Parkinson's: single mutated copy of parkin may lead to earlier symptom onset


Mutations in a gene already known to play a role in causing an inherited form of Parkinson disease may also influence the age at which symptoms of the neurological disorder appear.
While inheriting two abnormal copies of the parkin gene previously had been associated with the development of early-onset Parkinson's, a new study, led by Massachusetts General Hospital ( MGH ) researchers, found that even a single mutated copy of parkin reduces the age of onset of the disease.

The findings is published in the Archives of Neurology.

" This study reinforces the fact that there are multiple mechanisms behind Parkinson disease and will lead us to examine other pathways with which parkin interacts," says James Gusella, director of the MGH Center for Human Genetic Research, the study's senior author. The report is part of the larger GenePD project, an international collaborative study of siblings with Parkinson disease, which is based at Boston University Medical Center and led by Richard Myers.

Parkinson disease is a neurodegenerative disorder characterized by tremors, rigidity, difficulty walking and other symptoms. It is caused by the destruction of brain cells that produce the neurotransmitter dopamine and is the second most common neurodegenerative disorder.
The condition's prevalence increases with age, appearing in 1 percent of those over 60 and 4 to 5 percent of those over 85, but it can develop in much younger patients. While the cause of most cases of Parkinson's is unknown, there are rare, inherited forms.
Five genes have been identified as increasing the risk for Parkinson's, parkin mutations inherited from both parents being the most common genetic cause of early-onset disease, but additional susceptibility genes are yet to be found.

Since finding new genes is a goal of the GenePD study, a preliminary step is to identify those whose familial Parkinson's can be attributed to one of the known genes.
Focusing on parkin, the researchers began by analyzing samples from 329 families with at least two affected members, collected from 20 sites in North America, Europe and Australia. From this collection, samples from two groups of families were selected: those in which affected siblings have inherited identical versions of the chromosome 6 region in which parkin resides and those in which at least one affected member developed symptoms before age 54, since early-onset Parkinson's involves symptoms appearing before the age of 50.

For each of the 183 families selected, complete genetic screens were done on the patient with the earliest onset of symptoms. If that patient was found to have parkin mutations, genetic screens were completed on other affected family members.
Parkin mutations were found in 23 ( 12.6 percent ) of the 183 screened families.
Among the families with parkin mutations, 13 had at least one member with mutations on both copies of the gene, while in 10 families affected members had a single mutated copy of parkin. Eighteen different parkin mutations were identified, four of which had not previously been described.

The average age of onset in all those with parkin mutations was about 43. But among the families in which the parkin chromosome markers were identical, those with no mutations in the gene developed symptoms at an average age of about 61, those with a single abnormal copy of parkin at around age 50, and those who inherited two mutated copies had onset at around age 36.

" This is the first time anyone has shown that a single parkin mutation can lower the age of onset," Gusella says. " We don't know if that would be sufficient to cause the disease. It's more likely that these mutations increase susceptibility to other factors underlying the development of Parkinson's.”

Source: Massachusetts General Hospital, 2006


XagenaMedicine2006