Abstract
Essential Tremor (ET) is a prevalent neurological disease characterized by an 8–10 Hz action tremor. Molecular mechanisms of ET remain poorly understood. Clinical data suggest the importance of the cerebellum in disease pathophysiology, and pathological studies indicate Purkinje Cells (PCs) incur damage. Our recent cerebellar cortex and PC-specific transcriptome studies identified alterations in calcium (Ca2+) signaling pathways that included ryanodine receptor type 1 (RyR1) in ET. RyR1 is an intracellular Ca2+ release channel located on the Endoplasmic Reticulum (ER), and in cerebellum is predominantly expressed in PCs. Under stress conditions, RyR1 undergoes several post-translational modifications (protein kinase A [PKA] phosphorylation, oxidation, nitrosylation), coupled with depletion of the channel-stabilizing binding partner calstabin1, which collectively characterize a “leaky channel” biochemical signature. In this study, we found markedly increased PKA phosphorylation at the RyR1-S2844 site, increased RyR1 oxidation and nitrosylation, and calstabin1 depletion from the RyR1 complex in postmortem ET cerebellum. Decreased calstabin1-RyR1-binding affinity correlated with loss of PCs and climbing fiber-PC synapses in ET. This ‘leaky’ RyR1 signature was not seen in control or Parkinson’s disease cerebellum. Microsomes from postmortem cerebellum demonstrated excessive ER Ca2+ leak in ET vs. controls, attenuated by channel stabilization. We further studied the role of RyR1 in tremor using a mouse model harboring a RyR1 point mutation that mimics constitutive site-specific PKA phosphorylation (RyR1-S2844D). RyR1-S2844D homozygous mice develop a 10 Hz action tremor and robust abnormal oscillatory activity in cerebellar physiological recordings. Intra-cerebellar microinfusion of RyR1 agonist or antagonist, respectively, increased or decreased tremor amplitude in RyR1-S2844D mice, supporting a direct role of cerebellar RyR1 leakiness for tremor generation. Treating RyR1-S2844D mice with a novel RyR1 channel-stabilizing compound, Rycal, effectively dampened cerebellar oscillatory activity, suppressed tremor, and normalized cerebellar RyR1-calstabin1 binding. These data collectively support that stress-associated ER Ca2+ leak via RyR1 may contribute to tremor pathophysiology.
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Acknowledgements
Human brain tissue was derived from the New York Brain Bank at Columbia University and the NIH NeuroBioBank (University of Miami, Miami FL; University of Maryland, Baltimore MD).
We would like to thank all the patients and families that contributed to brain donation and the staff at the ETCBR at the New York Brain Bank and the NIH NeuroBioBank. We thank Dr. Marco C. Miotti for creating the illustration of the RyR1 macromolecular complex of kinases, phosphatases, and accessory scaffold proteins.
Funding
Funding for this project was provided from the National Institutes of Health (NIH)/NINDS (R01 NS124854 [SHK and PLF], R01 NS118179 [SHK], R01 NS117745 [PLF and EDL], RF1 NS114570 [ARM], R01 NS104423 [SHK], R01 NS088257 [EDL], R01 NS086736 [EDL]; from the NIH/NHLBI (R25 HL156002 [ARM], R01 HL145473 [ARM], R01 HL140934 [ARM], R01 HL142903 [ARM], T32 HL120826 [ARM]) and from the NIH/NIDDK (R01 DK118240 [ARM]).
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All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by RTM, M-LC, SR, LRS, DSR, C-LN, C-CL, M-KP, ARM, S-HK, and PLF. The first draft of the manuscript was written by RTM and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.
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ARM and Columbia University own shares in ARMGO Pharma, Inc. a biotech company developing RyR targeted therapeutics. All other authors declare no competing interests or conflicts.
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401_2023_2602_MOESM1_ESM.tif
Supplemental Figure 1: RyR1 macromolecular complex of kinases, phosphatases, and accessory scaffold proteins. Cryo-EM structures of RyR1 (grey, PDB: 7M6A) with subunit calstabin-1 bound (yellow) and endoplasmic reticulum (ER) membrane (black), PP1/Spinophilin complex (blue/green PDB: 3EGG), PDE4 (purple, PDB:5K1I), mAKAP (cyan, AlphaFold), and PKA (orange, PDB:6MM5). Domain-domain interaction information among proteins is still missing. Spatial placement of proteins is just schematic. mAKAP = muscle A-kinase anchoring protein; PDE4 = phosphodiesterase-4; PKA = protein kinase A; PP1 = protein phosphatase 1; RyR1 = ryanodine receptor type 1 (TIF 25619 KB)
401_2023_2602_MOESM2_ESM.tif
Supplemental Figure 2: Additional Western blot correlations for RyR1 macromolecular scaffold proteins. Quantification of immunoblot from Figure 1a for a. Spinophillin/RyR1, b. PDE4/RyR1 and c. PKA/RyR1 showing no significant difference between ET and control (n = 8 for each), although the decrease in spinophillin protein is trending towards significance (p = 0.063) (TIF 5730 KB)
401_2023_2602_MOESM3_ESM.xlsx
Supplemental Table 1: Clinical demographic and pathological metrics for all patient samples. Clinical and pathological information for each patient cerebellum that was utilized in the biochemical analysis of the ‘leaky’ RyR channel complex via immunoprecipitation and for correlation with calstabin1-RyR1 binding assay. Purkinje cell (PC)/mm and torpedo/mm quantifications were analyzed from a LH&E (luxol fast blue-hematoxylin & eosin) stained slide of cerebellum. LH&E is a general histologic tissue stain that identifies cell bodies, nuclei and myelin sheaths. VGlut2 immunostain is used to quantify density of climbing fiber (CF) synapses on PC dendrites and % CFs in outer 20% of the cerebellar molecular layer (ML). Samples are indicated as being used in RyR1, RyR2 or both Western blot assays, and RyR1 binding assay (XLSX 15 KB)
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Martuscello, R.T., Chen, ML., Reiken, S. et al. Defective cerebellar ryanodine receptor type 1 and endoplasmic reticulum calcium ‘leak’ in tremor pathophysiology. Acta Neuropathol 146, 301–318 (2023). https://doi.org/10.1007/s00401-023-02602-z
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DOI: https://doi.org/10.1007/s00401-023-02602-z