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Impaired Nt-acetylation and the Golgi, a new disease mechanism leading to autosomal recessive primary familial brain calcifications

V. Chelban, H. Aksnes, L. Lamonica, R. Maroofian, L. Seabra, P. Devic, J. Vandrovcova, D. Murphy, A. Pagnamenta, N. Wood, R. Horvath, A. Ernst, J. Rothman, M. Mcentagart, Y. Crow, G. Nicolas, T. Arnesen, H. Houlden (London, United Kingdom)

Meeting: 2023 International Congress

Abstract Number: 1137

Keywords: Basal ganglia, Familial neurodegenerative diseases, Parkinsonism

Category: Rare Genetic and Metabolic Diseases

Objective: To identify new disease-gene in unsolved autosomal recessive primary familial brain calcifications.

Background: Primary familial brain calcification (PFBC) is characterized by calcium deposition in the brain, causing progressive movement disorders, psychiatric symptoms, and cognitive decline. PFBC is a heterogeneous disorder currently linked to variants in six different genes, but most patients remain genetically undiagnosed.

Method: We performed genome-wide sequencing, homozygosity mapping, segregation analysis and in-depth clinical and neuroimaging phenotyping for novel disease-causing gene discovery. We used immunofluorescence and fluorescence microscopy to assess subcellular distribution and characterization of disease variants as well as an in vitro carbon [14-C]-Nt-acetylation assay on immunoprecipitated variants to investigate their enzymatic activity. We used a zebra fish to model the disease and assess the phenotype. Pathogenicity was further confirmed by surface biotinylation assays and extracellular free phosphate quantification on patient-derived fibroblasts.

Results: Here, we identify biallelic NAA60 variants in seven individuals from four families with autosomal recessive PFBC. The NAA60 variants lead to loss-of-function with lack of protein N-terminal (Nt)-acetylation activity. We show that the phosphate importer SLC20A2 is a substrate of NAA60 in vitro. In cells, loss of NAA60 caused reduced surface levels of SLC20A2 and a reduction in extracellular phosphate uptake. A zebrafish disease model of NAA60 deficiency displayed a motor deficit with altered phosphate homeostasis.

Conclusion: This study establishes NAA60 as a causal gene for PFBC, provides a biochemical explanation of its disease-causing mechanisms and underscores NAA60-mediated Nt-acetylation of transmembrane proteins as a fundamental process for healthy neurobiological functioning.

To cite this abstract in AMA style:

V. Chelban, H. Aksnes, L. Lamonica, R. Maroofian, L. Seabra, P. Devic, J. Vandrovcova, D. Murphy, A. Pagnamenta, N. Wood, R. Horvath, A. Ernst, J. Rothman, M. Mcentagart, Y. Crow, G. Nicolas, T. Arnesen, H. Houlden. Impaired Nt-acetylation and the Golgi, a new disease mechanism leading to autosomal recessive primary familial brain calcifications [abstract]. Mov Disord. 2023; 38 (suppl 1). https://www.mdsabstracts.org/abstract/impaired-nt-acetylation-and-the-golgi-a-new-disease-mechanism-leading-to-autosomal-recessive-primary-familial-brain-calcifications/. Accessed November 5, 2026.
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