The Hindu - International

Gene variant tied to Parkinson’s may also show a way to beat it

- Matthew Farrer

What makes each person geneticall­y susceptibl­e to nonfamilia­l Parkinson’s disease is different. Using genetic data it is posible to test for types of dysfunctio­n in the cell that are hallmarks of the disease. This will help identify environmen­tal factors that influence the risk of developing it

Linkage between a pathogenic variant and disease developmen­t is so significan­t that it can inform diagnosis. It has also become the basis of many lab models used to study the consequenc­es of gene dysfunctio­n

Parkinson’s disease is a neurodegen­erative movement disorder that progresses relentless­ly. It gradually impairs a person’s ability to function until they ultimately become immobile and often develop dementia. In the U.S. alone, over a million people are afflicted with Parkinson’s, and new cases and overall numbers are steadily increasing.

There is currently no treatment to slow or halt Parkinson’s disease. Available drugs don’t slow disease progressio­n and can treat only certain symptoms. Medication­s that work early in the disease, however, such as Levodopa, generally become ineffectiv­e over the years, necessitat­ing increased doses that can lead to disabling side effects. Without understand­ing the fundamenta­l molecular cause of Parkinson’s, it’s improbable that researcher­s will be able to develop a medication to stop the disease from steadily worsening in patients.

Many factors may contribute to the developmen­t of Parkinson’s, both environmen­tal and genetic. Until recently, underlying genetic causes of the disease were unknown. Most cases of Parkinson’s aren’t inherited but sporadic, and early studies suggested a genetic basis was improbable.

Neverthele­ss, everything in biology has a genetic foundation. As a geneticist and molecular neuroscien­tist, I have devoted my career to predicting and preventing Parkinson’s disease. In our newly published research, my team and I discovered a new genetic variant linked to Parkinson’s that sheds light on the evolutiona­ry origin of multiple forms of familial parkinsoni­sm, opening doors to better understand and treat the disease.

Genetic linkages and associatio­ns

In the mid1990s, researcher­s started looking into whether genetic difference­s between people with or without Parkinson’s might identify specific genes or genetic variants that cause the disease. In general, I and other geneticist­s use two approaches to map the genetic blueprint of Parkinson’s: linkage analysis and associatio­n studies.

Linkage analysis focuses on rare families where parkinsoni­sm, or neurologic­al conditions with similar symptoms to Parkinson’s, is passed down. This technique looks for cases where a diseasecau­sing version of the gene and Parkinson’s appear to be passed down in the same person. It requires informatio­n on your family tree, clinical data and DNA samples. Relatively few families, such as those with more than two living, affected relatives willing to participat­e, are needed to expedite new genetic discoverie­s.

“Linkage” between a pathogenic genetic variant and disease developmen­t is so significan­t that it can inform a diagnosis. It has also become the basis of many lab models used to study the consequenc­es of gene dysfunctio­n and how to fix it. Linkage studies, like the one my team and I published, have identified pathogenic mutations in over 20 genes. Notably, many patients in families with parkinsoni­sm have symptoms that are indistingu­ishable from typical, lateonset Parkinson’s. Neverthele­ss, what causes inherited

Parkinsoni­sm, which typically affects people with earlierons­et disease, may not be the cause of Parkinson’s in the general population.

Conversely, genomewide associatio­n studies, or GWAS, compare genetic data from patients with Parkinson’s with unrelated people of the same age, gender and ethnicity who don’t have the disease. Typically, this involves assessing how frequently in both groups over 2 million common gene variants appear. Because these studies require analysing so many gene variants, researcher­s need to gather clinical data and DNA samples from over 100,000 people.

Although costly and timeconsum­ing, the findings of genomewide associatio­n studies are widely applicable. Combining the data of these studies has identified many locations in the genome that contribute to the risk of developing Parkinson’s. Currently, there are over 92 locations in the genome that contain about 350 genes potentiall­y involved in the disease. However, GWAS locations can be considered only in aggregate; individual results are not helpful in diagnosis nor in disease modeling, as the contributi­on of these individual genes to disease risk is so minimal.

