly (p=0.060). The erythrocyte membrane PC/PE ratio was decreased (p=0.002) and inversely correlated to TLR9 levels. Erythrocyte TLR9 levels correlated inversely with CD47, and positively with MCP-1 release. TSP-1 was decreased in MAFLD erythrocytes (p=0.0017) and correlated positively with CD47 and negatively with TLR9 levels. In vitro, erythrocytes of MAFLD patients bound less TSP-1 molecules. Erythrocytes of MAFLD patients also exhibit decreased arginase-1 protein (p=0.009) and activity (p=0.042). Glutaminase activity was increased, albeit to not statistically significantly different levels (p=0.25). The levels of CD35 were not different (p=0.65), excluding the role of erythrocyte aging for explaining these events. In MAFLD patients, erythrocyte TLR9 is upregulated and is associated with erythrocyte sphingolipid and glycerophospholipid perturbation, CD47 loss, MCP1 release, reduced TSP-1 scavenging, decreased arginase and increased glutaminase.

IntroductionZellweger spectrum disorder (ZSD) is an autosomal recessive disorder caused by mutations in any of 13 PEX genes encoding proteins required for peroxisome assembly and function. Chronic liver disease is one of the major clinical manifestations in patients and impacts quality of life and survival. However, the pathophysiology of liver disease is ZSD remains largely unknown, and current interventions are limited. To further study the liver disease mechanism, we use the PEX1-Gly844Asp (G844D) mouse model for mild ZSD, which was previously shown to develop hepatomegaly and cholestasis, similar to ZSD patients. MethodsThe natural history of hepatopathy was broadly characterized in PEX1-G844D mice and littermate controls from 1 to 18 months of age using liver histology, electron microscopy, cultured hepatocytes and blood. Metabolite and mechanism analysis included liver functions, respiratory chain dynamics, lipidomics, peroxisome metabolites, gene and protein expression assays. ResultsPEX1-G844D mice featured liver disease progression from hepatomegaly (1 month) to cluster cell death (4 months), hepatosteatosis (6 months), inflammation (8 months), fibrosis, and hepatic cancer (12 and 15 months). Hepatocyte proliferation and reduced glycogen was observed across all ages. Measurement of peroxisomal functions showed defective peroxisomal import and secondary mitochondrial defects in cultured hepatocytes. In blood and liver, plasmalogens were decreased, and C26:0 lyso-phosphatidylcholine and C27 bile acid intermediates were elevated. In liver, we observed accumulation of triglycerides and cholesterol, and reduced membrane phospholipids and sphingolipids. In contrast, in serum we observed reduced triglycerides, cholesterol and membrane lipids. Gene expression profiles confirmed by immunoblotting supported reduced hepatic de novo lipogenesis, increased hepatic lipid uptake and oxidation, PPAR activation, and modulated glucose and glycogen metabolism. Liver X receptor agonist (T0901317) applied to cultured hepatocytes enhanced hepatic lipogenesis and lipid secretion, but aggravated steatosis. ConclusionTaken together, these results suggested the following mechanisms of hepatopathy progression. We propose that global peroxisome dysfunction (1) causes PPAR activation, leading to chronic hyperplasia and partially contributing to disrupted hepatic lipid homeostasis with hepatosteatosis, and (2) underlies chronic hypoglycemia, causing hypoinsulinemia and contributing to reduced hepatic lipogenesis and systemic lipid deficiency. Growth restriction in the mouse model and in ZSD patients could be attributable to systemic lipid deficiency. Our mechanistic delineation of the pathophysiology provides other additional novel potential therapeutic targets to halt liver disease in ZSD.

X-linked adrenoleukodystrophy (X-ALD) is an inherited progressive metabolic disorder caused by pathogenic variants in the ABCD1 gene, which leads to accumulation of very long chain fatty acids in body fluids and tissues including brain and spinal cord. In the absence of a clear genotype-phenotype correlation the molecular mechanisms of the severe cerebral adrenoleukodystrophy (cALD) and the milder adrenomyeloneuropathy (AMN) phenotypes remain unknown. Given our previous evidence of role of astrocytes in the neuroinflammatory response in X-ALD we investigated the metabolic and molecular profiles of astrocytes derived from induced pluripotent stem cells (iPSC). The iPSCs were in turn generated from skin fibroblasts from healthy controls and patients with AMN or cALD. AMN and cALD astrocytes exhibited lack of ABCD1 and accumulation of very long chain fatty acids, a hallmark of X-ALD disease. Further, cALD astrocytes harbor significantly higher phosphorylation of STAT3, increased Toll-like receptor expression and higher chemokine and cytokine expression. In this first report of miRNA sequencing in X-ALD astrocytes, we observed that miR-9 expression was associated with increasing disease severity phenotype. CRISPR-Cas9 knock-in of ABCD1ABCD1 gene expression differentially affected the expression of key molecular, metabolic and microRNA targets in AMN and cALD astrocytes. Extensive characterization of the AMN and cALD iPSC-derived astrocyte model demonstrates critical aspects of X-ALD inflammatory disease in response to ABCD1ABCD1 mutation and can be further utilized for exploring the contribution of astrocytes to differential inflammatory response in cALD.

The retina has one of the highest energy demands in the human body, and proper regulation of metabolism among the cell types of the retina is required for functional vision. Recent studies have reported that retinal metabolism is disrupted during retinal degeneration and aging, while therapies designed to enhance metabolism can slow or prevent degeneration. Here, we show that multiple metabolic pathways, including those regulated by a key ATP sensor and regulator of metabolism, AMP-activated-kinase (AMPK), were dysregulated in a model of inherited retinal degeneration. In order to assess the direct role of AMPK in regulating retinal metabolism, we used mice with retina-specific knockout of AMPK activity. Conditional loss of AMPK resulted in impaired visual function at an early age, with slow photoreceptor loss observed in older mice. Moreover, we found that loss of AMPK resulted in decreased metabolic flux from glucose, decreased mitochondrial DNA copy number, decreased mitochondrial-related gene expression, and alterations in mitochondrial morphology in the photoreceptors, all of which preceded degeneration. Surprisingly, metabolic changes from the loss of AMPK in retinal neurons also resulted in secondary degeneration of retinal pigment epithelial (RPE) cells. Together, these data show that AMPK signaling is important for maintaining metabolic homeostasis of the retina and support the hypothesis that photoreceptors and RPE have a shared metabolic ecosystem that is controlled, in part, by AMPK.