Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Article
  • Published:

Ataxia with isolated vitamin E deficiency is caused by mutations in the α–tocopherol transfer protein

Abstract

Ataxia with isolated vitamin E deficiency (AVED) is an autosomal recessive neurodegenerative disease which maps to chromosome 8q13. AVED patients have an impaired ability to incorporate α–tocopherol into lipoproteins secreted by the liver, a function putatively attributable to the α–tocopherol transfer protein (α–TTP). Here we report the identification of three frame–shift mutations in the αTTP gene. A 744delA mutation accounts for 68% of the mutant alleles in the 17 families analysed and appears to have spread in North Africa and Italy. This mutation correlates with a severe phenotype but alters only the C–terminal tenth of the protein. Two other mutations were found in single families. The finding of αTTP gene mutations in AVED patients substantiates the therapeutic role of vitamin E as a protective agent against neurological damage in this disease.

This is a preview of subscription content, access via your institution

Access options

Buy this article

Prices may be subject to local taxes which are calculated during checkout

Similar content being viewed by others

References

  1. Muller, D.P., Lloyd, J.K. & Wolff, O.H. Vitamin E and neurological function. Lancet 1, 225–228 (1983).

    Article  CAS  PubMed  Google Scholar 

  2. Burck, U., Goebel, H.H., Kuhlendahl, H.D., Meier, C. & Goebel, K.M. Neuromyopathy and vitamin E deficiency in man. Neuropediatrics 12, 267–278 (1981).

    Article  CAS  PubMed  Google Scholar 

  3. Harding, A.E., Matthews, S., Jones, S., Ellis, C.J., Booth, I.W. & Muller, D.P. Spinocerebellar degeneration associated with a selective defect of vitamin E absorption. N. Engl. J. Med. 313, 32–35 (1985).

    Article  CAS  PubMed  Google Scholar 

  4. Krendel, D.A., Gilchrist, J.M., Johnson, A.O. & Bossen, E.H. Isolated deficiency of vitamin E with progressive neurologic deterioration. Neurology 37, 538–540 (1987).

    Article  CAS  PubMed  Google Scholar 

  5. Yokota, T., Wada, Y., Furukawa, T., Tsukagoshi, H., Uchihara, T. & Watabiki, S. Adult-onset spinocerebellar syndrome with idiopathic vitamin E deficiency. Ann. Neurol. 22, 84–87 (1987).

    Article  CAS  PubMed  Google Scholar 

  6. Stumpf D.A. et al. Friedreich's disease: V. Variant form with vitamin E deficiency and normal fat absorption. Neurology 37, 68–74 (1987).

    Article  CAS  PubMed  Google Scholar 

  7. Sokol, R.J. et al. Isolated vitaminE deficiency in the absence of fat malabsorption — familial and sporadic cases: characterization and investigation of causes. J. lab. clin. Med. 111, 548–559 (1988).

    CAS  PubMed  Google Scholar 

  8. Laplante, P., Vanasse, M., Michaud, J., Geoffroy, G. & Brochu, P. A progressive neurological syndrome associated with an isolated vitamin E deficiency. Can. J. Neurol. Sci. 11, 561–564 (1984).

    Article  CAS  PubMed  Google Scholar 

  9. Kohlschütter, A., Hubner, C., Jansen, W. & Lindner, S.G. A treatable familial neuromyopathy with vitamin E deficiency, normal absorption, and evidence of increased consumption of vitamin E. J. Inher. Metab. 11, 149–152 (1988).

    Article  Google Scholar 

  10. Trabert, W., Stober, T., Mielke, V., Siu Heck, F. & Schimrigk, K. Isolierter Vitamin-E-Managel. Fortschr. Neurol. Psychiat. 57, 495–501 (1989).

    Article  CAS  PubMed  Google Scholar 

  11. Ben Hamida, M. et al. Friedreich's ataxia phenotype not linked to chromosome 9 and associated with selective autosomal recessive vitamin E deficiency in two inbred Tunisian families. Neurology 43, 2179–2183 (1993).

    Article  CAS  PubMed  Google Scholar 

  12. Ben Hamida, C. et al. Localization of Friedreich ataxia phenotype with selective vitamin E deficiency to chromosome 8q by homozygosity mapping. Nature Genet. 5, 195–200 (1993).

    Article  CAS  PubMed  Google Scholar 

  13. Dærflinger, N. et al. Ataxia with vitamin E deficiency: refinement of genetic localisation and analysis of linkage disequilibrium using new markers in 14 families. Am. J. hum. Genet. (in the press).

  14. Traber, M.G. et al. Impaired ability of patients with familial isolated vitamin E deficiency to incorporate α-tocopherol into lipoproteins secreted by the liver. J. clin. Invest. 85, 397–407 (1990).

