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Human Molecular Genetics Advance Access published online on October 7, 2003

Human Molecular Genetics, doi:10.1093/hmg/ddg339
© 2003 by Oxford University Press
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©2003 Oxford University Press

Article

NORADRENERGIC NEURONAL DEVELOPMENT IS IMPAIRED BY MUTATION OF THE PRONEURAL HASH-1 GENE IN CONGENITAL CENTRAL HYPOVENTILATION SYNDROME (ONDINE'S CURSE)

Loïc de Pontual 1, Virginie Népote 2, Tania Attié-Bitach 1, Hassan Al Halabiah 2, Ha Trang 2, Vincent Elghouzzi 1, Béatrice Levacher 2, Karim Benihoud 3, Joëlle Augé 1, Christophe Faure 2, Béatrice Laudier 1, Michel Vekemans 1, Arnold Munnich 1, Michel Perricaudet 3, François Guillemot 4, Claude Gaultier 2, Stanislas Lyonnet 1, Michel Simonneau 2, and Jeanne Amiel 1*

1 Unité de Recherches sur les Handicaps Génétiques de l'Enfant INSERM U-393, and Département de Génétique, Hôpital Necker-Enfants Malades, 149, rue de Sèvres, 75743 Paris cedex 15, France
2 Service de Physiologie, INSERM E9935, and CIC INSERM 9202, Hôpital Robert Debré, Paris
3 UMR 1582 CNRS, IGR, Villejuif, France
4 NIMR, Mill Hill, United Kingdom

* To whom correspondence should be addressed. E-mail: amiel{at}necker.fr.


   Abstract

Congenital central hypoventilation syndrome (CCHS, Ondine's curse) is a rare disorder of the chemical control of breathing. It is frequently associated with a broad spectrum of dysautonomic symptoms, suggesting the involvement of genes widely expressed in the autonomic nervous system (ANS). In particular, the HASH-1-PHOX2A-PHOX2B developmental cascade was proposed as a candidate pathway because it controls the development of neurons with a definitive or transient noradrenergic phenotype, upstream from the RET receptor tyrosine kinase and tyrosine hydroxylase (TH). We recently showed that PHOX2B is the major CCHS locus, whose mutation accounts for 60% of cases. We also studied the proneural HASH-1 gene and identified a heterozygous nucleotide substitution in 3 CCHS patients. To analyze the functional consequences of HASH-1 mutations, we developed an in vitro model of noradrenergic differentiation in neuronal progenitors derived from the mouse vagal neural crest, reproducing in vitro the HASH-PHOX-RET pathway. All HASH-1 mutant alleles impaired noradrenergic neuronal development, when overexpressed from adenoviral constructs. Thus, HASH-1 mutations may contribute to the CCHS phenotype in rare cases, consistent with the view that the abnormal chemical control of breathing observed in CCHS patients is due to the impairment of noradrenergic neurons during early steps of brainstem development.


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