exam 2 Flashcards

1
Q

neurodegenerative disorders show symptoms of impaired balance or uncoordinated movement

A

ataxia

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2
Q

Most common inherited ataxia
-progressive gait ataxia

A

Friedreich Ataxia (FRDA)

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3
Q

Autosomal recessive disorder caused by expansion of an unstable GAA repeat in the first intron of the FRDA gene, which encodes _____

A

frataxin

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4
Q

GAA expansion causes inhibition of transcriptional elongation,
resulting in (increase or decrease) frataxin levels

A

decrease

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5
Q

-iron‐binding protein and localizes to the inner mitochondrial membrane
-important in mitochondrial iron storage and regulation of iron levels

A

frataxin

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6
Q
  1. Accumulation of iron in the mitochondria and impair biosynthesis of Fe‐S cluster‐
    containing enzymes
  2. Decreased cellular energy production
  3. Increased free radical production, and increased sensitivity to oxidative stress
A

loss of frataxin causes

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7
Q

what are the potential therapeutics for frataxin

A
  1. antioxidant
  2. histone deacetylase inhibitor to increase frataxin levels
  3. agents to decrease iron accumulation
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8
Q

Autosomal dominantly inherited disorder
* _____ is the most common form of adult muscular dystrophy

A

Myotonic dystrophy type I (DM1)

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9
Q

Symptoms for both DM1 and DM2 include _____ ____

A

muscle degeneration

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10
Q

caused by expansion of a noncoding CTG repeat in the 3’‐UTR of DMPK (kinase)

A

DM1

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11
Q

caused by expansion of a CCTG repeat in intron 1 of ZNF9 (transcription factor)

A

DM2

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12
Q

is there functional similarity btw DMPK and ZFN9

A

no

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13
Q

t/f RNA from both mutant alleles are transcribed and spliced normally but are retained in foci within the nucleus and ARE TRANSLATED INTO PROTEINS

A

F, it is not translated into proteins

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14
Q

The expanded CUG/CCUG repeats in untranslated regions cause ______ of alternative splicing of certain RNAs (gain of toxic function of the RNA)

A

misregulation

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15
Q

Expanded CUG and CCUG repeats affect RNA splicing in a ____ fashion: DMPK and
ZFN9 RNAs are processed normally but splicing of other RNAs is affected

A

trans

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16
Q

Toxic RNAs affect functions of two splicing factors, _____ and ____

A

CUG‐BP1 and MBNL

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17
Q
A
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18
Q

FXTAS is cause by _____ _____ of FMR1 gene

A

permutation allele

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19
Q

Symptoms: late‐onset ataxia

-caused by an RNA gain‐of‐function‐based mechanism by altering the function of RNA‐binding protein (different to loss of protein function mechanism in Fragile X Syndrome)

A
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20
Q

t/f FMR1 mRNA is not translated to protein and CGG repeat‐containing transcripts

A

t

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21
Q

encoding the protein FMRP

A

Mutations in FMR1

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22
Q

Mutation causes an expansion of an unstable noncoding CGG repeat in the 5’‐UTR of _____

A

FMR1

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23
Q

repeat length rarely causing a disease but that is likely to expand to disease‐causing mutation length in successive generations

A

Premutation

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24
Q

expansion of a CAG repeat in the coding region of the _____ receptor
(AR) gene (a polyglutamine disorder; protein gain‐of‐function‐based mechanism)

A

androgen

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25
Q

AR is a transcription factor belonging to the ___ receptor superfamily

A

nuclear

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26
Q

Spinobulbar Muscular Atrophy __- linked recessive disorder

A

x

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27
Q

Mutation causes gain‐of‐function mutant androgen receptor (AR) and ____ ____ is androgen dependent in spinobulbar muscular atrophy

**Mostly affects males

A

mutant phenotype

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28
Q

Binding of androgen to the polyglutamine‐expanded AR and the subsequent translocation of mutated AR to the nucleus are NOT required for onset of disease t/f

