A Neuropatia Axonal Gigante (GAN) é uma doença degenerativa que causa uma lesão progressiva nos nervos, afetando a movimentação e a sensibilidade, tanto no sistema nervoso periférico (os nervos que se espalham pelo corpo) quanto no central (cérebro e medula espinhal).
Introdução
O que você precisa saber de cara
A Neuropatia Axonal Gigante (GAN) é uma doença degenerativa que causa uma lesão progressiva nos nervos, afetando a movimentação e a sensibilidade, tanto no sistema nervoso periférico (os nervos que se espalham pelo corpo) quanto no central (cérebro e medula espinhal).
Escala de raridade
<1/50kMuito rara
1/20kRara
1/10kPouco freq.
1/5kIncomum
1/2k
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Sinais e sintomas
O que aparece no corpo e com que frequência cada sintoma acontece
Partes do corpo afetadas
+ 24 sintomas em outras categorias
Características mais comuns
Os sintomas variam de pessoa para pessoa. Abaixo estão as 51 características clínicas mais associadas, ordenadas por frequência.
Linha do tempo da pesquisa
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Genética e causas
O que está alterado no DNA e como passa nas famílias
Genes associados
1 gene identificado com associação a esta condição. Padrão de herança: Autosomal recessive.
Probable cytoskeletal component that directly or indirectly plays an important role in neurofilament architecture. May act as a substrate-specific adapter of an E3 ubiquitin-protein ligase complex which mediates the ubiquitination and subsequent proteasomal degradation of target proteins. Controls degradation of TBCB. Controls degradation of MAP1B and MAP1S, and is critical for neuronal maintenance and survival
CytoplasmCytoplasm, cytoskeleton
Giant axonal neuropathy 1, autosomal recessive
A severe autosomal recessive sensorimotor neuropathy affecting both the peripheral nerves and the central nervous system. Axonal loss and the presence of giant axonal swellings filled with neurofilaments on nerve biopsies are the hallmarks of this neurodegenerative disorder.
Variantes genéticas (ClinVar)
162 variantes patogênicas registradas no ClinVar.
Classificação de variantes (ClinVar)
Distribuição de 754 variantes classificadas pelo ClinVar.
Vias biológicas (Reactome)
2 vias biológicas associadas aos genes desta condição.
Diagnóstico
Os sinais que médicos procuram e os exames que confirmam
Tratamento e manejo
Remédios, cuidados de apoio e o que precisa acompanhar
Onde tratar no SUS
Hospitais de referência no Brasil e o protocolo oficial do SUS (PCDT)
🇧🇷 Atendimento SUS — Neuropatia axonal gigante
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Dados de DATASUS/CNES, SBGM, ABNeuro e Ministério da Saúde. Sempre confirme a disponibilidade diretamente com o estabelecimento.
Pesquisa ativa
Ensaios clínicos abertos e novidades científicas recentes
Ensaios em destaque
Pesquisa e ensaios clínicos
2 ensaios clínicos encontrados, 1 ativos.
Publicações mais relevantes
Childhood-Onset Giant Axonal Neuropathy: A Clinicopathological Case Report.
The Kelch 3 motif on gigaxonin mediates the interaction with NUDCD3 and regulates vimentin filament morphology.
Gigaxonin is an intermediate filament (IF)-interacting partner belonging to the Kelch-like (KLHL) protein family. Gigaxonin is encoded by the KLHL16 gene, which is mutated in Giant Axonal Neuropathy (GAN). The lack of functional gigaxonin in GAN patient cells impairs IF proteostasis by affecting IF protein degradation and transport. This leads to focal abnormal accumulations of IFs and compromised cellular function, with neurons being most severely impacted. We hypothesized that gigaxonin forms molecular interactions via specific sequence motifs to regulate IF proteostasis. The goal of this study was to examine how distinct Kelch motifs on gigaxonin regulate IF protein degradation and filament morphology. We analyzed vimentin IFs in HEK293 cells overexpressing wild type (WT) gigaxonin, or gigaxonin lacking each of the six individual Kelch motifs, K1-K6. All six gigaxonin deletion mutants (ΔK1-ΔK6) promoted the degradation of soluble vimentin. Compared to WT-gigaxonin, ΔK3-gigaxonin exhibited increased soluble vimentin degradation and increased presence of thick bundles of vimentin IFs. The ΔK4 mutant showed similar, but milder phenotypes compared to ΔK3. Using mass spectrometry proteomics we found that, relative to WT gigaxonin, ΔK3 gigaxonin had increased associations with ubiquitination-associated and mitochondrial proteins but lost the association with the NudC domain-containing protein 3 (NUDCD3), a molecular chaperone enriched in the nervous system. AlphaFold modeling revealed loss of gigaxonin-NUDCD3 binding with ΔK3 and altered binding with ΔK4. Collectively, our cell biological data show the induction of an abnormal GAN-like IF phenotype in cells expressing ΔK3- and, to a lesser extent, ΔK4-gigaxonin, while our proteomic profiling links the loss of gigaxonin-NUDCD3 interactions with defective IF proteostasis.
