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Base teórica: A qualidade de vida é uma variável amplamente estudada nas ciências da saúde e tem se tornado, cada vez mais, um indicativo importante na avaliação dos estados e desfechos de saúde. As doenças crônicas se caracterizam por curso prolongado, por vezes acompanhando o portador por toda sua vida, o que pode influenciar a percepção que o indivíduo tem de si mesmo e de sua vida. A Neurofibromatose tipo 1 (NF1) é uma doença crônica, genética, que atinge cerca de 1:3500 nascimentos. Além de ser uma doença que acarreta uma maior predisposição ao desenvolvimento de tumores, a NF1 possui sintomas físicos de fácil identificação. Objetivo: O presente estudo visa estudar a qualidade de vida e algumas variáveis emocionais de pessoas com neurofibromatose tipo 1. Método: Trata-se de um estudo transversal. Foram avaliadas as variáveis de qualidade de vida genérica (WHOQOL-bref e SF-36), qualidade de vida específica para pessoas com problemas de pele (DLQI-bra), sintomas depressivos (BDI), sintomas de ansiedade(BAI), percepção de suporte familiar (IPSF) e estratégias de enfrentamento (Inventário de Estratégias de Coping de Folkman e Lazarus). Os participantes deste estudo também foram avaliados quanto à gravidade (Escala de Riccardi) e visibilidade dos sintomas da doença (Ablon). Resultados: Foram coletados dados de 71 pacientes adultos com NF1. Do total 60,0% da amostra foram pessoas do sexo feminino, a média de idade foi de ± 40,36 anos. Dos 52 pacientes avaliados pela escala de Riccardi, 11,3% apresentou gravidade leve, 40,4% gravidade moderada, 42% sintomas graves de gravidade e 6,5% sintomas muito graves da doença. Com relação a visibilidade dos sintomas medidos pela escala de Ablon, 36,5% apresentam visibilidade leve de sintomas, 30,8% visibilidade moderada e 32.7% visibilidade severa dos sintomas. Conclusão: Os resultados da avaliação de qualidade de vida de pessoas com NF1, ao serem comparados com os dados normativos para amostra, não apresentou diferença estatisticamente significativa. A análise dos sintomas depressivos indicou que grande parte dos entrevistados apresentam sintomas leves de depressão e os dados da escala BAI referente aos sintomas de ansiedade constatou que a média dos entrevistados apresentam sintomas graves de ansiedade, podendo sugerir que a ansiedade seja uma característica importante dessa população. As estratégias de enfrentamento mais utilizadas por esta população foram a reavaliação e o suporte social. Com relação aos resultados da percepção de suporte familiar, podemos perceber que os dados da amostra não apresentaram diferença significativa ao serem comparados com os dados normativos da escala. / Theoretical basis: Quality of life is an important studied variable in health sciences and has become an important indicator in assessing states and health outcome. Chronic diseases are characterized by a prolonged course, sometimes accompanying the carrier all his life, which can influence the perception that the individual has of himself and of his life. The neurofibromatosis type 1 (NF1) is a chronic and genetics condition that affects about 1: 3500 births. Besides being a disease that leads to a greater predisposition to develop tumors, NF1 has physical symptoms of easy identification. Objective: This project aims to study the quality of life and emotional variables of people with neurofibromatosis type 1. Method: This is an observational study. The overall quality of life variables were evaluated (WHOQOL-bref and SF-36), specific quality of life for people with skin problems (DLQI-bra), depressive symptoms (BDI), anxiety symptoms (BAI), perception of family supports (IPSF) and coping strategies (coping strategies Inventory of Folkman and Lazarus). The participants were also evaluated for the severity (Riccardi Scale) and visibility of disease symptoms (Ablon). Results: Were collected data from 71 adults patients with NF1. From all sample 60% were female. The mean age was ± 40.36 years . Of the 52 patients evaluated for Riccardi scale , 11.3 % had mild severity , 40.4 % moderate severity , 42% Severity of symptoms and 6.5 % symptoms very severe. The data of the visibility of the symptoms were measure by Ablon scale , 36.5 % have mild symptoms visibility , 30.8 % moderate and 32.7 % severe visibility of symptoms. Conclusion: The results of the quality of life of people with NF1, when compared with the normative data for sample, indicate no statistically significant difference. The analysis of depressive symptoms indicated that the majority of respondents have mild symptoms of depression and the BAI scale data related to symptoms of anxiety found that the average of respondents have severe anxiety symptoms and may suggest that anxiety can be an important feature of this population. Coping strategies most used by this population were the re-evaluation and social support. Regarding the results of the perception of family support, we can see that the sample data showed no significant difference when compared with the normative data range.

