Impaired brainstem responses to homeostatic challenges during sleep may result in the sudden infant death syndrome (SIDS). Previously we reported a deficiency of serotonin (5-HT) and its key biosynthetic enzyme, tryptophan hydroxylase (TPH2), in SIDS infants in the medullary 5-HT system that modulates homeostatic responses during sleep. Yet, the underlying basis of the TPH2 and 5-HT deficiency is unknown. In this study, we tested the hypothesis that proteomics would uncover previously unrecognized abnormal levels of proteins related to TPH2 and 5-HT regulation in SIDS cases compared with controls, which could provide novel insight into the basis of their deficiency. We first performed a discovery proteomic analysis of the gigantocellularis of the medullary 5-HT system in the same data set with deficiencies of TPH2 and 5-HT levels. Analysis in 6 SIDS cases and 4 controls revealed a 42-75% reduction in abundance in 5 of the 6 isoforms identified of the 14-3-3 signal transduction family, which is known to influence TPH2 activity (p < 0.07). These findings were corroborated in an additional SIDS and control sample using an orthogonal MS E -based quantitative proteomic strategy. To confirm these proteomics results in a larger data set (38 SIDS, 11 controls), we applied Western blot analysis in the gigantocellularis and found that 4/7 14-3-3 isoforms identified were significantly reduced in SIDS cases (p < 0.02), with a 43% reduction in all 14-3-3 isoforms combined (p < 0.001). Abnormalities in 5-HT and TPH2 levels and 5-HT 1A receptor binding were associated with the 14-3-3 deficits in the same SIDS cases. These data suggest a potential molecular defect in SIDS related to TPH2 regulation, as 14-3-3 is critical in this process. Molecular & Cellular Proteomics 11: 10.1074/mcp.M111.009530, 1-17, 2012.
The sudden infant death syndrome (SIDS)1 is the sudden unexpected death of an infant less than 1 year of age, with onset of the fatal episode apparently occurring during sleep, that remains unexplained after a thorough investigation, including performance of a complete autopsy and review of the circumstances of death and clinical history (1). It is the leading cause of postneonatal infant mortality in the United States today; with an overall incidence of 0.53/1000 live birth(s) (2). Typically, a seemingly healthy infant is found dead after a sleep period, either in the early morning or after a day-time nap (1,3,4). Impaired brainstem responses to homeostatic challenges during sleep may result in the sleep-related sudden death characteristic of SIDS (4). We have reported various abnormalities in serotonergic (5-HT) receptors, 5-HT transporter, and 5-HT cellular maturation in the medullary 5-HT system in SIDS cases in three independent data sets over the last decade (5-7). This system within the medulla oblongata is a neural network comprised of 5-HT source neurons and their projection sites that help mediate homeostatic responses during the sleep-wake cycle (3). The medullary 5-HT system is defined by us as the regions of t...