Charcot-Marie-Tooth-like presentation in giant axonal neuropathy: clinical variability and prevalence in a large Japanese case series.
Giant axonal neuropathy 1 (GAN) is a rare neurodegenerative disorder with autosomal recessive inheritance and significant phenotypic heterogeneity, ranging from milder presentations resembling Charcot-Marie-Tooth disease (CMT) to classical presentations involving central and peripheral nervous systems. We investigated the genetic and clinical spectrum of GAN in Japanese patients with inherited peripheral neuropathies (IPNs). We conducted genetic screening of 3315 Japanese patients diagnosed with IPNs between 2007 and 2023 using targeted next-generation or whole-exome sequencing. Variant pathogenicity, clinical features, and neurophysiological and neuroimaging findings were reviewed. We identified seven biallelic GAN variants in five patients from four unrelated families, including one homozygous and three compound heterozygous genotypes. Two novel pathogenic variants were identified: c.922G > T (p.Glu308*) and c.456dup (p.Ala153Cysfs*27). Two families exhibited the classical phenotype, whereas the other two exhibited a CMT-like phenotype. Mean onset age was 4.4 years (range 1.5-8), and gait disturbance was the initial symptom. The most common findings included distal weakness (n = 5), sensory impairment (n = 4), scoliosis (n = 3), autonomic dysfunction (n = 2). Neurophysiologically, all patients had sensorimotor axonal polyneuropathy. One patient with mild phenotype maintained a CMT-like state without systemic involvement until the age of 43 years and was still alive at 72, representing the longest documented survival in GAN. This study expands the genetic and phenotypic spectrum of GAN by identifying novel variants and a long-term survivor. These findings underscore the importance of systematic genetic screening for GAN in pediatric-onset CMT, even in the absence of classical features.
Hair Changes in Giant Axonal Neuropathy.
Disease mutation in gigaxonin-E3 ligase recapitulates giant axonal neuropathy in mice.
The nervous system evolved a variety of connections and neuron types to sustain diverse functions. While challenging, unlocking the universal mechanisms that support neuron integrity can be addressed in giant axonal neuropathy (GAN), a rare and fatal disease with broad deterioration of the nervous system. Here, we describe a new mouse strain that recapitulates key aspects of the GAN pathology following the introduction of a disease-causing mutation in GAN. Unlike previous GAN knock-out mice which show no overt phenotype, GANA49E/A49E mice exhibit early sensory-motor deficits and ataxia, giant axons and demyelination which, together with increased abundance, dramatic compaction and disorganization of neurofilaments across the nervous system, mimics the human disease. Using this model, we uncover novel alterations within neuromuscular junctions and muscles that might contribute to GAN pathogenesis. Interestingly, we pinpoint a sex bias whereby females show more severe histopathological damage and disease severity. Altogether, the GANA49E strain provides the first robust rodent model for GAN, recapitulating the symptoms and histological hallmarks of the human pathology. This model will be invaluable when investigating the cellular and molecular mechanisms that uphold neuron integrity along with effective therapies for GAN.
Publicações recentes
Childhood-Onset Giant Axonal Neuropathy: A Clinicopathological Case Report.
Disease mutation in gigaxonin-E3 ligase recapitulates giant axonal neuropathy in mice.
O-GlcNAcylation: A molecular switch linking brain health to neurodegeneration.
T2 Hyperintensities in Gracile Tracts of Cervical Spinal Cord in Giant Axonal Neuropathy (GAN).
