Bi-allelic <em>ACBD6</em> variants lead to a neurodevelopmental syndrome with progressive and complex movement disorders

\ua9 The Author(s) 2023. Published by Oxford University Press on behalf of the Guarantors of Brain. The acyl-CoA-binding domain-containing protein 6 (ACBD6) is ubiquitously expressed, plays a role in the acylation of lipids and proteins and regulates the N-myristoylation of proteins via N-myristoyltransferase enzymes (NMTs). However, its precise function in cells is still unclear, as is the consequence of ACBD6 defects on human pathophysiology. Using exome sequencing and extensive international data sharing efforts, we identified 45 affected individuals from 28 unrelated families (consanguinity 93%) with bi-allelic pathogenic, predominantly loss-of-function (18/20) variants in ACBD6. We generated zebrafish and Xenopus tropicalis acbd6 knockouts by CRISPR/Cas9 and characterized the role of ACBD6 on protein N-myristoylation with myristic acid alkyne (YnMyr) chemical proteomics in the model organisms and human cells, with the latter also being subjected further to ACBD6 peroxisomal localization studies. The affected individuals (23 males and 22 females), aged 1-50 years, typically present with a complex and progressive disease involving moderate-to-severe global developmental delay/intellectual disability (100%) with significant expressive language impairment (98%), movement disorders (97%), facial dysmorphism (95%) and mild cerebellar ataxia (85%) associated with gait impairment (94%), limb spasticity/hypertonia (76%), oculomotor (71%) and behavioural abnormalities (65%), overweight (59%), microcephaly (39%) and epilepsy (33%). The most conspicuous and common movement disorder was dystonia (94%), frequently leading to early-onset progressive postural deformities (97%), limb dystonia (55%) and cervical dystonia (31%). A jerky tremor in the upper limbs (63%), a mild head tremor (59%), parkinsonism/hypokinesia developing with advancing age (32%) and simple motor and vocal tics were among other frequent movement disorders. Midline brain malformations including corpus callosum abnormalities (70%), hypoplasia/agenesis of the anterior commissure (66%), short midbrain and small inferior cerebellar vermis (38% each) as well as hypertrophy of the clava (24%) were common neuroimaging findings. Acbd6-deficient zebrafish and Xenopus models effectively recapitulated many clinical phenotypes reported in patients including movement disorders, progressive neuromotor impairment, seizures, microcephaly, craniofacial dysmorphism and midbrain defects accompanied by developmental delay with increased mortality over time. Unlike ACBD5, ACBD6 did not show a peroxisomal localization and ACBD6-deficiency was not associated with altered peroxisomal parameters in patient fibroblasts. Significant differences in YnMyr-labelling were observed for 68 co- and 18 post-translationally N-myristoylated proteins in patient-derived fibroblasts. N-myristoylation was similarly affected in acbd6-deficient zebrafish and X. tropicalis models, including Fus, Marcks and Chchd-related proteins implicated in neurological diseases. The present study provides evidence that bi-allelic pathogenic variants in ACBD6 lead to a distinct neurodevelopmental syndrome accompanied by complex and progressive cognitive and movement disorders

Effects of different levels of dietary crude protein and threonine on performance, humoral immune responses and intestinal morphology of broiler chicks

The present study aimed at investigating the effects of different dietary crude protein (CP) and threonine (Thr) levels on the performance, immune responses and jejunal morphology of broiler chicks. A total of 432 broiler chicks were randomly assigned to a 3×3 factorial arrangement of treatments including three different CP dietary levels (90, 95, and 100% of Ross 308 recommendations) and Thr (100, 110, and 120% of Ross specifications) dietary levels. Performance parameters were recorded for the starter (1-12 days), grower (13-24 days) and finisher (25-42 days) periods. Birds were subjected to different antigen inoculations to evaluate antibody responses. At day 42 of age, two randomly-selected birds per replicate were slaughtered to measure carcass traits. Although Thr dietary supplementation had no marked effect on Newcastle antibody titers, particularly the supplementation of Thr up to 110% of Ross specifications improved (p<0.05) antibody titers against sheep red blood cells during both primary and secondary responses. Reduction of dietary CP level resulted in significant decrease in villus height (p<0.05) and crypt depth (p<0.01) in jejunal epithelial cells, but the supplementation of low-CP diets with Thr up to 110 and 120% of the recommended values allowed overcoming these changes. Except for the starter period, reducing dietary CP level to 90% of Ross recommendations had no harmful effects on performance parameters; however, the best values were obtained with diets containing 110% Thr. The present results indicate that it is possible to reduce dietary CP level up to 10% after the starter period without any detrimental impact on growth performance, and dietary Thr supplementation up to 110% of Ross values may compensate for low CP-induced growth delay in broiler chicks