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Restoring protein synthesis in a neuronal model of Charcot-Marie-Tooth disease
Dissertation   Open access

Restoring protein synthesis in a neuronal model of Charcot-Marie-Tooth disease

Julianna Koenig
University of Iowa
Doctor of Philosophy (PhD), University of Iowa
Autumn 2025
DOI: 10.25820/etd.008209
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Abstract

Charcot-Marie-Tooth disease (CMT) is an inherited peripheral neuropathy characterized by progressive sensory dysfunction and muscle weakness that begins in the distal limbs and spreads proximally. More than one hundred genes are implicated in CMT, with enrichment for activities in myelination, axon transport, and protein synthesis. A large proportion of these implicated genes encode cytoplasmic aminoacyl-tRNA synthetases (aaRS), enzymes essential for charging tRNAs. The recurring involvement of aaRS suggests a shared pathogenic mechanism linking protein synthesis to CMT pathology. To address this question, I investigated how CMT-associated aaRS variants affect protein synthesis and neuronal vulnerability. Expression of CMT-linked variants in tyrosyl-tRNA synthetase (CMT-YARS) in primary sensory neurons produced a marked reduction in production synthesis, preceding the onset of caspase dependent axon degeneration and cell death. Surprisingly, dissociating and replating these neurons, a procedure that stimulates axon regeneration, restored protein synthesis in an mTOR-dependent manner. CMT-YARS neurons also displayed a reduction in short-lived axon maintenance factors, NMNAT2 and STMN2. Depletion of these factors sensitized the neurons to SARM-1 dependent cell death after exposure to a secondary stressor, when otherwise this stressor is non-toxic. Collectively, this work highlights the diverse framework of CMT and the different avenues through which new treatment strategies may be developed. For instance, rescuing protein synthesis in CMT mutant neurons could offer new and exciting therapeutic options beyond symptom management.

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