“…Most of the missense mutations studied to date disrupt the trafficking of PLP to the cell surface (Gow et al, 1994b;Gow and Lazzarini, 1996;Woodward, 2008), and it is generally believed that the pathogenic mechanism underlying PMD is the accumulation of misfolded PLP in the ER leading to activation of the UPR and oligodendrocyte apoptosis (Gow and Lazzarini, 1996;Gow et al, 1998;Southwood et al, 2002). However, the disease caused by missense mutations can range in phenotypic severity from mild PMD and late-onset spastic paraplegia type 2 (SPG2), which is characterised by hypomyelination and thinning of the myelin sheath (Hodes et al, 1997;Kobayashi et al, 1994), to severe connatal PMD associated with widespread oligodendrocyte apoptosis and a virtual absence of compact myelin Hudson et al, 1989). The critical factors that determine whether a particular mutation of the gene encoding PLP gives rise to a mild disease with hypomyelination or a severe disease with oligodendrocyte apoptosis are currently poorly understood (Dhaunchak and Nave, 2007;Gow and Lazzarini, 1996;Gow et al, 1998;Kramer-Albers et al, 2006;Southwood and Gow, 2001).…”