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Gibson JT, Sadeghi-Alavijeh O, Gale DP, Rothe H, Savige J. Pathogenicity of missense variants affecting the collagen IV α5 carboxy non-collagenous domain in X-linked Alport syndrome. Sci Rep 2022; 12:11257. [PMID: 35789182 PMCID: PMC9253329 DOI: 10.1038/s41598-022-14928-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2022] [Accepted: 06/15/2022] [Indexed: 12/05/2022] Open
Abstract
X-linked Alport syndrome is a genetic kidney disease caused by pathogenic COL4A5 variants, but little is known of the consequences of missense variants affecting the NC1 domain of the corresponding collagen IV α5 chain. This study examined these variants in a normal (gnomAD) and other databases (LOVD, Clin Var and 100,000 Genomes Project) to determine their pathogenicity and clinical significance. Males with Cys substitutions in the collagen IV α5 NC1 domain reported in LOVD (n = 25) were examined for typical Alport features, including age at kidney failure. All NC1 variants in LOVD (n = 86) were then assessed for structural damage using an online computational tool, Missense3D. Variants in the ClinVar, gnomAD and 100,000 Genomes Project databases were also examined for structural effects. Predicted damage associated with NC1 substitutions was then correlated with the level of conservation of the affected residues. Cys substitutions in males were associated with the typical features of X-linked Alport syndrome, with a median age at kidney failure of 31 years. NC1 substitutions predicted to cause structural damage were overrepresented in LOVD (p < 0.001), and those affecting Cys residues or 'buried' Gly residues were more common than expected (both p < 0.001). Most NC1 substitutions in gnomAD (88%) were predicted to be structurally-neutral. Substitutions affecting conserved residues resulted in more structural damage than those affecting non-conserved residues (p < 0.001). Many pathogenic missense variants affecting the collagen IV α5 NC1 domain have their effect through molecular structural damage and 3D modelling is a useful tool in their assessment.
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Affiliation(s)
- Joel T Gibson
- Department of Medicine (Melbourne Health and Northern Health), The University of Melbourne, Parkville, VIC, 3050, Australia
| | - Omid Sadeghi-Alavijeh
- Department of Renal Medicine, University College London, London, UK
- Genomics England, Queen Mary University of London, London, UK
| | - Daniel P Gale
- Department of Renal Medicine, University College London, London, UK
- Genomics England, Queen Mary University of London, London, UK
| | - Hansjörg Rothe
- Centre for Nephrology and Metabolic Disorders, 02943, Weisswasser, Germany
| | - Judy Savige
- Department of Medicine (Melbourne Health and Northern Health), The University of Melbourne, Parkville, VIC, 3050, Australia.
- Genomics England, Queen Mary University of London, London, UK.
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Roy S, Nalwa A, Keith J, Weck K, Singh H, Nickeleit V. Pseudolinear C4d deposits in a hereditary glomerulopathy caused by a rare NC1 collagen-4-alpha-5 missense mutation: a "new disease entity"? Ultrastruct Pathol 2019; 43:209-215. [PMID: 31682783 DOI: 10.1080/01913123.2019.1683666] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
C4d positive glomerulopathies with pseudolinear capillary wall deposits caused by basement membrane (GBM) remodeling have sporadically been reported in renal transplants. Here we describe the case of a hypertensive 60 year-old male with a 5 month history of nephrotic range proteinuria in the setting of normal serum creatinine, complement and ANA levels. Work-up showed MGUS (IgG/kappa restricted). A diagnostic renal biopsy to search for monoclonal gammopathy of renal significance demonstrated thickened glomerular capillary walls with strong pseudolinear complement factor C4d deposits by immunofluorescence microscopy (IF); all other IF studies including stains for Col4A3 were unrevealing with only minor abnormalities seen for Col4A5. The strong and unusual C4d staining of undetermined direct diagnostic significance triggered additional electron microscopic studies uncovering marked structural GBM changes suggestive of a hereditary nephropathy. Further genetic testing revealed a very rare X-linked single missense mutation in the NC1 domain of Col4A5 (exon 51) with a single amino acid substitution (COL4A5 p.A1581S) that has thus far not been reported in hereditary nephropathies. Our case provides further support for pseudolinear glomerular C4d deposits as general markers of GBM remodeling, in our case an unexpected hereditary nephropathy in an older male. Pseudolinear C4d: a general signpost for architectural GBM disturbance and a stimulus for in-depth studies including electron microscopy.
