Die Spinalen Muskelatrophie (SMA) ist eine neurodegenerative Krankheit, die durch einen Mangel an Survival Motor Neuron (SMN) Protein verursacht wird. Die vorliegende Dissertation vergleicht drei SMA-Mausmodelle, um festzustellen, ob sich die Pathologien und die zeitliche Abfolge gleichen. Das SMN-Delta7-Modell zeigt umfassende Defekte im motorischen System, einschließlich der Degeneration von Motoneuronen, sowie der Denervierung von spinalen exzitatorischen Synapsen und neuromuskulären Endplatten. Im Gegensatz dazu weist das Taiwanese Modell milde Motoneuron-Pathologien, aber einen frühen Verlust zentraler Synapsen auf. Beim intermediären Smn2B/- Modell treten starke Pathologien in zentralen exzitatorischen Synapsen und Neuromuskulären Endplatten auf, gefolgt von einem späten Absterben der Motoneurone, das p53-abhängig ist. Diese Ereignisse korrelieren mit einer SMN-abhängigen Störung der Splicing-Regulation bestimmter mRNAs. Die Studie liefert eine Wissensgrundlage für zukünftige Untersuchungen und identifiziert die zentrale exzitatorische Synaptopathie als Schlüsselmerkmal der motorischen Pathologie bei SMA.:Inhaltsverzeichnis Abbildungsverzeichnis .................................................................................................. III Abkürzungsverzeichnis.................................................................................................IV 1 Bibliographische Zusammenfassung............................................................... 1 2 Einführung ......................................................................................................... 2 2.1 Der sensomotorische Schaltkreis im Rückenmark .................................... 2 2.2 Grundlagen der spinalen Muskelatrophie (SMA)....................................... 6 2.3 Mechanismen der Motoneurondegeneration in SMA ................................ 9 2.4 Die Rolle peripherer und zentraler Synapsen in SMA…………………….11 3 Ziele der Arbeit................................................................................................. 16 4 Publikationsmanuskript .................................................................................. 17 5 Zusammenfassung .......................................................................................... 45 6 Literaturverzeichnis………………………………………………………………….50 7 Anlagen ............................................................................................................ 55 7.1 Supplemental Material ............................................................................. 55 7.2 Erklärung über den wissenschaftlichen Beitrag des Promovenden zur Publikation................................................................................................ 66 7.3 Selbstständigkeitserklärung ..................................................................... 67 7.4 Lebenslauf................................................................................................ 68 7.5 Publikationen............................................................................................ 70 7.6 Danksagung ............................................................................................. 71

Motor neuron diseases (MNDs) encompass a variety of clinically and genetically heterogeneous disorders, which lead to the degeneration of motor neurons (MNs) and impaired motor functions. MNs coordinate and control movement by transmitting their signal to a target muscle cell. The synaptic endings of the MN axon and the contact site of the muscle cell thereby form the presynaptic and postsynaptic structures of the neuromuscular junction (NMJ). In MNDs, synaptic dysfunction and synapse elimination precede MN loss suggesting that the NMJ is an early target in the pathophysiological cascade leading to MN death. In this study, we established new experimental strategies to analyze human MNDs by patient derived induced pluripotent stem cells (iPSCs) and investigated pathophysiological mechanisms in two different MNDs. To study human MNDs, specialized cell culture systems that enable the connection of MNs to their target muscle cells are required to allow the formation of NMJs. In the first part of this study, we established and validated a human neuromuscular co-culture system consisting of iPSC derived MNs and 3D skeletal muscle tissue derived from myoblasts. We generated 3D muscle tissue by culturing primary myoblasts in a defined extracellular matrix in self-microfabricated silicone dishes that support the 3D tissue formation. Subsequently, iPSCs from healthy donors and iPSCs from patients with the progressive MND Amyotrophic Lateral Sclerosis (ALS) were differentiated into MNs and used for 3D neuromuscular co-cultures. Using a combination of immunohistochemistry, calcium imaging, and pharmacological stimulations, we characterized and confirmed the functionality of the 3D muscle tissue and the 3D neuromuscular co-cultures. Finally, we applied this system as an in vitro model to study the pathophysiology of ALS and found a decrease in neuromuscular coupling, muscle contraction, and axonal outgrowth in co-cultures with MNs harboring ALS-linked superoxide dismutase 1 (SOD1) mutation. In summary, this co-culture system presents a human model for MNDs that can recapitulate aspects of ALS pathophysiology. In the