CDKL5

CDKL5
Available structures
PDB	Ortholog search: PDBe RCSB
List of PDB id codes
	4BGQ
Identifiers
Aliases	CDKL5, EIEE2, ISSX, STK9, CFAP247, cyclin dependent kinase like 5, DEE2
External IDs	OMIM: 300203; MGI: 1278336; HomoloGene: 55719; GeneCards: CDKL5; OMA:CDKL5 - orthologs
Gene location (Human)
Chr.	X chromosome (human)
End	18,653,629 bp
Gene location (Mouse)
Chr.	X chromosome (mouse)
End	159,777,700 bp
RNA expression pattern
	Top expressed in
	frontal pole; ; Brodmann area 23; ; lateral nuclear group of thalamus; ; middle temporal gyrus; ; endothelial cell; ; palpebral conjunctiva; ; primary visual cortex; ; superior frontal gyrus; ; entorhinal cortex; ; visceral pleura;
	Top expressed in
	medial dorsal nucleus; ; medial geniculate nucleus; ; primary motor cortex; ; lateral geniculate nucleus; ; lateral septal nucleus; ; cingulate gyrus; ; piriform cortex; ; Region I of hippocampus proper; ; prefrontal cortex; ; olfactory tubercle;
	More reference expression data
	n/a
Gene ontology
Molecular function	transferase activity; protein kinase activity; nucleotide binding; kinase activity; protein serine/threonine kinase activity; ATP binding; cyclin-dependent protein serine/threonine kinase activity;
Cellular component	dendritic growth cone; nucleoplasm; ruffle membrane; nucleus; cytosol; dendrite cytoplasm; synapse; perinuclear region of cytoplasm; centrosome; ciliary basal body; ciliary tip; cytoplasm; microtubule organizing center; cytoskeleton; cell projection; glutamatergic synapse; postsynaptic density, intracellular component;
Biological process	phosphorylation; neuron migration; protein phosphorylation; positive regulation of GTPase activity; positive regulation of dendrite morphogenesis; protein autophosphorylation; positive regulation of axon extension; regulation of dendrite development; positive regulation of dendritic spine development; regulation of cilium assembly; regulation of cell cycle; regulation of postsynapse organization;
	Sources:Amigo / QuickGO
Orthologs
	6792
	382253
	ENSG00000008086
	ENSMUSG00000031292
	O76039
	Q3UTQ8
	NM_001037343; NM_003159; NM_001323289
	NM_001024624
	NP_001032420; NP_001310218; NP_003150
	NP_001019795
	Wikidata
View/Edit Human	View/Edit Mouse

CDKL5 is a gene that provides instructions for making a protein called cyclin-dependent kinase-like 5 also known as serine/threonine kinase 9 (STK9) that is essential for normal brain development. Mutations in the gene can cause deficiencies in the protein. The gene regulates neuronal morphology through cytoplasmic signaling and controlling gene expression.^[5] The CDKL5 protein acts as a kinase, which is an enzyme that changes the activity of other proteins by adding a cluster of oxygen and phosphorus atoms (a phosphate group) at specific positions. Researchers are currently working to determine which proteins are targeted by the CDKL5 protein.^[6]

The CDKL5 protein acts as a kinase, which is an enzyme that modulates the activity of other proteins by adding a phosphate group to specific positions. The CDKL5 protein regulates neuronal morphology through cytoplasmic signaling and by controlling gene expression, playing a crucial role in the development and maintenance of the nervous system.

Studies have shown that the CDKL5 protein interacts with various signaling pathways and plays a role in controlling neurotransmitter release, synaptic plasticity, and cell survival. The CDKL5 protein has also been shown to regulate the activity of genes involved in neuronal development and the formation of synaptic connections.

Researchers are actively working to better understand the role of the CDKL5 protein in brain development and the underlying mechanisms of CDKL5 disorders. Further studies are needed to determine which proteins are targeted by the CDKL5 protein, as well as to develop effective treatments for individuals affected by CDKL5 disorders.

