Scientists discover biological mechanisms in high-risk autism gene

ACTIN


Actin (yellow) and tubulin (red) distribution in young mouse cortical neurons deficient in giant ankyrin-B CREDIT Lorenzo Lab, UNC SOM

Scientists at the University of North Carolina at Chapel Hill School of Medicine and colleagues have demonstrated that rare variants in the ANK2 gene, consistently found in individuals with autism spectrum disorder (ASD), can alter architecture and organization of neurons, potentially contributing to autism and neurodevelopmental comorbidities.

The discovery, published in the journal eLife, was led by Damaris Lorenzo, PhD, an assistant professor in the UNC Department of Cell Biology and Physiology and member of the UNC Neuroscience Center and the UNC Intellectual and Developmental Disabilities Research Center.

ANK2 instructs neurons and other cell types how to make ankyrin-B, a protein with multiple functions in the nervous system. ANK2 encodes for various versions (isoforms) of ankyrin-B through a process known as alternatively splicing, whereby portions of the protein are excluded in the final molecules.

Mammals, such as mice and humans, express the full-size (giant) ankyrin-B isoform only in neurons; another highly abundant isoform half its size is found in virtually every type of cell and organ. Multiple genetic studies have consistently identified rare variants in ANK2 in individuals with ASD, making it one of the high-confidence risk genes associated with the condition. Depending on their type and location in the gene, ANK2 variants can affect giant ankyrin-B exclusively or both isoforms simultaneously.

“Together with its high prevalence and striking clinical presentation, ASD’s uncertain cause is a major limiting step in advancing therapeutic options,” Lorenzo said. “The evidence of ASD’s genetic origin is strong but also complex, with at least 100 other high-risk genes linked to the disorder.”

Revealing the cause of ASD is made even more complicated because single genes such as ANK2 and the isoforms they encode can have multiple cellular functions. However, based on how subgroups of these genes overlap functionally, or work together to enact biological pathways, scientists have proposed convergent mechanisms that may be predominantly affected in individuals with ASD. One of these common mechanisms is neuron communication, which is determined in part by alterations in axons – the long extensions that carry signals from neurons to other neurons. Underlying these processes within a single neuron is the axonal cytoskeleton, a complex network of filament-like proteins that plays pivotal roles in each neuron’s growth, shape, and plasticity. The axonal cytoskeleton is thought to be another major functional axis affected in ASD.

Previous work by Lorenzo published in JCB showed that simultaneous loss of both major isoforms of ankyrin-B in the brain of mice resulted in profound anatomical defects involving axonal wiring, underscoring the importance of ankyrin-B in brain architecture and function. In a later study published in PNAS, Lorenzo and colleagues from Duke University observed that eliminating only the giant ankyrin-B isoform in neurons cultured in the lab resulted in more axon branches, which implicated deficits in the dynamics of microtubules, an essential cytoskeleton component.

In this new study, the Lorenzo lab showed that selective loss of the giant ankyrin-B isoform leads to more axon branches in mouse brains and volumetric increases of multiple axonal bundles including the corpus callosum. In collaboration with Eva Anton, PhD, at the UNC Neuroscience Center and co-author of the eLife paper, they found that the giant ankyrin-B isoform is required to maintain the topographic order of callosal axons arising from the somatosensory cortex during brain development and to ensure the specific targeting and refinement of callosal projections on the opposite side of the brain. The team did not observe increases in axon branches in a novel mouse model they engineered that only lacks the shorter ankyrin-B isoform.

“These findings confirm divergent roles of ankyrin-B isoforms and support critical and specialized roles of giant ankyrin-B in axon collateral branch formation, targeting, and refinement,” Lorenzo said. 

In collaboration with a team led by Meng Meng Fu, PhD, at the National Institute of Neurological Disorders and Stroke and co-authors of the eLife paper, the researchers verified that the observed corpus callosum abnormalities did not involve changes in myelination and in the number and maturation of oligodendrocytes, a non-neuronal brain cell type implicated in similar pathologies.

“Brain cortical regions have been the most directly linked to ASD pathology. The changes we observed in cortical structural connectivity likely result from combined defects in axon branch initiation, guidance, and pruning of misdirected or overabundant projections during development due to giant ankyrin-B deficiency,” Lorenzo said.

Cues outside of cells modulate these processes to trigger changes in neurons through attractive and repulsive effects. Lorenzo’s research team showed that cortical neurons require the giant ankyrin-B isoform to make possible the repulsive effects of semaphorin 3A, a molecule that interacts with and collapses the tips of axons and their branches. The team also showed that ANK2 variants exclusively affecting giant ankyrin-B have similar loss of response to the Semaphorin 3A molecule, revealing a possible mechanistic contribution to ASD.

