Modifying factors and phenotypic diversity in Wilson's disease

Ann N Y Acad Sci. 2014 May:1315:56-63. doi: 10.1111/nyas.12420. Epub 2014 Apr 4.

Abstract

Wilson's disease (WD) is a human disorder of copper homeostasis caused by mutations in the copper-transporting ATPase ATP7B. WD is characterized by copper accumulation, predominantly in the liver and brain, hepatic pathology, and wide differences between patients in the age of onset and the spectrum of symptoms. Several factors contribute to the phenotypic variability of WD. The WD-causing mutations produce a wide range of changes in stability, activity, intracellular localization, and trafficking of ATP7B; the nonpathogenic genetic polymorphisms may contribute to the phenotype. In Atp7b(-/-) mice, a mouse model of WD, an abnormal intracellular distribution of copper in the liver triggers distinct changes in the transcriptome; these mRNA profiles might be used to more specifically define disease progression. The major effect of accumulating copper on lipid metabolism and especially cholesterol homeostasis in mice and humans suggests the importance of fat and cholesterol metabolism as modifying factors in WD.

Keywords: ATP7B; Atp7b−/− mice; Wilson's disease; cholesterol; copper.

Publication types

  • Research Support, N.I.H., Extramural
  • Review

MeSH terms

  • Adenosine Triphosphatases / chemistry
  • Adenosine Triphosphatases / deficiency
  • Adenosine Triphosphatases / genetics
  • Animals
  • Cation Transport Proteins / chemistry
  • Cation Transport Proteins / deficiency
  • Cation Transport Proteins / genetics
  • Cholesterol / metabolism
  • Copper / metabolism
  • Copper-Transporting ATPases
  • Disease Models, Animal
  • Hepatolenticular Degeneration / genetics*
  • Hepatolenticular Degeneration / metabolism*
  • Humans
  • Lipid Metabolism
  • Liver / metabolism
  • Mice
  • Mice, Knockout
  • Mutation
  • Phenotype
  • Transcriptome

Substances

  • Atp7a protein, mouse
  • Cation Transport Proteins
  • Copper
  • Cholesterol
  • Adenosine Triphosphatases
  • ATP7B protein, human
  • Copper-Transporting ATPases