Overlap of ALS-associated genes in different data bases
A comprehensive analysis of 7 databases for canonical ALS-associated proteins, yielded 656 proteins linked to ALS (Fig. 2, Supplementary Table S 1). There was a surprisingly low overlap between the ALS-associated proteins obtained from the 7 sources we used to build the dataset (see Fig. 2). Even considering the diversity of the sources, this appears to indicate a level of uncertainty whether these genes are truly associated with ALS. A set of only 29 proteins had a high level of agreement in 5 out of 7 data sources (Table 1), indicating the most comprehensively studied subset of ALS related genes. Among these genes are the known players of ALS pathology such as SOD1, C9ORF72, TARDBP, as well as many less well-established genes, which are thought to constitute additional risk factors for causation, modification or progression of ALS (for example SQSTM1 and VCP [4]). Other putative ALS-associated genes are found only in one database or in literature and their contribution to ALS pathogenesis needs to be studied further.
Table 1: ALS-associated genes/proteins supported by 5 or more resources
29 proteins found in >= 1 data source. 8 out of the most frequent proteins were found in one or more of the 26 ALS core modules.
|
Resource
|
|
Protein information
|
Gene name
|
ALSGene
(n = 17)
|
ALSoD
(n = 111)
|
GAD
(n = 224)
|
Genotator
(n = 289)
|
HuGE GWAS
(n = 118)
|
HuGE GeneProspector
(n = 224)
|
Text Mining
(n = 164)
|
|
UniProt entry
|
Protein name
|
C9ORF72
|
•
|
•
|
•
|
•
|
•
|
•
|
•
|
|
CI072_HUMAN
|
Protein C9orf72
|
DPP6
|
|
•
|
•
|
•
|
•
|
•
|
•
|
|
DPP6_HUMAN
|
Dipeptidyl aminopeptidase-like protein 6
|
ITPR2
|
|
•
|
•
|
•
|
•
|
•
|
•
|
|
ITPR2_HUMAN
|
Inositol 1,4,5-trisphosphate receptor type 2
|
KIFAP3
|
|
•
|
•
|
•
|
•
|
•
|
•
|
|
KIFA3_HUMAN
|
Kinesin-associated protein 3
|
SOD1
|
|
•
|
•
|
•
|
•
|
•
|
•
|
Tier 1
|
SODC_HUMAN
|
Superoxide dismutase [Cu-Zn]
|
UNC13A
|
|
•
|
•
|
•
|
•
|
•
|
•
|
|
UN13A_HUMAN
|
Protein unc-13 homolog A
|
ALS2
|
|
•
|
•
|
•
|
|
•
|
•
|
|
ALS2_HUMAN
|
Alsin
|
ALS6, FUS
|
|
•
|
•
|
•
|
|
•
|
•
|
Tier 1
|
FUS_HUMAN
|
RNA-binding protein FUS
|
ANG
|
|
•
|
•
|
•
|
|
•
|
•
|
|
ANGI_HUMAN
|
Angiogenin
|
CHMP2B
|
|
•
|
•
|
•
|
|
•
|
•
|
|
CHM2B_HUMAN
|
Charged multivesicular body protein 2b
|
CST3
|
|
•
|
•
|
•
|
|
•
|
•
|
Tier 2
|
CYTC_HUMAN
|
Cystatin-C
|
DCTN1
|
|
•
|
•
|
•
|
|
•
|
•
|
Tier 1
|
DCTN1_HUMAN
|
Dynactin subunit 1
|
DYNC1H1
|
|
•
|
•
|
•
|
|
•
|
•
|
|
DYHC1_HUMAN
|
Cytoplasmic dynein 1 heavy chain 1
|
ELP3
|
|
•
|
•
|
•
|
|
•
|
•
|
|
ELP3_HUMAN
|
Elongator complex protein 3
|
FGGY
|
|
•
|
•
|
•
|
|
•
|
•
|
|
FGGY_HUMAN
|
FGGY carbohydrate kinase domain-containing protein
|
HFE
|
|
•
|
•
|
•
|
|
•
|
•
|
|
HFE_HUMAN
|
Hereditary hemochromatosis protein
|
