The importance of a disturbed lipid metabolism in Charcot-Marie-Tooth disease

Confocal image of a giant plasma membrane vesicle, part of the spectral analysis to detect the composition of ordered and disordered lipids in the membranes of patient Schwann cells. Image by Dr. Tim Vangansewinkel
Confocal image of a giant plasma membrane vesicle, part of the spectral analysis to detect the composition of ordered and disordered lipids in the membranes of patient Schwann cells. Image by Dr. Tim Vangansewinkel

Leuven, 4 June 2024 - Charcot-Marie-Tooth disease (CMT), a group of heritable disorders that affect the peripheral nerves, is marked by specific genetic changes. Research by the team of Prof. Ludo Van Den Bosch (VIB-KU Leuven) now reveals the effects of one such genetic cause. They found that the duplication of the gene PMP22 causes problems in the cell membrane of Schwann cells that provide the insulating cover for nerves. The results appeared in the journal Brain.

Gene duplication in CMT1A

Charcot-Marie-Tooth disease is a group of inherited disorders that affect the peripheral nerves, leading to muscle weakness and sensory loss in the extremities. Among the various subtypes of CMT, CMT1A is the most common form, characterized by a duplication of the PMP22 gene. Despite being a well-known genetic abnormality associated with CMT1A, the precise mechanisms by which PMP22 duplication contributes to the disease have remained elusive until now.

The PMP22 gene codes for ‘peripheral myelin protein 22’, a protein that is part of the myelin sheath – the protective cover – of peripheral nerves. That myelin sheath degrades in CMT1A. Because the PMP22 protein is produced by Schwann cells, that's where the lab of Prof. Ludo Van Den Bosch (VIB-KU Leuven Center for Brain & Disease Research) focused their attention. By investigating human cell cultures and animal models of CMT with the PMP22 duplication, the researchers could assess the impact of PMP22 duplication on developing Schwann cells.

Lipids and membranes

Starting from induced pluripotent stem cells (iPSCs) differentiated into human Schwann cells and using advanced imaging techniques and molecular analyses, the researchers were able to elucidate the intricate pathways through which PMP22 duplication dysregulates lipid metabolism and disrupts the normal functioning of Schwann cells.

Dr. Robert Prior, co-first author of the study (previously VIB-KU Leuven, now UKB Bonn, Germany): "One of our key findings was the identification of dysregulated lipids in the plasma membrane of developing human Schwann cells carrying the PMP22 duplication. This impairs the structural integrity and bending properties of the plasma membrane, compromising the ability of the Schwann cells to ‘wrap’ around the peripheral nerves, producing a lipid-rich cover called myelin. This myelin sheath electrically insulates the nerves and Schwann cells also provide metabolic support. The dysregulation of lipids in the plasma membrane finally allows us to understand why the communication between CMT1A patient Schwann cells and peripheral nerves breaks down, even before the onset of myelination."

Moreover, the researchers discovered that targeting the dysregulated lipid pathways in Schwann cells could potentially reverse some of the detrimental effects of the PMP22 duplication. By modulating lipid metabolism and restoring plasma membrane organization, novel therapeutic strategies could be developed to alleviate the symptoms of CMT1A and to improve the quality of life for affected individuals.

Prof. Ludo Van Den Bosch: "Using patient-derived cells, our work provides a foundation for the development of targeted therapies that address the underlying molecular defects in CMT1A. By understanding how PMP22 duplication disrupts lipid homeostasis, we can now explore innovative approaches to restore cellular function and potentially halt the progression of this devastating disease."

As researchers continue to explore the complexities of genetic disorders like CMT1A, new opportunities emerge for the development of therapies that target the root causes of disease. In this case, the effect of a gene duplication on developing Schwann cells points the way ahead to future therapeutic interventions.

Perturbed lipid homeostasis during human CMT1A Schwann cell development. The figure was created with BioRender.com. Credit: Alessio Silva, Dr. Robert Prior, Dr. Tim Vangansewinkel.
Perturbed lipid homeostasis during human CMT1A Schwann cell development. The figure was created with BioRender.com. Credit: Alessio Silva, Dr. Robert Prior, Dr. Tim Vangansewinkel.

Publication

PMP22 duplication dysregulates lipid homeostasis and plasma membrane organization in developing human Schwann cells. Prior, Silva, Vangansewinkel, et al. Brain, 2024. DOI: 10.1093/brain/awae158

Funding

The research (team) was supported by VIB, KU Leuven, VLIR (iBOF23), ABMM, the Muscular Dystrophy Association (MDA), the Association Française les Myopathies (AFM), the ALS Liga Belgium, the National Health and Medical Research Council (NHMRC), the Generet Award for Rare Diseases, and the Prinses Beatrix Spierfonds.

Collaborations

Progress in research is only possible through collaborations both at the national and international level. This research was a close collaboration between the laboratories of Prof. Ludo Van Den Bosch and Prof. Esther Wolfs (UHasselt). For the lipidomic analysis, the expertise of the laboratory of Prof. Johan Swinnen (KU Leuven) was pivotal. In addition, there was an international collaboration with the laboratory of Prof. Kees Fluiter and Prof. Frank Baas (Leiden University Medical Center, The Netherlands). Researchers working in Belgium, The Netherlands, Germany, the Czech Republic, and Australia were involved in this project.


India Jane Wise

India Jane Wise

Science Communications Expert, VIB

Joran Lauwers

Joran Lauwers

Science & Business Communications Expert, VIB


About the VIB-KU Leuven Center for Brain & Disease Research

Scientists at the VIB-KU Leuven Center for Brain & Disease study how brain cells are organized and how they communicate with each other. These mechanisms reveal and provide insights into what goes wrong in brain diseases such as Alzheimer's, Parkinson's, ALS, and dystonia. This basic work should ultimately lead to new drugs for use against these currently incurable diseases.

About VIB

VIB is an independent research institute that translates insights in biology into impactful innovations for society. Collaborating with the five Flemish universities, it conducts research in plant biology, cancer, neuroscience, microbiology, inflammatory diseases, artificial intelligence and more. VIB connects science with entrepreneurship and stimulates the growth of the Flemish biotech ecosystem. The institute contributes to solutions for societal challenges such as new methods for diagnostics and treatments, as well as innovations for agriculture. 

Learn more at www.vib.be.

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