Mutations

Mutations in the CDKL5 gene cause CDKL5 deficiency disorder.^[7] CDKL5 deficiency disorder had, earlier, been thought of as a variant of Rett syndrome, due to some similarities in the clinical presentation.^[8] CDKL5 deficiency syndrome is now known to be an independent clinical entity caused by mutations in a distinct X-linked gene, and is considered separate from Rett Syndrome, rather than a variant of it.^[9] While CDKL5 is primarily found in girls, it has been seen in boys as well.^[10] This disorder includes many of the features of classic Rett syndrome, including developmental problems, loss of language skills, and repeated hand-wringing or "hand-washing" movements), but also causes recurrent seizures, beginning in infancy. Some CDKL5 mutations alter a single amino acid in a region of the CDKL5 protein that is critical for its kinase function. Other mutations lead to the production of an abnormally short, nonfunctioning version of the protein. At least 50 disease-causing mutations in this gene have been discovered.^[11]

Further confirmation that CDKL5 is an independent disorder with its own characteristics is provided by a 2016 study which concluded that the clinical presentations of the two disorders were not identical.^[12] At one time, mutations in the CDKL5 gene were thought to cause a disorder called X-linked infantile spasm syndrome (ISSX),^[13]^[14] or West syndrome.^[15]^[16] Studies have established CDKL5 disorder as a distinct clinical entity.

Animal studies

GSK3β inhibitors in CDKL5 knockout (CDKL5 -/Y) mice permit normal hippocampal development and learning.^[17]

IGF-1 treatment in CDKL5 knockout mice restores synaptic function.^{[further explanation needed]}^[18]

Therapeutics

Anticonvulsants were the mainstay of treatment for most affected people. These have limited efficacy, pointing to a strong need to develop new treatment strategies for patients.^[19] Some treatments might show efficacy in a relevant proportion of patients, such as valproic acid, vigabatrin, clobazam or sodium channel blockers, as well as a ketogenic diet^[20]^[21]

Ganaxolone (brand name Ztalmy) was approved for medical use in the United States in March 2022^[22]^[23] and considered by the US Food and Drug Administration (FDA) to be a first-in-class medication.^[24] Ganaxolone, a neuroactive steroid gamma-aminobutyric acid (GABA) A receptor positive modulator, treats seizures in those with CDKL5 deficiency disorder.^[22]

A CDKL5 protein replacement therapy is in development.^[25]

Location

The CDKL5 gene is located on the short (p) arm of the X chromosome at position 22.^[26] More precisely, the CDKL5 gene is located from base pair 18,443,724 to base pair 18,671,748 on the X chromosome.^[6]

