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Infantile SOD1 deficiency syndrome caused by a homozygous SOD1 variant with absence of enzyme activity.

Abstract
Pathogenic variants in SOD1, encoding superoxide dismutase 1, are responsible for about 20% of all familial amyotrophic lateral sclerosis cases, through a gain-of-function mechanism. Recently, two reports showed that a specific homozygous SOD1 loss-of-function variant is associated with an infantile progressive motor-neurological syndrome. Exome sequencing followed by molecular studies, including cDNA analysis, SOD1 protein levels and enzymatic activity, and plasma neurofilament light chain levels, were undertaken in an infant with severe global developmental delay, axial hypotonia and limb spasticity. We identified a homozygous 3-bp in-frame deletion in SOD1. cDNA analysis predicted the loss of a single valine residue from a tandem pair (p.Val119/Val120) in the wild-type protein, yet expression levels and splicing were preserved. Analysis of SOD1 activity and protein levels in erythrocyte lysates showed essentially no enzymatic activity and undetectable SOD1 protein in the child, whereas the parents had ∼50% protein expression and activity relative to controls. Neurofilament light chain levels in plasma were elevated, implying ongoing axonal injury and neurodegeneration. Thus, we provide confirmatory evidence of a second biallelic variant in an infant with a severe neurological syndrome and suggest that the in-frame deletion causes instability and subsequent degeneration of SOD1. We highlight the importance of the valine residues at positions V119-120, and suggest possible implications for future therapeutics research.
AuthorsShlomit Ezer, Muhannad Daana, Julien H Park, Shira Yanovsky-Dagan, Ulrika Nordström, Adily Basal, Simon Edvardson, Ann Saada, Markus Otto, Vardiella Meiner, Stefan L Marklund, Peter Munch Andersen, Tamar Harel
JournalBrain : a journal of neurology (Brain) Vol. 145 Issue 3 Pg. 872-878 (04 29 2022) ISSN: 1460-2156 [Electronic] England
PMID34788402 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
Copyright© The Author(s) (2021). Published by Oxford University Press on behalf of the Guarantors of Brain. All rights reserved. For permissions, please email: [email protected].
Chemical References
  • DNA, Complementary
  • SOD1 protein, human
  • Superoxide Dismutase
  • Superoxide Dismutase-1
  • Valine
Topics
  • Amyotrophic Lateral Sclerosis (metabolism)
  • DNA, Complementary
  • Humans
  • Infant
  • Mutation (genetics)
  • Superoxide Dismutase (genetics, metabolism)
  • Superoxide Dismutase-1 (genetics)
  • Syndrome
  • Valine (genetics)

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