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Amado NG, Nosyreva ED, Thompson D, Egeland TJ, Ogujiofor OW, Yang M, Fusco AN, Passoni N, Mathews J, Cantarel B, Baker LA, Syeda R. PIEZO1 loss-of-function compound heterozygous mutations in the rare congenital human disorder Prune Belly Syndrome. Nat Commun 2024; 15:339. [PMID: 38184690 PMCID: PMC10771463 DOI: 10.1038/s41467-023-44594-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2023] [Accepted: 12/21/2023] [Indexed: 01/08/2024] Open
Abstract
Prune belly syndrome (PBS), also known as Eagle-Barret syndrome, is a rare, multi-system congenital myopathy primarily affecting males. Phenotypically, PBS cases manifest three cardinal pathological features: urinary tract dilation with poorly contractile smooth muscle, wrinkled flaccid ventral abdominal wall with skeletal muscle deficiency, and intra-abdominal undescended testes. Genetically, PBS is poorly understood. After performing whole exome sequencing in PBS patients, we identify one compound heterozygous variant in the PIEZO1 gene. PIEZO1 is a cation-selective channel activated by various mechanical forces and widely expressed throughout the lower urinary tract. Here we conduct an extensive functional analysis of the PIEZO1 PBS variants that reveal loss-of-function characteristics in the pressure-induced normalized open probability (NPo) of the channel, while no change is observed in single-channel currents. Furthermore, Yoda1, a PIEZO1 activator, can rescue the NPo defect of the PBS mutant channels. Thus, PIEZO1 mutations may be causal for PBS and the in vitro cellular pathophysiological phenotype could be rescued by the small molecule, Yoda1. Activation of PIEZO1 might provide a promising means of treating PBS and other related bladder dysfunctional states.
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Affiliation(s)
- Nathalia G Amado
- Department of Urology, University of Texas Southwestern Medical Center, Dallas, TX, USA
- The Kidney and Urinary Tract Center, The Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, OH, USA
| | - Elena D Nosyreva
- Department of Neuroscience, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - David Thompson
- Department of Neuroscience, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Thomas J Egeland
- Department of Urology, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Osita W Ogujiofor
- Department of Neuroscience, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Michelle Yang
- Department of Urology, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Alexandria N Fusco
- Department of Urology, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Niccolo Passoni
- Department of Urology, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Jeremy Mathews
- Department of Bioinformatics, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Brandi Cantarel
- Department of Bioinformatics, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Linda A Baker
- Department of Urology, University of Texas Southwestern Medical Center, Dallas, TX, USA.
- The Kidney and Urinary Tract Center, The Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, OH, USA.
| | - Ruhma Syeda
- Department of Neuroscience, University of Texas Southwestern Medical Center, Dallas, TX, USA.
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Lopes RI, Baker LA, Dénes FT. Modern management of and update on prune belly syndrome. J Pediatr Urol 2021; 17:548-554. [PMID: 34016542 PMCID: PMC8502198 DOI: 10.1016/j.jpurol.2021.04.010] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Revised: 04/15/2021] [Accepted: 04/15/2021] [Indexed: 01/22/2023]
Abstract
Prune belly syndrome (PBS) is characterized by the triad of abdominal flaccidity, a variable degree of urinary tract involvement and cryptorchidism. Most cases of PBS are sporadic and have a normal karyotype, with 95% patients being male. In the last decade, mutations in known genes that regulate embryonic genitourinary myogenesis have been identified and with increasing knowledge of these critical genes involved in bladder maldevelopment, advances can be made in genetic counseling. A multidisciplinary approach is necessary and individualization of care is recommended according to phenotypic severity. Some patients require abdominal and urinary tract reconstruction while others require as little as bilateral orchiopexies. Major treatment objectives are: preservation of renal function and upper urinary tract; polyuria management; adequate bladder emptying; improvement of corporal image and quality of life; preservation of fertility and adequate sexual function. Long-term surveillance of the urinary tract is essential up to adulthood, because functional dynamics can change over time.