A

FALSE, IT IS REQUIRED

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29
Q

Ligand‐induced nuclear translocation of mutant AR but not the transactivation activity of AR is a crucial for ____ pathogenesis

A

SBMA

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30
Q

both fragile X syndrome and fragile x-associated tremor ataxia syndrome (FXTAS) are caused by a repeat expansion in the same gene, the FMR2, but they show different clinical symptoms, why? ***ON EXAM

A

b/c FMRI transcripts are not translated in FXTAS, resulting in the RNA gain of function based pathogenic mechanism and DRAXA us caused by a different loss of protein function based mechanism

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31
Q

why does spinobulbar muscular atrophy mainly affect males **ON EXAM

A

females do not have enough androgens to bring mutated androgen receptors to the nucleus to mediate their pathogenic functions

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32
Q

-This family of diseases is caused by expansions of pre‐existing unstable tandem repeat sequences within the affected gene

  • occur within either coding or non‐coding regions of the genes

-The expansions of unstable repeats is caused by the slippage of the DNA polymerase
during DNA replication or DNA repair

A

Trinucleotide Repeat Diseases

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33
Q

Repeat mutations cause three pathogenic mechanism:

A

(1) loss of function of the protein,
(2) gain of function of the RNA or
(3) gain of function of protein (expansion of a CAG‐ repeat causing Polyglutamine disorders: Huntington Disease/Spinocerebellar Ataxia)

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34
Q
  1. inherited
  2. dynamic mutations (intergenerational repeat instability)
  3. anticipation
  4. variability in expressivity or severity
  5. selective vulnerability of certain neurons but consistency target motor system
A

Features of the trinucleotide repeat diseases

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35
Q

instability of the
repeat length sudden expansion of the length of the tandem repeat in one generation

A

Dynamic mutations (intergenerational repeat instability)

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36
Q

the offspring with the further‐expanded repeat have an
earlier onset and more severe disease course than did the parent

A

Anticipation

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37
Q

Thelargertheexpansion,theearliertheonsetandthemoreseverethe
course (the repeat length is inversely correlated with disease onset)

A

Variability in expressivity or severity of the disease phenotype

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38
Q

_____ disorders caused by a gain‐of‐function mechanism [The repeat unit is (CAG)n in all these disorders]

A

Polyglutamine

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39
Q

-Mental retardation segregated as an X‐linked trait
Symptoms: moderate‐to‐severe mental retardation

A

Fragile X Syndrome (FRAXA)

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40
Q

neuropathology of Fragile X Syndrome (FRAXA)

A
  1. Dendritic abnormalities
  2. Abnormal spine shapes and number in the cortex
  3. Increase of immature long spines
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41
Q

____ repeat expansion on fragile site in fragile X chromosome

A

CGG

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42
Q

Repeat expansion in fragile X syndrome causes aberrant ______ of CpG island in the 5’‐UTR resulting in decreased histone acetylation and loss of FMR1 expression and FMRP function

A

hypermethylation

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43
Q

-FMRP is a RNA‐binding protein

-FMRP associates with polyribosomes to control local protein synthesis by
suppressing the translation of mRNAs it binds

A

Fragile X Syndrome ‐mutation and gene product

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44
Q
  • FMRP plays a crucial role in regulating mRNA translation at the synapse
  • FMRP binds to mRNA targets and most of these targets are involved in
    synaptic function and development
    -FMRP suppress translation
A

FMRP functions

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45
Q

FMRP mutant mice have selective enhancement of _____ dependent long‐term depression (LTD), causing abnormal synapse development and function

A

(mGluR)

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46
Q

FMRP –> FMRP loses expression in fragile x syndrome –> mRNAs of proteins require LTD –> uncontrolled tralation of mRNA for LTD –> LTD–> ___ ____development, causing immature synapses and synaptic dysfunction

A

abnormal synapse

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47
Q

AMPAR internalization and mGluR‐LTD are exaggerated, resulting in long immature spines and synaptic dysfunction

A

No FMRP results in maximum expression of LTD proteins:

