A Recurrent Missense Variant in AP2M1 Impairs Clathrin-Mediated Endocytosis and Causes Developmental and Epileptic Encephalopathy
Ingo Helbig
(1, 2, 3)
,
Tania Lopez-Hernandez
(4)
,
Oded Shor
(5)
,
Peter Galer
(1)
,
Shiva Ganesan
(1)
,
Manuela Pendziwiat
(6, 2)
,
Annika Rademacher
(2)
,
Colin Ellis
(3)
,
Nadja Hümpfer
(4)
,
Niklas Schwarz
(7)
,
Simone Seiffert
(7)
,
Joseph Peeden
,
Joseph Shen
(8)
,
Katalin Štěrbová
(9)
,
Trine Bjørg Hammer
,
Rikke Møller
(10)
,
Deepali Shinde
(11)
,
Sha Tang
(11)
,
Lacey Smith
(12)
,
Annapurna Poduri
(13, 14)
,
Roland Krause
(15)
,
Felix Benninger
(5)
,
Katherine Helbig
(1)
,
Volker Haucke
(4)
,
Yvonne Weber
(7, 16)
,
Rudi Balling
,
Nina Barisic
,
Stéphanie Baulac
(17)
,
Hande Caglayan
,
Dana Craiu
,
Peter de Jonghe
,
Christel Depienne
(17)
,
Renzo Guerrini
,
Helle Hjalgrim
,
Dorota Hoffman-Zacharska
,
Johanna Jähn
,
Karl Martin Klein
,
Bobby P.C. Koeleman
,
Vladimir Komarek
,
Eric Leguern
(17)
,
Anna-Elina Lehesjoki
,
Johannes Lemke
,
Holger Lerche
,
Tarja Linnankivi
,
Carla Marini
,
Patrick May
,
Hiltrud Muhle
,
Deb Pal
,
Aarno Palotie
,
Felix Rosenow
,
Susanne Schubert-Bast
,
Kaja Selmer
,
Jose Serratosa
,
Sanjay Sisodiya
,
Ulrich Stephani
,
Pasquale Striano
,
Arvid Suls
,
Tiina Talvik
,
Sarah von Spiczak
,
Sarah Weckhuysen
,
Federico Zara
,
Paul Avillach
,
Anna Bartels
,
Sawona Biswas
,
Florence Bourgeois
,
Batsal Devkota
,
Tracy Glauser
,
Barbara Hallinan
,
Allison Heath
,
Joel Hirschhorn
,
Judson Kilbourn
,
Sek Won Kong
,
Ian Krantz
,
In-Hee Lee
,
Kenneth Mandl
,
Eric Marsh
,
Kristen Sund
,
Deanne Taylor
,
Peter White
,
Rudi Balling
,
Nina Barisic
,
Stéphanie Baulac
,
Hande Caglayan
,
Dana Craiu
,
Peter De Jonghe
,
Christel Depienne
,
Renzo Guerrini
,
Helle Hjalgrim
,
Dorota Hoffman-Zacharska
,
Johanna Jähn
,
Karl Martin Klein
,
Bobby P.C. Koeleman
,
Vladimir Komarek
,
Eric Leguern
,
Anna-Elina Lehesjoki
,
Johannes R. Lemke
,
Holger Lerche
,
Tarja Linnankivi
,
Carla Marini
,
Patrick May
,
Hiltrud Muhle
,
Deb K. Pal
,
Aarno Palotie
,
Felix Rosenow
,
Susanne Schubert-Bast
,
Kaja Selmer
,
Jose M. Serratosa
,
Sanjay Sisodiya
,
Ulrich Stephani
,
Pasquale Striano
,
Arvid Suls
,
Tiina Talvik
,
Sarah Von Spiczak
,
Sarah Weckhuysen
,
Federico Zara
,
Paul Avillach
,
Anna Bartels
,
Sawona Biswas
,
Florence Bourgeois
,
Batsal Devkota
,
Tracy Glauser
,
Barbara Hallinan
,
Allison Heath
,
Joel Hirschhorn
,
Judson Kilbourn
,
Sek Won Kong
,
Ian Krantz
,
In-Hee Lee
,
Kenneth D. Mandl
,
Eric Marsh
,
Kristen Sund
,
Deanne Taylor
,
Peter White
1
CHOP -
Children’s Hospital of Philadelphia
2 CAU - Christian-Albrechts-Universität zu Kiel = Christian-Albrechts University of Kiel = Université Christian-Albrechts de Kiel
3 Perelman School of Medicine
4 FMP - Leibniz Forschungsinstitut für Molekulare Pharmakolgie = Leibniz Institute for Molecular Pharmacology [Berlin, Allemagne]
5 Sackler School of Medicine
6 UKSH - University Medical Center of Schleswig–Holstein = Universitätsklinikum Schleswig-Holstein
7 Hertie Institute for Clinical Brain Research [Tubingen]
8 UC San Francisco - University of California [San Francisco]
9 University Hospital Motol [Prague]
10 SDU - University of Southern Denmark
11 Ambry Genetics [Aliso Viejo, CA, USA]
12 Boston Children's Hospital
13 Boston Children's Hospital
14 HMS - Harvard Medical School [Boston]
15 LCSB - Luxembourg Centre For Systems Biomedicine