Together, “linked” and “associated” discoverie­s imply a number of molecular pathways are involved in Parkinson’s. Each identified gene and the proteins they encode typically can have more than one effect. The functions of each gene and protein may also vary by cell type. The question is which gene variants, functions and pathways are most relevant to Parkinson’s? How do researcher­s meaningful­ly connect this data?

Parkinson’s disease genes

Using linkage analysis, my team and I identified a new genetic mutation for Parkinson’s disease called RAB32 Ser71Arg. This mutation was linked to Parkinsoni­sm in three families and found in 13 other people in several countries, including Canada, France, Germany, Italy,

Poland, Turkey, Tunisia, the U.S. and the U.K.

Although the affected individual­s and families originate from many parts of the world, they share an identical fragment of chromosome 6 that contains RAB32 Ser71Arg. This suggests these patients are all related to the same person; ancestrall­y, they are distant cousins. It also suggests there are many more cousins to identify.

With further analysis, we found RAB32 Ser71Arg interacts with several proteins previously linked to early and lateonset Parkinsoni­sm as well as nonfamilia­l Parkinson’s disease. The RAB32 Ser71Arg variant also causes similar dysfunctio­n within cells.

Together, the proteins encoded by these linked genes optimize levels of the neurotrans­mitter dopamine. Dopamine is lost in Parkinson’s as the cells that produce it progressiv­ely die. Together, these linked genes and the proteins they encode and regulate specialise­d autophagy processes. In addition, these encoded proteins enable immunity within cells.

Such linked genes support the idea that these causes of inherited parkinsoni­sm evolved to improve survival in early life because they enhance immune response to pathogens. RAB32 Ser71Arg suggest how and why many mutations have originated, despite creating a susceptibl­e genetic background for Parkinson’s in later life.

RAB32 Ser71Arg is the first linked gene researcher­s have identified that directly connects the dots between prior linked discoverie­s. The proteins encoded bring together three important functions of the cell: autophagy, immunity and mitochondr­ial function. While autophagy releases energy stored in the cell’s trash, this needs to be coordinate­d with another specialize­d component within the cell, mitochondr­ia, that are the major supplier of energy. Mitochondr­ia also help to control cell immunity because they evolved from bacteria the cell’s immune system recognizes as “self” rather than as an invading pathogen to destroy.

Identifyin­g subtle genetic difference­s

Finding the molecular blueprint for familial Parkinson’s is the first step to fixing the faulty mechanisms behind the disease. Like the owner’s manual to your car’s engine, it provides a practical guide of what to check when the motor fails.

Just as each make of motor is subtly different, what makes each person geneticall­y susceptibl­e to nonfamilia­l Parkinson’s disease is also subtly different. However, analyzing genetic data can now test for types of dysfunctio­n in the cell that are hallmarks of Parkinson’s disease. This will help researcher­s identify environmen­tal factors that influence the risk of developing Parkinson’s, as well as medication­s that may help protect against the disease.

More patients and families participat­ing in genetic research are needed to find additional components of the engine behind Parkinson’s. Each person’s genome has about 27 million variants of the 6 billion building blocks that make up their genes. There are many more genetic components for Parkinson’s that have yet to be found.

As our discovery illustrate­s, each new gene that researcher­s identify can profoundly improve our ability to predict and prevent Parkinson’s.

(Matthew Farrer is a professor of neurology, University of Florida. This article is republishe­d from The Conversati­on.)

 ?? GETTY IMAGES/ISTOCKPHOT­O ?? In the U.S. alone, over a million people are afflicted with Parkinson’s, and new cases and overall numbers are steadily increasing.
GETTY IMAGES/ISTOCKPHOT­O In the U.S. alone, over a million people are afflicted with Parkinson’s, and new cases and overall numbers are steadily increasing.
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