Entry - *605078 - TAR DNA-BINDING PROTEIN; TARDBP - OMIM
 
* 605078

TAR DNA-BINDING PROTEIN; TARDBP


Alternative titles; symbols

TAR DNA-BINDING PROTEIN, 43-KD; TDP43


HGNC Approved Gene Symbol: TARDBP

Cytogenetic location: 1p36.22   Genomic coordinates (GRCh38) : 1:11,012,654-11,030,528 (from NCBI)


Gene-Phenotype Relationships
Location Phenotype Phenotype
MIM number
Inheritance Phenotype
mapping key
1p36.22 Amyotrophic lateral sclerosis 10, with or without FTD 612069 AD 3
Frontotemporal lobar degeneration, TARDBP-related 612069 AD 3

TEXT

Description

TARDBP is a predominantly nuclear RNA/DNA-binding protein that functions in RNA processing and metabolism, including RNA transcription, splicing, transport, and stability. Following cell stress, TARDBP also localizes to cytoplasmic stress granules and may play a role in stress granule formation (summary by Xia et al., 2016).


Cloning and Expression

Human immunodeficiency virus (HIV)-1, the causative agent of acquired immunodeficiency syndrome (AIDS), contains an RNA genome that produces a chromosomally integrated DNA during the replicative cycle. The HIV Tat protein (see 601409), a transcription-activating protein that binds to the bulge region of a stable stem-bulge-loop structure, TAR RNA, activates the HIV-1 long terminal repeat (LTR). Tat activates the LTR less efficiently in rodent than in human cells, suggesting that cellular RNA-binding proteins are also involved in the regulation of HIV replication. TAR DNA may possess distinct regulatory elements that play a role in modulating HIV-1 gene expression. To characterize cellular factors that bind to TAR DNA, Ou et al. (1995) screened a HeLa cell cDNA library using a TAR DNA probe and identified a cDNA encoding a 43-kD TAR DNA-binding protein, TARDBP, which they called TDP43. The deduced 414-amino acid TARDBP contains a ribonucleoprotein (RNP)-binding domain and a glycine-rich region. Northern blot analysis detected a ubiquitously expressed, 2.8-kb TARDBP transcript. SDS-PAGE analysis showed that recombinant and native TARDBP are expressed as 43-kD proteins.

By database analysis and cDNA cloning, Wang et al. (2004) determined that the TARDBP gene generates at least 11 mRNA species by alternative splicing. The shorter transcripts encode proteins lacking the glycine-rich domain, which is required for the exon-skipping activity of TARDBP.

Benajiba et al. (2009) stated that TDP43 contains 2 RNA recognition motifs, a nuclear export domain, and a C-terminal domain that is essential for binding to heterogeneous nuclear ribonucleoproteins (hnRNPs) and for splicing inhibition. TDP43 is normally localized in the nucleus, but in pathologic conditions, the cleaved form of TDP43 is mainly present in the cytoplasm.


Gene Structure

Wang et al. (2004) determined that the TARDBP gene contains 6 exons.


Mapping

By genomic sequence analysis, Wang et al. (2004) mapped the TARDBP gene to chromosome 1p36.21. They also identified intronless TARDBP-like pseudogenes on chromosomes 2, 6, 8, 13, and 20 that likely originated from retrotransposition events. Wang et al. (2004) mapped the mouse Tardbp gene to chromosome 4E2 in a region that shows homology of synteny to human chromosome 1p36.


Gene Function

Functional analysis by Ou et al. (1995) indicated that TARDBP does not bind RNA. Gel retardation analysis followed by Western blot analysis (Shift-Western analysis) demonstrated that the RNP-binding motifs of TARDBP bind to the pyrimidine-rich motifs of TAR DNA. In an in vitro transcription analysis, increasing amounts of TARDBP, in the presence or absence of Tat, decreased the level of transcription from the HIV-1 LTR but not from the adenovirus major late promoter.

Using reporter plasmids, Wang et al. (2004) determined that deletion of the glycine-rich domain of mouse Tardbp resulted in loss of about 90% of its ability to activate exon skipping in the CFTR gene (602421).

RNA splicing mutations in the CFTR gene are thought to lead to dysfunction of several organs such as lung, sweat glands, genital tract, intestine and pancreas, producing the complex symptoms of cystic fibrosis (219700). Buratti et al. (2001) showed that TDP43 promotes skipping of exon 9 of the CFTR gene by binding specifically to the UG repeat sequence in intron 8 of the CFTR pre-mRNA. Buratti and Baralle (2001) reported the characterization and functional implications of the RNA binding properties of TDP43. Wang et al. (2004) found that the mouse homolog of human TDP43 also inhibits human CFTR exon 9 splicing in a minigene system. Buratti et al. (2004) described experiments consistent with the model in which the TG repeats in the CFTR intron 8 bind to TDP43, and this protein, in turn, inhibits splicing of exon 9. They suggested that their results provide a mechanistic explanation for the association data of Groman et al. (2004) and also an explanation for the variable phenotypic penetrance of the TG repeats. Individual and tissue-specific variability in the concentration of this inhibitory splicing factor may even determine whether an individual will develop multisystemic (non-classic CF) or monosymptomatic (CBAVD) disease.

Neumann et al. (2006) found that a hyperphosphorylated, ubiquitinated, and cleaved form of TDP43, known as pathologic TDP43, is the major disease protein in ubiquitin-positive, tau-, and alpha-synuclein-negative frontotemporal dementia (FTLD-U; 607485) and in ALS (see 105400). The signature of pathologic TDP43 in FTLD-U includes the presence of C-terminal breakdown and/or cleavage products migrating at approximately 25 kD, a 45 kD variant, and a high molecular weight TDP43-immunoreactive smear. TDP43 is normally localized primarily to the nucleus, but Neumann et al. (2006) suggested that, under pathologic conditions in FTLD-U, TDP43 is eliminated from nuclei of ubiquitinated inclusion-bearing neurons, a consequence of which may be a loss of TDP43 nuclear functions. Arai et al. (2006) also identified TDP43 as a component of ubiquitin-positive tau-negative neuronal and glial inclusions in frontotemporal lobar degeneration and ALS. Biochemical analysis suggested that abnormal phosphorylation of TDP43 may be involved in the pathogenesis of these disorders. The findings were similar to those reported by Neumann et al. (2006).

Mackenzie et al. (2007) identified TDP43-immunoreactive neuronal and glial cytoplasmic inclusions in 59 cases of sporadic ALS, 26 cases of ALS with dementia, and 11 cases of SOD1 (147450)-negative familial ALS. Immunofluorescence confirmed colocalization of TDP43 and ubiquitin within the inclusions. In contrast, TDP43 was not detected in any of 15 patients with SOD1-positive ALS. The authors suggested that these findings represented differing pathogenic mechanisms.

Elden et al. (2010) showed that ataxin-2 (601517), a polyglutamine (polyQ) protein mutated in spinocerebellar ataxia type 2 (183090), is a potent modifier of TDP43 toxicity in animal and cellular models of ALS. ATXN2 and TDP43 associate in a complex that depends on RNA. In spinal cord neurons of ALS patients, ATXN2 is abnormally localized; likewise, TDP43 shows mislocalization in spinocerebellar ataxia-2. To assess the involvement of ATXN2 in ALS, Elden et al. (2010) analyzed the length of the polyQ repeat in the ATXN2 gene in 915 ALS patients and 980 controls. The authors found that intermediate-length polyQ expansions (27 to 33 glutamines) in ATXN2 were significantly associated with ALS (4.7% of cases; 1.4% of controls).

Armakola et al. (2012) reported results from 2 genomewide loss-of-function TDP43 toxicity suppressor screens in yeast. The strongest suppressor of TDP43 toxicity was deletion of DBR1 (607024), which encodes an RNA lariat debranching enzyme. Armakola et al. (2012) showed that, in the absence of DBR1 enzymatic activity, intronic lariats accumulate in the cytoplasm and likely act as decoys to sequester TDP43, preventing it from interfering with essential cellular RNAs and RNA-binding proteins. Knockdown of DBR1 in a human neuronal cell line or in primary rat neurons was also sufficient to rescue TDP43 toxicity. Armakola et al. (2012) concluded that their findings provided insight into TDP43-mediated cytotoxicity and suggested that decreasing DBR1 activity could be a potential therapeutic approach for ALS.

Ling et al. (2015) found that depletion of Tardbp in mouse embryonic stem cells resulted in the splicing of cryptic exons into mRNA, often disrupting their translation and promoting nonsense-mediated mRNA decay. Similar results were observed in human HeLa cells. Enforced repression of cryptic exons prevented cell death in Tardbp-deficient cells. The findings suggested that TARDBP normally acts to repress the splicing of nonconserved cryptic exons, thereby maintaining intron integrity. Postmortem brain tissue from patients with ALS/FTD showed that repression of cryptic exons was impaired, suggesting that this splicing defect could contribute to TARDBP-proteinopathy in certain neurodegenerative diseases.

By immunoprecipitation analysis of transfected HEK293 cells, followed by protein pull-down assays, Xia et al. (2016) showed that folliculin (FLCN; 607273) interacted directly with TDP43. Overexpression of FLCN led to localization of TDP43 in cytoplasm, where it colocalized with markers of lysosomes, autophagosomes, and the ubiquitin-proteasome system. Under arsenite stress, TDP43 colocalized with stress granules. In contrast, RNA interference-mediated depletion of FLCN in arsenite-treated cells caused dissociation of TDP43 from stress granules and nuclear accumulation of TDP43. Xia et al. (2016) concluded that FLCN is critical for TDP43 translocation from nucleus to cytoplasm, which is required for stress granule assembly.

Woerner et al. (2016) analyzed the compartment specificity of aggregate toxicity using artificial beta-sheet proteins, as well as fragments of mutant huntingtin (613004) and TDP43. Aggregation in the cytoplasm interfered with nucleocytoplasmic protein and RNA transport. In contrast, the same proteins did not inhibit transport when forming inclusions in the nucleus at or around the nucleolus. Protein aggregation in the cytoplasm, but not the nucleus, caused the sequestration and mislocalization of proteins containing disordered and low-complexity sequences, including multiple factors of the nuclear import and export machinery. Thus, Woerner et al. (2016) concluded that impairment of nucleocytoplasmic transport may contribute to the cellular pathology of various aggregate deposition diseases.

A decrease in ataxin-2 (601517) suppresses TDP43 toxicity in yeast and flies, and intermediate-length polyglutamine expansions in the ataxin-2 gene increase the risk of ALS (see 183090). Becker et al. (2017) used 2 independent approaches to test whether decreasing ataxin-2 levels could mitigate disease in a mouse model of TDP43 proteinopathy. First, they crossed ataxin-2 knockout mice with TDP43 transgenic mice. The decrease in ataxin-2 reduced aggregation of TDP43, markedly increased survival, and improved motor function. Second, in a more therapeutically applicable approach, Becker et al. (2017) administered antisense oligonucleotides targeting ataxin-2 to the central nervous system of TDP43 transgenic mice. This single treatment markedly extended survival. Becker et al. (2017) suggested that because TDP43 aggregation is a component of nearly all cases of ALS, targeting ataxin-2 could represent a broadly effective therapeutic strategy.