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Affiliation(s)
- Sanjeet Roy
- Department of Pathology, Division of Nephropathology, University of North Carolina at Chapel Hill, Chapel Hill, United States
| | - Aasma Nalwa
- Department of Pathology, Division of Nephropathology, University of North Carolina at Chapel Hill, Chapel Hill, United States
| | - Jared Keith
- Blue Ridge Nephrology and Hypertension Center, Boone, NC, USA
| | - Karen Weck
- Department of Pathology, Molecular Genetics Laboratory, University of North Carolina at Chapel Hill, Chapel Hill, USA
| | - Harsharan Singh
- Department of Pathology, Division of Nephropathology, University of North Carolina at Chapel Hill, Chapel Hill, United States
| | - Volker Nickeleit
- Department of Pathology, Division of Nephropathology, University of North Carolina at Chapel Hill, Chapel Hill, United States
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Papazachariou L, Papagregoriou G, Hadjipanagi D, Demosthenous P, Voskarides K, Koutsofti C, Stylianou K, Ioannou P, Xydakis D, Tzanakis I, Papadaki A, Kallivretakis N, Nikolakakis N, Perysinaki G, Gale DP, Diamantopoulos A, Goudas P, Goumenos D, Soloukides A, Boletis I, Melexopoulou C, Georgaki E, Frysira E, Komianou F, Grekas D, Paliouras C, Alivanis P, Vergoulas G, Pierides A, Daphnis E, Deltas C. Frequent COL4 mutations in familial microhematuria accompanied by later-onset Alport nephropathy due to focal segmental glomerulosclerosis. Clin Genet 2017. [PMID: 28632965 DOI: 10.1111/cge.13077] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Familial microscopic hematuria (FMH) is associated with a genetically heterogeneous group of conditions including the collagen-IV nephropathies, the heritable C3/CFHR5 nephropathy and the glomerulopathy with fibronectin deposits. The clinical course varies widely, ranging from isolated benign familial hematuria to end-stage renal disease (ESRD) later in life. We investigated 24 families using next generation sequencing (NGS) for 5 genes: COL4A3, COL4A4, COL4A5, CFHR5 and FN1. In 17 families (71%), we found 15 pathogenic mutations in COL4A3/A4/A5, 9 of them novel. In 5 families patients inherited classical AS with hemizygous X-linked COL4A5 mutations. Even more patients developed later-onset Alport-related nephropathy having inherited heterozygous COL4A3/A4 mutations that cause thin basement membranes. Amongst 62 heterozygous or hemizygous patients, 8 (13%) reached ESRD, while 25% of patients with heterozygous COL4A3/A4 mutations, aged >50-years, reached ESRD. In conclusion, COL4A mutations comprise a frequent cause of FMH. Heterozygous COL4A3/A4 mutations predispose to renal function impairment, supporting that thin basement membrane nephropathy is not always benign. The molecular diagnosis is essential for differentiating the X-linked from the autosomal recessive and dominant inheritance. Finally, NGS technology is established as the gold standard for the diagnosis of FMH and associated collagen-IV glomerulopathies, frequently averting the need for invasive renal biopsies.
