The Pathophysiology of Spinal Bulbar Muscular Atrophy: a Longitudinal Analysis of Mouse Muscle and Spinal Cord
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The pathophysiology of Spinal Bulbar Muscular Atrophy: a longitudinal analysis of mouse muscle and spinal cord By Leonette Victoria Naakuma Delali Annan University College London, Institute of Neurology PhD Supervisors: Professor Linda Greensmith and Professor Gyorgy Szabadkai A Thesis submitted for the degree of Doctor of Philosophy (PhD) October 2017 1 Declaration I, Leonette Victoria Naakuma Delali Annan, confirm that the work presented in this Thesis is my own. Where information has been derived from other sources, I confirm that this has been indicated in the Thesis. 2 Acknowledgements I would like to express my huge gratitude to Professor Linda Greensmith who has provided immense guidance, support and mentoring throughout my time in her lab. I would like to thank Jim Dick, the Graham Watts Lab Manager, who is simply phenomenal in his assistance to all members of the lab. I would also like to thank the Greensmith lab Post-Docs: Dr Bilal Malik, Dr Mhoriam Ahmed, Dr Barney Bryson, Dr Ching-Hua Lu and Dr Bernadett Kalmar for their day-to-day laboratory guidance and stimulating discussions. Lastly, I would like to thank my fellow students for their company and support. This Thesis was funded by a Wellcome Trust 4-year PhD in Neuroscience Studentship. This Thesis is dedicated to my beloved sisters, Anouska and Suzette Annan. All Glory and Honour be to God. 3 Abstract Spinal Bulbar Muscular Atrophy (SBMA), also known as Kennedy's disease, is an X- linked, late-onset progressive neurodegenerative disease. SBMA is characterised by the selective loss of spinal and bulbar motor neurons and progressive muscle weakness. The disease is caused by an expansion in the CAG repeat in the androgen receptor (AR) gene which encodes a polyglutamine tract in the protein. The underlying pathophysiology of the disease is thought to be related to abnormal accumulation of the pathogenic AR protein within the nucleus. The AR100 transgenic mouse model of SBMA has a progressive neuromuscular phenotype accompanied by motor neuron degeneration, thereby mirroring the human disease. Since ER stress has been suggested to play a role in motor neuron death in SBMA, I investigated the underlying mechanism by which ER stress may result in cell death. In particular, I tested whether the motor neuron-specific Fas/NO cell death pathway plays a role in SBMA. In addition, I examined whether the ER chaperone, Calreticulin forms a link between the Fas/NO MN-specific death pathway and ER stress. I found that Fas/NO induced cell death is not observed in AR100 MNs. However, an increase in Calreticulin is observed in the spinal cord of AR100 mice, suggesting it may contribute to SBMA pathology. Although SBMA is considered to be a neurodegenerative disease affecting motor neurons, emerging evidence suggests that SBMA may also involve a primary muscle deficit. I examined this possibility by characterising muscle histopathology longitudinally, at different stages of disease progression, in AR100 mice. My results show that muscle atrophy is evident during early stages of disease, prior to any loss of motor neurons. Physiological deficits were accompanied by a change in the properties of the muscle fibres such as increase in oxidative capacity and signs of myogenic and neurogenic induced muscle atrophy. Furthermore, RNA-sequencing and pathway enrichment analysis of hindlimb muscles of AR100 mice identified some of the molecular signalling pathways which may underlie the changes within the muscle. These findings indicate that muscle deficits are an early and primary manifestation of disease in SBMA. 4 Contents The pathophysiology of Spinal Bulbar Muscular Atrophy: a longitudinal analysis of mouse muscle and spinal cord .................................................................................... 1 Declaration ................................................................................................................... 2 Acknowledgements ...................................................................................................... 3 Abstract ........................................................................................................................ 4 Contents ....................................................................................................................... 5 List of Figures ............................................................................................................. 12 List of Tables ............................................................................................................... 16 Abbreviations ............................................................................................................. 17 Chapter 1 General Introduction ........................................................................... 19 Introduction ............................................................................................................... 20 1.1 Patient Symptoms ....................................................................................... 20 1.2 Genetic cause of SBMA ............................................................................... 21 1.3 Polyglutamine Disorders ............................................................................. 21 1.3.1 Toxicity of the expanded polyglutamine tract ............................................... 21 1.4 The androgen receptor structure and function .......................................... 24 1.4.1 Non-genomic roles of the Androgens ............................................................ 26 1.5 Pathogenic mechanisms of SBMA ............................................................... 26 1.5.1 Impaired protein homeostasis ....................................................................... 26 1.5.2 Disrupted axonal transport ............................................................................ 27 1.5.3 Reduced neurotrophic support ...................................................................... 28 1.5.4 Transcriptional dysregulation ........................................................................ 28 1.6 Cellular models of SBMA ............................................................................. 29 1.6.1 Induced pluripotent stem cell models of SBMA ............................................ 30 1.7 Chronological review of mouse models of SBMA ....................................... 31 5 1.7.1 Early mouse models of SBMA ........................................................................ 31 1.7.2 The AR97Q mouse model of SBMA ................................................................ 33 1.7.3 The AR112Q mouse model of SBMA .............................................................. 33 1.7.4 The AR100 mouse model of SBMA ................................................................ 34 1.7.5 The knock-in model of SBMA ......................................................................... 34 1.7.6 The WT over-expressor model of SBMA ........................................................ 35 1.7.7 The AR121mouse model of SBMA ................................................................. 36 1.7.8 The AR113 mouse model of SBMA ................................................................ 36 1.8 Therapeutic approaches in SBMA ............................................................... 39 1.8.1 Androgen deprivation .................................................................................... 39 1.8.2 Targeting the AR structure as a therapeutic strategy .................................... 41 1.8.3 Targeting the Heat Shock Response as a therapeutic strategy ..................... 41 1.9 Summary of Thesis Aims ............................................................................. 43 Chapter 2 Mechanisms of MN degeneration in the AR100 Mouse model of SBMA…………. ............................................................................................................. 45 2.1 Introduction ................................................................................................. 46 2.1.1 ER stress, Calreticulin and the Fas/NO Cell death pathway: Do they play a role in SBMA? ................................................................................................................. 46 2.1.2 The Unfolded Protein Response .................................................................... 46 2.1.3 Calcium Homeostasis ..................................................................................... 49 2.1.4 Endoplasmic Reticulum stress in Poly Q Diseases and Motor Neuron Diseases…. ...................................................................................................................... 50 2.1.5 ER Stress in SBMA mouse models .................................................................. 52 2.1.6 ER stress and the Fas/NO cell death pathway ............................................... 53 2.1.7 Aims of this Chapter ....................................................................................... 57 2.2 Materials and Methods ............................................................................... 58 2.2.1 Maintenance and identification of AR100 and SOD1G93A mice ...................... 58 2.2.2 Primary Motor Neuron Cultures .................................................................... 59 6 2.2.3 Spinal Cord Dissection and storage for Western Blotting .............................. 61 2.2.4 Mouse Perfusion, Spinal Cord dissection and sectioning for immunohistochemistry .................................................................................................