second part of this study, we identified an impaired unconventional protein secretion (UPS) of Sod1 as pathological mechanisms in Pleckstrin homology domain-containing family G member 5 (Plekhg5)-associated MND. Sod1 is a leaderless cytosolic protein which is secreted in an autophagy-dependent manner. We found that Plekhg5 depletion in primary MNs and NSC34 cells leads to an impaired secretion of wildtype Sod1, indicating that Plekhg5 drives the UPS of Sod1 in vitro. By interfering with different steps during the biogenesis of autophagosomes, we could show that Plekhg5-regulated Sod1 secretion is determined by autophagy. To analyze our findings in a clinically more relevant model we utilized human iPSC MNs from healthy donors and ALS patients with SOD1 mutations. We observed reduced SOD1 secretion in ALS MNs which coincides with reduced protein expression of PLEKHG5 compared to healthy and isogenic control MNs. To confirm this correlation, we depleted PLEKHG5 in control MNs and found reduced extracellular SOD1 levels, implying that SOD1 secretion depends on PLEKHG5. In summary, we found that Plekh5 regulates the UPS of Sod1 in mouse and human MNs and that Sod1 secretion occurs in an autophagy dependent manner. Our data shows an unreported mechanistic link between two MND-associated proteins. / Motoneuronerkrankungen (MNE) umfassen eine Vielzahl klinisch und genetisch heterogener Erkrankungen, die zur Degeneration von Motoneuronen (MN) und zu beeinträchtigten motorischen Funktionen führen. MN koordinieren und steuern Muskelbewegungen, indem sie ihr Signal an eine Zielmuskelzelle übertragen. Die synaptischen Endungen des MN-Axons und die Kontaktstelle der Muskelzelle bilden dabei die präsynaptischen und postsynaptischen Strukturen der neuromuskulären Endplatte (NME). Bei MNE zeichnen sich synaptische Dysfunktion und Synapseneliminierung bereits vor dem Verlust von MN ab, was darauf hindeutet, dass die NME ein frühes Ziel in der pathophysiologischen Kaskade ist, die zum MN-Tod führt. In dieser Studie haben wir neue experimentelle Strategien zur Analyse humaner MNE mithilfe von humanen induzierten pluripotenten Stammzellen (iPSZ) entwickelt und pathophysiologische Mechanismen bei zwei verschiedenen MNE untersucht. Um humane MNE zu untersuchen sind Zellkultursysteme erforderlich, die die Verbindung von MN mit ihren Zielmuskelzellen ermöglichen, um NME zu bilden. Im ersten Teil dieser Studie haben wir ein humanes neuromuskuläres Co-Kultursystem etabliert und validiert, das aus iPSZ abgeleiteten MN und 3D Skelettmuskelgewebe aus Myoblasten besteht. Wir haben 3D Muskelgewebe erzeugt, indem wir primäre Myoblasten in einer definierten extrazellulären Matrix in selbst gefertigten Silikonschalen kultivierten, die die 3D-Gewebebildung unterstützen. Anschließend wurden iPSZ von gesunden Spendern und iPSZ von Patienten mit der MNE Amyotrophe Lateralsklerose (ALS) in MN differenziert und für neuromuskuläre 3D Co-Kulturen verwendet. Mithilfe von immunhistochemischen Untersuchungen, Calcium-Imaging und pharmakologischen Stimulationen konnten wir die Funktionalität des 3D Muskelgewebes und neuromuskulären 3D Co-Kulturen charakterisieren und validieren. Anschließend wurde das System als in vitro Modell zur Untersuchung der Pathophysiologie von ALS verwendet. ALS Co-Kulturen mit MN, die eine Superoxid Dismutase 1 (SOD1)-Genmutation aufwiesen, zeigten eine Abnahme der neuromuskulären Verbindung, der Muskelkontraktion und des axonalen Wachstums. Zusammenfassend stellt dieses Co-Kultursystem ein humanes Modell für die Untersuchung von MNE dar, das Aspekte der ALS-Physiologie rekapitulieren kann. Im zweiten Teil dieser Studie konnten wir eine Beeinträchtigung der unkonventionellen Proteinsekretion (UPS) von Sod1 als pathologischen Mechanismus bei Pleckstrin homology domain-containing family G member 5 (Plekhg5)-assoziiertem MNE identifizieren. Sod1 ist ein cytosolisches Protein ohne Signalsequenz für konventionelle Sekretion. Stattdessen wird die UPS über sekretorische Autophagie-Mechanismen reguliert. Unsere Ergebnisse zeigen, dass Plekhg5-Depletion in primären MN und NSC34-Zellen zu einer beeinträchtigten Sekretion von Wildtyp-Sod1 führt, was darauf hinweist, dass die UPS von Sod1 Plekgh5 abhängig ist. Indem verschiedene Schritte während der Biogenese von Autophagosomen gestört wurden, konnten wir nachweisen, dass die Plekhg5-regulierte Sod1-Sekretion Autophagie abhängig ist. Um unsere Ergebnisse in einem klinisch relevanteren Modell zu analysieren, wurden humane iPSZ-MN von gesunden Spendern und ALS-Patienten mit SOD1-Mutationen untersucht. Hier fand sich, dass die Sekretion von mutiertem SOD1 in ALS-MN im Vergleich zu gesunden und isogenen Kontrollen verringert ist. Dabei konnten wir zeigen, dass eine verringerte SOD1 Sekretion in ALS-MNs mit einer verringerten Expression von PLEKHG5 einhergeht. Um diese Korrelation zu bestätigen, wurden Kontroll-MN nach PLEKHG5-Depletion untersucht und eine verminderte SOD1-Sekretion dokumentiert, was auf eine PLEKHG5 Abhängigkeit hindeutet. Zusammenfassend konnten wir zeigen, dass Plekh5 die UPS von Sod1 in Maus MN und humanen MN reguliert und dass die Sod1-Sekretion Autophagie abhängig erfolgt. Unsere Daten belegen eine bislang noch nicht gezeigte mechanistische Verknüpfung zwischen zwei MNE-assoziierten Proteinen.

