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SAT 465 A Novel Mutation of the Human Carboxypeptidase E Gene Results in Loss of Neuroprotective Function Y. Peng Loh , Lin Cong, Yong Cheng, Niamh X. Cawley and Saravana R.K. Murthy Section on Cellular Neurobiology, Eunice Kennedy Shriver National Institute of Child Health and Human Development, NIH, Bethesda, MD 20892 Introduction 1. Carboxypeptidase E (CPE) is a prohormone processing enzyme and recently it is also known as Neurotrophic factor α-1 2. Intracellularly, CPE is an exopeptidase involved in cleaving C-terminal basic amino acid residues from endoproteolytically cleaved prohormone intermediates. It also acts as a sorting receptor at the trans Golgi network for directing prohormones to the regulated secretory pathway. 3. CPE acts extracellularly as a neurotrophic factor involved in neuroprotection, anti-depression and stem cell differentiation. Homozygous CPE null mutation CLINICAL FEATURES: Obesity: At the time of examination, she had a weight of 130.2 kg and height of 1.59 m with body mass index (BMI) 51.5 kg/m2. Type 2 Diabetes: she had glucose level 383 mg/dL, HbA1c 114 mmol/mol. Hypogonadotrophic hypogonadism: primary amenorrhea (serum oestradiol 78 pmol/L [postmenopausal range <100 pmol/L], 21.2 pg/mL; LH 2.7 IU/L, FSH 2.0 IU/L). Serum hormone analysis excluded other causes of amenorrhoea including polycystic ovary syndrome and hyperprolactinaemia (testosterone 1.2 nmol/L (normal <2.7), 0.35 ng/mL (normal <0.78); normal androstenedione, 17hydroxyprogesterone, dehydroepiandrosterone sulphate (DHEAS), prolactin). Intellectual disability: despite adequate schooling she was unable to read or write words. Ref: Alsters et al 2015 PlosOne 10(6):e0131417 KO WT Absence of CPE/NF-α1 leads to obesity, diabetes, infertility, neurodegeneration, learning and memory deficits and depression. WT KO CPE 6weeks Nissl 6weeks Weaning stress at 3 weeks. Nissl 3weeks Note hippocampal CA3 region degeneration A human carboxypeptidase E /NF-α1 gene mutation in an Alzheimer’s disease patient leads to memory loss , dementia and depression in mice Cheng Y, Cawley NX, Yanik T, Murthy SR, Liu C, Kasikci F, Abebe D, Loh YP. Transl Psychiatry. 2016 Dec 6;6(12):e973. doi: 10.1038/tp.2016.237. { Histopathology of CPE-QQ and WT mouse hippocampus (50weeks old). (a) Confocal images showing fewer dendrites indicating neurodegeneration in CPE-QQ mice (b) Confocal images showing hyper phosphorylation of tau in DG of hippocampus QQ mice. (c, d) Western blot analysis more tau phosphorylation in hippocampus of CPE-QQ than WT mice. t-test, n=6, *P<0.05. T to C CPE mutation was found in human Mutation found in 12.5 % of the AGI_ASP population of patients made up of 40 African-Americans and Caucasians (dbSNPrs cluster id: rs34516004). (PLoS One. 2017 Jan 23;12(1):e0170169) TC CPE mutation has no enzymatic activity Over expression of TC CPE on neuroprotection Decreased expression and secretion of TC-CPE and loss of neuroprotective activity TC CPE “hijacks” WT CPE Decreased secretion of WT-CPE when coexpressed with CPE-QQ TC-CPE increases ER stress Conclusions 1) T980C mutation of the CPE gene causes ER stress, poor secretion of the mutant protein and diminished neuroprotective activity against oxidative stress in N2A cells, unlike WT-CPE which is neuroprotective. 2) Humans homozygous for this mutation is expected to result in obesity, diabetes and neurodegeneration. Humans heterozygous for this mutation is expected to result in the reduction of WT protein by a dominant recessive mechanism leading to neurodegeneration . 3) CPE is a potential therapeutic target for treating neurodegenerative disease. 4) Rosiglitazone, an anti-diabetic drug which up-regulates CPE expression is a potential drug for treating dementia.