The neuropathology associated with repeat expansions in the C9ORF72 gene
Abstract
An abnormal expansion of a GGGGCC hexanucleotide repeat in a non-coding region of the chromosome 9 open reading frame 72 gene (C9ORF72) is the most common genetic abnormality in familial and sporadic FTLD and ALS and the cause in most families where both, FTLD and ALS, are inherited. Pathologically, C9ORF72 expansion cases show a combination of FTLD-TDP and classical ALS with abnormal accumulation of TDP-43 into neuronal and oligodendroglial inclusions consistently seen in the frontal and temporal cortex, hippocampus and pyramidal motor system. In addition, a highly specific feature in C9ORF72 expansion cases is the presence of ubiquitin and p62 positive, but TDP-43 negative neuronal cytoplasmic and intranuclear inclusions. These TDP-43 negative inclusions contain dipeptide-repeat (DPR) proteins generated by unconventional repeat-associated translation of C9ORF72 transcripts with the expanded repeats and are most abundant in the cerebellum, hippocampus and all neocortex regions. Another consistent pathological feature associated with the production of C9ORF72 transcripts with expanded repeats is the formation of nuclear RNA foci that are frequently observed in the frontal cortex, hippocampus and cerebellum. Here, we summarize the complexity and heterogeneity of the neuropathology associated with the C9ORF72 expansion. We discuss implications of the data to the current classification of FTLD and critically review current insights from clinico-pathological correlative studies regarding the fundamental questions as to what processes are required and sufficient to trigger neurodegeneration in C9ORF72 disease pathogenesis.
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In C9orf72-related ALS and FTD, SQSTM1 accumulates together with ubiquitin in neurons and glia as well as muscle fibers.
“In the most commonly inherited form of ALS and FTD due to mutations in the C9orf72 gene (described below), SQSTM1 accumulates together with ubiquitin in neurons and glia [119–121] as well as muscle fibers [122].”
From Autophagy and ALS: mechanistic insights and therapeutic implications (2022) · cites this paper as [120]
ALS-FTD due to C9orf72 mutations displays TARDBP pathology, consisting of granular neuronal cytoplasmic inclusions, diffuse neuronal cytoplasmic staining, and glial cytoplasmic inclusions rich in TARDBP.
“ALS-FTD due to C9orf72 mutations displays TARDBP pathology, consisting of granular neuronal cytoplasmic inclusions, diffuse neuronal cytoplasmic staining, and glial cytoplasmic inclusions rich in TARDBP [120].”
From Autophagy and ALS: mechanistic insights and therapeutic implications (2022) · cites this paper as [120]
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Tsoi, K. K. F., Jia, P., Dowling, N. M., Titiner, J. R., Wagner, M., Capuano, A. W., & Donohue, M. (2022) · Cambridge Prisms Precision Medicine · doi:10.1017/pcm.2022.10 · Cited by 32 · see citing works
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Trudler, D., Ghatak, S., & Lipton, S. A. (2021) · International Journal of Molecular Sciences · doi:10.3390/ijms22158196 · Cited by 30 · see citing works
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Woolley, S. C., & Rush, B. K. (2017) · Archives of Clinical Neuropsychology · doi:10.1093/arclin/acx089 · Cited by 29 · see citing works
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Lines, G., Casey, J. M., Preza, E., & Wray, S. (2020) · Molecular and Cellular Neuroscience · doi:10.1016/j.mcn.2020.103553 · Cited by 28 · see citing works
ALS skin fibroblasts reveal oxidative stress and ERK1/2-mediated cytoplasmic localization of TDP-43
Romano, N., Catalani, A., Lattante, S., Belardo, A., Proietti, S., Bertini, L., Silvestri, F., Catalani, E., Cervia, D., Zolla, L., et al. (2020) · Cellular Signalling · doi:10.1016/j.cellsig.2020.109591 · Cited by 28 · see citing works
- Authors
- Mackenzie, I. R. A., Frick, P., & Neumann, M.
- Affiliations
- University of British Columbia (CA)
- German Center for Neurodegenerative Diseases (DE)
- Corresponding author
- Neumann, Manuela
- Venue
- Acta Neuropathologica
- Published
- 2013-12-20
- Volume
- 127
- Issue
- 3
- Pages
- 347-357
- ISSN
- 0001-6322 (ISSN-L)
- 1432-0533
- OpenAlex
- W2121553631
- Cited by
- 206
- References
- 69
- Citations by year
- 2026: 4 · 2025: 6 · 2024: 17 · 2023: 13 · 2022: 20 · 2021: 14 · 2020: 17 · 2019: 17 · 2018: 20 · 2017: 16 · 2016: 23 · 2015: 28 · 2014: 11
- FWCI
- 2.71
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- www.springer.com/tdm (tdm)
- Locations
- Acta Neuropathologica (publishedVersion)
- PubMed (publishedVersion)
- DZNE Pub (submittedVersion)
- Funders
- Canadian Institutes of Health Research (74580)
- Topics
- Health Sciences › Medicine › Neurology › Amyotrophic Lateral Sclerosis Research
- Life Sciences › Neuroscience › Cellular and Molecular Neuroscience › Genetic Neurodegenerative Diseases
- Health Sciences › Medicine › Physiology › Alzheimer's disease research and treatments
- Keywords
- C9orf72, GGGGCC repeat expansion, frontotemporal lobar degeneration, amyotrophic lateral sclerosis, TDP-43, dipeptide repeat proteins, repeat-associated non-AUG translation, ubiquitin-positive inclusions, p62, neurodegeneration, neuropathology, FTLD-TDP
- MeSH terms
- C9orf72 Protein, Brain, DNA-Binding Proteins, Humans, Phenotype, Proteins, Neurodegenerative Diseases, DNA Repeat Expansion, Frontotemporal Lobar Degeneration
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