The Kelch 3 motif on gigaxonin mediates the interaction with NUDCD3 and regulates vimentin filament morphology.
📚 EuropePMC181 artigos no totalmostrando 80
Childhood-Onset Giant Axonal Neuropathy: A Clinicopathological Case Report.
Annals of Indian Academy of NeurologyDisease mutation in gigaxonin-E3 ligase recapitulates giant axonal neuropathy in mice.
Acta neuropathologica communicationsO-GlcNAcylation: A molecular switch linking brain health to neurodegeneration.
Neural regeneration researchT2 Hyperintensities in Gracile Tracts of Cervical Spinal Cord in Giant Axonal Neuropathy (GAN).
Muscle & nerveThe Kelch 3 motif on gigaxonin mediates the interaction with NUDCD3 and regulates vimentin filament morphology.
European journal of cell biologyCharcot-Marie-Tooth-like presentation in giant axonal neuropathy: clinical variability and prevalence in a large Japanese case series.
Journal of neurologyNeurofilament accumulation disrupts autophagy in giant axonal neuropathy.
JCI insightGiant axonal neuropathy (GAN): cross-sectional data on phenotypes, genotypes, and proteomic signature from a German cohort.
Journal of neurologyHair Changes in Giant Axonal Neuropathy.
Indian journal of pediatricsGiant axonal neuropathy: a rare inherited neuropathy with a novel mutation.
NeurogeneticsMolecular mechanisms of neurofilament alterations and its application in assessing neurodegenerative disorders.
Ageing research reviewsGigaxonin, mutated in Giant Axonal Neuropathy, interacts with TDP-43 and other RNA binding proteins.
bioRxiv : the preprint server for biologyGene therapy for the leukodystrophies: From preclinical animal studies to clinical trials.
Neurotherapeutics : the journal of the American Society for Experimental NeuroTherapeuticsImmune responses to central nervous system directed adeno-associated virus gene therapy: Does direct CNS delivery make a difference?
Neurotherapeutics : the journal of the American Society for Experimental NeuroTherapeuticsSafety and efficacy of intra-erythrocyte dexamethasone sodium phosphate in children with ataxia telangiectasia (ATTeST): a multicentre, randomised, double-blind, placebo-controlled phase 3 trial.
The Lancet. NeurologyIntrathecal Gene Therapy for Giant Axonal Neuropathy.
The New England journal of medicineGiant Axonal Neuropathy: A Case Report of Subclinical Childhood Manifestations.
CureusO-GlcNAcylation and Its Roles in Neurodegenerative Diseases.
Journal of Alzheimer's disease : JADThe CRL3gigaxonin ubiquitin ligase-USP15 pathway governs the destruction of neurofilament proteins.
Proceedings of the National Academy of Sciences of the United States of AmericaIntermediate filament dysregulation in astrocytes in the human disease model of KLHL16 mutation in giant axonal neuropathy (GAN).
Molecular biology of the cell[Involvement of autonomic nervous system since middle age in elderly patient with giant axonal neuropathy caused by novel genetic mutation].
Rinsho shinkeigaku = Clinical neurologyAxonal Transport Defect in Gigaxonin Deficiency Rescued by Tubastatin A.
Neurotherapeutics : the journal of the American Society for Experimental NeuroTherapeuticsA multilevel screening pipeline in zebrafish identifies therapeutic drugs for GAN.
EMBO molecular medicineA New Mouse Model of Giant Axonal Neuropathy with Overt Phenotypes and Neurodegeneration Driven by Neurofilament Disorganization.
The Journal of neuroscience : the official journal of the Society for NeuroscienceGigaxonin is required for intermediate filament transport.
FASEB journal : official publication of the Federation of American Societies for Experimental BiologyIntermediate filament dysregulation and astrocytopathy in the human disease model of KLHL16 mutation in giant axonal neuropathy (GAN).
bioRxiv : the preprint server for biologyExpanding the genetic spectrum of giant axonal neuropathy: Two novel variants in Iranian families.
Molecular genetics & genomic medicineGenetic Approaches for the Treatment of Giant Axonal Neuropathy.
Journal of personalized medicineEvaluation of hair structural abnormalities in children with different neurological diseases.
