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Brain Advance Access published online on September 12, 2008

Brain, doi:10.1093/brain/awn216
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© The Author (2008). Published by Oxford University Press on behalf of the Guarantors of Brain. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Review Article

Seipinopathy: a novel endoplasmic reticulum stress-associated disease

Daisuke Ito and Norihiro Suzuki

Department of Neurology, School of Medicine, Keio University, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan

Correspondence to: Daisuke Ito, MD, PhD, Department of Neurology, School of Medicine, Keio University, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan E-mail: d-ito{at}jk9.so-net.ne.jp

The Seipin/BSCL2 gene was originally identified as a loss-of-function gene for congenital generalized lipodystrophy type 2 (CGL2), a condition characterized by severe lipoatrophy, insulin resistance, hypertriglyceridaemia and mental retardation. Recently, gain-of-toxic-function mutations (namely, mutations N88S and S90L) in the seipin gene have been identified in autosomal dominant motor neuron diseases such as Silver syndrome/spastic paraplegia 17 (SPG17) (OMIM #270685) and distal hereditary motor neuropathy type V (dHMN-V) (OMIM #182960). Detailed phenotypic analyses have revealed that upper motor neurons, lower motor neurons and peripheral motor axons are variously affected in patients with these mutations. The clinical spectrum for these mutations is broad, encompassing Silver syndrome, some variants of Charcot-Marie-Tooth disease type 2, dHMNV and spastic paraplegia, even within a common pedigree. Therefore, we propose that seipin-related motor neuron diseases can be collectively referred to as ‘seipinopathies’. Expression of the seipin protein can be detected in motor neurons in the spinal cord and white matter in the frontal lobe. This is consistent with the distribution of seipinopathies in the upper and lower motor neurons. Recent studies have shown that seipin, an endoplasmic reticulum (ER)-resident membrane protein, is an N-glycosylated protein that is proteolytically cleaved into N- and C-terminal fragments and is polyubiquitinated. Interestingly, the N88S and S90L mutations are in the N-glycosylation motif, and these mutations enhance ubiquitination and degradation of seipin by the ubiquitin–proteasome system (UPS). Furthermore, both mutations appear to result in proteins that are improperly folded, which leads to accumulation of the mutant protein in the ER. We have shown that expression of mutant forms of seipin in cultured cells activates the unfolded protein response (UPR) pathway and induces ER stress-mediated cell death. These findings suggest that seipinopathies are novel conformational diseases and that neurodegeneration in these diseases is tightly associated with ER stress, which has recently been reported to be associated with other neurodegenerative diseases. Further study of the pathological mechanisms of the mutant forms of seipin may lead to important new insights into motor neuron diseases, including other spastic paraplegia diseases and amyotrophic lateral sclerosis.

Key Words: BSCL2; endoplasmic reticulum stress; lipodystrophy; motor neuron disease; seipin; unfolded protein response

Abbreviations: AGPAT2, 1-acyl-sn-glycerol-3-phosphate acyltransferase beta; ALS, amyotrophic lateral sclerosis; BSCL2, Berardinelli–Seip congenital lipodystrophy type 2; CGL2, congenital generalized lipodystrophy type 2; CMT, Charcot-Marie-Tooth disease; dHMN-V, distal hereditary motor neuropathy type V; ER, endoplasmic reticulum; GARS, glycyl-tRNA synthetase; HSP, hereditary spastic paraplegia; SPG17, spastic paraplegia 17; UPR, unfolded protein response

Received June 13, 2008. Revised July 19, 2008. Accepted August 1, 2008.


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