Precision therapy for a new disorder of AMPA receptor recycling due to mutations in ATAD1
RC Ahrens-Nicklas, GKE Umanah…�- Neurology�…, 2017 - AAN Enterprises
Neurology: Genetics, 2017•AAN Enterprises
Objective: ATAD1 encodes Thorase, a mediator of α-amino-3-hydroxy-5-methylisoxazole-4-
proprionate (AMPA) receptor recycling; in this work, we characterized the phenotype
resulting from ATAD1 mutations and developed a targeted therapy in both mice and
humans. Methods: Using exome sequencing, we identified a novel ATAD1 mutation (p.
E276X) as the etiology of a devastating neurologic disorder characterized by hypertonia,
seizures, and death in a consanguineous family. We postulated that pathogenesis was a�…
proprionate (AMPA) receptor recycling; in this work, we characterized the phenotype
resulting from ATAD1 mutations and developed a targeted therapy in both mice and
humans. Methods: Using exome sequencing, we identified a novel ATAD1 mutation (p.
E276X) as the etiology of a devastating neurologic disorder characterized by hypertonia,
seizures, and death in a consanguineous family. We postulated that pathogenesis was a�…
Objective
ATAD1 encodes Thorase, a mediator of α-amino-3-hydroxy-5-methylisoxazole-4-proprionate (AMPA) receptor recycling; in this work, we characterized the phenotype resulting from ATAD1 mutations and developed a targeted therapy in both mice and humans.
Methods
Using exome sequencing, we identified a novel ATAD1 mutation (p.E276X) as the etiology of a devastating neurologic disorder characterized by hypertonia, seizures, and death in a consanguineous family. We postulated that pathogenesis was a result of excessive AMPA receptor activity and designed a targeted therapeutic approach using perampanel, an AMPA-receptor antagonist.
Results
Perampanel therapy in ATAD1 knockout mice reversed behavioral defects, normalized brain MRI abnormalities, prevented seizures, and prolonged survival. The ATAD1 patients treated with perampanel showed improvement in hypertonicity and resolution of seizures.
Conclusions
This work demonstrates that identification of novel monogenic neurologic disorders and observation of response to targeted therapeutics can provide important insights into human nervous system functioning.
American Academy of Neurology