“Our new insights together with our tools and methods will help us assign pathogenicity to other ANK2 variants. We are certain there is undiscovered biology relevant to brain function and ASD involving this gene and we are pursuing it,” Lorenzo said. “Our bottom-up approach of discovery and functional validation contributes to the underdeveloped knowledge database of ASD functional etiology. This is critical because this heterogeneous and complex disorder likely requires personalized strategies for clinical intervention.”

7 ways to cope with chronic illness during the holidays

7 ways to cope with chronic illness during the holidays - YouTube


Holidays are meaningful, fun, and enjoyable for many people. Yet, it’s easy to make a big production out of them when we try and accomplish too many holiday “to-dos.” Cue the cooking marathon, never-ending errands, perfectly orchestrated family pictures, Instagram-worthy homemade meals, … should I say more? Planning out the “perfect” holiday season while navigating chronic illness can become overwhelming. In fact, chronic illness is emotionally and physically taxing any day of the year, so adding to it the pressure of checking off every holiday “must-do” can lead to undue pain, fatigue, and symptoms flare. Below are 7 ideas and tips to reclaim the fun of this holiday season and alleviate some of the stress.

1. Set boundaries

Setting boundaries can be as easy as saying NO! “I appreciate the invitation but I won’t be able to attend”, “I love that you’re hosting this event, I’ll pass this year. Hope you have a fun time!” And give yourself permission to turn down invitations without justifying yourself if you don’t want to. Limit the number of events that you will attend. Identify the ones you really want to be part of, whether you’re hosting or attending, and RSVP no to the other ones. And before attending a party, it can be helpful to have an idea of how much time you plan on spending there. Know your limits! If you know from experience that you become fatigued and your pain increases significantly after one hour of mingling, standing, or being in a loud environment, give yourself permission to leave at the 55-minute mark. It can also help to share a “code word” with your partner or a friend giving you a ride. This way, they know that when you say “blue cheese” it’s time to leave!

2. Prioritize the things that bring you most joy and meaning

Be wise about how you spend your time, energy (and even money)! Prioritize activities, events, experiences that bring you joy or meaning. Ditch those that you don’t particularly care about. It’s okay if your list of “must-do holiday things” looks different from that of your next-door neighbor or even from your list from the previous year.

3. Simplify your life as much as possible

Some holiday experiences or items may be important to you, yet you’d rather not be in charge of planning or executing them. For instance, you may enjoy nicely wrapped gifts but wrapping gifts for hours increases your pain. You enjoy eating a traditional thanksgiving meal but can’t stand for hours cooking in the kitchen. Delegate! Find support to make the holiday season meaningful without having to be the one in charge of all the logistics. And allow yourself to take off your list all the activities and items that you’ve been doing but that don’t really bring you or your family much joy or meaning. It’s not rare that we find ourselves doing things out of habit only to realize that it’s not something that speaks to our values.

4. Self-care

Now is the time to double-up on self-care! The holiday season is without an ounce of a doubt one of the most stressful and busy time of year. Holidays are physically, emotionally, financially taxing. It’s important to be even more intentional about making time for your needs and prioritize your body and mind. And if you don’t enjoy the holidays, it can also be difficult to go through this season. So taking care of yourself and reaching out for support might be much needed.

5. Pace yourself

Pacing is an important aspect of living with chronic illness. The holidays should be no exception. While your schedule might be more packed than usual and your to-do list might run longer, try as much as possible to plan errands and events in a way that allows for resting and recovery. The key word here is to plan!

6. Keep up with your routine

Make a list of your non-negotiable health routines and plug them into your schedule before planning anything else. Then, you can schedule other events and errands around your routines, as much as possible.

7. Create traditions that are meaningful to you and your family

Creating fun traditions that are meaningful for you and your family AND respect your health needs is especially important. One family for instance started a new tradition for Thanksgiving, when each family member would order in their favorite food, and they would then share a meal in bed, picnic style, and it made for great memories! You can also plan on having a virtual Friendsgiving, which allows you to rest as needed and turn down the volume when you need to take a break. As we enter this holiday season, take some time to reflect on what you want this season to look like and how you can focus on the most meaningful experiences without adding too much physical and emotional stress


Holidays Can Be A Big Adjustment For (Autism And Christmas)

autistic girl | The Aspie World

Holidays and Christmas are a big adjustment for children with autism.

