Diseases of connexins expressed in myelinating glia.

Connexins are a family of integral membrane proteins most of which form gap junctions and many of which form hemichannels as well. Mutations in at least 9 of the 21 genes encoding human connexin proteins cause human diseases. Mutations in GJB1 (Cx32), expressed in both Schwann cells and oligodendrocytes, cause both a form of inherited peripheral neuropathy and a variety of CNS symptoms. Mutations in GJC2 (Cx47), expressed in oligodendrocytes cause three disorders: a severe early onset dysmyelinating disorder, Pelizaeus-Merzbacher-Like disease (PMLD1 or HLD2); hereditary spastic paraplegia (SPG44), which has a milder phenotype and later onset; and a subclinical leukodystrophy. The clinical phenotypes and genetics associated with each disorder will be reviewed, focusing on features which may provide clues to pathogenesis. In vitro and animal model data which may shed light on these phenotypes will then be discussed along with recent work which may impact on therapeutic approaches for these disorders.