The Turkish journal of pediatricsCalpain-mediated proteolysis of vimentin filaments is augmented in giant axonal neuropathy fibroblasts exposed to hypotonic stress.
Frontiers in cell and developmental biologyDevelopment of a high-throughput tailored imaging method in zebrafish to understand and treat neuromuscular diseases.
Frontiers in molecular neuroscienceTwo novel pathogenic mutations of GAN gene identified in a chinese family with giant axonal neuropathy: a case report.
Molecular biology reportsSacsin Deletion Induces Aggregation of Glial Intermediate Filaments.
CellsGiant axonal neuropathy (GAN) in an 8-year-old girl caused by a homozygous pathogenic splicing variant in GAN gene.
American journal of medical genetics. Part AAnesthetic Management of Children and Adolescents With Giant Axonal Neuropathy: A Large Case Series.
A&A practiceGiant axonal neuropathy: cross-sectional analysis of a large natural history cohort.
Brain : a journal of neurologyExtensive rod and cone photoreceptor-cell degeneration in rat models of giant axonal neuropathy: implications for gene therapy of human disease.
Ophthalmic geneticsGiant axonal neuropathy with novel GAN pathogenic variant in a patient of consanguineous origin from Poonch Jammu and Kashmir-India.
Molecular biology reportsCurrent Clinical Applications of In Vivo Gene Therapy with AAVs.
Molecular therapy : the journal of the American Society of Gene TherapyE3 Ubiquitin Ligases in Neurological Diseases: Focus on Gigaxonin and Autophagy.
Frontiers in physiologyGiant axonal neuropathy: The first Iranian case with a variation in the gigaxonin gene and a glance to the other cases.
Current journal of neurologyExpanding the genotype-phenotype correlation of childhood sensory polyneuropathy of genetic origin.
Scientific reportsOrphan Peripheral Neuropathies.
Journal of neuromuscular diseasesPostnatal Woolly Hair: A Key to Diagnosis in Giant Axonal Neuropathy.
Actas dermo-sifiliograficasIdentification of Novel Compound Heterozygous Mutations in the GAN Gene of a Chinese Patient Diagnosed With Giant Axonal Neuropathy.
Frontiers in neuroscienceGiant axonal neuropathy: A differential diagnosis of consideration.
The Turkish journal of pediatricsGigaxonin glycosylation regulates intermediate filament turnover and may impact giant axonal neuropathy etiology or treatment.
JCI insightThe rare Alus element-mediated chimerism of multiple de novo complex rearrangement sequences in GAN result in giant axonal neuropathy.
Clinica chimica acta; international journal of clinical chemistryAn update on clinical, pathological, diagnostic, and therapeutic perspectives of childhood leukodystrophies.
Expert review of neurotherapeuticsGiant axonal neuropathy: a multicenter retrospective study with genotypic spectrum expansion.
NeurogeneticsSonic Hedgehog repression underlies gigaxonin mutation-induced motor deficits in giant axonal neuropathy.
The Journal of clinical investigationThe role of neurofilament aggregation in neurodegeneration: lessons from rare inherited neurological disorders.
Molecular neurodegenerationObservation of novel COX20 mutations related to autosomal recessive axonal neuropathy and static encephalopathy.
Human geneticsAdvancing the pathologic phenotype of giant axonal neuropathy: early involvement of the ocular lens.
Orphanet journal of rare diseasesGiant Axonal Neuropathy: Clinical, Radiological, and Genetic Features.
Annals of Indian Academy of NeurologyA Review of Copy Number Variants in Inherited Neuropathies.
Current genomicsGiant Axonal Neuropathy with Unusual Neuroimagings Caused by Compound Heterozygous Mutations in GAN Gene.
Chinese medical journalTwo novel mutations in the GAN gene causing giant axonal neuropathy.
World journal of pediatrics : WJPDevelopment of Intrathecal AAV9 Gene Therapy for Giant Axonal Neuropathy.
Molecular therapy. Methods & clinical developmentKLHL16 Degrades Epidermal Keratins.
The Journal of investigative dermatologyAAV gene delivery to the spinal cord: serotypes, methods, candidate diseases, and clinical trials.
Expert opinion on biological therapyGiant axonal neuropathy alters the structure of keratin intermediate filaments in human hair.