16 Eberhard Karls Universität Tübingen = University of Tübingen
17 ICM - Institut du Cerveau et de la Moëlle Epinière = Brain and Spine Institute
2 CAU - Christian-Albrechts-Universität zu Kiel = Christian-Albrechts University of Kiel = Université Christian-Albrechts de Kiel
3 Perelman School of Medicine
4 FMP - Leibniz Forschungsinstitut für Molekulare Pharmakolgie = Leibniz Institute for Molecular Pharmacology [Berlin, Allemagne]
5 Sackler School of Medicine
6 UKSH - University Medical Center of Schleswig–Holstein = Universitätsklinikum Schleswig-Holstein
7 Hertie Institute for Clinical Brain Research [Tubingen]
8 UC San Francisco - University of California [San Francisco]
9 University Hospital Motol [Prague]
10 SDU - University of Southern Denmark
11 Ambry Genetics [Aliso Viejo, CA, USA]
12 Boston Children's Hospital
13 Boston Children's Hospital
14 HMS - Harvard Medical School [Boston]
15 LCSB - Luxembourg Centre For Systems Biomedicine
16 Eberhard Karls Universität Tübingen = University of Tübingen
17 ICM - Institut du Cerveau et de la Moëlle Epinière = Brain and Spine Institute
Joseph Peeden
- Function : Author
Trine Bjørg Hammer
- Function : Author
Rudi Balling
- Function : Author
Nina Barisic
- Function : Author
Hande Caglayan
- Function : Author
Dana Craiu
- Function : Author
Peter de Jonghe
- Function : Author
Renzo Guerrini
- Function : Author
Helle Hjalgrim
- Function : Author
Dorota Hoffman-Zacharska
- Function : Author
Johanna Jähn
- Function : Author
Karl Martin Klein
- Function : Author
Bobby P.C. Koeleman
- Function : Author
Vladimir Komarek
- Function : Author
Anna-Elina Lehesjoki
- Function : Author
Johannes Lemke
- Function : Author
Holger Lerche
- Function : Author
Tarja Linnankivi
- Function : Author
Carla Marini
- Function : Author
Patrick May
- Function : Author
Hiltrud Muhle
- Function : Author
Deb Pal
- Function : Author
Aarno Palotie
- Function : Author
Felix Rosenow
- Function : Author
Susanne Schubert-Bast
- Function : Author
Kaja Selmer
- Function : Author
Jose Serratosa
- Function : Author
Sanjay Sisodiya
- Function : Author
Ulrich Stephani
- Function : Author
Pasquale Striano
- Function : Author
Arvid Suls
- Function : Author
Tiina Talvik
- Function : Author
Sarah von Spiczak
- Function : Author
Sarah Weckhuysen
- Function : Author
Federico Zara
- Function : Author
Paul Avillach
- Function : Author
Anna Bartels
- Function : Author
Sawona Biswas
- Function : Author
Florence Bourgeois
- Function : Author
Batsal Devkota
- Function : Author
Tracy Glauser
- Function : Author
Barbara Hallinan
- Function : Author
Allison Heath
- Function : Author
Joel Hirschhorn
- Function : Author
Judson Kilbourn
- Function : Author
Sek Won Kong
- Function : Author
Ian Krantz
- Function : Author
In-Hee Lee
- Function : Author
Kenneth Mandl
- Function : Author
Eric Marsh
- Function : Author
Kristen Sund
- Function : Author
Deanne Taylor
- Function : Author
Peter White
- Function : Author
Rudi Balling
- Function : Author
Nina Barisic
- Function : Author
Stéphanie Baulac
- Function : Author
Hande Caglayan
- Function : Author
Dana Craiu
- Function : Author
Peter De Jonghe
- Function : Author
Christel Depienne
- Function : Author
Renzo Guerrini
- Function : Author
Helle Hjalgrim
- Function : Author
Dorota Hoffman-Zacharska
- Function : Author
Johanna Jähn
- Function : Author