LIPC
|
|
•
|
•
|
•
|
•
|
•
|
|
Tier 1
|
LIPC_HUMAN
|
Hepatic triacylglycerol lipase
|
PON1
|
|
•
|
•
|
•
|
|
•
|
•
|
|
PON1_HUMAN
|
Serum paraoxonase/arylesterase 1
|
PON2
|
|
•
|
•
|
•
|
|
•
|
•
|
|
PON2_HUMAN
|
Serum paraoxonase/arylesterase 2
|
PON3
|
|
•
|
•
|
•
|
|
•
|
•
|
|
PON3_HUMAN
|
Serum paraoxonase/lactonase 3
|
PRPH
|
|
•
|
•
|
•
|
|
•
|
•
|
|
PERI_HUMAN
|
Peripherin
|
SMN2
|
|
•
|
•
|
•
|
|
•
|
•
|
|
SMN_HUMAN
|
Survival motor neuron protein
|
SUSD1
|
|
•
|
•
|
•
|
•
|
•
|
|
|
SUSD1_HUMAN
|
Sushi domain-containing protein 1
|
TARDBP
|
|
•
|
•
|
•
|
|
•
|
•
|
Tier 1
|
TADBP_HUMAN
|
TAR DNA-binding protein 43
|
VAPB
|
|
•
|
•
|
•
|
|
•
|
•
|
Tier 2
|
VAPB_HUMAN
|
Vesicle-associated membrane protein-associated protein B/C
|
VCP
|
|
•
|
•
|
•
|
|
•
|
•
|
Tier 1
|
TERA_HUMAN
|
Transitional endoplasmic reticulum ATPase
|
VEGF, VEGFA
|
|
•
|
•
|
•
|
|
•
|
•
|
|
VEGFA_HUMAN
|
Vascular endothelial growth factor A
|
VPS54
|
|
•
|
•
|
•
|
|
•
|
•
|
|
VPS54_HUMAN
|
Vacuolar protein sorting-associated protein 54
|
ZFP64
|
|
•
|
•
|
•
|
•
|
•
|
|
|
ZF64A_HUMAN
|
Zinc finger protein 64 homolog, isoforms 1 and 2
|
ZFP64
|
|
•
|
•
|
•
|
•
|
•
|
|
|
ZF64B_HUMAN
|
Zinc finger protein 64 homolog, isoforms 3 and 4
|
ALS-associated genes with network support
Without biological context, individual genes that are identified to be associated with ALS may be useful for diagnosis but do not contribute to the understanding of the molecular pathophysiology and the subsequent search for prevention or treatment [34]. However, if these genes are part of networks which are significantly enriched in ALS-associated proteins, it can help to reinforce the evidence for more weakly supported proteins. To investigate this further, we evaluated a collection of 282 PPI network modules for overrepresentation of ALS-associated proteins (see Methods for details). 26 ALS modules were significantly enriched for ALS-associated proteins after multiple testing correction using the Benjamini-Hochberg procedure (q < 0.1). Five of these were also significant after correcting for multiple testing using Bonferroni correction (p < 0.05/282). The set of five modules significant after Bonferroni correction are in the following termed 'Tier 1', while the remaining 21 modules are termed 'Tier 2'. Tier 1 and Tier 2 modules are collectively referred to as ‘ALS core modules’.
36 ALS-associated genes/proteins are supported by Tier 1 modules (Table 2). Nine of these proteins were only mentioned in one source, often found only by text mining. The link to Tier 1 ALS core modules strengthens the likelihood that these genes are indeed ALS-relevant genes. Further 108 genes/proteins have Tier 2 support for a total of 144 genes/proteins having Tier 1/2 network support (see Supplementary Table S 1 for full list).