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Affiliation(s)
- Roberto I Lopes
- Pediatric Urology Unit, Division of Urology, Hospital Das Clínicas, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Linda A Baker
- University of Texas Southwestern Medical Center at Dallas Children's Health, Dallas, USA
| | - Francisco T Dénes
- Pediatric Urology Unit, Division of Urology, Hospital Das Clínicas, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil.
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Iqbal NS, Jascur TA, Harrison SM, Edwards AB, Smith LT, Choi ES, Arevalo MK, Chen C, Zhang S, Kern AJ, Scheuerle AE, Sanchez EJ, Xing C, Baker LA. Prune belly syndrome in surviving males can be caused by Hemizygous missense mutations in the X-linked Filamin A gene. BMC MEDICAL GENETICS 2020; 21:38. [PMID: 32085749 PMCID: PMC7035669 DOI: 10.1186/s12881-020-0973-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/27/2019] [Accepted: 02/12/2020] [Indexed: 12/12/2022]
Abstract
Background Prune belly syndrome (PBS) is a rare, multi-system congenital myopathy primarily affecting males that is poorly described genetically. Phenotypically, its morbidity spans from mild to lethal, however, all isolated PBS cases manifest three cardinal pathological features: 1) wrinkled flaccid ventral abdominal wall with skeletal muscle deficiency, 2) urinary tract dilation with poorly contractile smooth muscle, and 3) intra-abdominal undescended testes. Despite evidence for a genetic basis, previously reported PBS autosomal candidate genes only account for one consanguineous family and single cases. Methods We performed whole exome sequencing (WES) of two maternal adult half-brothers with syndromic PBS (PBS + Otopalatodigital spectrum disorder [OPDSD]) and two unrelated sporadic individuals with isolated PBS and further functionally validated the identified mutations. Results We identified three unreported hemizygous missense point mutations in the X-chromosome gene Filamin A (FLNA) (c.4952 C > T (p.A1448V), c.6727C > T (p.C2160R), c.5966 G > A (p.G2236E)) in two related cases and two unrelated sporadic individuals. Two of the three PBS mutations map to the highly regulatory, stretch-sensing Ig19–21 region of FLNA and enhance binding to intracellular tails of the transmembrane receptor β-integrin 1 (ITGβ1). Conclusions FLNA is a regulatory actin-crosslinking protein that functions in smooth muscle cells as a mechanosensing molecular scaffold, transmitting force signals from the actin-myosin motor units and cytoskeleton via binding partners to the extracellular matrix. This is the first evidence for an X-linked cause of PBS in multiple unrelated individuals and expands the phenotypic spectrum associated with FLNA in males surviving even into adulthood.
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Affiliation(s)
- Nida S Iqbal
- Department of Urology, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX, 75390, USA.
| | - Thomas A Jascur
- Department of Urology, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX, 75390, USA
| | - Steven M Harrison
- Department of Urology, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX, 75390, USA.,Broad Institute of MIT and Harvard, Cambridge, MA, USA
| | - Angelena B Edwards
- Department of Urology, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX, 75390, USA
| | - Luke T Smith
- Department of Urology, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX, 75390, USA
| | - Erin S Choi
- Department of Urology, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX, 75390, USA
| | - Michelle K Arevalo
- Department of Urology, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX, 75390, USA
| | - Catherine Chen
- Department of Urology, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX, 75390, USA
| | - Shaohua Zhang
- Department of Urology, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX, 75390, USA
| | - Adam J Kern
- Department of Urology, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX, 75390, USA
| | - Angela E Scheuerle
- Department of Pediatrics, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX, 75390, USA.,McDermott Center for Human Growth and Development, Department of Bioinformatics, Department of Clinical Sciences, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX, 75390, USA
| | - Emma J Sanchez
- Department of Urology, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX, 75390, USA.,Children's Health Dallas, 2350 N. Stemmons Freeway, Suite F4300, Dallas, TX, 75207, USA
| | - Chao Xing
- McDermott Center for Human Growth and Development, Department of Bioinformatics, Department of Clinical Sciences, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX, 75390, USA
| | - Linda A Baker
- Department of Urology, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX, 75390, USA. .,Children's Health Dallas, 2350 N. Stemmons Freeway, Suite F4300, Dallas, TX, 75207, USA.
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