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48
Q

demethylating agents
mGLUR antagonists

A

Fragile X Syndrome ‐potential therapeutics

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49
Q

-mild mental retardation
-Expansion of a CCG repeat in the 5’‐UTR of FMR2
-causing loss of protein function

A

Fragile XE Syndrome (FRAXE)

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50
Q

Common symptoms for all SCAs and DRPLA

A

ataxia, tremor, and dysarthria

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51
Q

Common pathologies: cerebellar atrophy in all SCAs and DRPLA, ______ _____ ____

A

Purkinje cell loss

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52
Q

Expansions of a translated CAG repeat in Ataxin‐1 cause SCA ___
– all autosomal dominant disorders (all polyglutamine disorders)

A

1

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53
Q

SCA1 is caused by____ ___ ____ _____ mutation in Ataxin‐1 protein (ATXN1)

A

gain‐of‐protein‐function

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54
Q

Mutant Ataxin‐1 contributes to SCA1 pathogenesis through perturbation
of the transcriptional _____/______ pathway

A

corepressors/coactivators

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55
Q

-autosomal dominantly inherited disorder
- inverse relationship between age of onset
and repeat length
-Symptoms: _____ (jerky involuntary movements)

A

chorea in HD

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56
Q

Atrophy of the caudate and putamen (striatum) causes loss of indirect output pathway in ____ ____ in HD

A

basal ganglia

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57
Q

Huntington’s disease is a _____ movement disorder

A

hyperkinetic

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58
Q

In HD, medium spiny neurons that project to the ____ ____external degenerate

A

globus pallidus

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59
Q

Loss of inhibitory input from caudate/putamen → abnormally ac􏰀va􏰀on of globus pallidus external → diminished excitatory subthalamic output to globus pallidus internal → less tonic inhibi􏰀on of thalamus → increased excita􏰀on of motor cortex neurons → undesired _____ (“dancelike”) movement in HD

A

choreiform

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60
Q

HD is caused by expansion of a translated ___ repeat encoded _____ (also a polyglutamine disorder)

A

CAG; huntingtin

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61
Q

______ is most often seen in Huntington’s Disease ― Paternal inheritance is associated with increased likelihood of repeat‐
length expansion, leading to earlier onset and more severe disease course in the next generation

A

Anticipation

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62
Q

Huntingtin uses HEAT repeats to mediate protein‐protein interactions and is a
______ ____ protein

**ON EXAM

A

multifunctional scaffold protein

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63
Q

t/f normal and mutated huntingtin interact differently with numerous other proteins

A

t

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64
Q

gene: FMR1/FMRP

Gene function: mitochondrial iron binding protein

pathogenic mechanism: loss of protein function

inherited mode: autosomal recessive

pathology: Impair biosynthesis of Fe‐S cluster‐containing enzymes, decreased energy production, oxidative stress

clinical features: ataxia

A

Friedreich Ataxia

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65
Q

gene: Frataxin

Gene function: RNA binding protein for ↓translation

pathogenic mechanism: loss of protein function

inherited mode: X linked

pathology: exaggerated LTD causes abnormal synapse development

clinical features: mental retardation

A

fragile X syndrome

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66
Q

gene: DMPK &ZNF9

Gene function: mRNA never translated to proteins

pathogenic mechanism: gain function of toxic RNA

inherited mode: autosomal dominant

pathology: Changed activity of splicing factors cause misregulation of alternative splicing of target mRNAs

clinical features: Muscle degeneration & multisystem disorders

A

Myotonic Dystrophy I & II

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67
Q

gene: FMR1

Gene function: mRNA never translated to proteins

pathogenic mechanism: gain function of toxic RNA

inherited mode: x-linked

pathology: Altering the function of RNA‐ binding protein (splicing factor)

clinical features: late‐onset ataxia

A

Fragile X– Associated Tremor Ataxia

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68
Q

gene: Androgen
receptor

Gene function: nuclear
receptor transcription factor

pathogenic mechanism: gain function of toxic protein

inherited mode: x-linked

pathology: Mutant ARs translocated to nucleus and cause toxicity

clinical features: Only affect males (phenotype is androgen dependent); muscle cramps; hypogonadism