Vogler et al. (2018) demonstrated that TDP43 is an essential protein for normal skeletal muscle formation that unexpectedly forms cytoplasmic, amyloid-like oligomeric assemblies, which the authors termed myogranules, during regeneration of skeletal muscle in mice and humans. Myogranules bind to mRNAs that encode sarcomeric proteins and are cleared as myofibers mature. Although myogranules occur during normal skeletal muscle regeneration, myogranules can seed TDP43 amyloid fibrils in vitro and were increased in a mouse model of inclusion body myopathy. Therefore, increased assembly or decreased clearance of functionally normal myogranules could be the source of cytoplasmic TDP43 aggregates that commonly occur in neuromuscular diseases such as ALS and inclusion body myopathy.

Taylor et al. (2018) showed that patients with FTLD with tau inclusions (see 600274) or TDP43 inclusions had elevated expression of both TTBK1 (619415) and TTBK2 (611695) in cortical and hippocampal neurons and that TTBK1 and TTBK2 colocalized with phosphorylated proteins.

Shao et al. (2022) studied the interplay of the FTD-ALS-associated genes C9ORF72 (614260), TBK1 (604834), and TDP43. Shao et al. (2022) found that TBK1 is phosphorylated in response to C9ORF72 poly(gly-ala; GA) aggregation and sequestered into inclusions, resulting in decreased TBK1 activity and contributing to neurodegeneration. Reducing TBK1 activity in mice using a knockin mutation exacerbated poly(GA)-induced phenotypes, including increased TDP43 pathology and the accumulation of defective endosomes in poly(GA)-positive neurons. The authors postulated a disruption of the endosomal-lysosomal pathway in FTD-ALS, leading to increased susceptibility to protein aggregation, driving TDP43 proteinopathy and neurodegeneration.

Hruska-Plochan et al. (2024) generated human neural stem cells from induced pluripotent stem cells derived from normal human skin fibroblasts and found that they were self-renewing and could form functional networks, which the authors called iNets, with neuronal and glial maturation similar to that of cortical organoids. Overexpression of wildtype TDP43 in a minority of neurons within iNets led to progressive fragmentation and aggregation of TDP43, resulting in partial loss of function and neurotoxicity. Single-cell transcriptomic analysis revealed a novel set of misregulated RNA targets in TDP43-overexpressing neurons and in patients with TDP43 proteinopathies exhibiting loss of nuclear TDP43. The strongest misregulated target was NPTX2 (600750), whose levels were controlled by TDP43 binding to its 3-prime UTR. NPTX2 exhibited neurotoxicity when overexpressed in iNets, whereas correcting NPTX2 misregulation partially rescued neurons from TDP43-induced neurodegeneration. NPTX2 was consistently misaccumulated in neurons from patients with ALS and frontotemporal lobar degeneration with TDP43 pathology. The results directly linked TDP43 misregulation and NPTX2 accumulation, thereby revealing a TDP43-dependent pathway of neurotoxicity.


Molecular Genetics

Lattante et al. (2013) provided a review of TARDBP mutations associated with ALS10 (612069). TARDPB mutations occur in about 3% of patients with familial ALS and in 1.5% of patients with sporadic disease.

Gitcho et al. (2009) noted that TDP43 was first identified as the major pathologic protein of ubiquitin-positive, tau-negative inclusions of frontotemporal lobar degeneration (FTLDU; 607485), FTLD with motor neuron disease (FTDMND; 105500), and ALS/MND (ALS10). These disorders are now considered to represent different clinical manifestations of the same underlying molecular pathology, namely TDP43 proteinopathy. The differing clinical phenotypes of these overlapping disorders most likely reflect the selective vulnerability of different segments of the neuraxis to neurodegeneration.

In a family segregating autosomal dominant ALS and 2 sporadic cases (see ALS10, 612069), Sreedharan et al. (2008) identified mutations in the TARDBP gene. All 3 mutations, M337V (605078.0001), Q331K (605078.0002), and G294A (605078.0001) occurred in a highly conserved region of the C terminus of TDP43 involved in protein-protein interactions. To assess the functional significance of these mutations, Sreedharan et al. (2008) expressed tagged TDP43(wildtype), TDP43(Q331K), and TDP43(M337V) in Chinese hamster ovary (CHO) cells. Immunofluorescent staining of cells 48 hours after transfection showed abundant expression of transfected TDP43, with no obvious differences in subcellular distribution or aggregation between mutant and wildtype proteins. Expression of these tagged proteins in spinal cord of stage 14 chick embryos demonstrated dramatic reduction in maturation in embryos expressing mutant versus wildtype TDP43, with a failure to develop normal limb and tail buds. While chick embryo development proceeded normally over 48 hours with TDP43(wildtype), at 24 hours only 5 to 15% of those embryos expressing mutant TDP43 had reached the normal stage of maturation. TUNEL staining demonstrated a significant increase in the number of apoptotic nuclei in embryos expressing either mutant when compared with wildtype. Sreedharan et al. (2008) concluded that their results suggested a toxic gain-of-function or dominant-negative effect of mutant TDP43.

In affected members of a Japanese family with ALS previously described by Tagawa et al. (2007), Yokoseki et al. (2008) identified a heterozygous mutation in the TARDBP gene (Q343R; 605078.0008).

In affected members of a European family with ALS10, Gitcho et al. (2008) identified a heterozygous mutation in the TARDBP gene (A315T; 605078.0009).

Van Deerlin et al. (2008) identified heterozygous mutations in the TARDBP gene (605078.0004; 605078.0005) in affected individuals of 2 unrelated families with autosomal dominant ALS10.

Kabashi et al. (2008) screened a panel of familial and sporadic ALS cases for TARDBP mutations. They found 8 missense mutations in 9 individuals, 6 from individuals with sporadic ALS and 3 from those with familial ALS, and a concurring increase of a smaller TDP43 product.

By sequence analysis, Kabashi et al. (2009) did not find any pathogenic mutations in the TARDBP gene among 125 French Canadian patients with dopa-responsive Parkinson disease (PD; 168600).

Kuhnlein et al. (2008) identified mutations in the TARDBP gene in 2 (6.5%) of 31 probands with non-SOD1 familial ALS.

Kovacs et al. (2009) identified a heterozygous mutation in the TARDBP gene (K263E; 605078.0011) in a Hungarian man with frontotemporal lobar degeneration beginning at age 35 years. He had a rapidly progressive course, resulting in death at age 37., Neurologic examination showed supranuclear gaze palsy, hyperkinetic choreiform movements, motor stereotypies, and primitive reflexes. Motor neuron disease signs, rigidity, and cerebellar ataxia were not present. Phospho-TDP43-immunoreactive deposits were present in neuronal cytoplasmic inclusions in various brain regions, including the cortex,

Gitcho et al. (2009) identified a heterozygous 2076G-A transition in the 3-prime untranslated region of the TARDBP gene (605078.0012) in affected members of 2 unrelated families with either ALS10 with or without frontotemporal dementia or FTLD (see 612069). The first family had 2 mutation carriers with a variable phenotype: the proband was a woman with frontotemporal dementia without motor disease, whereas her brother had lower motor neuron disease without dementia. The father and mother, from whom DNA was not available, had ALS and lower motor neuron disease, respectively, and it was not clear which parent likely transmitted the TARDBP mutation. Neuropathologic analysis of the proband, who did not have motor neuron disease, showed cortical atrophy, neuronal loss in the hippocampus, hippocampal sclerosis, and TDP43-positive neuronal cytoplasmic inclusions in the cortex and hippocampus. The brother's neuropathologic findings were consistent with ALS and showed TDP43-immunoreactivity in the anterior horn cells of the spinal cord and neuronal cytoplasmic inclusions in the hippocampus. The second family included a patient with familial ALS; no neuropathology was available for that patient.

Millecamps et al. (2010) identified 6 different missense mutations in the TARDBP gene in 7 (4.3%) of 162 French probands with familial ALS. Three of the families had been previously reported. Patients with TARDBP mutations had disease onset predominantly in the upper limb. One-third of patients had rapid disease progression, two-thirds had a medium disease course, and 1 had a slow disease course. There was evidence of incomplete penetrance. One TARDBP mutation carrier developed frontotemporal dementia 1 year after the onset of motor weakness.

Kabashi et al. (2010) tested the effects of 3 reported TARDBP mutations, A315T, (605078.0009), G348C (605078.0007), and A382T (605078.0013), in cell lines, primary cultured motor neurons, and living zebrafish embryos. Each of the 3 mutants and wildtype human TDP43 localized to nuclei when expressed in COS-1 and Neuro2A cells by transient transfection. However, when expressed in motor neurons from dissociated spinal cord cultures, these mutant TARDBP alleles were neurotoxic, concomitant with perinuclear localization and aggregation of TDP43. Overexpression of mutant human TARDBP caused a motor phenotype in zebrafish embryos consisting of shorter motor neuronal axons, premature and excessive branching, as well as swimming deficits. Knockdown of zebrafish Tardbp led to a similar phenotype, which was rescued by coexpressing wildtype but not mutant human TARDBP. Kabashi et al. (2010) suggested that both a toxic gain of function as well as a novel loss of function may be involved in the molecular mechanism by which mutant TDP43 contributes to disease pathogenesis.


Genotype/Phenotype Correlations

Corcia et al. (2012) identified 19 patients from 9 families with ALS10 and 9 patients with apparently sporadic ALS10. The patients were French, and all carried mutations in the TARDBP gene. The mean age at onset was 53.4 years, and the upper limb was the most common site of onset. Only 2 patients had dementia. The median disease duration was 63 months; 2 patients were alive after 8 years. These patients were pooled with 117 ALS10 patients reported in the literature. Among all those with TARDBP mutations, Caucasians tended to have upper limb onset, while Asians tended to have bulbar onset. The G298S mutation (605078.0005) was associated with the shortest survival, whereas A315T (605078.0009) and M337V (605078.0001) were associated with longest duration.

By expression of 7 pathogenic ALS-associated mutant TDP43 proteins (e.g., M337V, 605078.0001; A382T, 605078.0013; G298S, 605078.0005; G348C, 605078.0007; Q343R, 605078.0008; and A315T, 605078.0009) in a differentiated neuronal cell line, Watanabe et al. (2013) found that all had consistently longer half-lives compared to the wildtype protein. Patients carrying mutations with longer half-lives showed earlier disease onset (p = 0.00252), although there was no correlation between protein half-lives and disease duration. Proteins with mutations in the nuclear export signal had an extremely long half-life, whereas a second group of mutations generated within the nuclear localization signal were less stable than wildtype. In additional studies, most of 18 ALS-linked mutant TDP43 proteins showed lower solubility to the detergent Sarkosyl compared to wildtype. A cell model in which wildtype TDP43 was stabilized caused cytotoxicity, nuclear accumulation, insolubility, proteasomal impairment with increased numbers of misfolded C-terminal cleaved TDP43 products, and dysregulation of normal mRNA processing. The findings suggested that increased stability of either wildtype or mutant TDP43 can cause a gain of toxicity through abnormal proteostasis.