Table 2: ALS-associated proteins in Tier 1 Modules
36 ALS-associated proteins present in at least of the five Tier 1 networks. A full list of ALS-associated proteins found in >= 1 of the ALS core modules is found in Supplementary Table S 1..
|
Resource
|
Protein information
|
Gene name
|
ALSGene
(n = 17)
|
ALSoD
(n = 111)
|
GAD
(n = 224)
|
Genotator
(n = 289)
|
HuGE GWAS
(n = 118)
|
HuGE GeneProspector
(n = 224)
|
Text Mining
(n = 164)
|
Overlap
|
UniProt entry
|
Protein name
|
SOD1
|
|
•
|
•
|
•
|
•
|
•
|
•
|
6
|
SODC_HUMAN
|
Superoxide dismutase [Cu-Zn]
|
DCTN1
|
|
•
|
•
|
•
|
|
•
|
•
|
5
|
DCTN1_HUMAN
|
Dynactin subunit 1
|
ALS6, FUS
|
|
•
|
•
|
•
|
|
•
|
•
|
5
|
FUS_HUMAN
|
RNA-binding protein FUS
|
LIPC
|
|
•
|
•
|
•
|
•
|
•
|
|
5
|
LIPC_HUMAN
|
Hepatic triacylglycerol lipase
|
TARDBP
|
|
•
|
•
|
•
|
|
•
|
•
|
5
|
TADBP_HUMAN
|
TAR DNA-binding protein 43
|
VCP
|
|
•
|
•
|
•
|
|
•
|
•
|
5
|
TERA_HUMAN
|
Transitional endoplasmic reticulum ATPase
|
APOE
|
|
•
|
•
|
•
|
|
•
|
|
4
|
APOE_HUMAN
|
Apolipoprotein E
|
ATXN2
|
|
•
|
|
•
|
|
•
|
•
|
4
|
ATX2_HUMAN
|
Ataxin-2
|
SQSTM1
|
|
•
|
|
•
|
|
•
|
•
|
4
|
SQSTM_HUMAN
|
Sequestosome-1
|
MAPT
|
|
•
|
|
•
|
|
•
|
•
|
4
|
TAU_HUMAN
|
Microtubule-associated protein tau
|
UBQLN2
|
|
•
|
|
•
|
|
•
|
•
|
4
|
UBQL2_HUMAN
|
Ubiquilin-2
|
APOA4
|
|
|
•
|
•
|
|
•
|
|
3
|
APOA4_HUMAN
|
Apolipoprotein A-IV
|
LPA
|
|
|
•
|
•
|
|
•
|
|
3
|
APOA_HUMAN
|
Apolipoprotein(a)
|
APOB
|
|
|
•
|
•
|
|
•
|
|
3
|
APOB_HUMAN
|
Apolipoprotein B-100
|
APOC3
|
|
|
•
|
•
|
|
•
|
|
3
|
APOC3_HUMAN
|
Apolipoprotein C-III
|
CCS
|
|
•
|
|
•
|
|
|
•
|
3
|
CCS_HUMAN
|
Copper chaperone for superoxide dismutase
|
CETP
|
|
|
•
|
•
|
|
•
|
|
3
|
CETP_HUMAN
|
Cholesteryl ester transfer protein
|
CNTF
|
|
•
|
|
•
|
|
|
•
|
3
|
CNTF_HUMAN
|
Ciliary neurotrophic factor
|
LDLR
|
|
|
•
|
•
|
|
•
|
|
3
|
LDLR_HUMAN
|
Low-density lipoprotein receptor
|
LPL
|
|
|
•
|
•
|
|
•
|
|
3
|
LIPL_HUMAN
|
Lipoprotein lipase
|
RNF19A
|
|
•
|
|
•
|
|
|
•
|
3
|
RN19A_HUMAN
|
E3 ubiquitin-protein ligase RNF19A
|
HNRNPA1
|
|
•
|
|
|
|
•
|
•
|
3
|
ROA1_HUMAN
|
Heterogeneous nuclear ribonucleoprotein A1
|
CHGB
|
|
|
•
|
•
|
|
•
|
|
3
|
SCG1_HUMAN
|
Secretogranin-1
|
UBQLN1
|
|
|
|
•
|
|
•
|
•
|
3
|
UBQL1_HUMAN
|
Ubiquilin-1
|
ARHGEF28, RGNEF
|
|
•
|
|
|
|
•
|
|
2
|
ARG28_HUMAN
|
Rho guanine nucleotide exchange factor 28
|
P4HB
|
|
|
|
|
|
•
|
•
|
2
|
PDIA1_HUMAN
|
Protein disulfide-isomerase
|
BCL2
|
|
|
|
|
|
|
•
|
1
|
BCL2_HUMAN
|
Apoptosis regulator Bcl-2
|
CASP3
|
|
|
|
|
|
|
•
|
1
|
CASP3_HUMAN
|
Caspase-3
|
DERL1
|
|
|
|
|
|
|
•
|
1
|
DERL1_HUMAN
|
Derlin-1
|
HDAC6
|
|
|
|
|
|
|
•
|
1
|
HDAC6_HUMAN
|
Histone deacetylase 6
|
HECW1
|
|
|
|
|
|
|
•
|
1
|
HECW1_HUMAN
|
E3 ubiquitin-protein ligase HECW1
|
HS3ST3A1
|
|
|
•
|
|
|
|
|
1
|
HS3SA_HUMAN
|
Heparan sulfate glucosamine 3-O-sulfotransferase 3A1
|
MYLIP
|
|
|
•
|
|
|
|
|
1
|
MYLIP_HUMAN
|
E3 ubiquitin-protein ligase MYLIP
|
NEFM
|
|
|
|
|
|
|
•
|
1
|
NFM_HUMAN
|
Neurofilament medium polypeptide
