Progeria. Premature human aging: t he progerias. Progerias as models for aging. Hutchinson-Gilford syndrome. Definition:

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Premature human aging: t he progerias Reading: Genetic alterations in accelerated ageing syndromes Do they play a role in natural ageing? Monika Puzianowska- Kuznicka. Jacek Kuznicki. 2005. IJBCB, 37; 947 960 Definition: Progeria A disease characterized by symptoms of premature aging. A&S300-002 Jim Lund Progeria OMIM entries Progerias as models for aging Are progerias premature aging or a disease condition? How well do they parallel aging? One aspect or every aspect? Many diseases lead to the disruption of some biological process--but aren t aging. 1

First described by Jonathan Hutchinson in 1886. Hastings Gilford gave it the name progeria and described it in 1904. Hutchinson-Gilford progeria syndrome is an exceedingly rare disorder characterized by precocious senility of a striking degree. Death from coronary artery disease is frequent and may occur before 10 years of age. Clinical Features Slow growth, dwarfism. Lack of hair Disproportionately large head Pinched' facial features Lipodystrophy (almost complete absence of subcutaneous fat). Incomplete extension at the knees and elbows indicating stiffness of joints. Coronary artery disease. Generally a senile appearance By 10 patients start turning grey, die in teens typically of heart disease. Inheritance: both autosomal dominant and autosomal recessive cases have been reported, the classic cases are autosomal dominant. Incidence: 1 in 8,000,000 2

gene Gene isolated: Eriksson et al. (2003) Caused by mutations in the lamin A gene. Gene symbol: LMNA. Lamins are structural protein components of the nuclear lamina, a protein network underlying the inner nuclear membrane that determines nuclear shape and size. The lamins constitute a class of intermediate filaments Cloning and molecular genetics The gene was initially localized to chromosome 1q by observing 2 cases of uniparental isodisomy of 1q, and 1 case with a 6-Mb paternal interstitial deletion. Eighteen of 20 classic cases harbored the identical de novo single-base substitution, a C-to-T transition resulting in a silent gly-to-gly change at codon 608 within exon 11 Mutations activate a cryptic splice site within exon 11 of the lamin A gene, resulting in production of a protein product that deletes 50 amino acids near the C terminus. Lamins Nuclear lamina - a protein network underlying the inner nuclear membrane that determines nuclear shape and size. Major components: Lamin A, B, and C. Lamins are a class of intermediate filaments. Model for aging? Differences between Hutchinson-Gilford syndrome and aging. Not part of : Males don t develop prostate problems. No increased risk of cancer or cataracts. High blood pressure is rare. Diabetes rare. Don t get Alzheimer s disease or suffer mental degeneration. 3

Werner s syndrome Werner s syndrome Clinical features Also called adult progeria. Scleroderma-like skin changes, especially in the extremities (hardening and tightening of the skin) Cataracts Subcutaneous calcification Premature arteriosclerosis Diabetes mellitus Cancer A wizened and prematurely aged facies. Werner s syndrome Inheritance: autosomal recessive Incidence: 1 in 1,000,000 In Japan, the syndrome occurs more often, affecting between 1 in 20,000 and 1 in 40,000 people. 4

Werner s syndrome: cellular features Normal human fibroblasts achieve approximately 60 population doublings in culture. Werner syndrome cells usually achieve only about 20 population doublings. (lower Hayflick limit). Werner s syndrome gene Gene isoloated: Yu et al. (1996) Gene: WRN/RECQL2, a DNA helicase. homolog of the E. coli RecQ DNA helicase. Mutations are typically loss of function/null mutations. Some patients have LMNA mutations (autosomal dominant). Model for aging? Differences between Werner s syndrome and aging. Not part of Werner s syndrome: Prostate problems (other cancers common) High blood pressure Stroke Don t get Alzheimer s disease or suffer mental degeneration. Many diseases have progeriod aspects: Premature loss or graying of hair: 18+ genes Early cardiovascular disease: 30+ genes. Early senility: 50+ genes. Not good general models for aging. 5

Down syndrome: a progeria Caused by trisomy 21. Incidence: 1 in 700. Premature greying/hair loss Early vascular disease Early onset Alzheimer s disease: universal by 35-40. But no: prostate or breast cancer, high blood pressure, wrinkles, osteoporosis, cataracts. Diabetes has features of progeria Progeriod features: Cataracts Atherosclerosis Heart attacks Strokes Lung and joint stiffening Major causative factor is Advanced Glycosylation Products (AGEs) damage. 6