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Les motoneurones spinaux occupent la place centrale du système moteur. Ils intègrent l’ensemble des informations provenant de système nerveux central et périphérique pour élaborer une commande motrice finale adaptée aux demandes de l’organisme et aux contraintes de l’environnement. En particulier, le seuil de recrutement et la fréquence de décharge des motoneurones sont des paramètres déterminants dans l’élaboration d’un signal approprié à l’intensité de l’effort requis. Il permet de définir l’ordre dans lequel les unités motrices sont recrutées au cours d’une activité physique : des unités motrices de type lent (S) pour le maintien de la posture, aux unités motrices de type rapide pour les efforts d’intensité modérée (FR) et de forte intensité (FF). Cette étude met en évidence l’existence d’un nouvel acteur mis en jeu dans la régulation de l’excitabilité motoneuronale. Il s’agit du canal chlorure activé par le calcium TMEM16F exprimé spécifiquement dans les motoneurones α au niveau des synapses cholinergiques appelées « bouton C ». A l’instar du rôle des boutons C, TMEM16F est nécessaire pour l’exécution d’un effort de forte intensité. En effet, en adéquation avec les enregistrements électrophysiologiques montrant une élévation du seuil de recrutement des motoneurones rapides TMEM16F-/-, la perte de TMEM16F induit des défauts moteurs à l’effort.La sclérose latérale amyotrophique (SLA), est une maladie neurodégénérative conduisant à la mort sélective des motoneurones. Parmi les processus pathologiques décrits, nous savons que l’excitabilité motoneuronale et l’homéostasie calcique constituent des éléments majeurs de la progression de la SLA. Ce sont des facteurs de vulnérabilité qui participent à la dégénérescence séquentielle des motoneurones FF et suivie des motoneurones FR. Étant donné la sensibilité de TMEM16F au calcium et son implication dans la régulation de l’excitabilité motoneuronale, nous avons inhibé l’expression de ce canal dans un modèle murin de SLA SOD1G93A et réalisé une étude longitudinale. Celle-ci met en évidence un effet protecteur de la délétion de TMEM16F qui est dépendant du genre. / Spinal motoneurons have a prominent place in motor system. Motoneurons integrate all inputs from the central and peripheral nervous systems to construct a motor output adapted to the organism's demands and environmental constraints. In particular, recruitment threshold and firing frequency are key motoneuronal parameters in developing an appropriate signal regarding task-dependent demands. During muscle activity, motor units are orderly recruited beginning with slow-type (S) motor units for posture maintenance, followed by fast-type motor units for moderate intensity tasks (FR) and high intensity tasks (FF). Our study highlights a new factor involved in the regulation of motoneuron excitability. This refers to a calcium-activated chloride channel called TMEM16F, specifically expressed in α motoneurons at cholinergic C-bouton synapse. Likewise C-boutons, TMEM16F is required for the procution of high intensity effort. Indeed, in accordance with electrophysiological recordings showing an increase in recruitment threshold of fast TMEM16F-/- motoneurons, TMEM16F loss of function induces motor defects during an effort.Amyotrophic lateral sclerosis (ALS) is a neurodegenerative disease leading to the selective death of motoneurons. Among the pathological processes already described, we know that motoneuronal excitability and calcium homeostasis are major features in ALS progression. Those are vulnerability factors which contribute to sequential degeneration starting with FF motoneurons and followed by FR motoneurons. Given the TMEM16F sensitivity to calcium and its involvement in regulating motoneuron excitability, we inhibited its expression in a SOD1G93A mouse model of ALS and conducted a longitudinal study. It highlights a gender-dependent protective effect of TMEM16F loss.