|
PARK7
|
|
|
|
•
|
|
|
|
1
|
PARK7_HUMAN
|
Protein deglycase DJ-1
|
SORT1
|
|
|
|
|
|
|
•
|
1
|
SORT_HUMAN
|
Sortilin
|
An effort to identify new ALS-associated proteins through a combination of text mining and database searches revealed a set of 140 proteins not present in the initial data survey (Supplementary Table S 2). 17 (12.1 %) new proteins are found in one or more Tier1 + Tier2 disease modules, which is a significant overlap (p = 0.03).
ALS network collection
The collection of all 282 ALS-associated PPI networks, offers the opportunity to investigate the biology of networks closely associated with ALS related genes, as well as a framework for mapping experimental data (e.g. gene expression data) to the networks. The networks are available for download as a Cytoscape session file as part of the supplementary materials. A separate Cytoscape session is available for download containing only the ALS core modules, with Tier 1 vs. Tier 2 clearly marked in the overview. Furthermore, it contains all metadata and graphical styles needed to generate the visualization of the disease modules shown in this publication, thus allowing for further exploration of the ALS core modules.
ALS core modules in overview
Investigating the spectrum of molecular biology represented in the 26 ALS core modules (Fig. 3), by evaluating the Gene Ontology categories overrepresented in them, leads to the following observations: Apoptosis is represented in most (19) of the modules, as is protein degradation (19). A large proportion (19) of the modules are enriched for genes/proteins involved in protein- modification (15) or -localization (11). Axon guidance, and immune response are represented in 12 and 13 core modules, respectively.
Some GO terms were only represented in Tier 2 core modules and not in Tier 1 modules. These include GO terms are centered around muscle, nervous system, synapse and glutamate, which are classically linked to ALS.
With a focus on the five Tier 1 core modules this analysis showed that most core modules are representing apoptosis and most often linking it to protein degradation or core module specific additional GO terms, for example core module 93 exclusively contains lipoprotein.
Table 3: Top 50 diseases most commonly co-mentioned with ALS in PubMed abstracts
List of the 50 diseases most commonly co-mentioned with ALS in scientific literature. Diseases have manually been categorized into ‘Disease types’ guided by the tree structure in Disease Ontology [32, 33]. ID: Disease Ontology ID. Abbreviation: Short name for disease used in Figure 5-9. Name: Disease name in Disease Ontology. Occurences: Number PubMed abstracts mentioning disease. Co-mentionings: Number of PubMed abstracts where both disease and ALS is mentioned. Overrep. ratio: Overrepresentation ratio of co-mentionings. P-value: Significance of hypergeometric test of the overlap between disease and ALS. Disease type: Manual classification of diseases.
