A somatic mutation in erythro-myeloid progenitors causes neurodegenerative disease

• Published in: Nature (London) 2017-09, Vol.549 (7672), p.389-393
• Main Authors: Mass, Elvira, Jacome-Galarza, Christian E., Blank, Thomas, Lazarov, Tomi, Durham, Benjamin H., Ozkaya, Neval, Pastore, Alessandro, Schwabenland, Marius, Chung, Young Rock, Rosenblum, Marc K., Prinz, Marco, Abdel-Wahab, Omar, Geissmann, Frederic
• Format: Article
• Language: English
• Subjects: 631/136/232/2059; 631/250/371; 64; 64/110; 64/60; 692/617/375/365; Activation; Alzheimer's disease; Amyloid precursor protein; Animals; Ataxia; Bone marrow; Cell lineage; Clone Cells - enzymology; Clone Cells - metabolism; Clone Cells - pathology; Cytokines; Development and progression; Disease; Disease Models, Animal; Erythroid Precursor Cells - enzymology; Erythroid Precursor Cells - metabolism; Erythroid Precursor Cells - pathology; Extracellular signal-regulated kinase; Extracellular Signal-Regulated MAP Kinases - metabolism; Female; Fetuses; Gene expression; Genetic aspects; Genomes; Genotype & phenotype; Gliosis; Health aspects; Hematopoietic stem cells; Histiocytosis; Histiocytosis - enzymology; Histiocytosis - genetics; Histiocytosis - metabolism; Histiocytosis - pathology; Humanities and Social Sciences; Humans; Kinases; letter; Macrophages; Macrophages - enzymology; Macrophages - metabolism; Macrophages - pathology; Male; MAP kinase; MAP Kinase Signaling System; Metabolic pathways; Mice; Microglia; Microglia - enzymology; Microglia - metabolism; Microglia - pathology; Mitogen-activated protein kinases; Mosaicism; multidisciplinary; Mutation; Myeloid cells; Myeloid Progenitor Cells - enzymology; Myeloid Progenitor Cells - metabolism; Myeloid Progenitor Cells - pathology; Neural stem cells; Neurodegeneration; Neurodegenerative diseases; Neurodegenerative Diseases - enzymology; Neurodegenerative Diseases - genetics; Neurodegenerative Diseases - metabolism; Neurodegenerative Diseases - pathology; Neurological diseases; Neuronal-glial interactions; Organogenesis; Pathophysiology; Patients; Physiological aspects; Proto-Oncogene Proteins B-raf - antagonists & inhibitors; Proto-Oncogene Proteins B-raf - genetics; Proto-Oncogene Proteins B-raf - metabolism; Rodents; Science; Stem cell transplantation; Stem cells
• ISSN: 0028-0836; 1476-4687
• DOI: 10.1038/nature23672

Braf  V600E expression in resident macrophage progenitors leads to clonal expansion of ERK-activated microglia, which causes synaptic and neuronal loss in the brain and results in lethal neurodegenerative disease in adult mice. BRAF mutation begets brain disease Microglia—immune cells in the brain—derive from yolk-sac erythro-myeloid progenitors (EMPs), which are distinct from haematopoietic stem cells (HSCs). Frederic Geissmann and colleagues show that mosaic expression of a mutant BRAF, which activates the RAS–MEK–ERK pathway and causes tumours when expressed in HSCs, results in expansion of tissue-resident macrophages and late-onset neurodegeneration when expressed in EMPs. They show in a mouse model that neurobehavioural abnormalities, astrogliosis, deposition of amyloid precursor protein, synaptic loss and neuronal death are driven by ERK-activated microglia and can be prevented by BRAF inhibition. These results show that, in mice, activation of the MAP kinase pathway in microglia can cause neurodegeneration. These findings may explain the neurodegeneration observed in patients with histiocytosis—disorders of myeloid cell expansion associated with somatic mutations in the RAS–MEK–ERK pathway, such as the BRAF mutation studied here. The pathophysiology of neurodegenerative diseases is poorly understood and there are few therapeutic options. Neurodegenerative diseases are characterized by progressive neuronal dysfunction and loss, and chronic glial activation 1 . Whether microglial activation, which is generally viewed as a secondary process, is harmful or protective in neurodegeneration remains unclear 1 , 2 , 3 , 4 , 5 , 6 , 7 , 8 . Late-onset neurodegenerative disease observed in patients with histiocytoses 9 , 10 , 11 , 12 , which are clonal myeloid diseases associated with somatic mutations in the RAS–MEK–ERK pathway such as BRAF(V600E) 13 , 14 , 15 , 16 , 17 , suggests a possible role of somatic mutations in myeloid cells in neurodegeneration. Yet the expression of BRAF(V600E) in the haematopoietic stem cell lineage causes leukaemic and tumoural diseases but not neurodegenerative disease 18 , 19 . Microglia belong to a lineage of adult tissue-resident myeloid cells that develop during organogenesis from yolk-sac erythro-myeloid progenitors (EMPs) distinct from haematopoietic stem cells 20 , 21 , 22 , 23 . We therefore hypothesized that a somatic BRAF(V600E) mutation in the EMP lineage may cause neurodegeneration. Here we show that mosaic expressio