Animal Model

Wegorzewska et al. (2009) found that transgenic mice expressing a Tdp43 A315T mutation (605078.0009) developed progressive gait abnormalities at about 3 to 4 months of age and died at about 5 months of age. Postmortem examination showed accumulation of ubiquitinated proteins selectively in the cytoplasm of neurons in cortical layer 5, including the motor cortex. The inclusions did not stain for TDP43, but the changes were associated with neuronal loss and increased glial reaction. Examination of the spinal cord of mutant mice showed degeneration of descending motor axons and ubiquitin pathology in large neurons of the ventral horn; there was also loss of motor neurons. Mutant mice also showed Tdp43 C-terminal fragments in the brain and spinal cord prior to the onset of gait abnormalities. Wegorzewska et al. (2009) concluded that since cytoplasmic Tdp43 aggregates were not present in mutant mice, they are not required for neurodegeneration. These results indicated that the selective neuronal vulnerability in Tdp43-related neurodegeneration is related to altered DNA/RNA-binding protein function rather than to toxic aggregation.

Using translating ribosome affinity purification and microarray analysis, MacNair et al. (2016) found that several mRNAs were abnormally regulated in 10-month-old symptomatic Tdp43 A315T transgenic mice compared with wildtype controls and 5-month-old presymptomatic Tdp43 A315T mice. Those upregulated over 2-fold in older Tdp43 A315T mice included Ccl4 (182284), Tdp43, Pkib (606914), and Ddx58 (609631), and those downregulated included Prickle4 (611389), Pes1 (605819), and Mthfsd (616820). Expression of DDX58 and MTHFSD was similarly misregulated in human ALS motor neurons, and RNA immunoprecipitation analysis showed that Mthfsd and Ddx58 were direct targets of Tdp43 in transfected mouse neuroblastoma cells.

Tsai et al. (2010) generated an FTLDU mouse model by transgenically overexpressing Tdp43 in forebrain. Transgenic mice exhibited impaired learning and memory, progressive motor dysfunction, and hippocampal atrophy. The impairments were accompanied by reduced levels of phosphorylated Erk (see MAPK1; 176948) and phosphorylated Creb (CREB1; 123810) and increased levels of gliosis in the brains of transgenic mice. Cells with Tdp43-positive, ubiquitin-positive neuronal cytoplasmic inclusions (NCIs) and Tdp43-deleted nuclei appeared in transgenic mouse brains in an age-dependent manner. Tsai et al. (2010) concluded that increased levels of TDP43 protein in forebrain are sufficient to lead to formation of TDP43-positive, ubiquitin-positive NCIs and neurodegeneration.

Independently, Wils et al. (2010) observed neurodegeneration in transgenic mice overexpressing wildtype human TDP43. Homozygous and hemizygous transgenic mice showed dose-dependent degeneration of cortical and spinal motor neurons and developed spastic quadriplegia similar to ALS. Transgenic mice also developed dose-dependent degeneration of nonmotor cortical and subcortical neurons characteristic of FTLD. Affected neurons of the spinal cord and brain showed nuclear and cytoplasmic aggregates of ubiquitinated and phosphorylated TDP43. The characteristic, approximately 25-kD TDP43 C-terminal fragments were also recovered from nuclear fractions and correlated with disease development and progression in transgenic mice.

Ash et al. (2010) engineered panneuronal expression of human TDP43 in C. elegans to generate an in vivo model of TDP43 function and neurotoxicity. Transgenic worms with neuronal expression of human TDP43 exhibited an 'uncoordinated' phenotype and had abnormal motoneuron synapses. C. elegans contains a single putative ortholog of TDP43, designated tdp1, which could support alternative splicing of CFTR (602421) in a cell-based assay. Neuronal overexpression of tdp1 also resulted in an uncoordinated phenotype, whereas deletion of the tdp1 gene did not affect movement or alter motoneuron synapses. Wildtype human TDP43 expressed in C. elegans localized to the nucleus. TDP43 mutants missing either RNA recognition domain RRM1 or RRM2 completely blocked neurotoxicity, as did a mutant missing its C-terminal domain. These TDP43 mutants still accumulated in the nucleus, although their subnuclear distribution was altered. Fusion of the tdp1 C-terminal domain to a TDP43 N terminus restored normal subnuclear localization and toxicity in C. elegans and CFTR splicing in cell-based assays. Overexpression of wildtype TDP43 in differentiated M17 cells also resulted in cell toxicity. Ash et al. (2010) concluded that overexpression of wildtype TDP43 is sufficient to induce neurotoxicity.

Diaper et al. (2013) found that deletion of the TAR DNA-binding protein homolog (Tbph) in Drosophila caused impaired synaptic transmission at the larval and adult neuromuscular junction. Impaired presynaptic transmission was the earliest Tbph-related defect. Overexpression of Tbph in adults also resulted in synaptic defects and age-related progressive degeneration of neurons involved in motor control. Progressive neurodegeneration was also seen with inactivated Tbph.

Taylor et al. (2018) showed that transgenic C. elegans expressing the kinase catalytic domain of human TTBK1 or TTBK2 were behaviorally normal. However, coexpression of TTBK1, but not TTBK2, with TDP43 led to behavioral abnormalities and increased phosphorylation of TDP43.


ALLELIC VARIANTS ( 13 Selected Examples):

.0001 AMYOTROPHIC LATERAL SCLEROSIS 10 WITHOUT FRONTOTEMPORAL DEMENTIA AND WITH TDP43 INCLUSIONS

TARDBP, MET337VAL
  
RCV000005539...

In an English family segregating autosomal dominant amyotrophic lateral sclerosis without frontotemporal dementia (612069), Sreedharan et al. (2008) identified an A-to-G transition at nucleotide 1009 in exon 6 of the TARDBP gene, resulting in a methionine-to-valine substitution at codon 337 (M337V). Methionine at this position is invariant in human, orangutan, mouse, opossum, chicken, frog, and zebrafish.


.0002 AMYOTROPHIC LATERAL SCLEROSIS 10 WITHOUT FRONTOTEMPORAL DEMENTIA AND WITH TDP43 INCLUSIONS

TARDBP, GLN331LYS
  
RCV000005540

In a 72-year-old Caucasian British man who developed limb-onset ALS (612069) with a disease duration of 3 years, Sreedharan et al. (2008) identified a C-to-A transversion at nucleotide 991 in exon 6 of the TARDBP gene, resulting in a glutamine-to-lysine substitution at codon 331 (Q331K).


.0003 AMYOTROPHIC LATERAL SCLEROSIS 10 WITHOUT FRONTOTEMPORAL DEMENTIA AND WITH TDP43 INCLUSIONS

TARDBP, GLY294ALA
  
RCV000005541...

In an Australian man who developed limb-onset ALS (612069) at age 65 with a disease duration of 5 years and no atypical features, Sreedharan et al. (2008) identified a G-to-C transversion at nucleotide 881 in exon 6 of the TARDBP gene, resulting in a glycine-to-alanine substitution at codon 294 (G294A).

Luquin et al. (2009) identified the G294A mutation in postmortem brain tissue from a patient with sporadic ALS. No clinical information was given.


.0004 AMYOTROPHIC LATERAL SCLEROSIS 10 WITHOUT FRONTOTEMPORAL DEMENTIA AND WITH TDP43 INCLUSIONS

TARDBP, GLY290ALA
  
RCV000005542...

In a Caucasian father and daughter with autosomal dominant ALS10 (612069), Van Deerlin et al. (2008) identified a heterozygous 869G-C transversion in exon 6 of the TARDBP gene, resulting in a gly290-to-ala (G290A) substitution in the C-terminal region of TDP43. The mutation was not identified in 747 white controls. The daughter presented with dysarthria and dysphagia at age 51 years and had a rapidly progressive course involving the limbs and respiration. She died after 13 months. Her father had presented with arm weakness at age 47 years and died after 16 months. Postmortem examination showed findings consistent with ALS.


.0005 AMYOTROPHIC LATERAL SCLEROSIS 10 WITHOUT FRONTOTEMPORAL DEMENTIA AND WITH TDP43 INCLUSIONS

TARDBP, GLY298SER
  
RCV000005543...

In affected members of a Chinese family with autosomal dominant ALS10 (612069), Van Deerlin et al. (2008) identified a heterozygous 892G-A transition in exon 6 of the TARDBP gene, resulting in a gly298-to-ser (G298S) substitution in the C-terminal region of TDP43. The mutation was not identified in 747 white controls or 380 Chinese controls. Five patients in 2 generations were affected with onset between ages 41 and 60 years. Most showed rapid progression with death within 1 or 2 years. Postmortem examination of 2 patients showed changes consistent with ALS as well as TDP43-positive inclusions in upper and lower motor neurons and in various brain regions.


.0006 AMYOTROPHIC LATERAL SCLEROSIS 10 WITHOUT FRONTOTEMPORAL DEMENTIA AND WITH TDP43 INCLUSIONS

TARDBP, ASP169GLY
  
RCV000005544

In a 56-year-old female with amyotrophic lateral sclerosis (612069), Kabashi et al. (2008) found a heterozygous A-to-G transition in exon 4 of the TARDBP gene (640A-G) that resulted in an asp169-to-gly substitution (D169G) in TDP43. The mutation occurred in the first RNA recognition motif (RRM1) and was predicted to abrogate RNA binding.


.0007 AMYOTROPHIC LATERAL SCLEROSIS 10 WITHOUT FRONTOTEMPORAL DEMENTIA AND WITH TDP43 INCLUSIONS

TARDBP, GLY348CYS
  
RCV000005545...

In a 30-year-old female patient with amyotrophic lateral sclerosis (612069), Kabashi et al. (2008) detected a heterozygous G-to-T transversion at nucleotide 1176 in exon 6 of the TARDBP gene that resulted in substitution of cys for gly at codon 348 of TDP43 (G348C). The mutation, which introduced a cysteine to the C-terminal hnRNP interaction region, was predicted to increase the propensity for aggregation through the formation of intermolecular disulfide bridges.

Kuhnlein et al. (2008) identified the G348C mutation in affected members of a German family with ALS10. The proband presented at age 55 years with paresis of the right hand, which progressed rapidly to involve the arms and lower limbs and left her wheelchair-bound within 2.5 years. She died of respiratory insufficiency 3 years after disease onset. The patient's mother had died of respiratory insufficiency due to a similar disorder. There were no clinically relevant bulbar symptoms and no cognitive impairment.


.0008 AMYOTROPHIC LATERAL SCLEROSIS 10 WITHOUT FRONTOTEMPORAL DEMENTIA AND WITH TDP43 INCLUSIONS

TARDBP, GLN343ARG
  
RCV000005546

In affected members of a Japanese family with amyotrophic lateral sclerosis (612069), Yokoseki et al. (2008) identified heterozygosity for a 1028A-G transition in the TARDBP gene, resulting in a gln343-to-arg (Q343R) substitution. The mutation occurs in a highly conserved residue and was not present in 534 chromosomes in Japanese control subjects.