A

Spinobulbar Muscular Atrophy
(polyQ)
disease)

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69
Q

Amyotrophic lateral sclerosis is NOT a polyglutamine disease t/f

A

t

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70
Q

gene: Ataxin‐1

Gene function: transcription
repressor

pathogenic mechanism: gain function of toxic protein

pathology: Perturbation of the transcriptional corepressor pathway causes Purkinje cell loss and cerebellar atrophy

clinical features: ataxia

A

SCA 1 (poly q)

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71
Q

gene: Huntingtin

Gene function: multifunctional
scaffold protein
for protein
interactions

pathogenic mechanism: gain function of toxic protein

pathology: N‐terminal polyQ fragments of mutant huntingtin form aggregates and interact and interfere with different proteins

clinical features: Atrophy of the striatum; choreiform movement

A

Huntington’s Disease
(polyQ) disease)

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72
Q

also as known as Lou Gehrig’s disease or classical motor neuron disease is a
neurodegenerative disease that affects both lower motor neurons in brainstem and spinal cord, and the upper motor neurons in the motor cortex: loss of these neurons leads to muscle atrophy and weakness

A

ALS

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73
Q

Amyotrophic lateral sclerosis and frontotemporal lobe degeneration are the same or different disease

A

same

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74
Q

ALS patients not only have motor symptoms but usually have ____ symptoms at some time during disease progression

A

FTLD

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75
Q

_____ is a pathological process that occurs in frontotemporal dementia (FTD)and is
characterized by frontal and temporal lobe atrophy with behavioral or language
abnormalities

76
Q

Some FTLD patients also have clinical pathological motor symptoms similar to those in ____ patients

77
Q

*** ON EXAM
which disease affects what type of neuron in ALS, PLS, PMA, SMA

A

ALS– both upper and lower

PLS – upper motor neurons

PMA – lower motor neurons

SMA – lower motor neuron and is INHERITED

78
Q

ALS patients and FTLD patients have the same protein (____ & ____) inclusions

A

TDP43 and FUS

79
Q

Many FTLD patients have neuronal inclusions containing TAR DNA‐binding protein
43 (______), similar to what is found in motor neurons of ALS patients
FTLD and ALS patients also have another same pathological accumulations, the
neuronal inclusions containing fused in sarcoma (_____) protein

A

TDP43; FUS

80
Q

common genetic cause for ALS and FTLD, the chromosome ___ _____ ____ _____ ___ (C9ORF72) mutation, confirmed that ALS and FTLD are at opposite ends of the clinical spectrum of a single disease

A

chromosome 9 open reading frame 72

81
Q

ALS and FTLD are the same disease with same or different clinical spectrums

82
Q

what is the clinical phenotype for FTLD

A

FTD (frontotemporal dementia)

83
Q

FTLP‐TDP pathology all resulting in _______ accumulation

84
Q

____ is an RNA‐binding protein that contains a prion‐like domain (a hydrophobic domain) and involved in regulation of RNA splicing

85
Q

____ is an RNA‐binding protein that contains a prion‐like domain and
involved in regulation of RNA splicing

86
Q

Both TDP‐43 and FUS are shuttled between the ____ and _____: pathological events cause their retention in the
cytoplasm and accumulation

A

nucleus; cytoplasm

87
Q

preferentially affect motor neurons (LMNs and UMNs) but may develop a frontotemporal syndrome

A

A multisystem disorder

88
Q

<15% of ALS patients present the typical features of a ______

89
Q

a specific hallmark of ALS

A

Bunina bodies

90
Q

predominantly TDP‐43 immunoreactive

A

Skein‐like inclusions

91
Q

what is the histopathology of ALS

A
  1. Bunina bodies
  2. skein-like inclusions
  3. basophilic inclusions
    5.Astrocytic gliosis and microglial reaction (reactivegliosis)
92
Q

which of the following neuronal types is involved in amyotrophic lateral sclerosis **ON EXAM

