FUS accumulates in the pathological cellular inclusions that characterize all cases of ALS with
FUS mutations and a variety of FTLD subtypes, collectively referred to as FTLD-FUS (
Kwiatkowski et al., 2009;
Munoz et al., 2009;
Neumann et al., 2009a,
b;
Vance et al., 2009;
Mackenzie et al., 2010b). Our knowledge of the underlying mechanisms leading to FUS accumulation and FUS-mediated cell death is still limited. So far, most insights come from studies analysing the functional consequences of
FUS mutations. As demonstrated in cell culture experiments, pathogenic
FUS mutations interfere with the Transportin-mediated nuclear import, leading to increased levels of cytoplasmic FUS where it is recruited into stress granules upon stress conditions (
Dormann et al., 2010;
Ito et al., 2011;
Kino et al., 2011). Since stress granule markers have been found in FUS-positive inclusions in FTLD-FUS and ALS-
FUS, it has been suggested that stress granules might be the precursors of pathological FUS-inclusions (
Dormann et al., 2010;
Dormann and Haass, 2011).
Although there is some clinical and pathological overlap between ALS-
FUS and FTLD-FUS, the presence of significant differences in the phenotypes and the morphological patterns of FUS pathology (
Mackenzie et al., 2011b) and the fact that no FTLD-FUS case has yet been associated with a
FUS mutation (
Neumann et al., 2009a,
b;
Rohrer et al., 2010;
Urwin et al., 2010;
Snowden et al., 2011), raise questions as to whether these conditions represent a clinicopathological spectrum of diseases with a shared pathomechanism or whether the pathogenic pathways triggered by
FUS mutations may be different from those involved in FTLD-FUS.
In the present study, we performed a detailed analysis of the role of the FUS homologues TAF15 and EWS in the spectrum of FUS-opathies and identified remarkable differences in the protein composition of inclusions between FTLD-FUS and ALS-FUS. These findings strongly support the idea that the pathological processes underlying cell death in ALS-FUS might be different from those in FTLD-FUS.
None of the ALS-
FUS cases investigated, including six cases with four different
FUS mutations, showed any alteration in the subcellular distribution of TAF15 or EWS and no evidence of co-accumulation of these proteins in the FUS-positive pathological inclusions. Importantly, we confirmed retention of the normal physiological staining pattern and the absence of TAF15 and EWS co-localization in the cytoplasmic FUS pathology (i.e. stress granules) that develops in cultured cells expressing ALS-associated
FUS mutations (
Dormann et al., 2010). Thus, cytoplasmic accumulation of FUS
per se does not trigger an alteration in the subcellular distribution of its homologues and does not lead to sequestration of TAF15 and EWS into FUS inclusions as a secondary phenomenon. This strongly implies that the pathological processes in ALS-
FUS are restricted to dysfunctions of FUS. Since the ALS-
FUS cases we studied do not cover the entire spectrum of reported
FUS mutations, we cannot exclude the possibility that other
FUS mutations, particularly those reported in exons 3, 5 or 6 (
Mackenzie et al., 2010a) might be associated with TAF15 and/or EWS pathology. However, since our analysis did include two cases with the most common
FUS mutation (p.R521C), this is unlikely to be a frequent finding.
In sharp contrast to ALS-
FUS, abnormal co-accumulation of all three FET proteins into pathological inclusions was a consistent and specific feature of all subtypes of FTLD-FUS. This finding further extends the similarities between the various subtypes of FTLD-FUS, thereby strongly supporting the idea, that atypical FTLD-U, NIFID and BIBD are closely related disease entities (
Mackenzie et al., 2011a). However, our results also suggest some important differences among distinct FET family members in the different FTLD-FUS subtypes. While antibodies against TAF15 robustly labelled virtually all FUS pathology in atypical FTLD-U, NIFID and BIBD, subtle disease-specific differences were observed for EWS. Only a proportion of inclusions in atypical FTLD-U cases labelled for EWS and the staining intensity was often weak. In contrast, inclusions in NIFID and BIBD were more consistently and robustly labelled for EWS. Because the quality of immunostaining obtained with the commercial EWS antibodies employed was not felt to be optimal in all sections, we are cautious in interpreting these results. However, they raise the possibility of subtle differences in the pathogenic pathways involved in the different FTLD-FUS subtypes, that may underlie the distinct clinico-pathological phenotypes previously described (
Mackenzie et al., 2011a).
Another difference in the pattern of immunostaining among the FET proteins in FTLD-FUS is worth noting for its potential functional significance. Whereas inclusion bearing cells often demonstrated at least partial retention of nuclear FUS and EWS localization, a dramatic and consistent reduction of physiological nuclear staining was observed for TAF15, suggesting a possible loss-of-function mechanism.
The mechanisms leading to the accumulation of all FET proteins in FTLD-FUS remain unclear. The results in human ALS-
FUS and in cultured cells expressing mutant FUS indicates that other FET proteins are not secondarily entrapped within FUS inclusions. An alternate mechanism is suggested by our cell culture data in which inhibition of Transportin-mediated nuclear import resulted in recruitment and co-localization of all FET proteins into stress granules. This favours a scenario in which a broader nuclear import defect in FTLD-FUS leads to increased cytoplasmic levels of all FET proteins (and possibly other proteins), which then predisposes to their abnormal accumulation. Although the underlying defect in nuclear import could reflect a direct dysfunction of the Transportin import machinery, preliminary studies in which we found no alterations in the subcellular distribution of other Transportin cargos, such as hnRNPA1, makes this mechanism more unlikely. Alternatively, altered post-translational modifications of FET proteins, such as phosphorylation or arginine methylation, might affect their subcellular localization and nuclear import in FTLD-FUS (
Tan and Manley, 2009;
Kovar, 2011). While biochemical analysis has so far revealed only a relative change in solubility for FET proteins (
Neumann et al., 2009b and this study), the presence of potential disease-associated post-translational modifications as well as alterations of the transportin machinery requires further studies.
Our findings in FTLD-FUS add TAF15 and EWS to the growing list of DNA/RNA binding proteins involved in neurodegenerative diseases. Despite the fact that we have not detected any pathogenic mutations in
TAF15 and
EWSR1 in our FTLD-FUS cases, both genes are considered promising candidates for genetic screens in FTLD and ALS and a very recent report has described coding variants in
TAF15 in ALS, although their pathogenicity remains to be confirmed (
Ticozzi et al., 2011).
In summary, this study demonstrates the co-accumulation of all members of the FET protein family in the characteristic inclusions as specific feature of FTLD-FUS but not of ALS-
FUS, thus allowing a clear separation between genetic and non-genetic forms of FUS-opathies by neuropathological features. More importantly, these findings imply that different pathomechanisms underlie inclusion body formation and cell death in ALS-
FUS versus FTLD-FUS. Our data indicate that neurodegeneration associated with
FUS mutations is probably the result of a restricted dysfunction of FUS, whereas a more complex dysregulation of all FET family members seems to be involved in FTLD-FUS pathogenesis. While the relative roles of the different FET proteins in the disease pathogenesis of FTLD-FUS remain to be determined in future studies, our data suggest that the conditions currently subsumed within the FTLD-FUS molecular subgroup might be more appropriately designated as FTLD-FET, in accordance with the recently proposed system of FTLD nomenclature (
Mackenzie et al., 2009).