ICD-10

G40.42

References

^ ^a ^b ^c GRCh38: Ensembl release 89: ENSG00000008086 – Ensembl, May 2017
^ ^a ^b ^c GRCm38: Ensembl release 89: ENSMUSG00000031292 – Ensembl, May 2017
^ "Human PubMed Reference:". National Center for Biotechnology Information, U.S. National Library of Medicine.
^ "Mouse PubMed Reference:". National Center for Biotechnology Information, U.S. National Library of Medicine.
^ Kilstrup-Nielsen C, Rusconi L, La Montanara P, Ciceri D, Bergo A, Bedogni F, Landsberger N (2012). "What we know and would like to know about CDKL5 and its involvement in epileptic encephalopathy". (secondary). Neural Plasticity. 2012: 1–11. doi:10.1155/2012/728267. PMC 3385648. PMID 22779007.
^ ^a ^b CDKL5 on Genetics Home Reference
^ "CDKL5 deficiency disorder". Medlineplus. Retrieved 30 June 2021.
^ Weaving LS, Ellaway CJ, Gécz J, Christodoulou J (January 2005). "Rett syndrome: clinical review and genetic update". (secondary). Journal of Medical Genetics. 42 (1): 1–7. doi:10.1136/jmg.2004.027730. PMC 1735910. PMID 15635068.
^ Fehr S, Wilson M, Downs J, Williams S, Murgia A, Sartori S, Vecchi M, Ho G, Polli R, Psoni S, Bao X, de Klerk N, Leonard H, Christodoulou J (March 2013). "The CDKL5 disorder is an independent clinical entity associated with early-onset encephalopathy". (primary). European Journal of Human Genetics. 21 (3): 266–73. doi:10.1038/ejhg.2012.156. PMC 3573195. PMID 22872100.
^ Wong VC, Kwong AK (April 2015). "CDKL5 variant in a boy with infantile epileptic encephalopathy: case report". Brain & Development. 37 (4): 446–8. doi:10.1016/j.braindev.2014.07.003. PMID 25085838. S2CID 29966110.
^ Šimčíková D, Heneberg P (December 2019). "Refinement of evolutionary medicine predictions based on clinical evidence for the manifestations of Mendelian diseases". Scientific Reports. 9 (1): 18577. Bibcode:2019NatSR...918577S. doi:10.1038/s41598-019-54976-4. PMC 6901466. PMID 31819097.
^ Mangatt M, Wong K, Anderson B, Epstein A, Hodgetts S, Leonard H, Downs J (2016-01-01). "Prevalence and onset of comorbidities in the CDKL5 disorder differ from Rett syndrome". Orphanet Journal of Rare Diseases. 11: 39. doi:10.1186/s13023-016-0418-y. PMC 4832563. PMID 27080038.
^ "Infantile spasm syndrome, X-linked". Archived from the original on 2011-02-27. Retrieved 2010-06-05.
^ Kalscheuer VM, Tao J, Donnelly A, Hollway G, Schwinger E, Kübart S, Menzel C, Hoeltzenbein M, Tommerup N, Eyre H, Harbord M, Haan E, Sutherland GR, Ropers HH, Gécz J (June 2003). "Disruption of the serine/threonine kinase 9 gene causes severe X-linked infantile spasms and mental retardation". (primary). American Journal of Human Genetics. 72 (6): 1401–11. doi:10.1086/375538. PMC 1180301. PMID 12736870.
^ "West Syndrome". Archived from the original on 2010-06-10. Retrieved 2010-06-05.
^ Kato M (August 2006). "A new paradigm for West syndrome based on molecular and cell biology". (secondary). Epilepsy Research. 70 (Suppl 1): S87–95. doi:10.1016/j.eplepsyres.2006.02.008. PMID 16806828. S2CID 9806578.
^ Fuchs C, Rimondini R, Viggiano R, Trazzi S, De Franceschi M, Bartesaghi R, Ciani E (2015). "Inhibition of GSK3β rescues hippocampal development and learning in a mouse model of CDKL5 disorder". Neurobiology of Disease. 82: 298–310. doi:10.1016/j.nbd.2015.06.018. PMID 26143616. S2CID 207069267.
^ Della Sala G, Putignano E, Chelini G, Melani R, Calcagno E, Michele Ratto G, Amendola E, Gross CT, Giustetto M, Pizzorusso T (2015). "Dendritic Spine Instability in a Mouse Model of CDKL5 Disorder Is Rescued by Insulin-like Growth Factor 1" (PDF). Biological Psychiatry. 80 (4): 302–311. doi:10.1016/j.biopsych.2015.08.028. hdl:2158/1012551. PMID 26452614. S2CID 206105378.
^ Müller A, Helbig I, Jansen C, Bast T, Guerrini R, Jähn J, et al. (January 2016). "Retrospective evaluation of low long-term efficacy of antiepileptic drugs and ketogenic diet in 39 patients with CDKL5-related epilepsy". European Journal of Paediatric Neurology. 20 (1): 147–51. doi:10.1016/j.ejpn.2015.09.001. hdl:10067/1315500151162165141. PMID 26387070.
^ Olson, Heather E.; Daniels, Carolyn I.; Haviland, Isabel; Swanson, Lindsay C.; Greene, Caitlin A.; Denny, Anne Marie M.; Demarest, Scott T.; Pestana-Knight, Elia; Zhang, Xiaoming; Moosa, Ahsan N.; Fidell, Andrea (December 2021). "Current neurologic treatment and emerging therapies in CDKL5 deficiency disorder". Journal of Neurodevelopmental Disorders. 13 (1): 40. doi:10.1186/s11689-021-09384-z. ISSN 1866-1947. PMC 8447578. PMID 34530725.
^ Aledo-Serrano, Ángel; Gómez-Iglesias, Patricia; Toledano, Rafael; Garcia-Peñas, Juan Jose; Garcia-Morales, Irene; Anciones, Carla; Soto-Insuga, Victor; Benke, Timothy A.; del Pino, Isabel; Gil-Nagel, Antonio (May 2021). "Sodium channel blockers for the treatment of epilepsy in CDKL5 deficiency disorder: Findings from a multicenter cohort". Epilepsy & Behavior. 118: 107946. doi:10.1016/j.yebeh.2021.107946. PMID 33848848. S2CID 233202425.
^ ^a ^b "DailyMed - ZTALMY- ganaxolone suspension". dailymed.nlm.nih.gov. Retrieved 2024-09-12.
^ Research, Center for Drug Evaluation and (2023-10-02). "Drug Trials Snapshots: ZTALMY". FDA.
^ Research, Center for Drug Evaluation and (2023-01-10). "New Drug Therapy Approvals 2022". FDA.
^ "Preclinical Program for Cyclin-Dependent Kinase-Like 5 (CDKL5) Deficiency". Amicus Therapeutics Press Release (Press release). 6 July 2016.
^ Montini E, Andolfi G, Caruso A, Buchner G, Walpole SM, Mariani M, Consalez G, Trump D, Ballabio A, Franco B (August 1998). "Identification and characterization of a novel serine-threonine kinase gene from the Xp22 region". (primary). Genomics. 51 (3): 427–33. doi:10.1006/geno.1998.5391. PMID 9721213.

