Hereditary sensory and autonomic neuropathies (HSAN) are a genetically diverse group of disorders. These disorders are not uncommon, and contribute to major disability from extremity pain, frequent ulcerations and amputations. Some varieties may also affect the central nervous system with dementia, hearing loss, and spinal cord involvements. Clinical heterogeneity between and within families leads to these conditions frequently being under diagnosed or wrongly diagnosed typically as primary acquired disorders. As part of a program to nurture the career development of a clinician-investigator, we propose to test the postulate that HSAN neuropathies are caused by genetic defects important in axon integrity. The causative mutation(s) are hypothesized to be either coding sequence alterations or dosage effect due to copy number change. Additionally, phenotypic variable expression is hypothesized to be related to copy number change in HSAN varieties. The conceptual framework of this proposal rests on our preliminary work identifying chromosomal localization in a large HSAN kindred with hearing loss and dementia. We have also collected many other HSAN kindreds available for analysis. Affected kindreds and a large number of sporadically affected individuals have undergone quantitative clinical testing for comparison. We will take advantage of next-generation sequencing combined with sequence capture of the targeted regions to identify the sequence alterations, and comparative genome hybridization array to identify copy number changes. We will also assess the possible copy number changes of the previously identified HSAN genes for other affected kindreds. This project is the first step towards understanding the molecular basis of these varieties of neurologic disorders, providing necessary training for investigating other inherited neuropathies and the foundation for downstream translational discoveries. The proposed project involves close interaction with the established mentor and co-mentors at an institution with a record of excellence in clinically relevant basic science research. The candidate has already demonstrated potential for independent patient-based laboratory research. With training in advanced technology, web bioinformatics applications and biostatistics provided by this project, the candidate will develop a successful independent research program in patient relevant translational research.
Project Narrative: The genetic cause of many forms of hereditary sensory and autonomic neuropathy is still unknown. Our research will result in the identification of causative genes and further understanding of molecular pathways involved in these disorders. The results from the present study will improve our knowledge of disease mechanism and our ability to diagnose, ultimately to provide effective treatments for patients with peripheral neuropathy.
|Klein, Christopher J; Benarroch, Eduardo E (2014) Epigenetic regulation: basic concepts and relevance to neurologic disease. Neurology 82:1833-40|
|Klein, Christopher J; Middha, Sumit; Duan, Xiaohui et al. (2014) Application of whole exome sequencing in undiagnosed inherited polyneuropathies. J Neurol Neurosurg Psychiatry 85:1265-72|
|Liewluck, Teerin; Klein, Christopher J; Jones Jr, Lyell K (2014) Cramp-fasciculation syndrome in patients with and without neural autoantibodies. Muscle Nerve 49:351-6|
|Berini, Sarah E; Spinner, Robert J; Jentoft, Mark E et al. (2014) Chronic meralgia paresthetica and neurectomy: a clinical pathologic study. Neurology 82:1551-5|
|Sun, Zhifu; Wu, Yanhong; Ordog, Tamas et al. (2014) Aberrant signature methylome by DNMT1 hot spot mutation in hereditary sensory and autonomic neuropathy 1E. Epigenetics 9:1184-93|
|Klein, Christopher J; Wu, Yanhong; Vogel, Peter et al. (2014) Ubiquitin ligase defect by DCAF8 mutation causes HMSN2 with giant axons. Neurology 82:873-8|
|Klein, Christopher J; Lennon, Vanda A; Aston, Paula A et al. (2013) Insights from LGI1 and CASPR2 potassium channel complex autoantibody subtyping. JAMA Neurol 70:229-34|
|Klein, Christopher J; Barbara, David W; Sprung, Juraj et al. (2013) Surgical and postpartum hereditary brachial plexus attacks and prophylactic immunotherapy. Muscle Nerve 47:23-7|
|Klein, Christopher J; Duan, Xiaohui; Shy, Michael E (2013) Inherited neuropathies: clinical overview and update. Muscle Nerve 48:604-22|
|Klein, Christopher J; Bird, Tom; Ertekin-Taner, Nilufer et al. (2013) DNMT1 mutation hot spot causes varied phenotypes of HSAN1 with dementia and hearing loss. Neurology 80:824-8|
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