2019
DOI: 10.1002/cm.21528
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New hypothesis for the etiology of SPAST‐based hereditary spastic paraplegia

Abstract: Mutations of the SPAST gene are the chief cause of hereditary spastic paraplegia. Controversy exists in the medical community as to whether the etiology of the disease is haploinsufficiency or toxic gain‐of‐function properties of the mutant spastin proteins. In recognition of strong reasons that support each possible mechanism, here we present a novel perspective, based in part on new studies with mouse models and in part on the largest study to date on patients with the disease. We posit that haploinsufficien… Show more

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Cited by 17 publications
(14 citation statements)
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“…Although this conclusion is based on correlation, human patients with SPG4 (spastin encoding gene) develop intellectual disabilities and late-onset dementia. In agreement with a recent hypothesis [48], some microtubule phenotypes observed in our study may be due to a toxic gain-of-function effect of the spastin-K388R mutant (Figs 3, 5 and 6) [48].…”
Section: Plos Biologysupporting
confidence: 93%
“…Although this conclusion is based on correlation, human patients with SPG4 (spastin encoding gene) develop intellectual disabilities and late-onset dementia. In agreement with a recent hypothesis [48], some microtubule phenotypes observed in our study may be due to a toxic gain-of-function effect of the spastin-K388R mutant (Figs 3, 5 and 6) [48].…”
Section: Plos Biologysupporting
confidence: 93%
“…Some HSPs are due to impaired sphingolipid metabolism, others to defective mitochondrial proteins, and others to gene mutations that code proteins involved in organelle trafficking and shape [34]. One of the latter, spastin, is considered particularly relevant in the disease pathogenesis suggesting that toxic gain-of-function mechanisms operate in a context of a nervous system made vulnerable by haploinsufficiency [121]. A reasonable hypothesis is that any imbalance between the amounts of individual sphingolipids may impair endocytic trafficking, affecting cargo load or autophagy directly, as proven for GBA variants.…”
Section: Discussionmentioning
confidence: 99%
“…Similarly, MTBd mediates spastin's interaction with tubulin, which is a prerequisite for severing. By contrast, the AAA domain mediates hexamer formation and catalyzes the severing of MTs (3,30,31).…”
Section: Structure and Functions Of Spastinmentioning
confidence: 99%
“…cK2 phosphorylates both kinesin-1 and dynein, which mediate cargo release from the motor (19). A recent review postulated that gain-of-function may be the primary cause of HSP-SPG4 pathogenesis, while haploinsufficiency makes axons more vulnerable to a second insult (31).…”
Section: Role Of Spastin In Hspmentioning
confidence: 99%