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Nat Med. 2014 Sep;20(9):1055-61. doi: 10.1038/nm.3664. Epub 2014 Aug 24.

Soluble neuregulin-1 modulates disease pathogenesis in rodent models of Charcot-Marie-Tooth disease 1A.

Author information

1
1] Department of Neurogenetics, Max Planck Institute of Experimental Medicine, Göttingen, Germany. [2].
2
1] Department of Neurogenetics, Max Planck Institute of Experimental Medicine, Göttingen, Germany. [2] Institute of Neuropathology, University Medical Center Göttingen, Göttingen, Germany. [3].
3
Department of Neurogenetics, Max Planck Institute of Experimental Medicine, Göttingen, Germany.
4
1] Department of Neurogenetics, Max Planck Institute of Experimental Medicine, Göttingen, Germany. [2] Institute of Clinical Pharmacology, University Medical Center Göttingen, Göttingen, Germany.
5
Department of Clinical Neurophysiology, University Medical Center Göttingen, Göttingen, Germany.
6
1] Department of Neurogenetics, Max Planck Institute of Experimental Medicine, Göttingen, Germany. [2] Department of Neurosurgery, University Medical Center, Johannes-Gutenberg University of Mainz, Mainz, Germany.
7
Institute of Neuropathology, University Medical Center Göttingen, Göttingen, Germany.
8
1] Department of Neurogenetics, Max Planck Institute of Experimental Medicine, Göttingen, Germany. [2] Department of Clinical Neurophysiology, University Medical Center Göttingen, Göttingen, Germany.

Abstract

Duplication of the gene encoding the peripheral myelin protein of 22 kDa (PMP22) underlies the most common inherited neuropathy, Charcot-Marie-Tooth 1A (CMT1A), a disease without a known cure. Although demyelination represents a characteristic feature, the clinical phenotype of CMT1A is determined by the degree of axonal loss, and patients suffer from progressive muscle weakness and impaired sensation. CMT1A disease manifests within the first two decades of life, and walking disabilities, foot deformities and electrophysiological abnormalities are already present in childhood. Here, we show in Pmp22-transgenic rodent models of CMT1A that Schwann cells acquire a persistent differentiation defect during early postnatal development, caused by imbalanced activity of the PI3K-Akt and the Mek-Erk signaling pathways. We demonstrate that enhanced PI3K-Akt signaling by axonally overexpressed neuregulin-1 (NRG1) type I drives diseased Schwann cells toward differentiation and preserves peripheral nerve axons. Notably, in a preclinical experimental therapy using a CMT1A rat model, when treatment is restricted to early postnatal development, soluble NRG1 effectively overcomes impaired peripheral nerve development and restores axon survival into adulthood. Our findings suggest a model in which Schwann cell differentiation within a limited time window is crucial for the long-term maintenance of axonal support.

PMID:
25150498
DOI:
10.1038/nm.3664
[Indexed for MEDLINE]

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