The COVID-19 pandemic and the holiday season may create increased stresses for children on the autism spectrum.

Think about creating a visual calendar with what activities will happen when; clearly communicating the challenges the person with autism is facing to family and friends so things do not get worse; and a gradual decorating of the house.

This time of year can be stressful for children with autism as it is, let alone a global pandemic.

Change is a usual thing that happens at this time of year with Christmas and everything but due to the COVID-19 pandemic there are larger changes that are difficult for children with autism.

Antibodies mimicking the virus may explain long haul COVID-19, rare vaccine side effects

Does COVID-19 vaccination affect rheumatic and musculoskeletal disease flares?

With around 256 million cases and more than 5 million deaths worldwide, the COVID-19 pandemic has challenged scientists and those in the medical field. Researchers are working to find effective vaccines and therapies, as well as understand the long-term effects of the infection.

While the vaccines have been critical in pandemic control, researchers are still learning how and how well they work. This is especially true with the emergence of new viral variants and the rare vaccine side effects like allergic reactions, heart inflammation (myocarditis) and blood-clotting (thrombosis).

Critical questions about the infection itself also remain. Approximately one in four COVID-19 patients have lingering symptoms, even after recovering from the virus. These symptoms, known as “long COVID,” and the vaccines’ off-target side effects are thought to be due to a patient’s immune response.

In an article published today in The New England Journal of Medicine, the UC Davis Vice Chair of Research and Distinguished Professor of Dermatology and Internal Medicine William Murphy and Professor of Medicine at Harvard Medical School Dan Longo present a possible explanation to the diverse immune responses to the virus and the vaccines.

Antibodies mimicking the virus

Drawing upon classic immunological concepts, Murphy and Longo suggest that the Network Hypothesis by Nobel Laureate Niels Jerne might offer insights.

Jerne’s hypothesis details a means for the immune system to regulate antibodies. It describes a cascade in which the immune system initially launches protective antibody responses to an antigen (like a virus). These same protective antibodies later can trigger a new antibody response toward themselves, leading to their disappearance over time.

These secondary antibodies, called anti-idiotype antibodies, can bind to and deplete the initial protective antibody responses. They have the potential to mirror or act like the original antigen itself. This may result in adverse effects.

Coronavirus and the immune system

When SARS-CoV-2, the virus causing COVID-19, enters the body, its spike protein binds with the ACE2 receptor, gaining entry to the cell. The immune system responds by producing protective antibodies that bind to the invading virus, blocking or neutralizing its effects.

As a form of down-regulation, these protective antibodies can also cause immune responses with anti-idiotype antibodies. Over time, these anti-idiotype responses can clear the initial protective antibodies and potentially result in limited efficacy of antibody-based therapies.

“A fascinating aspect of the newly formed anti-idiotype antibodies is that some of their structures can be a mirror image of the original antigen and act like it in binding to the same receptors that the viral antigen binds. This binding can potentially lead to unwanted actions and pathology, particularly in the long term,” Murphy said.

The authors suggest that the anti-idiotype antibodies can potentially target the same ACE2 receptors. In blocking or triggering these receptors, they could affect various normal ACE2 functions.

“Given the critical functions and wide distribution of ACE2 receptors on numerous cell types, it would be important to determine if these regulatory immune responses could be responsible for some of the off-target or long-lasting effects being reported,” Murphy commented. “These responses may also explain why such long-term effects can occur long after the viral infection has passed.”

As for COVID-19 vaccines, the primary antigen used is the SARS-CoV-2 spike protein. According to Murphy and Longo, current research studies on antibody responses to these vaccines mainly focus on the initial protective responses and virus-neutralizing efficacy, rather than other long-term aspects.

“With the incredible impact of the pandemic and our reliance on vaccines as our primary weapon, there is an immense need for more basic science research to understand the complex immunological pathways at play. This need follows to what it takes to keep the protective responses going, as well as to the potential unwanted side effects of both the infection and the different SARS-CoV-2 vaccine types, especially as boosting is now applied,” Murphy said. “The good news is that these are testable questions that can be partially addressed in the laboratory, and in fact, have been used with other viral models.”

Multiple Sclerosis Walker/Rollator Exercises

Multiple Sclerosis Walker/Rollator Exercises - YouTube


Ever wonder what strengthening exercises you can do with a rollator/walker? Check out this “unboxing” of the byAcre rollator followed by my favorite walking based strengthening exercises! These are great for those with Multiple Sclerosis who have goals of improving walking and balance.