.0009 AMYOTROPHIC LATERAL SCLEROSIS 10 WITHOUT FRONTOTEMPORAL DEMENTIA AND WITH TDP43 INCLUSIONS

TARDBP, ALA315THR
  
RCV000005547...

In affected members of a European family with amyotrophic lateral sclerosis (612069), Gitcho et al. (2008) identified heterozygosity for a 1077G-A transition in exon 6 of the TARDBP gene, resulting in an ala315-to-thr substitution. The mutation occurs in a highly conserved residue and was not found in 1,505 ethnically matched elderly control subjects.


.0010 AMYOTROPHIC LATERAL SCLEROSIS 10 WITH OR WITHOUT FRONTOTEMPORAL DEMENTIA AND WITH TDP43 INCLUSIONS

TARDBP, GLY295SER
  
RCV000020674...

In a woman with ALS10 (612069), Benajiba et al. (2009) identified a heterozygous 883G-A transition in exon 6 of the TARDBP gene, resulting in a gly295-to-ser (G295S) substitution in the hnRNP-binding domain. She also developed semantic frontotemporal dementia. Her sister, who carried the mutation, and their deceased father, who presumably carried the mutation, both had motor neuron disease without dementia. The G295S mutation was also identified in an unrelated woman with the behavioral variant of frontotemporal dementia and motor neuron disease. The mutation was not found in 400 control individuals.


.0011 FRONTOTEMPORAL DEMENTIA WITH TDP43 INCLUSIONS, TARDBP-RELATED

TARDBP, LYS263GLU
  
RCV000005549

In a Hungarian man with frontotemporal lobar degeneration (see 612069), Kovacs et al. (2009) identified a heterozygous A-to-G transition in exon 6 of the TARDBP gene, resulting in a lys263-to-glu (K263E) substitution in the highly conserved C terminus. The mutation was not found in 530 controls. The patient developed personality changes beginning at age 35 years. This was followed by a rapid deterioration in attention and thinking, with psychomotor agitation and insomnia, consistent with FTD. Neurologic examination showed supranuclear gaze palsy, hyperkinetic choreiform movements, motor stereotypies, and primitive reflexes. Motor neuron disease signs, rigidity, and cerebellar ataxia were not present. He died at age 37 years of pulmonary edema secondary to cardiac failure. Neuropathologic examination neuronal loss and astrogliosis in the subcortical gray matter. Phospho-TDP43-immunoreactive deposits were present in neuronal cytoplasmic inclusions in various brain regions, including the cortex, basal ganglia, thalamus, and brainstem. The findings indicated that TARDBP mutations can be associated with a wider clinicopathologic spectrum of disorders than originally thought.


.0012 AMYOTROPHIC LATERAL SCLEROSIS 10 WITH OR WITHOUT FRONTOTEMPORAL DEMENTIA AND WITH TDP43 INCLUSIONS

FRONTOTEMPORAL DEMENTIA WITH TDP43 INCLUSIONS, TARDBP-RELATED, INCLUDED
TARDBP, 2076G-A, 3-PRIME UTR
  
RCV000005550...

In affected members of 2 unrelated families with either ALS10 with or without frontotemporal dementia (612069) or FTLD (see 612069), Gitcho et al. (2009) identified a heterozygous 2076G-A transition in the 3-prime untranslated region of the TARDBP gene adjacent to the last exon, exon 6. The first family had 2 mutation carriers with a variable phenotype: the proband was a woman with frontotemporal dementia without motor disease, whereas her brother had lower motor neuron disease without dementia. The father and mother, from whom DNA was not available, had ALS and lower motor neuron disease, respectively, and it was not clear which parent likely transmitted the TARDBP mutation. Neuropathologic analysis of the proband, who did not have motor neuron disease, showed cortical atrophy, neuronal loss in the hippocampus, hippocampal sclerosis, and TDP43-positive neuronal cytoplasmic inclusions in the cortex and hippocampus. There was no evidence of motor neuron loss from the motor nuclei of the brainstem. The brother's neuropathologic findings were consistent with ALS and showed TDP43-immunoreactivity in the anterior horn cells of the spinal cord and neuronal cytoplasmic inclusions in the hippocampus. The second family included a patient with familial ALS; no neuropathology was available for that patient. The 2076G-A variant is highly conserved across species, suggesting functional importance, and was not found in 974 control individuals. Allele-specific functional analysis showed that the 2076G-A variant was associated with a 2-fold increase in TARDBP expression. These findings suggested that a common molecular pathology can result in clinically heterogeneous phenotypes.


.0013 AMYOTROPHIC LATERAL SCLEROSIS 10 WITH OR WITHOUT FRONTOTEMPORAL DEMENTIA AND WITH TDP43 INCLUSIONS

FRONTOTEMPORAL DEMENTIA WITH TDP43 INCLUSIONS, TARDBP-RELATED, INCLUDED
TARDBP, ALA382THR
  
RCV000020663...

Amyotrophic Lateral Sclerosis 10

In 7 Italian probands with ALS10 (612069), Corrado et al. (2009) identified a heterozygous 1144G-A transition in exon 6 of the TARDBP gene, resulting in an ala382-to-thr (A382T) substitution. The patients were identified from a larger cohort of 666 Italian ALS patients. A382T was the most common of all TARDBP mutations and was found in 6 of 18 probands. All the patients had ALS with predominantly lower motor neuron disease affecting the upper limb, with proximal spreading; none had cognitive impairment. Haplotype analysis indicated a founder effect in 5 of 7 patients with the A382T mutation. Lymphocyte studies showed accumulation of aberrant TARDBP bands, suggesting instability of the mutant protein.

Chio et al. (2010) identified a heterozygous A382T mutation in affected members of 3 unrelated Italian families with ALS10 with frontotemporal dementia (612069). The mutation was not found in over 1,200 controls. Affected individuals developed rapidly progressive muscle atrophy and weakness associated with hyperreflexia, dysarthria, dysphagia, and respiratory insufficiency between ages 25 and 78 years. Frontotemporal dementia, characterized by disinhibition, emotional lability, apathy, and executive dysfunction, developed soon after the onset of ALS. One mutation carrier did not manifest neurologic symptoms at age 65 years.

Chio et al. (2011) identified the A382T mutation in 39 (28.7%) of 135 Sardinian patients with ALS, including 15 with familial disease and 24 with apparently sporadic disease. None of 156 ethnically matched controls carried the mutation. Haplotype analysis of 5 patients with the mutation identified a 94-SNP common risk haplotype spanning 663 kb across the TARDBP locus on chromosome 1p36.22. The findings suggested a founder effect in this population.

Frontotemporal Dementia

Synofzik et al. (2014) identified a heterozygous A382T mutation in a Sardinian man with behavioral variant frontotemporal dementia without motor signs (see 612069). The patient developed rapidly progressive dementia beginning at age 31, and was severely disabled with no meaningful communication or social interaction by age 37. Brain MRI showed generalized cerebral atrophy, particularly in the anterior temporal lobe and hippocampi. The patient had no evidence of ALS. His father, who was likely a carrier based on family history, did not show signs of dementia or ALS at age 63 years. Family history was positive for ALS without dementia in 2 individuals in antecedent generations; DNA was not available from these patients. The mutation was found by massively parallel sequencing of the proband and confirmed by Sanger sequencing. The findings confirmed that TARDBP mutations can cause a pure dementia phenotype.


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Bao Lige - updated : 06/05/2024
Ada Hamosh - updated : 11/28/2022
Bao Lige - updated : 06/30/2021
Ada Hamosh - updated : 02/22/2019
Ada Hamosh - updated : 03/12/2018
Ada Hamosh - updated : 09/14/2016
Patricia A. Hartz - updated : 06/07/2016
Patricia A. Hartz - updated : 2/16/2016
Cassandra L. Kniffin - updated : 10/27/2015
Patricia A. Hartz - updated : 4/8/2014
Cassandra L. Kniffin - updated : 3/6/2014
George E. Tiller - updated : 8/28/2013
Cassandra L. Kniffin - updated : 8/6/2013
Cassandra L. Kniffin - updated : 3/7/2013
Cassandra L. Kniffin - updated : 2/14/2013
Ada Hamosh - updated : 2/1/2013
Patricia A. Hartz - updated : 9/20/2012
Cassandra L. Kniffin - updated : 4/23/2012
Cassandra L. Kniffin - updated : 10/5/2011
George E. Tiller - updated : 2/8/2011
Paul J. Converse - updated : 2/7/2011
Cassandra L. Kniffin - updated : 1/14/2011
Cassandra L. Kniffin - updated : 9/28/2010
Ada Hamosh - updated : 9/14/2010
Cassandra L. Kniffin - updated : 10/27/2009
Cassandra L. Kniffin - updated : 7/14/2009
Cassandra L. Kniffin - updated : 3/27/2009
Cassandra L. Kniffin - updated : 3/18/2009
Carol A. Bocchini - updated : 11/7/2008
Cassandra L. Kniffin - updated : 10/8/2008
Victor A. McKusick - updated : 5/29/2008
Cassandra L. Kniffin - updated : 5/22/2008
Ada Hamosh - updated : 5/8/2008
Cassandra L. Kniffin - updated : 1/2/2008
Ada Hamosh - updated : 10/25/2006
Victor A. McKusick - updated : 5/28/2004
Patricia A. Hartz - updated : 2/6/2004
Creation Date:
Paul J. Converse : 6/26/2000
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mgross : 6/26/2000

* 605078

TAR DNA-BINDING PROTEIN; TARDBP


Alternative titles; symbols

TAR DNA-BINDING PROTEIN, 43-KD; TDP43


HGNC Approved Gene Symbol: TARDBP

Cytogenetic location: 1p36.22   Genomic coordinates (GRCh38) : 1:11,012,654-11,030,528 (from NCBI)


Gene-Phenotype Relationships

Location Phenotype Phenotype
MIM number
Inheritance Phenotype
mapping key
1p36.22 Amyotrophic lateral sclerosis 10, with or without FTD 612069 Autosomal dominant 3
Frontotemporal lobar degeneration, TARDBP-related 612069 Autosomal dominant 3

TEXT

Description

TARDBP is a predominantly nuclear RNA/DNA-binding protein that functions in RNA processing and metabolism, including RNA transcription, splicing, transport, and stability. Following cell stress, TARDBP also localizes to cytoplasmic stress granules and may play a role in stress granule formation (summary by Xia et al., 2016).


Cloning and Expression

Human immunodeficiency virus (HIV)-1, the causative agent of acquired immunodeficiency syndrome (AIDS), contains an RNA genome that produces a chromosomally integrated DNA during the replicative cycle. The HIV Tat protein (see 601409), a transcription-activating protein that binds to the bulge region of a stable stem-bulge-loop structure, TAR RNA, activates the HIV-1 long terminal repeat (LTR). Tat activates the LTR less efficiently in rodent than in human cells, suggesting that cellular RNA-binding proteins are also involved in the regulation of HIV replication. TAR DNA may possess distinct regulatory elements that play a role in modulating HIV-1 gene expression. To characterize cellular factors that bind to TAR DNA, Ou et al. (1995) screened a HeLa cell cDNA library using a TAR DNA probe and identified a cDNA encoding a 43-kD TAR DNA-binding protein, TARDBP, which they called TDP43. The deduced 414-amino acid TARDBP contains a ribonucleoprotein (RNP)-binding domain and a glycine-rich region. Northern blot analysis detected a ubiquitously expressed, 2.8-kb TARDBP transcript. SDS-PAGE analysis showed that recombinant and native TARDBP are expressed as 43-kD proteins.