External links

Human CDKL5 genome location and CDKL5 gene details page in the UCSC Genome Browser.
CDKL5+protein,+human at the U.S. National Library of Medicine Medical Subject Headings (MeSH)
Cure CDKL5 Disorder Archived 2016-07-13 at the Wayback Machine resources for Families and Professionals - based in the UK
International Foundation for CDKL5 Research - based in the US
CDKL5 Forum - a professional forum to share current research on CDKL5 and to stimulate peer-group discussion
CDKL5 Foundation Netherlands - CDKL5 Foundation based in holland for research, information and collaboration

[refGRCh38Ensembl-1] GRCh38: Ensembl release 89: ENSG00000008086 – Ensembl, May 2017

[refGRCm38Ensembl-2] GRCm38: Ensembl release 89: ENSMUSG00000031292 – Ensembl, May 2017

[3] "Human PubMed Reference:". National Center for Biotechnology Information, U.S. National Library of Medicine.

[4] "Mouse PubMed Reference:". National Center for Biotechnology Information, U.S. National Library of Medicine.

[pmid22779007-5] Kilstrup-Nielsen C, Rusconi L, La Montanara P, Ciceri D, Bergo A, Bedogni F, Landsberger N (2012). "What we know and would like to know about CDKL5 and its involvement in epileptic encephalopathy". (secondary). Neural Plasticity. 2012: 1–11. doi:10.1155/2012/728267. PMC 3385648. PMID 22779007.

[CDKL5-6] CDKL5 on Genetics Home Reference

[7] "CDKL5 deficiency disorder". Medlineplus. Retrieved 30 June 2021.

[pmid15635068-8] Weaving LS, Ellaway CJ, Gécz J, Christodoulou J (January 2005). "Rett syndrome: clinical review and genetic update". (secondary). Journal of Medical Genetics. 42 (1): 1–7. doi:10.1136/jmg.2004.027730. PMC 1735910. PMID 15635068.

[9] Fehr S, Wilson M, Downs J, Williams S, Murgia A, Sartori S, Vecchi M, Ho G, Polli R, Psoni S, Bao X, de Klerk N, Leonard H, Christodoulou J (March 2013). "The CDKL5 disorder is an independent clinical entity associated with early-onset encephalopathy". (primary). European Journal of Human Genetics. 21 (3): 266–73. doi:10.1038/ejhg.2012.156. PMC 3573195. PMID 22872100.

[10] Wong VC, Kwong AK (April 2015). "CDKL5 variant in a boy with infantile epileptic encephalopathy: case report". Brain & Development. 37 (4): 446–8. doi:10.1016/j.braindev.2014.07.003. PMID 25085838. S2CID 29966110.

[Šimčíková_2019_-_supplementary_table_S7-11] Šimčíková D, Heneberg P (December 2019). "Refinement of evolutionary medicine predictions based on clinical evidence for the manifestations of Mendelian diseases". Scientific Reports. 9 (1): 18577. Bibcode:2019NatSR...918577S. doi:10.1038/s41598-019-54976-4. PMC 6901466. PMID 31819097.

[12] Mangatt M, Wong K, Anderson B, Epstein A, Hodgetts S, Leonard H, Downs J (2016-01-01). "Prevalence and onset of comorbidities in the CDKL5 disorder differ from Rett syndrome". Orphanet Journal of Rare Diseases. 11: 39. doi:10.1186/s13023-016-0418-y. PMC 4832563. PMID 27080038.

[13] "Infantile spasm syndrome, X-linked". Archived from the original on 2011-02-27. Retrieved 2010-06-05.