Este trabalho descreve o desenvolvimento de um sistema de simulação de circuitos neuronais, com interface de utilização amigável e arquitetura baseada em web. O sistema é direcionado ao estudo de redes de neurônios da medula espinhal, responsáveis pelo controle motor, sujeitas à ativação por vias superiores e periféricas ou por estímulos elétricos. Sua utilidade está relacionada à criação de hipóteses ou teorias sobre o processamento neuronal realizado no caso são ou patológico, a atividades como a interpretação de resultados de experimentos eletrofisiológicos realizados em humanos e no direcionamento e validação de procedimentos experimentais. Para os propósitos deste projeto, a simulação computacional é o recurso mais indicado a se utilizar, considerando o grande número de variáveis envolvidas e o caráter não-linear dos elementos constituintes. As simulações devem retratar de maneira fidedigna as principais propriedades que caracterizam os núcleos neuronais a se estudar. Essas propriedades estão associadas ao recrutamento de unidades motoras, às relações de entrada-saída dos conjuntos neuronais, à influência das vias aferentes sobre os motoneurônios, ao papel da inibição recorrente e da inibição recíproca, à geração de força e do sinal eletromiográfico, entre outros. A simulação do reflexo H, que é uma técnica muito importante utilizada em estudos neurofisiológicos, está presente neste trabalho. Pretende-se que o sistema de simulação aqui proposto seja uma ferramenta útil para pesquisa e ensino da neurofisiologia do controle motor, provendo subsídios que levem a um melhor entendimento dos circuitos neuronais modelados. / This work describes the development of a simulation system of neuronal circuitry, having a user-friendly interface and based on web architecture. The system is intended for studying spinal cord neuronal networks responsible for muscle control, subjected to descending drive or electrical stimulation. It is potentially useful in many activities, such as the interpretation of electrophysiological experiments conducted with humans, the proposition of hypotheses or theories on neuronal processing. Computer simulation is the most indicated approach to attain the objectives of this project because of the huge number of variables and the non-linear characteristics of the constituting elements. The simulations should mimic in a faithful way the main properties related to the modeled neuronal nuclei. These properties are associated with: i) motor-unit recruitment, ii) neuronal nuclei input-output relations, iii) afferent tract influence on motoneurons, iv) effects of recurrent inhibition and reciprocal inhibition, v) generation of force and electromyogram, and others. The generation of the H-reflex by the Ia-motoneuron pool system, which is an important tool in human neurophysiology, is included in the simulation system. The biological reality obtained with the present simulator and its web-based implementation make it a powerful tool for researchers in neurophysiology.

Interactions between the Eph family of receptor tyrosine kinases, and their ligands, the ephrins, are required for the normal development and maintenance of many patterns of connectivity within the nervous system. Eph receptors and ephrins are expressed widely throughout both the developing and mature nervous system where they function as important regulators of cell migration and axon guidance. The studies presented in this thesis examine the role of one particular member of the Eph receptor family, EphA4, in regulating mechanisms that underlie the development and maintenance of certain neural connections within the nervous system. This thesis demonstrates that the EphA4 receptor is expressed within specific regions of the developing and mature nervous system, some of which are associated with the control of locomotor activity. Consistent with these observations are the locomotor defects exhibited by animals with a targeted disruption of the EphA4 gene. These animals exhibit abnormal bilateral limb movements and have severe disruptions of a number of major axonal pathways. One of these disrupted axonal pathways, the corticospinal tract (CST), is a particularly important mediator of locomotor activity. This thesis reveals that EphA4 is expressed on the axons that comprise the CST. It demonstrates that although EphA4 is not required for the initial development of the CST, repulsive interactions between EphA4-bearing CST axons and ephrinB3, a ligand for EphA4 that is expressed at the midline of the spinal cord, appear to prevent CST axons from aberrantly recrossing the spinal midline during development.

Interactions between the Eph family of receptor tyrosine kinases, and their ligands, the ephrins, are required for the normal development and maintenance of many patterns of connectivity within the nervous system. Eph receptors and ephrins are expressed widely throughout both the developing and mature nervous system where they function as important regulators of cell migration and axon guidance. The studies presented in this thesis examine the role of one particular member of the Eph receptor family, EphA4, in regulating mechanisms that underlie the development and maintenance of certain neural connections within the nervous system. This thesis demonstrates that the EphA4 receptor is expressed within specific regions of the developing and mature nervous system, some of which are associated with the control of locomotor activity. Consistent with these observations are the locomotor defects exhibited by animals with a targeted disruption of the EphA4 gene. These animals exhibit abnormal bilateral limb movements and have severe disruptions of a number of major axonal pathways. One of these disrupted axonal pathways, the corticospinal tract (CST), is a particularly important mediator of locomotor activity. This thesis reveals that EphA4 is expressed on the axons that comprise the CST. It demonstrates that although EphA4 is not required for the initial development of the CST, repulsive interactions between EphA4-bearing CST axons and ephrinB3, a ligand for EphA4 that is expressed at the midline of the spinal cord, appear to prevent CST axons from aberrantly recrossing the spinal midline during development.