Mutations in SLC39A14 disrupt manganese homeostasis and cause childhood-onset parkinsonism-dystonia
- Nat Commun. 2016 May 27;7:11601. doi: 10.1038/ncomms11601.
- 1. Genetics and Genomic Medicine, UCL Institute of Child Health, University College London, London WC1N 1EH, UK.
- 2. Department of Cell and Developmental Biology, University College London, London WC1E 6BT, UK.
- 3. Developmental Neurosciences, UCL Institute of Child Health, University College London, London WC1N 1EH, UK.
- 4. Department of Cell, Development and Cancer Biology, Oregon Health &Sciences University, Portland, Oregon 97239, USA.
- 5. Department of Chemistry, School of Life Sciences, University of Sussex, Brighton BN1 9QJ, UK.
- 6. Division of Genetics and Genomics, Department of Medicine, Boston Children's Hospital and Harvard Medical School, Boston, Massachusetts 02115, USA.
- 7. Division of Genetics and Molecular Medicine, King's College London School of Medicine, London SE1 9RT, UK.
- 8. Department of Radiology, Great Ormond Street Hospital for Children NHS Trust, London WC1N 3JH, UK.
- 9. Developmental Biology and Cancer, UCL Institute of Child Health and Department of Histopathology, Great Ormond Street Hospital for Children NHS Trust, London WC1N 3JH, UK.
- 10. Department of Pathology, Oregon Health &Science University, Portland, Oregon 97239, USA.
- 11. Developmental Biology and Cancer Programme, UCL Institute of Child Health, University College London, London WC1N 1EH, UK.
- 12. Department of Molecular &Medical Genetics, Oregon Health &Science University, Portland, Oregon 97239, USA.
- 13. Institute of Neurology, University College London, London WC1N 3BG, UK.
- 14. Alzheimer's Disease Research Centre, Department of Neurology, Harvard Medical School and Massachusetts General Hospital, Charlestown, Massachusetts 02129, USA.
- 15. Institute of Human Genetics, Technische Universität München, Munich 81675, Germany.
- 16. Institute of Human Genetics, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg 85764, Germany.
- 17. Unit of Molecular Neurogenetics, IRCCS, Foundation Neurological Institute 'C. Besta', Milan 20133, Italy.
- 18. Department of Medical and Molecular Genetics, University of Birmingham, Birmingham B15 2TT, UK.
- 19. Centre for Rare Diseases and Personalised Medicine, School of Clinical and Experimental Medicine, College of Medical and Dental Sciences, University of Birmingham, Birmingham B15 2TT, UK.
- 20. Department of Medical Genetics, School of Clinical Medicine, University of Cambridge, and Cambridge NIHR Biomedical Research Centre, Cambridge CB2 0QQ, UK.
- 21. MRC Laboratory for Molecular Cell Biology and Cell Biology Unit, University College London, London WC1E 6BT, UK.
- 22. Department of Metabolic Medicine, Great Ormond Street Hospital for Children NHS Trust, London WC1N 3JH, UK.
- 23. Department of Paediatric Neurology, Faculty of Medicine, Cairo University Children's Hospital, Cairo 11432, Egypt.
- 24. Department of Paediatrics, Section of Paediatric Nephrology, Genetics and Metabolism, Unit of Rare Diseases, University Hospital 'Germans Trias I Pujol', Universitat Autònoma de Barcelona, Badalona 08916, Spain.
- 25. Department of Paediatrics, Paediatric Neurology and Neonatology Unit, University Hospital 'Germans Trias I Pujol', Badalona 08916, Spain.
- 26. Neuroimmunology Group, Institute for Neuroscience and Muscle Research, Kids Research Institute at the Children's Hospital at Westmead, University of Sydney, Westmead NSW 2145, Australia.
- 27. Department of Neurological Sciences, Christian Medical College Hospital, Vellore 632 004, India.
- 28. Department of Neurology, Oregon Health &Science University, Portland, Oregon 97239, USA.
- 29. Department of Pediatrics, Oregon Health &Science University, Portland, Oregon 97239, USA.
Although manganese is an essential trace metal, little is known about its transport and homeostatic regulation. Here we have identified a cohort of patients with a novel autosomal recessive manganese transporter defect caused by mutations in SLC39A14. Excessive accumulation of manganese in these patients results in rapidly progressive childhood-onset parkinsonism-dystonia with distinctive brain magnetic resonance imaging appearances and neurodegenerative features on post-mortem examination. We show that mutations in SLC39A14 impair manganese transport in vitro and lead to manganese dyshomeostasis and altered locomotor activity in zebrafish with CRISPR-induced slc39a14 null mutations. Chelation with disodium calcium edetate lowers blood manganese levels in patients and can lead to striking clinical improvement. Our results demonstrate that SLC39A14 functions as a pivotal manganese transporter in vertebrates.