A

UMN, LMN, Frontal cortical neurons, temporal cortical neurons

93
Q

bulbar or respiratory onset ALS has more or less malignant phenotype

94
Q

cell death requires participation in what two things in ALS

A

microglia and astrocytes

95
Q

most ALS patients have inclusions containing ubiquitylated and phosphorylated ____

96
Q

WHICH MOTOR NEURON IS MOST VULNERABLE

A

FF motor neuron

97
Q

WHICH MOTOR NEURON IS LESS VULNERABLE

A

FFR motor neuron

98
Q

____ ____ motor neurons are most resistant in ALS

A

slow tonic motor neurons are most resistant in ALS

99
Q
  1. motor and frontotemporal neurons are affected to variable degrees
  2. not all types of motor neurons are affected in ALS
  3. large spinal motor neurons are affected than smaller ones
A

neuronal vulnerability in ALS

100
Q
  1. Differences in the stress‐coping capacity of different types of neurons
  2. Difference in regeneration potential of different types of neurons
  3. Spinal motor neurons are highly susceptible to glutamate‐induced excitotoxicity
  4. Spinal motor neuron are more susceptible to imbalance of calcium homeostasis
  5. Spinal motor neurons also have limited calcium‐buffering capacity
  6. Why neurons are particularly susceptible to TDP43 and FUS abnormalities
    —–TDP43 and FUS are splicing factors bind to long intronic stretches of RNA and nervous tissue contains relatively longer intron‐containing transcripts than other tissues
A

Why some types of motor neurons are particularly vulnerable?

101
Q

Mutations in _____ cause X‐linked fALS

102
Q

Sequestosome 1 (SQSTM1, aka ___) is a receptor for ubiquitylated proteins

103
Q

Genes/proteins involved in impaired protein degradation in ALS

A

UBQLN2, p62, VCP

104
Q

*** ON EXAM Which of the following statements referring ALS is not correct

A

glial cells are not involved in the pathogens of ALS

105
Q

*** ON EXAM which of the following statements regarding the pathogenic proteins in ALS is not correct

A

in ALS, only mutant superoxide dismutase 1 (SOD1) becomes misfiled and wild type SOD1 does not misfold

106
Q

-contains (prion‐like domain) and binds single‐stranded DNA (sDNA) or RNA
-binds sDNA and RNA and is involved in transcription, RNA splicing and transport
-shuttles between the nucleus and the cytoplasm ———————– In the cytoplasm, it associated with stress granules in which RNA is translationally silenced and transported to a target site for translation

107
Q

During starvation or oxidative stress, TDP43 is mainly in the _____, where it is incorporated into stress granules and the glycine‐rich domain of TDP43 is necessary for its accumulation into stress granules through its prion‐like properties

108
Q

TDP43 causes pathogenesis in a two‐step manner:

A
  1. the exit of TDP43 from the nucleus
  2. the irreversible formation of stress granule aggregate –> resulting in gain of function (cytoplasmic aggregation) and loss function (abnormal RNA processing) pathogenic mechanism
109
Q

t/f TDP43 always need to be mutated to cause ALS

110
Q

t/f Both TDP43 deficiency and TDP43 (wild‐type and mutant) overexpression are hazardous to the cell

111
Q
  1. FUS is an RNA‐binding protein containing a prion‐like domain
  2. FUS uses transportin as a carrier to shuttle between the nucleus and cytoplasm
  3. Most FUS mutations cause FUS
    mis‐localization in the cytoplasm, where it is recruited into stress granules that may form inclusions (basophilic inclusions)
  4. depletion of FUS alters the splicing of mRNAs
A

Mutations in RNA‐binding proteins cause ALS‐FUS

112
Q

TDP43 and FUS are both RNA‐binding proteins that contain a prion‐like domain which is necessary for ____ ____ formation