[pmid12736870-14] Kalscheuer VM, Tao J, Donnelly A, Hollway G, Schwinger E, Kübart S, Menzel C, Hoeltzenbein M, Tommerup N, Eyre H, Harbord M, Haan E, Sutherland GR, Ropers HH, Gécz J (June 2003). "Disruption of the serine/threonine kinase 9 gene causes severe X-linked infantile spasms and mental retardation". (primary). American Journal of Human Genetics. 72 (6): 1401–11. doi:10.1086/375538. PMC 1180301. PMID 12736870.

[15] "West Syndrome". Archived from the original on 2010-06-10. Retrieved 2010-06-05.

[pmid16806828-16] Kato M (August 2006). "A new paradigm for West syndrome based on molecular and cell biology". (secondary). Epilepsy Research. 70 (Suppl 1): S87–95. doi:10.1016/j.eplepsyres.2006.02.008. PMID 16806828. S2CID 9806578.

[pmid26143616-17] Fuchs C, Rimondini R, Viggiano R, Trazzi S, De Franceschi M, Bartesaghi R, Ciani E (2015). "Inhibition of GSK3β rescues hippocampal development and learning in a mouse model of CDKL5 disorder". Neurobiology of Disease. 82: 298–310. doi:10.1016/j.nbd.2015.06.018. PMID 26143616. S2CID 207069267.

[pmid26452614-18] Della Sala G, Putignano E, Chelini G, Melani R, Calcagno E, Michele Ratto G, Amendola E, Gross CT, Giustetto M, Pizzorusso T (2015). "Dendritic Spine Instability in a Mouse Model of CDKL5 Disorder Is Rescued by Insulin-like Growth Factor 1" (PDF). Biological Psychiatry. 80 (4): 302–311. doi:10.1016/j.biopsych.2015.08.028. hdl:2158/1012551. PMID 26452614. S2CID 206105378.

[19] Müller A, Helbig I, Jansen C, Bast T, Guerrini R, Jähn J, et al. (January 2016). "Retrospective evaluation of low long-term efficacy of antiepileptic drugs and ketogenic diet in 39 patients with CDKL5-related epilepsy". European Journal of Paediatric Neurology. 20 (1): 147–51. doi:10.1016/j.ejpn.2015.09.001. hdl:10067/1315500151162165141. PMID 26387070.

[20] Olson, Heather E.; Daniels, Carolyn I.; Haviland, Isabel; Swanson, Lindsay C.; Greene, Caitlin A.; Denny, Anne Marie M.; Demarest, Scott T.; Pestana-Knight, Elia; Zhang, Xiaoming; Moosa, Ahsan N.; Fidell, Andrea (December 2021). "Current neurologic treatment and emerging therapies in CDKL5 deficiency disorder". Journal of Neurodevelopmental Disorders. 13 (1): 40. doi:10.1186/s11689-021-09384-z. ISSN 1866-1947. PMC 8447578. PMID 34530725.

[21] Aledo-Serrano, Ángel; Gómez-Iglesias, Patricia; Toledano, Rafael; Garcia-Peñas, Juan Jose; Garcia-Morales, Irene; Anciones, Carla; Soto-Insuga, Victor; Benke, Timothy A.; del Pino, Isabel; Gil-Nagel, Antonio (May 2021). "Sodium channel blockers for the treatment of epilepsy in CDKL5 deficiency disorder: Findings from a multicenter cohort". Epilepsy & Behavior. 118: 107946. doi:10.1016/j.yebeh.2021.107946. PMID 33848848. S2CID 233202425.

[:0-22] "DailyMed - ZTALMY- ganaxolone suspension". dailymed.nlm.nih.gov. Retrieved 2024-09-12.

[23] Research, Center for Drug Evaluation and (2023-10-02). "Drug Trials Snapshots: ZTALMY". FDA.

[24] Research, Center for Drug Evaluation and (2023-01-10). "New Drug Therapy Approvals 2022". FDA.

[25] "Preclinical Program for Cyclin-Dependent Kinase-Like 5 (CDKL5) Deficiency". Amicus Therapeutics Press Release (Press release). 6 July 2016.

[pmid9721213-26] Montini E, Andolfi G, Caruso A, Buchner G, Walpole SM, Mariani M, Consalez G, Trump D, Ballabio A, Franco B (August 1998). "Identification and characterization of a novel serine-threonine kinase gene from the Xp22 region". (primary). Genomics. 51 (3): 427–33. doi:10.1006/geno.1998.5391. PMID 9721213.

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CDKL5

Mutations

Animal studies

Therapeutics

Location

ICD-10

See also

References

Further reading

External links

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