By database analysis and cDNA cloning, Wang et al. (2004) determined that the TARDBP gene generates at least 11 mRNA species by alternative splicing. The shorter transcripts encode proteins lacking the glycine-rich domain, which is required for the exon-skipping activity of TARDBP.

Benajiba et al. (2009) stated that TDP43 contains 2 RNA recognition motifs, a nuclear export domain, and a C-terminal domain that is essential for binding to heterogeneous nuclear ribonucleoproteins (hnRNPs) and for splicing inhibition. TDP43 is normally localized in the nucleus, but in pathologic conditions, the cleaved form of TDP43 is mainly present in the cytoplasm.


Gene Structure

Wang et al. (2004) determined that the TARDBP gene contains 6 exons.


Mapping

By genomic sequence analysis, Wang et al. (2004) mapped the TARDBP gene to chromosome 1p36.21. They also identified intronless TARDBP-like pseudogenes on chromosomes 2, 6, 8, 13, and 20 that likely originated from retrotransposition events. Wang et al. (2004) mapped the mouse Tardbp gene to chromosome 4E2 in a region that shows homology of synteny to human chromosome 1p36.


Gene Function

Functional analysis by Ou et al. (1995) indicated that TARDBP does not bind RNA. Gel retardation analysis followed by Western blot analysis (Shift-Western analysis) demonstrated that the RNP-binding motifs of TARDBP bind to the pyrimidine-rich motifs of TAR DNA. In an in vitro transcription analysis, increasing amounts of TARDBP, in the presence or absence of Tat, decreased the level of transcription from the HIV-1 LTR but not from the adenovirus major late promoter.

Using reporter plasmids, Wang et al. (2004) determined that deletion of the glycine-rich domain of mouse Tardbp resulted in loss of about 90% of its ability to activate exon skipping in the CFTR gene (602421).

RNA splicing mutations in the CFTR gene are thought to lead to dysfunction of several organs such as lung, sweat glands, genital tract, intestine and pancreas, producing the complex symptoms of cystic fibrosis (219700). Buratti et al. (2001) showed that TDP43 promotes skipping of exon 9 of the CFTR gene by binding specifically to the UG repeat sequence in intron 8 of the CFTR pre-mRNA. Buratti and Baralle (2001) reported the characterization and functional implications of the RNA binding properties of TDP43. Wang et al. (2004) found that the mouse homolog of human TDP43 also inhibits human CFTR exon 9 splicing in a minigene system. Buratti et al. (2004) described experiments consistent with the model in which the TG repeats in the CFTR intron 8 bind to TDP43, and this protein, in turn, inhibits splicing of exon 9. They suggested that their results provide a mechanistic explanation for the association data of Groman et al. (2004) and also an explanation for the variable phenotypic penetrance of the TG repeats. Individual and tissue-specific variability in the concentration of this inhibitory splicing factor may even determine whether an individual will develop multisystemic (non-classic CF) or monosymptomatic (CBAVD) disease.

Neumann et al. (2006) found that a hyperphosphorylated, ubiquitinated, and cleaved form of TDP43, known as pathologic TDP43, is the major disease protein in ubiquitin-positive, tau-, and alpha-synuclein-negative frontotemporal dementia (FTLD-U; 607485) and in ALS (see 105400). The signature of pathologic TDP43 in FTLD-U includes the presence of C-terminal breakdown and/or cleavage products migrating at approximately 25 kD, a 45 kD variant, and a high molecular weight TDP43-immunoreactive smear. TDP43 is normally localized primarily to the nucleus, but Neumann et al. (2006) suggested that, under pathologic conditions in FTLD-U, TDP43 is eliminated from nuclei of ubiquitinated inclusion-bearing neurons, a consequence of which may be a loss of TDP43 nuclear functions. Arai et al. (2006) also identified TDP43 as a component of ubiquitin-positive tau-negative neuronal and glial inclusions in frontotemporal lobar degeneration and ALS. Biochemical analysis suggested that abnormal phosphorylation of TDP43 may be involved in the pathogenesis of these disorders. The findings were similar to those reported by Neumann et al. (2006).

Mackenzie et al. (2007) identified TDP43-immunoreactive neuronal and glial cytoplasmic inclusions in 59 cases of sporadic ALS, 26 cases of ALS with dementia, and 11 cases of SOD1 (147450)-negative familial ALS. Immunofluorescence confirmed colocalization of TDP43 and ubiquitin within the inclusions. In contrast, TDP43 was not detected in any of 15 patients with SOD1-positive ALS. The authors suggested that these findings represented differing pathogenic mechanisms.

Elden et al. (2010) showed that ataxin-2 (601517), a polyglutamine (polyQ) protein mutated in spinocerebellar ataxia type 2 (183090), is a potent modifier of TDP43 toxicity in animal and cellular models of ALS. ATXN2 and TDP43 associate in a complex that depends on RNA. In spinal cord neurons of ALS patients, ATXN2 is abnormally localized; likewise, TDP43 shows mislocalization in spinocerebellar ataxia-2. To assess the involvement of ATXN2 in ALS, Elden et al. (2010) analyzed the length of the polyQ repeat in the ATXN2 gene in 915 ALS patients and 980 controls. The authors found that intermediate-length polyQ expansions (27 to 33 glutamines) in ATXN2 were significantly associated with ALS (4.7% of cases; 1.4% of controls).

Armakola et al. (2012) reported results from 2 genomewide loss-of-function TDP43 toxicity suppressor screens in yeast. The strongest suppressor of TDP43 toxicity was deletion of DBR1 (607024), which encodes an RNA lariat debranching enzyme. Armakola et al. (2012) showed that, in the absence of DBR1 enzymatic activity, intronic lariats accumulate in the cytoplasm and likely act as decoys to sequester TDP43, preventing it from interfering with essential cellular RNAs and RNA-binding proteins. Knockdown of DBR1 in a human neuronal cell line or in primary rat neurons was also sufficient to rescue TDP43 toxicity. Armakola et al. (2012) concluded that their findings provided insight into TDP43-mediated cytotoxicity and suggested that decreasing DBR1 activity could be a potential therapeutic approach for ALS.

Ling et al. (2015) found that depletion of Tardbp in mouse embryonic stem cells resulted in the splicing of cryptic exons into mRNA, often disrupting their translation and promoting nonsense-mediated mRNA decay. Similar results were observed in human HeLa cells. Enforced repression of cryptic exons prevented cell death in Tardbp-deficient cells. The findings suggested that TARDBP normally acts to repress the splicing of nonconserved cryptic exons, thereby maintaining intron integrity. Postmortem brain tissue from patients with ALS/FTD showed that repression of cryptic exons was impaired, suggesting that this splicing defect could contribute to TARDBP-proteinopathy in certain neurodegenerative diseases.

By immunoprecipitation analysis of transfected HEK293 cells, followed by protein pull-down assays, Xia et al. (2016) showed that folliculin (FLCN; 607273) interacted directly with TDP43. Overexpression of FLCN led to localization of TDP43 in cytoplasm, where it colocalized with markers of lysosomes, autophagosomes, and the ubiquitin-proteasome system. Under arsenite stress, TDP43 colocalized with stress granules. In contrast, RNA interference-mediated depletion of FLCN in arsenite-treated cells caused dissociation of TDP43 from stress granules and nuclear accumulation of TDP43. Xia et al. (2016) concluded that FLCN is critical for TDP43 translocation from nucleus to cytoplasm, which is required for stress granule assembly.

Woerner et al. (2016) analyzed the compartment specificity of aggregate toxicity using artificial beta-sheet proteins, as well as fragments of mutant huntingtin (613004) and TDP43. Aggregation in the cytoplasm interfered with nucleocytoplasmic protein and RNA transport. In contrast, the same proteins did not inhibit transport when forming inclusions in the nucleus at or around the nucleolus. Protein aggregation in the cytoplasm, but not the nucleus, caused the sequestration and mislocalization of proteins containing disordered and low-complexity sequences, including multiple factors of the nuclear import and export machinery. Thus, Woerner et al. (2016) concluded that impairment of nucleocytoplasmic transport may contribute to the cellular pathology of various aggregate deposition diseases.

A decrease in ataxin-2 (601517) suppresses TDP43 toxicity in yeast and flies, and intermediate-length polyglutamine expansions in the ataxin-2 gene increase the risk of ALS (see 183090). Becker et al. (2017) used 2 independent approaches to test whether decreasing ataxin-2 levels could mitigate disease in a mouse model of TDP43 proteinopathy. First, they crossed ataxin-2 knockout mice with TDP43 transgenic mice. The decrease in ataxin-2 reduced aggregation of TDP43, markedly increased survival, and improved motor function. Second, in a more therapeutically applicable approach, Becker et al. (2017) administered antisense oligonucleotides targeting ataxin-2 to the central nervous system of TDP43 transgenic mice. This single treatment markedly extended survival. Becker et al. (2017) suggested that because TDP43 aggregation is a component of nearly all cases of ALS, targeting ataxin-2 could represent a broadly effective therapeutic strategy.

Vogler et al. (2018) demonstrated that TDP43 is an essential protein for normal skeletal muscle formation that unexpectedly forms cytoplasmic, amyloid-like oligomeric assemblies, which the authors termed myogranules, during regeneration of skeletal muscle in mice and humans. Myogranules bind to mRNAs that encode sarcomeric proteins and are cleared as myofibers mature. Although myogranules occur during normal skeletal muscle regeneration, myogranules can seed TDP43 amyloid fibrils in vitro and were increased in a mouse model of inclusion body myopathy. Therefore, increased assembly or decreased clearance of functionally normal myogranules could be the source of cytoplasmic TDP43 aggregates that commonly occur in neuromuscular diseases such as ALS and inclusion body myopathy.

Taylor et al. (2018) showed that patients with FTLD with tau inclusions (see 600274) or TDP43 inclusions had elevated expression of both TTBK1 (619415) and TTBK2 (611695) in cortical and hippocampal neurons and that TTBK1 and TTBK2 colocalized with phosphorylated proteins.

Shao et al. (2022) studied the interplay of the FTD-ALS-associated genes C9ORF72 (614260), TBK1 (604834), and TDP43. Shao et al. (2022) found that TBK1 is phosphorylated in response to C9ORF72 poly(gly-ala; GA) aggregation and sequestered into inclusions, resulting in decreased TBK1 activity and contributing to neurodegeneration. Reducing TBK1 activity in mice using a knockin mutation exacerbated poly(GA)-induced phenotypes, including increased TDP43 pathology and the accumulation of defective endosomes in poly(GA)-positive neurons. The authors postulated a disruption of the endosomal-lysosomal pathway in FTD-ALS, leading to increased susceptibility to protein aggregation, driving TDP43 proteinopathy and neurodegeneration.