ID
|
Abbreviation
|
Name
|
Occurrences
|
Co-mentionings
|
Overrep. ratio
|
P-value
|
Disease type
|
DOID:11949
|
CJD
|
Creutzfeldt-Jakob disease
|
4,508
|
61
|
14.6
|
1.59E-48
|
Brain disease
|
DOID:12680
|
PseudoBulbPalsy
|
pseudobulbar palsy
|
392
|
22
|
60.5
|
7.41E-32
|
DOID:12859
|
Chorea
|
choreatic disease
|
3,001
|
38
|
13.7
|
7.75E-30
|
DOID:5702
|
PleoLiposac
|
pleomorphic liposarcoma
|
4,293
|
69
|
17.3
|
1.54E-59
|
Cancer
|
DOID:3939
|
LipoCanc
|
lipomatous cancer
|
4,378
|
69
|
17.0
|
5.59E-59
|
DOID:769
|
NeuroBlast
|
neuroblastoma
|
27,962
|
99
|
3.8
|
5.56E-28
|
DOID:2476
|
HS Paraplegia
|
hereditary spastic paraplegia
|
1,690
|
103
|
65.7
|
8.73E-147
|
Central nervous system disease
|
DOID:607
|
Paraplegia
|
paraplegia
|
9,017
|
114
|
13.6
|
5.10E-86
|
DOID:1307
|
Dementia
|
dementia
|
136,817
|
2,639
|
20.8
|
~0
|
Cognitive disorder
|
DOID:9255
|
FT Dementia
|
frontotemporal dementia
|
5,737
|
1,217
|
228.8
|
~0
|
DOID:12217
|
LB Dementia
|
Lewy body dementia
|
3,916
|
81
|
22.3
|
4.24E-78
|
DOID:5408
|
PBD
|
Paget's disease of bone
|
1,532
|
54
|
38.0
|
6.84E-65
|
Connective tissue disease
|
DOID:205
|
BoneHyp
|
hyperostosis
|
6,705
|
54
|
8.7
|
5.47E-32
|
DOID:4953
|
Poliomyelitis
|
poliomyelitis
|
7,184
|
95
|
14.3
|
1.04E-73
|
Infectious disease
|
DOID:4952
|
PPMSyn
|
postpoliomyelitis syndrome
|
535
|
35
|
70.6
|
4.20E-52
|
DOID:438
|
AIDNeuro
|
autoimmune disease of the nervous system
|
14,913
|
189
|
13.7
|
1.10E-141
|
Immune system disease
|
DOID:12842
|
GBSyn
|
Guillain-Barre syndrome
|
6,675
|
106
|
17.1
|
5.36E-90
|
DOID:437
|
MyaGrav
|
myasthenia gravis
|
8,408
|
105
|
13.5
|
7.67E-79
|
DOID:2033
|
ComDis
|
communication disorder
|
26,572
|
129
|
5.2
|
9.33E-50
|
Mental health
|
DOID:0060046
|
Aphasia
|
aphasia
|
9,060
|
57
|
6.8
|
2.56E-28
|
DOID:700
|
MitoMetaD
|
mitochondrial metabolism disease
|
5,245
|
45
|
9.3
|
4.82E-28
|
Metabolic disease
|
DOID:683
|
MotorNeu
|
motor neuritis
|
1,915
|
139
|
78.3
|
2.97E-208
|
Motor neuron disease
|
DOID:681
|
ProgBulbPalsy
|
progressive bulbar palsy
|
432
|
97
|
242.2
|
1.37E-196
|
DOID:0060161
|
SBMA
|
Kennedy's disease
|
787
|
96
|
131.6
|
6.91E-167
|
DOID:678
|
ProgSupraPalsy
|
progressive supranuclear palsy
|
2,782
|
119
|
46.1
|
7.26E-151
|
Movement disease
|
DOID:767
|
MuscAtrophy
|
muscular atrophy
|
14,482
|
897
|
66.8
|
~0
|
Muscle tissue disease
|
DOID:3429
|
IncBodyMyositis
|
inclusion body myositis
|
1,525
|
88
|
62.2
|
1.52E-123
|
DOID:11722
|
MyoDystT1
|
myotonic dystrophy type 1
|
3,772
|
74
|
21.2
|
7.35E-70
|
DOID:11723
|
DuchMuscDys
|
Duchenne muscular dystrophy
|
7,844
|
82
|
11.3
|
4.30E-56
|
DOID:12858
|
HD
|
Huntington's disease
|
11,696
|
642
|
59.2
|
~0
|
Neurodegenerative disease
|
DOID:14330
|
PD
|
Parkinson's disease
|
69,957
|
1,725
|
26.6
|
~0
|
DOID:10652
|
AD
|
Alzheimer's disease
|
92,611
|
1,658
|
19.3
|
~0
|
DOID:2377
|
MS
|
multiple sclerosis
|
49,375
|
686
|
15.0
|
~0
|
DOID:2478
|
SC Degen
|
spinocerebellar degeneration
|
8,342
|
232
|
30.0
|
1.35E-249
|
DOID:1441
|
SC Ataxia
|
spinocerebellar ataxia
|
7,104
|
211
|
32.0
|
4.70E-233
|
DOID:11870
|
PickD
|
Pick's disease
|
976
|
65
|
71.8
|
7.94E-96
|
DOID:9277
|
PC Degen
