Project Summary
Amyotrophic lateral sclerosis (ALS) is a neuromuscular disease characterized by motor neuron death and severe
muscle wasting; failure of the respiratory muscle is a common cause of mortality in ALS patients. While ALS is
generally considered as a “dying-forward” process of motor neurons, studies from us and other research groups
support that muscle appears to be a primary target of ALS, in addition to being a victim of axonal withdrawal.
This project builds on the scientific premise that ALS is a disease of systemic oxidative stress that impacts the
cellular processof muscle membrane repair and quality control, and consequently integrity of the neuromuscular
junction (NMJ) that provides the structural and functional framework for bidirectional crosstalk between motor
neuron and muscle fibers. We discovered that the ALS mouse (SOD1G93A) diaphragm muscle displays increased
membrane damage that occurs prior to the onset of ALS symptoms. We identified localized membrane repair
defects near the NMJ of ALS muscle, where segmented mitochondria dysfunction precedes the onset of ALS
disease. At the molecular level, we provide evidence that mitochondria-oxidative stress can affect the elemental
process of cell membrane repair that is governed by MG53, a member of the tripartite family protein that serves
essential roles in nucleating the assembly of repair patches at membrane injury sites. We also found that
compromised muscle repair and MG53 aggregation is a common pathology in human ALS. The recombinant
human MG53 (rhMG53) protein, when administered systemically, facilitated the repair of sarcolemma injury and
reduced oxidative stress, consequently improving NMJ innervation and prolonging the lifespan of the ALS mice.
In addition to facilitating membrane repair, MG53 also participates in autophagy signaling via its intrinsic E3-
ligase activity to contribute to cellular quality control, which could feedback to preserve membrane integrity under
stress condition. These findings support the multifaceted role of MG53 in alleviating neuromuscular function
decline in ALS. The long-term goals of our team-based research are to understand (1) how muscle mitochondrial
dysfunction and oxidative stress contribute to sarcolemma fragility in ALS, (2) how these pathological changes
impact MG53’s normal tissue repair function, (3) how the disruption of MG53’s normal function feeds back to
worsen tissue repair and oxidative stress, leading to a vicious cycle of NMJ degeneration, (4) the impact of MG53
signaling on autophagy pathway affecting the cellular quality control machinery in ALS, and (5) the therapeutic
potential and risk-benefits of exogenously administrated rhMG53 protein as a novel ALS therapy.