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Affiliation(s)
- L Papazachariou
- Molecular Medicine Research Center & Laboratory of Molecular and Medical Genetics, Department of Biological Sciences, University of Cyprus, Nicosia, Cyprus
| | - G Papagregoriou
- Molecular Medicine Research Center & Laboratory of Molecular and Medical Genetics, Department of Biological Sciences, University of Cyprus, Nicosia, Cyprus
| | - D Hadjipanagi
- Molecular Medicine Research Center & Laboratory of Molecular and Medical Genetics, Department of Biological Sciences, University of Cyprus, Nicosia, Cyprus
| | - P Demosthenous
- Molecular Medicine Research Center & Laboratory of Molecular and Medical Genetics, Department of Biological Sciences, University of Cyprus, Nicosia, Cyprus
| | - K Voskarides
- Molecular Medicine Research Center & Laboratory of Molecular and Medical Genetics, Department of Biological Sciences, University of Cyprus, Nicosia, Cyprus
| | - C Koutsofti
- Molecular Medicine Research Center & Laboratory of Molecular and Medical Genetics, Department of Biological Sciences, University of Cyprus, Nicosia, Cyprus
| | - K Stylianou
- Department of Nephrology, University of Crete-Greece, Heraklion, Greece
| | - P Ioannou
- Department of Nephrology, University of Crete-Greece, Heraklion, Greece
| | - D Xydakis
- Department of Nephrology, University of Crete-Greece, Heraklion, Greece
| | - I Tzanakis
- Department of Nephrology, General Hospital of Chania, Crete, Greece
| | - A Papadaki
- Department of Nephrology, General Hospital of Chania, Crete, Greece
| | - N Kallivretakis
- Department of Nephrology, General Hospital of Chania, Crete, Greece
| | - N Nikolakakis
- Division of Nephrology, General Hospital of Rethymno, Crete, Greece
| | - G Perysinaki
- Division of Nephrology, General Hospital of Rethymno, Crete, Greece
| | - D P Gale
- UCL Division of Medicine and Centre for Nephrology, University College London, London, UK
| | | | - P Goudas
- IATOS Dialysis Unit, Patra, Greece
| | - D Goumenos
- Department of Nephrology, Medical School, University of Patras, Patra, Greece
| | - A Soloukides
- Protypo Nefrologiko Athinon Dialysis Center, Athens, Greece
| | - I Boletis
- Department of Nephrology, Laikon Hospital, Athens, Greece
| | - C Melexopoulou
- Department of Nephrology, Laikon Hospital, Athens, Greece
| | - E Georgaki
- Pediatric Nephrology Unit, "IASO" Children's Hospital, Athens, Greece
| | - E Frysira
- Department of Pediatrics, Athens University Medical School, Agia Sophia Children's Hospital, Athens, Greece
| | - F Komianou
- Department of Medical Genetics, Athens University Medical School, Agia Sophia Children's Hospital, Athens, Greece
| | - D Grekas
- University Hospital AXEPA, Thessaloniki, Greece
| | - C Paliouras
- Department of Nephrology, General Hospital of Rhodes, Rhodes, Greece
| | - P Alivanis
- Department of Nephrology, General Hospital of Rhodes, Rhodes, Greece
| | - G Vergoulas
- Organ Transplant Unit, Hippokratio General Hospital, Thessaloniki, Greece
| | - A Pierides
- Molecular Medicine Research Center & Laboratory of Molecular and Medical Genetics, Department of Biological Sciences, University of Cyprus, Nicosia, Cyprus.,Department of Nephrology, Hippocrateon Hospital, Nicosia, Cyprus
| | - E Daphnis
- Department of Nephrology, University of Crete-Greece, Heraklion, Greece
| | - C Deltas
- Molecular Medicine Research Center & Laboratory of Molecular and Medical Genetics, Department of Biological Sciences, University of Cyprus, Nicosia, Cyprus
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Syndrome d’Alport : néphropathie héréditaire associée à des mutations dans les gènes codant les chaînes de collagène de type IV. Nephrol Ther 2016; 12:544-551. [DOI: 10.1016/j.nephro.2016.09.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Chen C, Lu CX, Wang Q, Cao LH, Luo Y, Zhang X. A Novel Splicing Mutation Identified in a Chinese Family with X-linked Alport Syndrome Using Targeted Next-Generation Sequencing. Genet Test Mol Biomarkers 2016; 20:203-7. [PMID: 26866448 DOI: 10.1089/gtmb.2015.0248] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