A

stress granule

113
Q
  1. The prion‐like domain renders the aggregation propensity of these proteins
  2. The prion‐like domain in these proteins may also contribute to the
    progressive, spreading nature of ALS — ALS usually affects regions in contiguity with the site of onset
  3. Proteins with a prion‐like domain promote aggregation by acting as a template to induce the conversion of natively folded proteins and trap the normal protein in the aggregate
A

stress granule formation

114
Q

proteins different from the mutant one can also be recruited in the aggregates

A

Cross‐seeding (co‐aggregation)

115
Q

Nucleotide repeat expansion mutations between two transcription initiation sites in _____ cause 50% fALS

116
Q

_______ causing lost‐of‐function pathogenic effect

A

haploinsufficiency; loss of protein function

117
Q

The expanded hexanucleotide repeat also forms nuclear RNA foci in neurons and may exert a deleterious gain‐of‐toxic RNA function effect, acting as a sink for nuclear RNA‐ binding proteins that then are unavailable for the correct splicing of other mRNAs

A

Gain of toxic RNA function

118
Q

Another possible pathogenic mechanism could be repeat‐associated non‐ATG (RAN) translation, results in the accumulation of dipeptide repeat (DPR) proteins

A

gain of toxic protein function

119
Q

dipeptide repeat proteins , poly(GA), poly(GP), and ploy(GR), were generated from repeat‐associated non‐ATG (___) translation from all three reading frames

120
Q

Three possible pathogenic mechanisms:

A

(1) loss of GEF function of the protein
(2) gain of function of the toxic RNA
(3) gain of function of toxic protein (DPR proteins)

121
Q

glial cells become increasingly activated and secrete inflammatory mediators as the disease progresses and modify disease process

A

Neuroinflammation

122
Q

Cell death in ALS is ___-___ _____ as astrocytes and microglial cells that surround motor neurons contribute to disease onset and progression

A

non‐cell autonomous

123
Q

in the mutant SOD1 mouse, ____ degenerate and loss of trophic support from _____ is toxic to motor neurons

A

oligodendrocytes

123
Q

Factors involved in the ____ ____, ___ ____, ___ ____release are involved in the pathogenesis of ALS

A

cytoskeletal organization, cellular transport and synaptic vesicle

124
Q

Cellular and molecular pathogenic events in ALS

A
  1. proteinopathy in ALS: impaired proteostasis
  2. RNopathy in ALS: impaired RNA metabolism
  3. glial cells cause inflammation modify disease process
  4. axonal architecture and transport fall
  5. progressive cellular failure and excitotoxicity
125
Q

neuronal cell bodies and synaptic connections

A

Gray matter

126
Q

(myelinated) axonal bundles or tracts/columns in the CNS

A

White matter

127
Q

disease of the central nervous system

A

Immune‐mediated demyelinating

128
Q

pathological hallmark of MS

A

focal areas of INFLAMMATION-MEDIATED DEMYELINATION and axonal transection/degeneration in the brain and spinal cord white matter

129
Q

85% of MS patients begin with a disease phase characterized by neurological deficits
followed by recovery, termed _____ - ______ ____

A

relapsing‐remitting MS (RRMS)

130
Q
  1. Relapse in RRMS is caused by focal areas of inflammatory demyelination
    where myelin‐forming oligodendrocytes and axons are destroyed
  2. Edema cause nerve conduction block
  3. Remission is due to
    (i) resolution of the inflammation and edema
    (ii) reorganization of axonal sodium channels on demyelinated axons
    (iii) remyelination to restore axonal conduction
A

relapsing‐remitting MS (RRMS)

131
Q

After one to two decades, majority of RRMS patients enter a second disease phase characterized by continuous irreversible neurological disability unassociated with relapses, term

A

secondary progressive state of MS (SPMS)

132
Q

Irreversible neurological functional decline in MS patients is mainly caused by _______ ______ (NOT inflammatory demyelination)