|
primary cerebellar degeneration
|
1,134
|
48
|
45.7
|
1.14E-61
|
DOID:12705
|
FR Ataxia
|
Friedreich ataxia
|
2,119
|
56
|
28.5
|
2.50E-60
|
DOID:10595
|
CMTD
|
Charcot-Marie-Tooth disease
|
8,334
|
647
|
83.7
|
0
|
Neuromuscular disease
|
DOID:3602
|
ToxEnceph
|
toxic encephalopathy
|
26,094
|
293
|
12.1
|
1.44E-204
|
Nervous system disease
|
DOID:12697
|
LockedInSyn
|
locked-in syndrome
|
5,900
|
72
|
13.2
|
6.12E-54
|
DOID:913
|
AtroMuscD
|
atrophic muscular disease
|
5,802
|
575
|
106.9
|
~0
|
Peripheral nervous system
|
DOID:5214
|
DemyelinPN
|
demyelinating polyneuropathy
|
3,391
|
69
|
22.0
|
2.59E-66
|
DOID:5213
|
CIDMPRN
|
chronic inflammatory demyelinating polyradiculoneuropathy
|
2,061
|
51
|
26.7
|
1.14E-53
|
DOID:4308
|
PR Neuropathy
|
polyradiculoneuropathy
|
9,689
|
74
|
8.2
|
1.09E-41
|
DOID:2491
|
SP Neuropathy
|
sensory peripheral neuropathy
|
3,520
|
41
|
12.6
|
1.12E-30
|
DOID:11162
|
Resp. Failure
|
respiratory failure
|
57,385
|
418
|
7.9
|
1.53E-220
|
Respiratory system disease
|
DOID:2733
|
Skin Atrophy
|
skin atrophy
|
12,885
|
80
|
6.7
|
1.16E-38
|
Skin disease
|
DOID:318
|
ProgMusc atrophy
|
progressive muscular atrophy
|
303
|
141
|
501.9
|
~0
|
Spinal cord disease
|
DOID:0050881
|
IBMPFD
|
inclusion body myopathy with Paget disease of bone and frontotemporal dementia
|
105
|
26
|
267.1
|
3.84E-55
|
Syndrome
|
Based on the 50 diseases most significantly co-mentioned with ALS in PubMed abstracts (Table 3) an overrepresentation analysis was performed. Disease-associated genes were then overlapped with the ALS core modules to identify connections to other diseases. A total of 37 diseases were overlapping with at least 1 ALS core module (Fig. 4). From the matrix of disease overrepresentation in ALS core modules some clear trends are seen. First of all, the well-known ALS comorbidity Dementia is strongly evident from the matrix: Dementia, broad term (13 modules), the clinically closely associated Frontotemporal Dementia (6 modules, 3 of which Tier 1) and Lewy Body Dementia (3 modules). Among the group of other nervous system diseases, the following conditions are also associated with the ALS core modules: Alzheimer’s Disease (12 modules of which 3 are in Tier 1), Parkinson’s Disease (8 modules), Huntington’s Disease (5 modules) and Muscular Atrophy (4 modules, 3 of which are in the Tier 1 collection). The remaining diseases have 2 or fewer modules associated – including Multiple Sclerosis with only 1 module (184), being significantly associated. The only other non-degenerative CNS-diseases being prominently represented by mostly overlapping ALS core modules are neuroblastoma (10 modules) and toxic encephalopathy, which is likely due to the many modules described by apoptosis GO terms and containing a significant enrichment of brain-associated proteins. It is interesting to note, that motor diseases (such as spastic paraplegia, paraplegia, and Friedreich’s ataxia) are not represented by any of the ALS core modules, while muscle diseases, such as atrophic muscular disease, muscular atrophy, myotonic dystrophy type 1 and inclusion body myositis are significantly represented by at least one ALS core module.