AIMS Alport syndrome (AS) is a genetically heterogeneous disorder, characterized by hematuria, progressive renal failure, sensorineural hearing loss, and ocular abnormalities caused by mutations in the COL4A3, COL4A4, and COL4A5 genes. The aim of this study was to identify underlying mutations in individuals from a Chinese family with X-linked AS. METHODS We performed targeted next-generation sequencing (NGS) to identify mutations associated with AS. The results were processed and visualized using an Integrated Genomics Viewer software. The most likely disease-causing variants were identified and confirmed by Sanger sequencing of reverse transcription-polymerase chain reaction products. RESULTS Visual inspection using Integrative Genomics Viewer software found that COL4A5 exon 10 was not covered by the disease panel, while coverage of exons 4, 17, 20, 21, 37, and 45 was incomplete. Sanger sequencing of these regions identified a novel splice-site mutation in intron 9 (c.547-3C>A) of the COL4A5 gene. Subsequent cDNA analysis revealed that c.547-3C>A led to skipping of exon 10, which resulted in an in-frame deletion of 21 amino acids from the α5 chain of type IV collagen. CONCLUSION We determined the molecular basis of AS in a Chinese family by targeted NGS and cDNA analysis. This is the first report of the novel c.547-3C>A splicing mutation in the collagen domain of COL4A5 gene.
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Affiliation(s)
- Chen Chen
- 1 The Research Center for Medical Genomics, Key Laboratory of Medical Cell Biology, Ministry of Education, College of Basic Medical Science, China Medical University , Shenyang, China
| | - Chao-Xia Lu
- 2 McKusick-Zhang Center for Genetic Medicine, State Key Laboratory of Medical Molecular Biology, Institute of Basic Medical Sciences , Chinese Academy of Medical Sciences and School of Basic Medicine Peking Union Medical College, Beijing, China
| | - Qiong Wang
- 1 The Research Center for Medical Genomics, Key Laboratory of Medical Cell Biology, Ministry of Education, College of Basic Medical Science, China Medical University , Shenyang, China
| | - Li-Hua Cao
- 1 The Research Center for Medical Genomics, Key Laboratory of Medical Cell Biology, Ministry of Education, College of Basic Medical Science, China Medical University , Shenyang, China
| | - Yang Luo
- 1 The Research Center for Medical Genomics, Key Laboratory of Medical Cell Biology, Ministry of Education, College of Basic Medical Science, China Medical University , Shenyang, China
| | - Xue Zhang
- 1 The Research Center for Medical Genomics, Key Laboratory of Medical Cell Biology, Ministry of Education, College of Basic Medical Science, China Medical University , Shenyang, China .,2 McKusick-Zhang Center for Genetic Medicine, State Key Laboratory of Medical Molecular Biology, Institute of Basic Medical Sciences , Chinese Academy of Medical Sciences and School of Basic Medicine Peking Union Medical College, Beijing, China
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Xiu X, Yuan J, Deng X, Xiao J, Xu H, Zeng Z, Guan L, Xu F, Deng S. A novel COL4A5 mutation identified in a Chinese Han family using exome sequencing. BIOMED RESEARCH INTERNATIONAL 2014; 2014:186048. [PMID: 25110662 PMCID: PMC4109303 DOI: 10.1155/2014/186048] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/14/2014] [Accepted: 06/20/2014] [Indexed: 11/17/2022]
Abstract
Alport syndrome (AS) is a monogenic disease of the basement membrane (BM), resulting in progressive renal failure due to glomerulonephropathy, variable sensorineural hearing loss, and ocular anomalies. It is caused by mutations in the collagen type IV alpha-3 gene (COL4A3), the collagen type IV alpha-4 gene (COL4A4), and the collagen type IV alpha-5 gene (COL4A5), which encodes type IV collagen α3, α4, and α5 chains, respectively. To explore the disease-related gene in a four-generation Chinese Han pedigree of AS, exome sequencing was conducted on the proband, and a novel deletion mutation c.499delC (p.Pro167Glnfs*36) in the COL4A5 gene was identified. This mutation, absent in 1,000 genomes project, HapMap, dbSNP132, YH1 databases, and 100 normal controls, cosegregated with patients in the family. Neither sensorineural hearing loss nor typical COL4A5-related ocular abnormalities (dot-and-fleck retinopathy, anterior lenticonus, and the rare posterior polymorphous corneal dystrophy) were present in patients of this family. The phenotypes of patients in this AS family were characterized by early onset-age and rapidly developing into end-stage renal disease (ESRD). Our discovery broadens the mutation spectrum in the COL4A5 gene associated with AS, which may also shed new light on genetic counseling for AS.