Neurofibromin (NF1) is a 2,818aa protein encoded by the very large NF1 tumour suppressor gene located on chromosome 17q11.2. Loss of function mutations and deletions in NF1 underlie Neurofibromatosis type-1 (NF-1) - the most common inherited syndrome of the nervous system in humans with a birth incidence of 1:3,000. The most visible feature of NF-1 is the neoplastic manifestations known as neurofibromas, however, the syndrome is also characterized by pigmentary defects, peripheral motor dysfunction, learning disabilities and several developmental abnormalities. The molecular etiology of many of these non-neoplastic phenotypes remains unknown. Here we demonstrate that the Tubulin Binding Domain (TBD) of NF1 is a binding partner of the Leucine Rich Pentatrico Peptide Repeat motif-Containing protein (LRPPRC) and cytoplasmic Dynein Heavy Chain (DHC). The NF1-LRPPRC interaction is of high significance as it links NF-1 with Leigh’s Syndrome, French Canadian variant (LSFC) – an autosomal recessive neurodegenerative disorder that arises due to mutations in the LRPPRC gene. This interaction occurs as part of an RNA granule complex, and use of transgenic mouse models establishes an important role of NF1 and LRPPRC in peripheral nerve development. The NF1-DHC interaction is of importance in melanocytes where our studies suggest a possible role in melanosome localization, disruptions in which may underlie the abnormal pigmentary features known as café-au-lait macules that are commonly associated with NF-1. The validation of LRPPRC and DHC as novel NF1 interactors reveal new roles of NF1, which open the door to better understanding the molecular mechanisms that underlie the myriad of NF-1 manifestations.

Neurofibromin (NF1) is a 2,818aa protein encoded by the very large NF1 tumour suppressor gene located on chromosome 17q11.2. Loss of function mutations and deletions in NF1 underlie Neurofibromatosis type-1 (NF-1) - the most common inherited syndrome of the nervous system in humans with a birth incidence of 1:3,000. The most visible feature of NF-1 is the neoplastic manifestations known as neurofibromas, however, the syndrome is also characterized by pigmentary defects, peripheral motor dysfunction, learning disabilities and several developmental abnormalities. The molecular etiology of many of these non-neoplastic phenotypes remains unknown. Here we demonstrate that the Tubulin Binding Domain (TBD) of NF1 is a binding partner of the Leucine Rich Pentatrico Peptide Repeat motif-Containing protein (LRPPRC) and cytoplasmic Dynein Heavy Chain (DHC). The NF1-LRPPRC interaction is of high significance as it links NF-1 with Leigh’s Syndrome, French Canadian variant (LSFC) – an autosomal recessive neurodegenerative disorder that arises due to mutations in the LRPPRC gene. This interaction occurs as part of an RNA granule complex, and use of transgenic mouse models establishes an important role of NF1 and LRPPRC in peripheral nerve development. The NF1-DHC interaction is of importance in melanocytes where our studies suggest a possible role in melanosome localization, disruptions in which may underlie the abnormal pigmentary features known as café-au-lait macules that are commonly associated with NF-1. The validation of LRPPRC and DHC as novel NF1 interactors reveal new roles of NF1, which open the door to better understanding the molecular mechanisms that underlie the myriad of NF-1 manifestations.

L'autisme et la déficience mentale (DM) sont des pathologies neurodéveloppementales fréquentes qui partagent des facteurs génétiques communs. Afin de mieux comprendre leur étiologie, nous avons étudié les mécanismes moléculaires de la neurofibromatose de type 1 (NF1), qui est souvent associée à l'autisme et à la DM. La neurofibromine, dont le gène est muté dans la NF1 interagit avec LIMK2. Cette protéine fait partie de la voie des Rho-GTPases dont des mutations de plusieurs membres ont été trouvés mutés dans des cas d'autisme et de DM. Chez le rat, nous avons montré que l’expression de Limk2d, une isoforme sans domaine kinase, augmente la croissance des neurites des cellules neuronales NSC-34. Chez l'homme, LIMK2-1 est la seule isoforme qui comporte un domaine inhibiteur de la phosphatase 1 (PP1i). Nous avons montré que l’expression de cette protéine diminue la longueur des neurites des cellules NSC-34 in vitro. Nous avons observé l'association de la variation située dans le domaine PP1i à la DM (p.S668P, rs151191437) (p=0,04, test de Fisher, OR = 3,29). Elle abolit l’effet inhibiteur de croissance des neurites de l'isoforme LIMK2-1 diminue l'interaction de LIMK2-1 avec la neurofibromine. La fréquence de l'autisme est plus élevée chez les patients atteints ayant des délétions de 14 gènes du locus NF1. Nous avons observé une association entre la variation R115K (rs111902263) du gène RNF135 de ce locus et l'autisme (p=0,00014, test de Fisher) ainsi qu’une anomalie du nombre de copies située dans l'intron 2 de ce gène chez un d’entre eux. Ce travail souligne la spécificité de deux