Hruska-Plochan et al. (2024) generated human neural stem cells from induced pluripotent stem cells derived from normal human skin fibroblasts and found that they were self-renewing and could form functional networks, which the authors called iNets, with neuronal and glial maturation similar to that of cortical organoids. Overexpression of wildtype TDP43 in a minority of neurons within iNets led to progressive fragmentation and aggregation of TDP43, resulting in partial loss of function and neurotoxicity. Single-cell transcriptomic analysis revealed a novel set of misregulated RNA targets in TDP43-overexpressing neurons and in patients with TDP43 proteinopathies exhibiting loss of nuclear TDP43. The strongest misregulated target was NPTX2 (600750), whose levels were controlled by TDP43 binding to its 3-prime UTR. NPTX2 exhibited neurotoxicity when overexpressed in iNets, whereas correcting NPTX2 misregulation partially rescued neurons from TDP43-induced neurodegeneration. NPTX2 was consistently misaccumulated in neurons from patients with ALS and frontotemporal lobar degeneration with TDP43 pathology. The results directly linked TDP43 misregulation and NPTX2 accumulation, thereby revealing a TDP43-dependent pathway of neurotoxicity.


Molecular Genetics

Lattante et al. (2013) provided a review of TARDBP mutations associated with ALS10 (612069). TARDPB mutations occur in about 3% of patients with familial ALS and in 1.5% of patients with sporadic disease.

Gitcho et al. (2009) noted that TDP43 was first identified as the major pathologic protein of ubiquitin-positive, tau-negative inclusions of frontotemporal lobar degeneration (FTLDU; 607485), FTLD with motor neuron disease (FTDMND; 105500), and ALS/MND (ALS10). These disorders are now considered to represent different clinical manifestations of the same underlying molecular pathology, namely TDP43 proteinopathy. The differing clinical phenotypes of these overlapping disorders most likely reflect the selective vulnerability of different segments of the neuraxis to neurodegeneration.

In a family segregating autosomal dominant ALS and 2 sporadic cases (see ALS10, 612069), Sreedharan et al. (2008) identified mutations in the TARDBP gene. All 3 mutations, M337V (605078.0001), Q331K (605078.0002), and G294A (605078.0001) occurred in a highly conserved region of the C terminus of TDP43 involved in protein-protein interactions. To assess the functional significance of these mutations, Sreedharan et al. (2008) expressed tagged TDP43(wildtype), TDP43(Q331K), and TDP43(M337V) in Chinese hamster ovary (CHO) cells. Immunofluorescent staining of cells 48 hours after transfection showed abundant expression of transfected TDP43, with no obvious differences in subcellular distribution or aggregation between mutant and wildtype proteins. Expression of these tagged proteins in spinal cord of stage 14 chick embryos demonstrated dramatic reduction in maturation in embryos expressing mutant versus wildtype TDP43, with a failure to develop normal limb and tail buds. While chick embryo development proceeded normally over 48 hours with TDP43(wildtype), at 24 hours only 5 to 15% of those embryos expressing mutant TDP43 had reached the normal stage of maturation. TUNEL staining demonstrated a significant increase in the number of apoptotic nuclei in embryos expressing either mutant when compared with wildtype. Sreedharan et al. (2008) concluded that their results suggested a toxic gain-of-function or dominant-negative effect of mutant TDP43.

In affected members of a Japanese family with ALS previously described by Tagawa et al. (2007), Yokoseki et al. (2008) identified a heterozygous mutation in the TARDBP gene (Q343R; 605078.0008).

In affected members of a European family with ALS10, Gitcho et al. (2008) identified a heterozygous mutation in the TARDBP gene (A315T; 605078.0009).

Van Deerlin et al. (2008) identified heterozygous mutations in the TARDBP gene (605078.0004; 605078.0005) in affected individuals of 2 unrelated families with autosomal dominant ALS10.

Kabashi et al. (2008) screened a panel of familial and sporadic ALS cases for TARDBP mutations. They found 8 missense mutations in 9 individuals, 6 from individuals with sporadic ALS and 3 from those with familial ALS, and a concurring increase of a smaller TDP43 product.

By sequence analysis, Kabashi et al. (2009) did not find any pathogenic mutations in the TARDBP gene among 125 French Canadian patients with dopa-responsive Parkinson disease (PD; 168600).

Kuhnlein et al. (2008) identified mutations in the TARDBP gene in 2 (6.5%) of 31 probands with non-SOD1 familial ALS.

Kovacs et al. (2009) identified a heterozygous mutation in the TARDBP gene (K263E; 605078.0011) in a Hungarian man with frontotemporal lobar degeneration beginning at age 35 years. He had a rapidly progressive course, resulting in death at age 37., Neurologic examination showed supranuclear gaze palsy, hyperkinetic choreiform movements, motor stereotypies, and primitive reflexes. Motor neuron disease signs, rigidity, and cerebellar ataxia were not present. Phospho-TDP43-immunoreactive deposits were present in neuronal cytoplasmic inclusions in various brain regions, including the cortex,

Gitcho et al. (2009) identified a heterozygous 2076G-A transition in the 3-prime untranslated region of the TARDBP gene (605078.0012) in affected members of 2 unrelated families with either ALS10 with or without frontotemporal dementia or FTLD (see 612069). The first family had 2 mutation carriers with a variable phenotype: the proband was a woman with frontotemporal dementia without motor disease, whereas her brother had lower motor neuron disease without dementia. The father and mother, from whom DNA was not available, had ALS and lower motor neuron disease, respectively, and it was not clear which parent likely transmitted the TARDBP mutation. Neuropathologic analysis of the proband, who did not have motor neuron disease, showed cortical atrophy, neuronal loss in the hippocampus, hippocampal sclerosis, and TDP43-positive neuronal cytoplasmic inclusions in the cortex and hippocampus. The brother's neuropathologic findings were consistent with ALS and showed TDP43-immunoreactivity in the anterior horn cells of the spinal cord and neuronal cytoplasmic inclusions in the hippocampus. The second family included a patient with familial ALS; no neuropathology was available for that patient.

Millecamps et al. (2010) identified 6 different missense mutations in the TARDBP gene in 7 (4.3%) of 162 French probands with familial ALS. Three of the families had been previously reported. Patients with TARDBP mutations had disease onset predominantly in the upper limb. One-third of patients had rapid disease progression, two-thirds had a medium disease course, and 1 had a slow disease course. There was evidence of incomplete penetrance. One TARDBP mutation carrier developed frontotemporal dementia 1 year after the onset of motor weakness.

Kabashi et al. (2010) tested the effects of 3 reported TARDBP mutations, A315T, (605078.0009), G348C (605078.0007), and A382T (605078.0013), in cell lines, primary cultured motor neurons, and living zebrafish embryos. Each of the 3 mutants and wildtype human TDP43 localized to nuclei when expressed in COS-1 and Neuro2A cells by transient transfection. However, when expressed in motor neurons from dissociated spinal cord cultures, these mutant TARDBP alleles were neurotoxic, concomitant with perinuclear localization and aggregation of TDP43. Overexpression of mutant human TARDBP caused a motor phenotype in zebrafish embryos consisting of shorter motor neuronal axons, premature and excessive branching, as well as swimming deficits. Knockdown of zebrafish Tardbp led to a similar phenotype, which was rescued by coexpressing wildtype but not mutant human TARDBP. Kabashi et al. (2010) suggested that both a toxic gain of function as well as a novel loss of function may be involved in the molecular mechanism by which mutant TDP43 contributes to disease pathogenesis.


Genotype/Phenotype Correlations

Corcia et al. (2012) identified 19 patients from 9 families with ALS10 and 9 patients with apparently sporadic ALS10. The patients were French, and all carried mutations in the TARDBP gene. The mean age at onset was 53.4 years, and the upper limb was the most common site of onset. Only 2 patients had dementia. The median disease duration was 63 months; 2 patients were alive after 8 years. These patients were pooled with 117 ALS10 patients reported in the literature. Among all those with TARDBP mutations, Caucasians tended to have upper limb onset, while Asians tended to have bulbar onset. The G298S mutation (605078.0005) was associated with the shortest survival, whereas A315T (605078.0009) and M337V (605078.0001) were associated with longest duration.

By expression of 7 pathogenic ALS-associated mutant TDP43 proteins (e.g., M337V, 605078.0001; A382T, 605078.0013; G298S, 605078.0005; G348C, 605078.0007; Q343R, 605078.0008; and A315T, 605078.0009) in a differentiated neuronal cell line, Watanabe et al. (2013) found that all had consistently longer half-lives compared to the wildtype protein. Patients carrying mutations with longer half-lives showed earlier disease onset (p = 0.00252), although there was no correlation between protein half-lives and disease duration. Proteins with mutations in the nuclear export signal had an extremely long half-life, whereas a second group of mutations generated within the nuclear localization signal were less stable than wildtype. In additional studies, most of 18 ALS-linked mutant TDP43 proteins showed lower solubility to the detergent Sarkosyl compared to wildtype. A cell model in which wildtype TDP43 was stabilized caused cytotoxicity, nuclear accumulation, insolubility, proteasomal impairment with increased numbers of misfolded C-terminal cleaved TDP43 products, and dysregulation of normal mRNA processing. The findings suggested that increased stability of either wildtype or mutant TDP43 can cause a gain of toxicity through abnormal proteostasis.


Animal Model

Wegorzewska et al. (2009) found that transgenic mice expressing a Tdp43 A315T mutation (605078.0009) developed progressive gait abnormalities at about 3 to 4 months of age and died at about 5 months of age. Postmortem examination showed accumulation of ubiquitinated proteins selectively in the cytoplasm of neurons in cortical layer 5, including the motor cortex. The inclusions did not stain for TDP43, but the changes were associated with neuronal loss and increased glial reaction. Examination of the spinal cord of mutant mice showed degeneration of descending motor axons and ubiquitin pathology in large neurons of the ventral horn; there was also loss of motor neurons. Mutant mice also showed Tdp43 C-terminal fragments in the brain and spinal cord prior to the onset of gait abnormalities. Wegorzewska et al. (2009) concluded that since cytoplasmic Tdp43 aggregates were not present in mutant mice, they are not required for neurodegeneration. These results indicated that the selective neuronal vulnerability in Tdp43-related neurodegeneration is related to altered DNA/RNA-binding protein function rather than to toxic aggregation.

Using translating ribosome affinity purification and microarray analysis, MacNair et al. (2016) found that several mRNAs were abnormally regulated in 10-month-old symptomatic Tdp43 A315T transgenic mice compared with wildtype controls and 5-month-old presymptomatic Tdp43 A315T mice. Those upregulated over 2-fold in older Tdp43 A315T mice included Ccl4 (182284), Tdp43, Pkib (606914), and Ddx58 (609631), and those downregulated included Prickle4 (611389), Pes1 (605819), and Mthfsd (616820). Expression of DDX58 and MTHFSD was similarly misregulated in human ALS motor neurons, and RNA immunoprecipitation analysis showed that Mthfsd and Ddx58 were direct targets of Tdp43 in transfected mouse neuroblastoma cells.

