Topaloğlu, A. KemalLomniczi, AlejandroKretzschmar, DorisDissen, Gregory A.Kotan, L. DamlaMcArdle, Craig A.Koç, A. FilizHamel, Ben C.Güçlü, MetinPapatya, Esra D.Eren, ErdalMengen, EdaGürbüz, FatihCook, MandyCastellano, Juan M.Kekil, M. BurcuMungan, Neslihan O.Yüksel, BilginOjeda, Sergio R.2024-08-152024-08-152014-10-010021-972Xhttps://doi.org/10.1210/jc.2014-1836https://europepmc.org/article/PMC/5393493https://hdl.handle.net/11452/44054https://academic.oup.com/jcem/article/99/10/E2067/2836237Context: Gordon Holmes syndrome (GHS) is characterized by cerebellar ataxia/atrophy and normosmic hypogonadotropic hypogonadism (nHH). The underlying pathophysiology of this combined neurodegeneration and nHH remains unknown.Objective: We aimed to provide insight into the disease mechanism in GHS.Methods: We studied a cohort of 6 multiplex families with GHS through autozygosity mapping and whole-exome sequencing.Results: We identified 6 patients from 3 independent families carrying loss-of-function mutations in PNPLA6, which encodes neuropathy target esterase (NTE), a lysophospholipase that maintains intracellular phospholipid homeostasis by converting lysophosphatidylcholine to glycerophosphocholine. Wild-type PNPLA6, but not PNPLA6 bearing these mutations, rescued a well-established Drosophila neurodegenerative phenotype caused by the absence of sws, the fly ortholog of mammalian PNPLA6. Inhibition of NTE activity in the L beta T2 gonadotrope cell line diminished LH response to GnRH by reducing GnRH-stimulated LH exocytosis, without affecting GnRH receptor signaling or LH beta synthesis.Conclusion: These results suggest that NTE-dependent alteration of phospholipid homeostasis in GHS causes both neurodegeneration and impaired LH release from pituitary gonadotropes, leading to nHH.eninfo:eu-repo/semantics/openAccessBoucher-neuhauser-syndromeGonadotropin-releasing-hormoneMotor-neuron diseaseHypogonadotropic hypogonadismCerebellar-ataxiaChorioretinal dystrophySpinocerebellar ataxiaProteinPhosphatidylcholineDrosophilaScience & technologyLife sciences & biomedicineEndocrinology & metabolismLoss-of-function mutations in PNPLA6 encoding neuropathy target esterase underlie pubertal failure and neurological deficits in gordon holmes syndromeArticle000343423300032E2067E2075991010.1210/jc.2014-18361945-7197