ABCD1 translation-initiator mutation demonstrates genotype-phenotype correlation for AMN

Gilmore N. O'Neill, Masashi Aoki, Robert H. Brown

Research output: Contribution to journalArticlepeer-review

20 Citations (Scopus)

Abstract

Background: Inherited mutations of the X-linked adrenoleukodystrophy (X-ALD) gene (ABCD1) cause two neuropathologically distinct disorders: cerebral adrenoleukodystrophy (ALD) and adrenomyeloneuropathy (AMN). The biochemical hallmark of these disorders is a reduction of very long chain fatty acid (VLCFA) β-oxidation with accumulation of VLCFA esters in neural white matter. More than 300 mutations of the ABCD1 gene have been described. Genotype-phenotype correlation in X-ALD has not been demonstrated; indeed, the two disorders coexist in individual pedigrees and in homozygotic twin pairs. Methods: The authors have identified one large kindred with a highly concordant AMN phenotype resembling an X-linked dominant hereditary spastic paraparesis. All obligate female carriers are clinically affected. The ABCD1 gene was examined by direct sequencing of genomic DNA and full-length cDNA. Mutant gene transcription was analyzed by reverse transcriptase PCR. ALD protein (ALDP) expression was tested by Western blotting and indirect immunofluorescence. VLCFA β-oxidation was examined by in vitro assay. Results: The authors have identified a novel deletion of the ABCD1 gene ATG translation initiation codon. The authors have demonstrated that an N-terminal truncated ALDP, missing the first 65 amino acids, is expressed by internal initiation of translation and is correctly trafficked to peroxisomes. They have documented complete penetrance of this mutant in all female carriers. They have also shown that VLCFA β-oxidation is reduced to 20% of normal in association with this mutant ALDP. Conclusion: It appears that initiation of translation at an internal AUG codon generates a truncated ALDP that uniformly leads to an AMN phenotype in this family. Possible models for action of this truncated ALDP and full disease penetrance in heterozygotes are reviewed.

Original languageEnglish
Pages (from-to)1956-1962
Number of pages7
JournalNeurology
Volume57
Issue number11
DOIs
Publication statusPublished - 2001 Dec 11

ASJC Scopus subject areas

  • Clinical Neurology

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