Tsai et al. (2010) generated an FTLDU mouse model by transgenically overexpressing Tdp43 in forebrain. Transgenic mice exhibited impaired learning and memory, progressive motor dysfunction, and hippocampal atrophy. The impairments were accompanied by reduced levels of phosphorylated Erk (see MAPK1; 176948) and phosphorylated Creb (CREB1; 123810) and increased levels of gliosis in the brains of transgenic mice. Cells with Tdp43-positive, ubiquitin-positive neuronal cytoplasmic inclusions (NCIs) and Tdp43-deleted nuclei appeared in transgenic mouse brains in an age-dependent manner. Tsai et al. (2010) concluded that increased levels of TDP43 protein in forebrain are sufficient to lead to formation of TDP43-positive, ubiquitin-positive NCIs and neurodegeneration.

Independently, Wils et al. (2010) observed neurodegeneration in transgenic mice overexpressing wildtype human TDP43. Homozygous and hemizygous transgenic mice showed dose-dependent degeneration of cortical and spinal motor neurons and developed spastic quadriplegia similar to ALS. Transgenic mice also developed dose-dependent degeneration of nonmotor cortical and subcortical neurons characteristic of FTLD. Affected neurons of the spinal cord and brain showed nuclear and cytoplasmic aggregates of ubiquitinated and phosphorylated TDP43. The characteristic, approximately 25-kD TDP43 C-terminal fragments were also recovered from nuclear fractions and correlated with disease development and progression in transgenic mice.

Ash et al. (2010) engineered panneuronal expression of human TDP43 in C. elegans to generate an in vivo model of TDP43 function and neurotoxicity. Transgenic worms with neuronal expression of human TDP43 exhibited an 'uncoordinated' phenotype and had abnormal motoneuron synapses. C. elegans contains a single putative ortholog of TDP43, designated tdp1, which could support alternative splicing of CFTR (602421) in a cell-based assay. Neuronal overexpression of tdp1 also resulted in an uncoordinated phenotype, whereas deletion of the tdp1 gene did not affect movement or alter motoneuron synapses. Wildtype human TDP43 expressed in C. elegans localized to the nucleus. TDP43 mutants missing either RNA recognition domain RRM1 or RRM2 completely blocked neurotoxicity, as did a mutant missing its C-terminal domain. These TDP43 mutants still accumulated in the nucleus, although their subnuclear distribution was altered. Fusion of the tdp1 C-terminal domain to a TDP43 N terminus restored normal subnuclear localization and toxicity in C. elegans and CFTR splicing in cell-based assays. Overexpression of wildtype TDP43 in differentiated M17 cells also resulted in cell toxicity. Ash et al. (2010) concluded that overexpression of wildtype TDP43 is sufficient to induce neurotoxicity.

Diaper et al. (2013) found that deletion of the TAR DNA-binding protein homolog (Tbph) in Drosophila caused impaired synaptic transmission at the larval and adult neuromuscular junction. Impaired presynaptic transmission was the earliest Tbph-related defect. Overexpression of Tbph in adults also resulted in synaptic defects and age-related progressive degeneration of neurons involved in motor control. Progressive neurodegeneration was also seen with inactivated Tbph.

Taylor et al. (2018) showed that transgenic C. elegans expressing the kinase catalytic domain of human TTBK1 or TTBK2 were behaviorally normal. However, coexpression of TTBK1, but not TTBK2, with TDP43 led to behavioral abnormalities and increased phosphorylation of TDP43.


ALLELIC VARIANTS 13 Selected Examples):

.0001   AMYOTROPHIC LATERAL SCLEROSIS 10 WITHOUT FRONTOTEMPORAL DEMENTIA AND WITH TDP43 INCLUSIONS

TARDBP, MET337VAL
SNP: rs80356730, gnomAD: rs80356730, ClinVar: RCV000005539, RCV000693006, RCV001090806

In an English family segregating autosomal dominant amyotrophic lateral sclerosis without frontotemporal dementia (612069), Sreedharan et al. (2008) identified an A-to-G transition at nucleotide 1009 in exon 6 of the TARDBP gene, resulting in a methionine-to-valine substitution at codon 337 (M337V). Methionine at this position is invariant in human, orangutan, mouse, opossum, chicken, frog, and zebrafish.


.0002   AMYOTROPHIC LATERAL SCLEROSIS 10 WITHOUT FRONTOTEMPORAL DEMENTIA AND WITH TDP43 INCLUSIONS

TARDBP, GLN331LYS
SNP: rs80356727, ClinVar: RCV000005540

In a 72-year-old Caucasian British man who developed limb-onset ALS (612069) with a disease duration of 3 years, Sreedharan et al. (2008) identified a C-to-A transversion at nucleotide 991 in exon 6 of the TARDBP gene, resulting in a glutamine-to-lysine substitution at codon 331 (Q331K).


.0003   AMYOTROPHIC LATERAL SCLEROSIS 10 WITHOUT FRONTOTEMPORAL DEMENTIA AND WITH TDP43 INCLUSIONS

TARDBP, GLY294ALA
SNP: rs80356721, gnomAD: rs80356721, ClinVar: RCV000005541, RCV002371764

In an Australian man who developed limb-onset ALS (612069) at age 65 with a disease duration of 5 years and no atypical features, Sreedharan et al. (2008) identified a G-to-C transversion at nucleotide 881 in exon 6 of the TARDBP gene, resulting in a glycine-to-alanine substitution at codon 294 (G294A).

Luquin et al. (2009) identified the G294A mutation in postmortem brain tissue from a patient with sporadic ALS. No clinical information was given.


.0004   AMYOTROPHIC LATERAL SCLEROSIS 10 WITHOUT FRONTOTEMPORAL DEMENTIA AND WITH TDP43 INCLUSIONS

TARDBP, GLY290ALA
SNP: rs121908395, ClinVar: RCV000005542, RCV001054737

In a Caucasian father and daughter with autosomal dominant ALS10 (612069), Van Deerlin et al. (2008) identified a heterozygous 869G-C transversion in exon 6 of the TARDBP gene, resulting in a gly290-to-ala (G290A) substitution in the C-terminal region of TDP43. The mutation was not identified in 747 white controls. The daughter presented with dysarthria and dysphagia at age 51 years and had a rapidly progressive course involving the limbs and respiration. She died after 13 months. Her father had presented with arm weakness at age 47 years and died after 16 months. Postmortem examination showed findings consistent with ALS.


.0005   AMYOTROPHIC LATERAL SCLEROSIS 10 WITHOUT FRONTOTEMPORAL DEMENTIA AND WITH TDP43 INCLUSIONS

TARDBP, GLY298SER
SNP: rs4884357, gnomAD: rs4884357, ClinVar: RCV000005543, RCV000713825, RCV001851670, RCV004754243

In affected members of a Chinese family with autosomal dominant ALS10 (612069), Van Deerlin et al. (2008) identified a heterozygous 892G-A transition in exon 6 of the TARDBP gene, resulting in a gly298-to-ser (G298S) substitution in the C-terminal region of TDP43. The mutation was not identified in 747 white controls or 380 Chinese controls. Five patients in 2 generations were affected with onset between ages 41 and 60 years. Most showed rapid progression with death within 1 or 2 years. Postmortem examination of 2 patients showed changes consistent with ALS as well as TDP43-positive inclusions in upper and lower motor neurons and in various brain regions.


.0006   AMYOTROPHIC LATERAL SCLEROSIS 10 WITHOUT FRONTOTEMPORAL DEMENTIA AND WITH TDP43 INCLUSIONS

TARDBP, ASP169GLY
SNP: rs80356717, ClinVar: RCV000005544

In a 56-year-old female with amyotrophic lateral sclerosis (612069), Kabashi et al. (2008) found a heterozygous A-to-G transition in exon 4 of the TARDBP gene (640A-G) that resulted in an asp169-to-gly substitution (D169G) in TDP43. The mutation occurred in the first RNA recognition motif (RRM1) and was predicted to abrogate RNA binding.


.0007   AMYOTROPHIC LATERAL SCLEROSIS 10 WITHOUT FRONTOTEMPORAL DEMENTIA AND WITH TDP43 INCLUSIONS

TARDBP, GLY348CYS
SNP: rs80356733, ClinVar: RCV000005545, RCV000516886, RCV001851671

In a 30-year-old female patient with amyotrophic lateral sclerosis (612069), Kabashi et al. (2008) detected a heterozygous G-to-T transversion at nucleotide 1176 in exon 6 of the TARDBP gene that resulted in substitution of cys for gly at codon 348 of TDP43 (G348C). The mutation, which introduced a cysteine to the C-terminal hnRNP interaction region, was predicted to increase the propensity for aggregation through the formation of intermolecular disulfide bridges.

Kuhnlein et al. (2008) identified the G348C mutation in affected members of a German family with ALS10. The proband presented at age 55 years with paresis of the right hand, which progressed rapidly to involve the arms and lower limbs and left her wheelchair-bound within 2.5 years. She died of respiratory insufficiency 3 years after disease onset. The patient's mother had died of respiratory insufficiency due to a similar disorder. There were no clinically relevant bulbar symptoms and no cognitive impairment.


.0008   AMYOTROPHIC LATERAL SCLEROSIS 10 WITHOUT FRONTOTEMPORAL DEMENTIA AND WITH TDP43 INCLUSIONS

TARDBP, GLN343ARG
SNP: rs80356731, ClinVar: RCV000005546

In affected members of a Japanese family with amyotrophic lateral sclerosis (612069), Yokoseki et al. (2008) identified heterozygosity for a 1028A-G transition in the TARDBP gene, resulting in a gln343-to-arg (Q343R) substitution. The mutation occurs in a highly conserved residue and was not present in 534 chromosomes in Japanese control subjects.


.0009   AMYOTROPHIC LATERAL SCLEROSIS 10 WITHOUT FRONTOTEMPORAL DEMENTIA AND WITH TDP43 INCLUSIONS

TARDBP, ALA315THR
SNP: rs80356726, gnomAD: rs80356726, ClinVar: RCV000005547, RCV001384596, RCV004546411

In affected members of a European family with amyotrophic lateral sclerosis (612069), Gitcho et al. (2008) identified heterozygosity for a 1077G-A transition in exon 6 of the TARDBP gene, resulting in an ala315-to-thr substitution. The mutation occurs in a highly conserved residue and was not found in 1,505 ethnically matched elderly control subjects.


.0010   AMYOTROPHIC LATERAL SCLEROSIS 10 WITH OR WITHOUT FRONTOTEMPORAL DEMENTIA AND WITH TDP43 INCLUSIONS

TARDBP, GLY295SER
SNP: rs80356723, gnomAD: rs80356723, ClinVar: RCV000020674, RCV003764615

In a woman with ALS10 (612069), Benajiba et al. (2009) identified a heterozygous 883G-A transition in exon 6 of the TARDBP gene, resulting in a gly295-to-ser (G295S) substitution in the hnRNP-binding domain. She also developed semantic frontotemporal dementia. Her sister, who carried the mutation, and their deceased father, who presumably carried the mutation, both had motor neuron disease without dementia. The G295S mutation was also identified in an unrelated woman with the behavioral variant of frontotemporal dementia and motor neuron disease. The mutation was not found in 400 control individuals.