ALS-Tier 1 core modules
The Tier 1 core modules were then investigated for known ALS disease biology and proteins associated with other neurodegenerative diseases (Fig. 5–9).
Module 83 – very ALS specific, contains SOD1, links oxidative stress and protein folding, (Fig. 5).
The identification of causative mutations in SOD1 gene was the first evidence of genetically inherited forms of ALS [35]. SOD1, with its many mutations is therefore the best studied protein in this disease and has been linked to two main pathogenic mechanisms which are thought to lead to ALS pathology. Both potential mechanisms are reflected in the underlying biology represented in this network. Mutations in SOD1, a ubiquitously expressed peroxide dismutase, have been linked to oxidative stress, either by a gain of function of this catabolic enzyme or also as a direct regulator of the NADPH dependent oxidation of RAC1 [36]. The network contains many other proteins playing part in the oxidative stress response, therefore the main GO term associated with this network is oxidative stress (Fig. 5B). Alternatively, mutations in SOD1 have been reported to induce its misfolding and aggregation (GFER, CCS, PDIA2) and thus to lead to loss of function [37]. Protein misfolding elicit a number of cellular mechanisms to protect the cell against the accumulations of aggregates. Representative of these rescue mechanisms are the large number of heat shock chaperones (for example HSPH1, HSPA2-6, DNAJB2) [38], where PARK7 is by itself redox sensitive. Ubiquitin ligases are also present in the proteasomal pathways (HECW1, STUB1, RNF19a). In the Tier 1 collection, module 83 is the most specific to ALS and shows minimal overlap with other neurological diseases. Changes in SOD1 associated function leading to a concomitant deficit in proteostasis may therefore be a unique feature of ALS pathology and its close relative frontotemporal dementia.
Module 196 Represented also in muscular atrophy, linked to protein degradation and apoptosis (F)
Represented also in muscular atrophy, linked to protein degradation and apoptosis (Fig. 6)
Module 196 is centered around HSPB1 (HSP27), which has a variety of functions relevant to ALS. This network shows a molecular link to HSPB1 to the crystallin chaperones, which are ZN2+ dependently activated and upregulated in neurological diseases [39]. Crystallin chaperones are also associated with myopathies consistent with their abundant expression in muscle where they stabilize Desmins [40]. HSPB1 oligomerization induced by stress, also TNF induced inflammatory stress. The TNF induced apoptotic signaling pathway is activated through MAPKAP, where HSPB1 deactivates DAXX [41]. Apart from its role in apoptosis, HSPB1 is also important in the proper function of proteasomes and can modulate reactive oxygen species. With this focus on responses to oxidative (and inflammatory stress) this network remains specific for ALS and with its interactive link to the crystallin chaperones makes the muscle particularly sensitive to dysregulation. This is reflected in the link of this network to muscular atrophy and Charcot Marie Tooth disease (Fig. 6) another neuropathy which is characterized by progressive muscular loss and genetic link to HSPB1 [42].
