Affiliation:
1. Department of Laboratory Medicine, Institute of Biomedicine University of Gothenburg Gothenburg Sweden
2. Department of Neurology, Cork University Hospital and College of Medicine and Health University College Cork Cork Ireland
3. Department of Neuropathology Cork University Hospital Cork Ireland
Abstract
AbstractAimsPolyglucosan storage disorders represent an emerging field within neurodegenerative and neuromuscular conditions, including Lafora disease (EPM2A, EPM2B), adult polyglucosan body disease (APBD, GBE1), polyglucosan body myopathies associated with RBCK1 deficiency (PGBM1, RBCK1) or glycogenin‐1 deficiency (PGBM2, GYG1). While the storage material primarily comprises glycans, this study aimed to gain deeper insights into the protein components by proteomic profiling of the storage material in glycogenin‐1 deficiency.MethodsWe employed molecular genetic analyses, quantitative mass spectrometry of laser micro‐dissected polyglucosan bodies and muscle homogenate, immunohistochemistry and western blot analyses in muscle tissue from a 45‐year‐old patient with proximal muscle weakness from late teenage years due to polyglucosan storage myopathy.ResultsThe muscle tissue exhibited a complete absence of glycogenin‐1 due to a novel homozygous deep intronic variant in GYG1 (c.7+992T>G), introducing a pseudo‐exon causing frameshift and a premature stop codon. Accumulated proteins in the polyglucosan bodies constituted components of glycogen metabolism, protein quality control pathways and desmin. Muscle fibres containing polyglucosan bodies frequently exhibited depletion of normal glycogen.ConclusionsThe absence of glycogenin‐1, a protein important for glycogen synthesis initiation, causes storage of polyglucosan that displays accumulation of several proteins, including those essential for glycogen synthesis, sequestosome 1/p62 and desmin, mirroring findings in RBCK1 deficiency. These results suggest shared pathogenic pathways across different diseases exhibiting polyglucosan storage. Such insights have implications for therapy in these rare yet devastating and presently untreatable disorders.