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Affiliation(s)
- Xiaofei Xiu
- Center for Experimental Medicine and Department of Neurology, The Third Xiangya Hospital, Central South University, Changsha, Hunan 410013, China
- Department of Pharmacy, Xiangya Hospital, Central South University, Xiangya Road 87, Kaifu District, Changsha, Hunan 410008, China
| | - Jinzhong Yuan
- Department of Nephrology, The Third Xiangya Hospital, Central South University, Changsha, Hunan 410013, China
| | - Xiong Deng
- Center for Experimental Medicine and Department of Neurology, The Third Xiangya Hospital, Central South University, Changsha, Hunan 410013, China
| | | | - Hongbo Xu
- Center for Experimental Medicine and Department of Neurology, The Third Xiangya Hospital, Central South University, Changsha, Hunan 410013, China
| | - Zhaoyang Zeng
- Cancer Research Institute, Xiangya Medical School of Central South University, Changsha, Hunan 410008, China
| | - Liping Guan
- BGI-Shenzhen, Shenzhen, Guangdong 518083, China
| | - Fengping Xu
- BGI-Shenzhen, Shenzhen, Guangdong 518083, China
| | - Sheng Deng
- Center for Experimental Medicine and Department of Neurology, The Third Xiangya Hospital, Central South University, Changsha, Hunan 410013, China
- Department of Pharmacy, Xiangya Hospital, Central South University, Xiangya Road 87, Kaifu District, Changsha, Hunan 410008, China
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Deltas C, Pierides A, Voskarides K. Molecular genetics of familial hematuric diseases. Nephrol Dial Transplant 2013; 28:2946-60. [PMID: 24046192 DOI: 10.1093/ndt/gft253] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
The familial hematuric diseases are a genetically heterogeneous group of monogenic conditions, caused by mutations in one of several genes. The major genes involved are the following: (i) the collagen IV genes COL4A3/A4/A5 that are expressed in the glomerular basement membranes (GBM) and are responsible for the most frequent forms of microscopic hematuria, namely Alport syndrome (X-linked or autosomal recessive) and thin basement membrane nephropathy (TBMN). (ii) The FN1 gene, expressed in the glomerulus and responsible for a rare form of glomerulopathy with fibronectin deposits (GFND). (iii) CFHR5 gene, a recently recognized regulator of the complement alternative pathway and mutated in a recently revisited form of inherited C3 glomerulonephritis (C3GN), characterized by isolated C3 deposits in the absence of immune complexes. A hallmark feature of all conditions is the age-dependent penetrance and a broad phenotypic heterogeneity in the sense that subsets of patients progress to added proteinuria or proteinuria and chronic renal failure that may or may not lead to end-stage kidney disease (ESKD) anywhere between the second and seventh decade of life. In addition to other excellent laboratory tools that assist the clinician in reaching the correct diagnosis, the molecular analysis emerges as the gold standard in establishing the diagnosis in many cases of doubt due to equivocal findings that complicate the differential diagnosis. Recent work led to the description of candidate genetic modifiers which confer a variable risk for progressing to chronic renal failure when co-inherited on the background of a primary glomerulopathy. Finally, more families are still waiting to be studied and more genes to be mapped and cloned that are responsible for other forms of heritable hematuric diseases. The study of such genes and their protein products will likely shed more light on the structure and function of the glomerular filtration barrier and other important glomerular components.