Journal of the Royal Society, InterfacePure motor axonal neuropathy triggered by antituberculous therapy in an undiagnosed case of acute intermittent porphyria.
BMJ case reportsPili canaliculi as manifestation of giant axonal neuropathy.
Anais brasileiros de dermatologiaIndustrializing rare disease therapy discovery and development.
Nature biotechnologyNovel homozygous missense mutation in GAN associated with Charcot-Marie-Tooth disease type 2 in a large consanguineous family from Israel.
BMC medical geneticsThe role of gigaxonin in the degradation of the glial-specific intermediate filament protein GFAP.
Molecular biology of the cellIntermediate filament aggregates cause mitochondrial dysmotility and increase energy demands in giant axonal neuropathy.
Human molecular geneticsAutonomic nervous system involvement in the giant axonal neuropathy (GAN) KO mouse: implications for human disease.
Clinical autonomic research : official journal of the Clinical Autonomic Research Society[Two novel pathogenic mutations of GAN gene identified in a patient with giant axonal neuropathy].
Zhonghua yi xue yi chuan xue za zhi = Zhonghua yixue yichuanxue zazhi = Chinese journal of medical geneticsA review of gigaxonin mutations in giant axonal neuropathy (GAN) and cancer.
Human geneticsDegradation of the Intermediate Filament Family by Gigaxonin.
Methods in enzymology[Therapy for Charcot-Marie-Tooth Disease: From the Standpoint of Neurologists].
Brain and nerve = Shinkei kenkyu no shinpoAbnormal intermediate filament organization alters mitochondrial motility in giant axonal neuropathy fibroblasts.
Molecular biology of the cellUnusual Neuroimaging Findings in Two Families with Giant Axonal Neuropathy.
The Canadian journal of neurological sciences. Le journal canadien des sciences neurologiquesKelch Domain of Gigaxonin Interacts with Intermediate Filament Proteins Affected in Giant Axonal Neuropathy.
PloS oneProduction of Recombinant Adeno-associated Virus Vectors Using Suspension HEK293 Cells and Continuous Harvest of Vector From the Culture Media for GMP FIX and FLT1 Clinical Vector.
Molecular therapy : the journal of the American Society of Gene TherapyA mild case of giant axonal neuropathy without central nervous system manifestation.
Brain & developmentGiant axonal neuropathy-like disease in an Alexandrine parrot (Psittacula eupatria).
Journal of veterinary diagnostic investigation : official publication of the American Association of Veterinary Laboratory Diagnosticians, IncNeurofilament dynamics and involvement in neurological disorders.
Cell and tissue researchAssociações
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Referências e fontes
Bases de dados externas citadas neste artigo
Publicações científicas
Artigos indexados no PubMed ligados a esta doença no grafo RarasNet — título, periódico e PMID direto da fonte, sem intermediação de IA.
- Childhood-Onset Giant Axonal Neuropathy: A Clinicopathological Case Report.
- The Kelch 3 motif on gigaxonin mediates the interaction with NUDCD3 and regulates vimentin filament morphology.
- Charcot-Marie-Tooth-like presentation in giant axonal neuropathy: clinical variability and prevalence in a large Japanese case series.
- Hair Changes in Giant Axonal Neuropathy.
- Disease mutation in gigaxonin-E3 ligase recapitulates giant axonal neuropathy in mice.
- O-GlcNAcylation: A molecular switch linking brain health to neurodegeneration.
- T2 Hyperintensities in Gracile Tracts of Cervical Spinal Cord in Giant Axonal Neuropathy (GAN).
Bases de dados e fontes oficiais
Identificadores e referências canônicas usadas para montar este verbete.
- ORPHA:643(Orphanet)
- OMIM OMIM:256850(OMIM)
- MONDO:0009749(MONDO)
- GARD:6500(GARD (NIH))
- Variantes catalogadas(ClinVar)
- Busca completa no PubMed(PubMed)
- Q3338682(Wikidata)
Dados compilados pelo RarasNet a partir de fontes abertas (Orphanet, OMIM, MONDO, PubMed/EuropePMC, ClinicalTrials.gov, DATASUS, PCDT/MS). Este conteúdo é informativo e não substitui avaliação médica.
Conteúdo mantido por Agente Raras · Médicos e pesquisadores podem colaborar
