Altered ceramide metabolism is a feature in the extracellular vesicle-mediated spread of alpha-synuclein in Lewy body disorders

Marzena Kurzawa-Akanbi*, Seshu Tammireddy, Ivo Fabrik, Lina Gliaudelytė, Mary K. Doherty, Rachel Heap, Irena Matečko-Burmann, Björn M. Burmann, Matthias Trost, John M. Lucocq, Anda V. Gherman, Graham Fairfoul, Preeti Singh, Florence Burté, Alison Green, Ian G. McKeith, Anetta Härtlova, Phillip D. Whitfield, Christopher M. Morris

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

31 Citations (Scopus)
1 Downloads (Pure)


Mutations in glucocerebrosidase (GBA) are the most prevalent genetic risk factor for Lewy body disorders (LBD)—collectively Parkinson’s disease, Parkinson’s disease dementia and dementia with Lewy bodies. Despite this genetic association, it remains unclear how GBA mutations increase susceptibility to develop LBD. We investigated relationships between LBD-specific glucocerebrosidase deficits, GBA-related pathways, and α-synuclein levels in brain tissue from LBD and controls, with and without GBA mutations. We show that LBD is characterised by altered sphingolipid metabolism with prominent elevation of ceramide species, regardless of GBA mutations. Since extracellular vesicles (EV) could be involved in LBD pathogenesis by spreading disease-linked lipids and proteins, we investigated EV derived from post-mortem cerebrospinal fluid (CSF) and brain tissue from GBA mutation carriers and non-carriers. EV purified from LBD CSF and frontal cortex were heavily loaded with ceramides and neurodegeneration-linked proteins including alpha-synuclein and tau. Our in vitro studies demonstrate that LBD EV constitute a “pathological package” capable of inducing aggregation of wild-type alpha-synuclein, mediated through a combination of alpha-synuclein–ceramide interaction and the presence of pathological forms of alpha-synuclein. Together, our findings indicate that abnormalities in ceramide metabolism are a feature of LBD, constituting a promising source of biomarkers, and that GBA mutations likely accelerate the pathological process occurring in sporadic LBD through endolysosomal deficiency.
Original languageEnglish
Number of pages24
JournalActa Neuropathologica
Publication statusPublished - 13 Sept 2021


  • Lewy body disorders
  • Glucocerebrosidase
  • Extracellular vesicles
  • Exosomes
  • Alpha-synuclein
  • Ceramide


Dive into the research topics of 'Altered ceramide metabolism is a feature in the extracellular vesicle-mediated spread of alpha-synuclein in Lewy body disorders'. Together they form a unique fingerprint.

Cite this