.0011   FRONTOTEMPORAL DEMENTIA WITH TDP43 INCLUSIONS, TARDBP-RELATED

TARDBP, LYS263GLU
SNP: rs267607102, ClinVar: RCV000005549

In a Hungarian man with frontotemporal lobar degeneration (see 612069), Kovacs et al. (2009) identified a heterozygous A-to-G transition in exon 6 of the TARDBP gene, resulting in a lys263-to-glu (K263E) substitution in the highly conserved C terminus. The mutation was not found in 530 controls. The patient developed personality changes beginning at age 35 years. This was followed by a rapid deterioration in attention and thinking, with psychomotor agitation and insomnia, consistent with FTD. Neurologic examination showed supranuclear gaze palsy, hyperkinetic choreiform movements, motor stereotypies, and primitive reflexes. Motor neuron disease signs, rigidity, and cerebellar ataxia were not present. He died at age 37 years of pulmonary edema secondary to cardiac failure. Neuropathologic examination neuronal loss and astrogliosis in the subcortical gray matter. Phospho-TDP43-immunoreactive deposits were present in neuronal cytoplasmic inclusions in various brain regions, including the cortex, basal ganglia, thalamus, and brainstem. The findings indicated that TARDBP mutations can be associated with a wider clinicopathologic spectrum of disorders than originally thought.


.0012   AMYOTROPHIC LATERAL SCLEROSIS 10 WITH OR WITHOUT FRONTOTEMPORAL DEMENTIA AND WITH TDP43 INCLUSIONS

FRONTOTEMPORAL DEMENTIA WITH TDP43 INCLUSIONS, TARDBP-RELATED, INCLUDED
TARDBP, 2076G-A, 3-PRIME UTR
SNP: rs387906334, ClinVar: RCV000005550, RCV000005551, RCV002512811

In affected members of 2 unrelated families with either ALS10 with or without frontotemporal dementia (612069) or FTLD (see 612069), Gitcho et al. (2009) identified a heterozygous 2076G-A transition in the 3-prime untranslated region of the TARDBP gene adjacent to the last exon, exon 6. The first family had 2 mutation carriers with a variable phenotype: the proband was a woman with frontotemporal dementia without motor disease, whereas her brother had lower motor neuron disease without dementia. The father and mother, from whom DNA was not available, had ALS and lower motor neuron disease, respectively, and it was not clear which parent likely transmitted the TARDBP mutation. Neuropathologic analysis of the proband, who did not have motor neuron disease, showed cortical atrophy, neuronal loss in the hippocampus, hippocampal sclerosis, and TDP43-positive neuronal cytoplasmic inclusions in the cortex and hippocampus. There was no evidence of motor neuron loss from the motor nuclei of the brainstem. The brother's neuropathologic findings were consistent with ALS and showed TDP43-immunoreactivity in the anterior horn cells of the spinal cord and neuronal cytoplasmic inclusions in the hippocampus. The second family included a patient with familial ALS; no neuropathology was available for that patient. The 2076G-A variant is highly conserved across species, suggesting functional importance, and was not found in 974 control individuals. Allele-specific functional analysis showed that the 2076G-A variant was associated with a 2-fold increase in TARDBP expression. These findings suggested that a common molecular pathology can result in clinically heterogeneous phenotypes.


.0013   AMYOTROPHIC LATERAL SCLEROSIS 10 WITH OR WITHOUT FRONTOTEMPORAL DEMENTIA AND WITH TDP43 INCLUSIONS

FRONTOTEMPORAL DEMENTIA WITH TDP43 INCLUSIONS, TARDBP-RELATED, INCLUDED
TARDBP, ALA382THR
SNP: rs367543041, gnomAD: rs367543041, ClinVar: RCV000020663, RCV000106321, RCV000413910, RCV002513146, RCV003944833

Amyotrophic Lateral Sclerosis 10

In 7 Italian probands with ALS10 (612069), Corrado et al. (2009) identified a heterozygous 1144G-A transition in exon 6 of the TARDBP gene, resulting in an ala382-to-thr (A382T) substitution. The patients were identified from a larger cohort of 666 Italian ALS patients. A382T was the most common of all TARDBP mutations and was found in 6 of 18 probands. All the patients had ALS with predominantly lower motor neuron disease affecting the upper limb, with proximal spreading; none had cognitive impairment. Haplotype analysis indicated a founder effect in 5 of 7 patients with the A382T mutation. Lymphocyte studies showed accumulation of aberrant TARDBP bands, suggesting instability of the mutant protein.

Chio et al. (2010) identified a heterozygous A382T mutation in affected members of 3 unrelated Italian families with ALS10 with frontotemporal dementia (612069). The mutation was not found in over 1,200 controls. Affected individuals developed rapidly progressive muscle atrophy and weakness associated with hyperreflexia, dysarthria, dysphagia, and respiratory insufficiency between ages 25 and 78 years. Frontotemporal dementia, characterized by disinhibition, emotional lability, apathy, and executive dysfunction, developed soon after the onset of ALS. One mutation carrier did not manifest neurologic symptoms at age 65 years.

Chio et al. (2011) identified the A382T mutation in 39 (28.7%) of 135 Sardinian patients with ALS, including 15 with familial disease and 24 with apparently sporadic disease. None of 156 ethnically matched controls carried the mutation. Haplotype analysis of 5 patients with the mutation identified a 94-SNP common risk haplotype spanning 663 kb across the TARDBP locus on chromosome 1p36.22. The findings suggested a founder effect in this population.

Frontotemporal Dementia

Synofzik et al. (2014) identified a heterozygous A382T mutation in a Sardinian man with behavioral variant frontotemporal dementia without motor signs (see 612069). The patient developed rapidly progressive dementia beginning at age 31, and was severely disabled with no meaningful communication or social interaction by age 37. Brain MRI showed generalized cerebral atrophy, particularly in the anterior temporal lobe and hippocampi. The patient had no evidence of ALS. His father, who was likely a carrier based on family history, did not show signs of dementia or ALS at age 63 years. Family history was positive for ALS without dementia in 2 individuals in antecedent generations; DNA was not available from these patients. The mutation was found by massively parallel sequencing of the proband and confirmed by Sanger sequencing. The findings confirmed that TARDBP mutations can cause a pure dementia phenotype.


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Contributors:
Bao Lige - updated : 06/05/2024
Ada Hamosh - updated : 11/28/2022
Bao Lige - updated : 06/30/2021
Ada Hamosh - updated : 02/22/2019
Ada Hamosh - updated : 03/12/2018
Ada Hamosh - updated : 09/14/2016
Patricia A. Hartz - updated : 06/07/2016
Patricia A. Hartz - updated : 2/16/2016
Cassandra L. Kniffin - updated : 10/27/2015
Patricia A. Hartz - updated : 4/8/2014
Cassandra L. Kniffin - updated : 3/6/2014
George E. Tiller - updated : 8/28/2013
Cassandra L. Kniffin - updated : 8/6/2013
Cassandra L. Kniffin - updated : 3/7/2013
Cassandra L. Kniffin - updated : 2/14/2013
Ada Hamosh - updated : 2/1/2013
Patricia A. Hartz - updated : 9/20/2012
Cassandra L. Kniffin - updated : 4/23/2012
Cassandra L. Kniffin - updated : 10/5/2011
George E. Tiller - updated : 2/8/2011
Paul J. Converse - updated : 2/7/2011
Cassandra L. Kniffin - updated : 1/14/2011
Cassandra L. Kniffin - updated : 9/28/2010
Ada Hamosh - updated : 9/14/2010
Cassandra L. Kniffin - updated : 10/27/2009
Cassandra L. Kniffin - updated : 7/14/2009
Cassandra L. Kniffin - updated : 3/27/2009
Cassandra L. Kniffin - updated : 3/18/2009
Carol A. Bocchini - updated : 11/7/2008
Cassandra L. Kniffin - updated : 10/8/2008
Victor A. McKusick - updated : 5/29/2008
Cassandra L. Kniffin - updated : 5/22/2008
Ada Hamosh - updated : 5/8/2008
Cassandra L. Kniffin - updated : 1/2/2008
Ada Hamosh - updated : 10/25/2006
Victor A. McKusick - updated : 5/28/2004
Patricia A. Hartz - updated : 2/6/2004

Creation Date:
Paul J. Converse : 6/26/2000

Edit History:
mgross : 06/05/2024
mgross : 06/05/2024
carol : 11/29/2022
alopez : 11/28/2022
alopez : 11/28/2022
mgross : 06/30/2021
alopez : 02/22/2019
alopez : 03/12/2018
carol : 04/27/2017
alopez : 09/14/2016
mgross : 06/07/2016
mgross : 2/16/2016
carol : 10/28/2015
ckniffin : 10/27/2015
carol : 2/4/2015
mgross : 4/17/2014
mcolton : 4/8/2014
alopez : 3/25/2014
mcolton : 3/7/2014
ckniffin : 3/6/2014
carol : 9/16/2013
carol : 9/11/2013
tpirozzi : 8/30/2013
tpirozzi : 8/28/2013
tpirozzi : 8/28/2013
carol : 8/9/2013
ckniffin : 8/6/2013
alopez : 3/13/2013
ckniffin : 3/7/2013
alopez : 2/20/2013
ckniffin : 2/14/2013
alopez : 2/7/2013
terry : 2/1/2013
mgross : 9/26/2012
terry : 9/20/2012
terry : 9/14/2012
terry : 7/27/2012
carol : 4/26/2012
ckniffin : 4/23/2012
carol : 10/13/2011
ckniffin : 10/5/2011
wwang : 5/18/2011
terry : 3/16/2011
wwang : 3/14/2011
terry : 2/8/2011
mgross : 2/8/2011
terry : 2/7/2011
wwang : 2/7/2011
ckniffin : 1/14/2011
ckniffin : 10/6/2010
wwang : 9/29/2010
ckniffin : 9/28/2010
alopez : 9/21/2010
alopez : 9/21/2010
terry : 9/14/2010
wwang : 11/16/2009
ckniffin : 10/27/2009
wwang : 7/31/2009
ckniffin : 7/14/2009
wwang : 3/31/2009
ckniffin : 3/27/2009
wwang : 3/26/2009
ckniffin : 3/18/2009
carol : 11/7/2008
wwang : 10/15/2008
ckniffin : 10/8/2008
alopez : 5/29/2008
alopez : 5/29/2008
ckniffin : 5/22/2008
alopez : 5/21/2008
terry : 5/8/2008
wwang : 1/22/2008
ckniffin : 1/2/2008
alopez : 11/2/2006
terry : 10/25/2006
alopez : 5/28/2004
mgross : 2/6/2004
mgross : 6/27/2000
mgross : 6/26/2000