A

axonal degeneration

133
Q

15% MS patients have a ___ ____ ___(PPMS) with rare or no relapses

A

primary progressive MS

134
Q

inflammatory demyelinating disease caused experimentally in rodents by inducing an immune response in animals to myelin components and is used as an animal model for MS

A

Experimental allergic encephalomyelitis (EAE)

135
Q

The presence of inflammatory cortical demyelination in early MS advocates a _____ ____ ____at this stage of disease

A

primary neurodegenerative process

136
Q

t/f MS is inherited

A

FALSE NOT INHERITED

137
Q

The only consistent MS‐associated gene is the ______gene

138
Q

Environmental factors also contribute to MS disease susceptibility and _____ are the most implicated factor

139
Q

MS brains show axonal ______ and loss or axonal retraction bulbs/axonal ovoids

A

transection

140
Q

At later stages of MS, after oligodendrocyte death, loss of ____ ___ and alterations in axonal cytoskeleton and fast axonal transport may lead to axonal transection/degeneration

A

trophic support

141
Q

Demyelination is mediated by _____ and monocytes/______

A

microglia; macrophages

142
Q
  1. Substances in the inflammatory microenvironment could injure axons
  2. Nitric oxide synthase (iNOS) is upregulated in acute inflammatory MS lesions, resulting in increased nitric oxide (NO) level
    — elevated NO is detrimental to axonal survival
  3. Cytotoxic CD8+ T cells can mediate axonal transection in acute lesion
  4. Excitotoxicity
  5. Loss of trophic support and myelin from oligodendrocytes
A

Mechanisms of Axonal Degeneration in Acute Inflammatory MS Lesions

143
Q

are cytotoxic CD8+ T cells involved in chronic or acute inflammatory MS lesions

144
Q

does genetics cause MS

145
Q

irreversible decline in MS phase is caused by inflammatory effects t/f

146
Q

what is the following statements regarding MS is not correct ** ON EXAM

A

the irreversible neurological decline in the secondary progressive state of MS is mainly caused by inflammatory demyelination

147
Q

which of the following events does not occur in the relapsing remitting phase of MS ***ON EXAM

A

irreversible neurological disability and dysfunction

148
Q

MS lesions can also involve gray matter in addition to common white matter lesions

A

cortical demyelination

149
Q

neuronal cell bodies and synaptic connections

A

gray matter

150
Q

(myelinated) axonal bundles or tracts/columns in the CNS

A

white matter

151
Q

white and gray matter lesions

A

type 1 lesions

152
Q

extensive gray matter only lesions

A

type 3 lesions

153
Q

t/f Cortical demyelination occurs with significant influx of hematogeneous leukocytes and lesions have intact blood‐brain barriers

A

f it is w/o significant influx of hematogeneous leukocytes

154
Q

Gray matter (cortical) lesions contained fewer inflammatory cells, but few activated by microglia t/f

A

f, many are activated by microglia

155
Q

t/f Cytotoxic T cells are significantly more in MS white matter lesions than in cortical lesions

156
Q

Cortical demyelination is probably not directly caused by immune cells (such as macrophages or CD8+ cytotoxic T cells) but could instead be caused by _____

157
Q

myelin is removed by _____ in cortical lesions

158
Q

axonal degeneration continue in environments other than the inflammatory demyelinating lesion

A

Chronic demyelinating lesion

159
Q

In addition to insulation of myelin sheath, _____ provide trophic support that is essential for long‐term axonal survival

A

oligodendrocytes

160
Q

Two parallel mechanisms of axonal degeneration: imbalance between energy supply and demand

what is the mechanism

A
  1. limited energy supply due to ischemic/hypoxia insults of white matter
  2. demyelination increases the energy demand of nerve conduction
    —-restores nerve conduction by the expense of increased energy demand
  3. Axoplasmic ATP production eventually becomes compromised in the chronically demyelinated axon, leading to an ionic imbalance that increases axoplasmic Ca2+, which eventually destroys the axon
161
Q

Degeneration of chronically _____ axons is a major contributor to neurological disability and brain atrophy