Karl Martin Klein
- Function : Author
Bobby P.C. Koeleman
- Function : Author
Vladimir Komarek
- Function : Author
Eric Leguern
- Function : Author
Anna-Elina Lehesjoki
- Function : Author
Johannes R. Lemke
- Function : Author
Holger Lerche
- Function : Author
Tarja Linnankivi
- Function : Author
Carla Marini
- Function : Author
Patrick May
- Function : Author
Hiltrud Muhle
- Function : Author
Deb K. Pal
- Function : Author
Aarno Palotie
- Function : Author
Felix Rosenow
- Function : Author
Susanne Schubert-Bast
- Function : Author
Kaja Selmer
- Function : Author
Jose M. Serratosa
- Function : Author
Sanjay Sisodiya
- Function : Author
Ulrich Stephani
- Function : Author
Pasquale Striano
- Function : Author
Arvid Suls
- Function : Author
Tiina Talvik
- Function : Author
Sarah Von Spiczak
- Function : Author
Sarah Weckhuysen
- Function : Author
Federico Zara
- Function : Author
Paul Avillach
- Function : Author
Anna Bartels
- Function : Author
Sawona Biswas
- Function : Author
Florence Bourgeois
- Function : Author
Batsal Devkota
- Function : Author
Tracy Glauser
- Function : Author
Barbara Hallinan
- Function : Author
Allison Heath
- Function : Author
Joel Hirschhorn
- Function : Author
Judson Kilbourn
- Function : Author
Sek Won Kong
- Function : Author
Ian Krantz
- Function : Author
In-Hee Lee
- Function : Author
Kenneth D. Mandl
- Function : Author
Eric Marsh
- Function : Author
Kristen Sund
- Function : Author
Deanne Taylor
- Function : Author
Peter White
- Function : Author
Abstract
The developmental and epileptic encephalopathies (DEEs) are heterogeneous disorders with a strong genetic contribution, but the underlying genetic etiology remains unknown in a significant proportion of individuals. To explore whether statistical support for genetic etiologies can be generated on the basis of phenotypic features, we analyzed whole-exome sequencing data and phenotypic similarities by using Human Phenotype Ontology (HPO) in 314 individuals with DEEs. We identified a de novo c.508C>T (p.Arg170Trp) variant in AP2M1 in two individuals with a phenotypic similarity that was higher than expected by chance (p = 0.003) and a phenotype related to epilepsy with myoclonic-atonic seizures. We subsequently found the same de novo variant in two individuals with neurodevelopmental disorders and generalized epilepsy in a cohort of 2,310 individuals who underwent diagnostic whole-exome sequencing. AP2M1 encodes the μ-subunit of the adaptor protein complex 2 (AP-2), which is involved in clathrin-mediated endocytosis (CME) and synaptic vesicle recycling. Modeling of protein dynamics indicated that the p.Arg170Trp variant impairs the conformational activation and thermodynamic entropy of the AP-2 complex. Functional complementation of both the μ-subunit carrying the p.Arg170Trp variant in human cells and astrocytes derived from AP-2μ conditional knockout mice revealed a significant impairment of CME of transferrin. In contrast, stability, expression levels, membrane recruitment, and localization were not impaired, suggesting a functional alteration of the AP-2 complex as the underlying disease mechanism. We establish a recurrent pathogenic variant in AP2M1 as a cause of DEEs with distinct phenotypic features, and we implicate dysfunction of the early steps of endocytosis as a disease mechanism in epilepsy.