isoformes de LIMK2 sur la croissance des neurites. Il renforce l’intérêt d’étudier l’implication du gène RNF135 dans l’autisme. Des études fonctionnelles seront entreprises afin de confirmer le rôle de LIMK2 et de RNF135 dans l'étiologie de l'autisme et de la DM. / Autism and mental deficiency (MD) are two neurodevelopemental diseases which share genetic factors in common. To better understand their etiologies, we studied the molecular mechanisms of neurofibromatosis type 1, a pathology frequently associated with autism and MD. Neurofibromatosis type 1 is due to deletions or mutations of the NF1 gene which encodes neurofibromin. This protein interacts with several proteins such as LIMK2. This protein belongs to the Rho-GTPases pathway in wich mutations of numerous members have been associated with autism and MD. In our study, we showed that LIMK2 isoforms do not only have important structural differencies but have also functional specificities. Limk2d, which lacks the kinase domain, promotes neurite outgrowth of NSC-34 cells. On the contrary, LIMK2-1, which is primate specific and has a C-terminal PP1i domain, inhibits neurite outgrowth. Analysis of the LIMK2-1 coding sequence, revealed the association between MD and a variation located in the PP1i domain, S668P (rs151191437) (p=0.04, Fisher test, OR = 3.29). This variation abrogated the LIMK2-1 effect on neurite outgrowth and inhibited LIMK2-1 interaction with neurofibromin. Deletions occuring in neurofibromatosis type 1 which include the NF1 gene and 13 others are associated with a higher frequency of autism. Mutations of one of them, RNF135, have been identified in patients with MD and overgrowth syndrome. Two of these patients also presented autistic features. By analysing RNF135 gene in autistic patients, we showed the association of the variation R115K (rs111902263) with autism. We also identified a duplication of a region located in RNF135 gene intron 2 in one patient presenting autism and MD. Our results highlight the importance and specificity of LIMK2 isoforms on neurite outgrowth and strengthen the importance to analyze both the sequence and copy-number of RNF135 gene. Further functional experiments will be undertaken to confirm the implication of LIMK2 and RNF135 in autism and MD etiology.

LIMK1 et LIMK2 sont des sérines/thréonine kinases capables de phosphoryler et d’inactiver la cofiline, un facteur de dépolymérisation de l’actine. Elles sont régulées négativement par la neurofibromine, responsable de la neurofibromatose de type 1, et pourraient être impliquées à la fois dans les aspects tumoraux et cognitifs de cette maladie par leur rôle dans la dynamique de l’actine. Nous avons étudié l’isoforme LIMK2‐1 de LIMK2, spécifique des hominidés et précédemment associée à la déficience intellectuelle. Cette isoforme possède un domaine kinase tronqué et un domaine inhibiteur de la phosphatase 1 (PP1i) en C‐terminal. Nos résultats montrent, d’une part, que LIMK2‐1 existe sous forme de protéine et qu’elle est exprimée dans le système nerveux central chez l’homme, en particulier au cours du neurodéveloppement. D’autre part, il apparaît que cette isoforme favorise la polymérisation de l’actine. Cette action semble indépendant de l’activité kinase puisque LIMK2‐1 ne phosphoryle pas la cofiline. Nous avons également montré que le domaine PP1i interagissait spécifiquement avec la phosphatase 1 et des résultats complémentaires suggèrent un rôle de ce domaine dans l’inhibition de la dépolymérisation de l’actine. Ces données mettent en évidence un mécanisme moléculaire nouveau pour une protéine de la famille des LIMK et soulignent l’intérêt d’étudier ces protéines afin de mieux comprendre leur implication dans les troubles cognitifs et dans la neurofibromatose de type 1. / LIMK1 and LIMK2 are serine/threonine kinases that phosphorylate and subsequently inactivate cofilin, an actin-depolymerizing factor. Neurofibromin, the protein responsible for neurofibromatosis type 1, negatively regulates these proteins that may be involved in tumoral and cognitive aspects of the disease through their role in actin dynamics. We studied LIMK2-1, a hominidae-specific isoform previously involved in intellectual disability. This isoform possesses a truncated kinase domain and a protein phosphatase 1 inhibitory (PP1i) domain at its C-terminal extremity. Our results showed that LIMK2-1 exists at a protein level and that it is expressed in human central nervous system, especially during neurodevelopment. Moreover, LIMK2-1 promotes actin polymerization independently from a kinase activity, since this isoform does not phosphorylate cofiline. We also highlighted an interaction between the PP1i domain and protein phosphatase 1 and complementary results suggest a role of this domain in the inhibition of actin depolymerization. These data highlight a new molecular mechanism for a LIMK protein and emphasize the interest of studying these proteins to understand their involvement in cognitive disorders and in neurofibromatosis type 1.