Module 93 Represented also in Alzheimer’s disease, linked to lipoproteins and lipid metabolism (Fig. 7)
Module 93 is the only Tier 1 network significantly linked to lipid metabolism (Fig. 7, panel B) through the presence lipoprotein receptors (LPRx), which are part of the cholesterol pathway genes as well as the APO protein family. Lipids and Lipoproteins are implicated in a whole range of biological process, where they are involved as energy substrates, building blocks, structural machinery and bioactive molecules [43]. In ALS, and AD, lipid metabolism has been thought to underlay denervation, mitochondrial dysfunction, excitotoxicity neural transport, cytoskeletal defect and impaired neurotransmitter release [43]. In the context of ALS, the energy metabolism, in particular, may have increased needs and in muscle a switch from glucose to lipid energy has been described [44], as well as changes in glycosphingolipids [45]. In addition, the brain strongly depends on fatty acid oxidation [46]. High fat and ketogenic diet in animals prolonged survival, while caloric restriction was detrimental in SOD1 transgenic mice [47, 48]. Therapeutically, this hypothesis has been tested with a high fat diet in a small clinical trial, which suggests that nutritional intervention needs to be followed up [49].
The high number of APO and LRP proteins in this network potentially drives the significant association with Alzheimer’s Disease, for which genotype of APOE is the main risk factor. While APOE in Alzheimer has been proposed to play a role in many processes [50], we suggest, based on this ALS core module, that its role in CNS lipid homeostasis is similar in ALS and AD, The use of high fat diets in AD has been discussed controversially, however.
Module 128 – Represented in many neurodegenerative diseases linked to protein metabolism and apoptosis (Fig. 8).
Module 128 represents a large network that contains a wide range of proteins. It is overlapping with 83 (SOD1, HDAC6, BCL2, SQSTM1)) as well as with 196 (SNCA, MAPT) as well as with 21 (HDAC6, SQSTM1, TARDP). The high degree of disease overrepresentation in this network may be due to the fact that it is the only network that has neuronal function associated proteins, such as the GABA receptors (GABAx), Glutamate receptors (GRIA1,3, GRIN2a) and neuronal related growth factors (NGF) and the microtubular system (HTT, MAPs). Interestingly, however, it is not associated with multiple sclerosis, suggesting that the dysfunction seen in the clinical presentation of MS is more strongly driven by a different mechanism such as immune dysfunction.
Similar to the other networks, this network contains proteins involved in ubiquitination (KEAP, TRIMs). As diseases are often caused by disturbance of homeostatic functions, these stress networks are found in many diseases activated, which may make this network so important also in non-degenerative diseases, such as neuroblastoma.
Module 21 – Represented in many neurodegenerative diseases, highest density of ALS genes, but little significant biology (Fig. 9).
This network is almost exclusively made up of ALS-associated genes. It directly links many ALS-risk genes (HDAC6, VCP, HNRNPA1, SQSTM1, ATXN2) into the same network with the major causative genetic mutations (TARDBP and FUS). In fact, mutations in most of the proteins in this network have been proposed to be linked in one or the other way to ALS. This may strengthen the importance of these genes in the overall ALS pathogenesis [51]. This module functionally links many ALS-associated genes into one network which may partly explain why such a large variety of mutations and risk factors lead to the same pathological and clinical features. This network links the two major pathogenetic theories about ALS that are currently discussed: defects in RNA processing [52] and proteasomal malfunction.. Dysfunctional mRNA processing, in addition to loss of function of these transcripts, may lead to an overload of the protein degradation system and thus to cellular dysfunction, independent of the aggregate per se. The finding that TDP-43 (the protein product of TARDBP), is also involved in low molecular weight neurofilament processing and aggregation [53], represents a very interesting insight into how general biological principles can become organ-, here neuron, specific pathologies. In recent years, many neurodegenerative diseases have been recognized and grouped as proteinopathies. Apart from the RNA-related malfunction that comes with mutations of FUS and TARDBP, some studies have recently suggested that these proteins contain prion like structures [54], which makes them prone to seeding and aggregation with other proteins or lead to dysfunction of the protein degradation pathway causing other proteins to aggregate [55]. In particular TDP43 is also found aggregated in other neurodegenerative diseases [56]. This module is therefore strongly associated with other neurodegenerative diseases that have protein deposits (Fig. 9C).