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  15. Traber, M.G. et al. Impaired discrimination between stereoisomers of α-tocopherol in patients with familial isolated vitamin E deficiency. J. Lipid Res. 34, 201–210 (1993).

    CAS  PubMed  Google Scholar 

  16. Traber, M.G., Ramakrishnan, R. & Kayden, H.J. Human plasma vitamin E kinetics demonstrate rapid recycling of plasma RRR-α-tocopherol. Proc. natn. Acad. Sci. U.S.A. 91, 10005–10008 (1994).

    Article  CAS  Google Scholar 

  17. Kayden, H.J. The neurologic syndrome of vitamin E deficiency: a significant cause of ataxia. Neurology 43, 2167–2169 (1993).

    Article  CAS  PubMed  Google Scholar 

  18. Mowri, H., Nakagawa, Y., Inoue, K. & Nojima, S. Enhancement of the transfer of α-tocopherol between liposomes and mitochondria by rat-liver protein (s). Eur. J Biochem. 117, 537–542 (1981).

    Article  CAS  PubMed  Google Scholar 

  19. Behrens, W.A. & Madere, R. Transfer of a-tocopherol to microsomes mediated by partially purified liver α-tocopherol binding protein. Nutr. Res. 2, 611–618 (1982).

    Article  CAS  Google Scholar 

  20. Sato, Y., Hagiwara, K., Arai, H. & Inoue, K. Purification and characterization of the α-tocopherol transfer protein from rat liver. FEBS 288, 41–45 (1991).

    Article  CAS  Google Scholar 

  21. Sato, Y. et al. Primary structure of α-tocopherol transfer protein from rat liver. J. biol. Chem. 268, 17705–17710 (1993).

    CAS  PubMed  Google Scholar 

  22. Arita, M. et al. Human α-tocopherol transfer protein-cDNA cloning, expression and chromosomal localisation. Biochem. J. (in the press).

  23. Cohen, D., Chumakov, I. & Weissenbach, J. A first-generation physical map of the human genome. Nature 366, 698–701 (1993).

    Article  CAS  PubMed  Google Scholar 

  24. Sirugo, G. et al. Friedreich ataxia locus in Louisiana Acadians: Demonstration of a founder effect by analysis of microsatellite-generated extended haplotypes. Am. J. hum. Genet. 50, 559–566 (1992).

    CAS  PubMed  PubMed Central  Google Scholar 

  25. Hästbacka, J., de la Chapelle, A., Kaitila, I., Sistonen, P., Weaver, A. & Lander, E.S. Linkage disequilibrium mapping in isolated founder population: diastrophic dysplasia in Finland. Nature Genet. 2, 204–211 (1993).

    Article  Google Scholar 

  26. Amiel, J. et al. Familial isolated vitamin Edeficiency. Study of a multiplex family with a 5 years therapeutic followup. J. inher. Metab. (in the press).

  27. Kayden, H.J. & Traber, M.G., bsorption, lipoprotein transport, and regulation of plasma concentrations of vitamin E in humans. J. Lipid Res. 34, 343–358 (1993).

    CAS  PubMed  Google Scholar 

  28. Sharp, D. et al. Cloning and gene defects in microsomal triglycerides transfer protein associated with abetalipoproteinaemia. Nature 365, 65–69 (1993).

    Article  CAS  PubMed  Google Scholar 

  29. Di Mascio, P., Murphy, M.E. & Sies, H. Antioxidant defense systems: the role of carotenoids, tocopherols, and thiols. Am. J. clin. Nutr. 53, 194S–200S (1991).

    Article  CAS  PubMed  Google Scholar 

  30. Schubert, D., Kimura, H. & Maher, P. Growth factors and vitamin E modify neuronal glutamate toxicity. Proc. natn. Acad. Sci. U.S.A. 89, 8264–8267 (1992).

    Article  CAS  Google Scholar 

  31. Rosen, D.R. et al. Mutation in Cu/Zn superoxide dismutase gene are associated with familial amyotrophic lateral sclerosis. Nature 362, 59–62 (1993).

    Article  CAS  PubMed  Google Scholar 

  32. Duclos, F., Rodius, F., Wrogemann, K., Mandel, J.-L. & Koenig, M., The Friedreich ataxia region: characterization of two novel genes and reduction of the critical region to 300 kb. Hum. molec. Genet. 3, 909–914 (1994).

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Ouahchi, K., Arita, M., Kayden, H. et al. Ataxia with isolated vitamin E deficiency is caused by mutations in the α–tocopherol transfer protein. Nat Genet 9, 141–145 (1995). https://doi.org/10.1038/ng0295-141

Download citation

  • Received:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1038/ng0295-141

This article is cited by

Search

Quick links

Nature Briefing

Sign up for the Nature Briefing newsletter — what matters in science, free to your inbox daily.

Get the most important science stories of the day, free in your inbox. Sign up for Nature Briefing