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Charcot-Marie-Tooth Type 2B: A New Phenotype Associated with a Novel RAB7A Mutation and Inhibited EGFR Degradation

Authors: Paola Saveri; Maria De Luca; Veronica Nisi; Chiara Pisciotta; Roberta Romano; Giuseppe Piscosquito; Mary M. Reilly; +11 Authors

Charcot-Marie-Tooth Type 2B: A New Phenotype Associated with a Novel RAB7A Mutation and Inhibited EGFR Degradation

Abstract

The rare autosomal dominant Charcot-Marie-Tooth type 2B (CMT2B) is associated with mutations in the RAB7A gene, involved in the late endocytic pathway. CMT2B is characterized by predominant sensory loss, ulceromutilating features, with lesser-to-absent motor deficits. We characterized clinically and genetically a family harboring a novel pathogenic RAB7A variant and performed structural and functional analysis of the mutant protein. A 39-year-old woman presented with early-onset walking difficulties, progressive distal muscle wasting and weakness in lower limbs and only mild sensory signs. Electrophysiology demonstrated an axonal sensorimotor neuropathy. Nerve biopsy showed a chronic axonal neuropathy with moderate loss of all caliber myelinated fibers. Next-generation sequencing (NGS) technology revealed in the proband and in her similarly affected father the novel c.377A>G (p.K126R) heterozygous variant predicted to be deleterious. The mutation affects the biochemical properties of RAB7 GTPase, causes altered interaction with peripherin, and inhibition of neurite outgrowth, as for previously reported CMT2B mutants. However, it also shows differences, particularly in the epidermal growth factor receptor degradation process. Altogether, our findings indicate that this RAB7A variant is pathogenic and widens the phenotypic spectrum of CMT2B to include predominantly motor CMT2. Alteration of the receptor degradation process might explain the different clinical presentations in this family.

Keywords

Adult, Male, autophagy, neurite outgrowth, Adolescent, Charcot–Marie–Tooth disease type 2B, EGFR, Biopsy, Neuronal Outgrowth, axons, Ligands, autophagy; axons; Charcot–Marie–Tooth disease type 2B; CMT2B; EGFR; endocytosis; lysosomes; mutations; neurite outgrowth; NGF; peripheral sensory neuropathy; RAB7; RAB7A, Article, Cell Line, Mice, lysosomes, CMT2B, Charcot-Marie-Tooth Disease, RAB7, endocytosis, Animals, Humans, Adaptor Proteins, Signal Transducing, NGF, QH573-671, Base Sequence, RAB7A, CMT2B; Charcot–Marie–Tooth disease type 2B; EGFR; NGF; RAB7; RAB7A; autophagy; axons; endocytosis; lysosomes; mutations; neurite outgrowth; peripheral sensory neuropathy, peripheral sensory neuropathy, Laminopathies, Fibroblasts, Middle Aged, mutations, ErbB Receptors, RAB7A, Charcot Marie Tooth disease type 2B, CMT2B, peripheral sensory neuropathy, NGF, RAB7, mutations, axons, lysosomes, autophagy, neurite outgrowth, endocytosis, EGFR, Mutation, Female, Mutant Proteins, Cytology

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    This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
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    This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
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    impulse
    This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
    Top 10%
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citations
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
26
Top 10%
Average
Top 10%
Green
gold