A

demyelinated

162
Q

Remyelination is the ____ response to demyelination

A

recapitulation hypothesis

163
Q
  1. migratation and proliferation
  2. differentiation and maturation into myelin forming OLs
  3. myelinated axons
A

Recapitulation hypothesis

164
Q

G ratio is ______ in remyelination

165
Q

In developmental myelination, _____ diameter axons are enwrapped with proportionally _____ myelin

in remyelination, the myelin sheath length and thickness remain roughly constant _____/_____regardless of the axon diameter

A

larger, thicker ; thinner/shorter

166
Q
  1. Patterning and Specification
    2.Sonic hedgehog (ventralizing signal)
  2. neural stem cells express Olig2
  3. neural stem cells specify to become OPCs
A

Patterning and Specification pathway

167
Q
  1. OPC activation
  2. Microglia, Astrocyte &
    inflammation
  3. injury signals
  4. OPCs upregulate Olig2 activation of OPCs
A

OPC activation pathway

168
Q

*** T/f G ratio is decreased in demyelination

A

false; it is increased

169
Q
  1. Proliferation and Migration
  2. PDGF & FGF
A

Proliferation and Migration pathway

170
Q
  1. I. OPCs are activated by acute injury induced signals produced from MICROGLIA and ASTROCYTES
    ——2. OPCs change morphology (HYPERTROPHY) and up regulation of several genes –> transcription factors OLIG2
A

Activation of adult OPCs

171
Q
  1. activated MICROGLIA and ASTROCYTES are major sources of OPC mitogens and chemotaxic factors
A

Recruitment or migration, and proliferation of adult OPCs

172
Q
  1. Differentiation and maturation of OPCs into remyelinating oligodendrocytes

expression of depression + activation of myelin genes

A

expression of depression + activation of myelin genes

173
Q

stages of remyelination

A
  1. activation
  2. recruitment, migration, + proliferation
  3. differentiation and remyelination
174
Q

Platelet‐derived growth factor (PDGF) and insulin‐like growth factor 1 (IGF‐1) are ____ ____

A

OPC mitogens

175
Q

_____acts as a chemokine and inhibits differentiation and promote recruitment (migration)

176
Q
  1. The role of the innate immune response to demyelination is to create an environment conducive to remyelination
  2. Phagocytic macrophages play a critical part in the removal of the myelin debris as CNS myelin contains proteins that inhibit OPC differentiation
A

Inflammatory response plays a key role to promote remyelination

177
Q

activation of _____ pathway inhibits OPC differentiation

178
Q

____ _____ is also a negative regulator of OPC differentiation and regulates kinetics (timing) of OPC differentiation

A

WNT signaling

179
Q

transcription factor such as ____has key roles in OPC development and differentiation in remyelination

180
Q

***differentiation failure represents a major cause of remyelination failure (failure happens mostly in the_____ stage)

A

differentiation

181
Q

t/f remyelination depends as much on the precise timing of action as on the presence or absence of certain factors

182
Q

___ is the most important factor for remyelination failure

183
Q
    1. An impaired macrophage response in aging and a delay in the expression of inflammatory cytokines and chemokines lead to POOR CLEARANCE OF MYELIN DEBRIS
  1. GROWTH FACTOR RESPONSIVENESS OF ADULT OPCs IS DECREASED IN AGING
  2. in old animals HDAC RECRUITMENT IS IMPAIRED, resulting in prolonged expression of these inhibitors, delayed OPC differentiation
A

Non‐disease‐related factors for remyelination failure

184
Q

____ expression to recruit of HDACs to downregulate inhibitors

185
Q

downregulate inhibitors
In older animals, recruitment of _____ to the promoters of the
inhibitory molecules is impaired, resulting in a environment that is skewed towards the inhibition of myelin genes

186
Q

Disease‐specific factors for remyelination failure

A
  1. Dysregulation (hyperactivation) of Notch or Wnt pathway could delay OPC differentiation
  2. missing a critical window of opportunity for remyelination