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Affiliation(s)
- Constantinos Deltas
- Molecular Medicine Research Center and Laboratory of Molecular and Medical Genetics, Department of Biological Sciences, University of Cyprus, Nicosia, Cyprus
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Beicht S, Strobl-Wildemann G, Rath S, Wachter O, Alberer M, Kaminsky E, Weber LT, Hinrichsen T, Klein HG, Hoefele J. Next generation sequencing as a useful tool in the diagnostics of mosaicism in Alport syndrome. Gene 2013; 526:474-7. [PMID: 23732293 DOI: 10.1016/j.gene.2013.05.045] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2013] [Revised: 05/01/2013] [Accepted: 05/08/2013] [Indexed: 10/26/2022]
Abstract
Alport syndrome (ATS) is a progressive hereditary nephropathy characterized by hematuria and/or proteinuria with structural defects of the glomerular basement membrane. It can be associated with extrarenal manifestations (high-tone sensorineural hearing loss and ocular abnormalities). Somatic mutations in COL4A5 (X-linked), COL4A3 and COL4A4 genes (both autosomal recessive and autosomal dominant) cause Alport syndrome. Somatic mosaicism in Alport patients is very rare. The reason for this may be due to the difficulty of detection. We report the case of a boy and his mother who presented with Alport syndrome. Mutational analysis showed the novel hemizygote pathogenic mutation c.2396-1G>A (IVS29-1G>A) at the splice acceptor site of the intron 29 exon 30 boundary of the COL4A5 gene in the boy. The mutation in the mother would not have been detected by Sanger sequencing without the knowledge of the mutational analysis result of her son. Further investigation of the mother using next generation sequencing showed somatic mosaicism and implied potential germ cell mosaicism. The mutation in the mother has most likely occurred during early embryogenesis. Analysis of tissue of different embryonic origin in the mother confirmed mosaicism in both mesoderm and ectoderm. Low grade mosaicism is very difficult to detect by Sanger sequencing. Next generation sequencing is increasingly used in the diagnostics and might improve the detection of mosaicism. In the case of definite clinical symptoms of ATS and missing detection of a mutation by Sanger sequencing, mutational analysis should be performed by next generation sequencing.
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Affiliation(s)
- Sonja Beicht
- Center for Human Genetics and Laboratory Medicine Dr. Klein, Dr. Rost and Colleagues, Martinsried, Germany
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9
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Voskarides K, Demosthenous P, Papazachariou L, Arsali M, Athanasiou Y, Zavros M, Stylianou K, Xydakis D, Daphnis E, Gale DP, Maxwell PH, Elia A, Pattaro C, Pierides A, Deltas C. Epistatic role of the MYH9/APOL1 region on familial hematuria genes. PLoS One 2013; 8:e57925. [PMID: 23516419 PMCID: PMC3597641 DOI: 10.1371/journal.pone.0057925] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2012] [Accepted: 01/27/2013] [Indexed: 11/18/2022] Open
Abstract
Familial hematuria (FH) is explained by at least four different genes (see below). About 50% of patients develop late proteinuria and chronic kidney disease (CKD). We hypothesized that MYH9/APOL1, two closely linked genes associated with CKD, may be associated with adverse progression in FH. Our study included 102 thin basement membrane nephropathy (TBMN) patients with three known COL4A3/COL4A4 mutations (cohort A), 83 CFHR5/C3 glomerulopathy patients (cohort B) with a single CFHR5 mutation and 15 Alport syndrome patients (cohort C) with two known COL4A5 mild mutations, who were categorized as “Mild” (controls) or “Severe” (cases), based on renal manifestations. E1 and S1 MYH9 haplotypes and variant rs11089788 were analyzed for association with disease phenotype. Evidence for association with “Severe” progression in CFHR5 nephropathy was found with MYH9 variant rs11089788 and was confirmed in an independent FH cohort, D (cumulative p value = 0.001, odds ratio = 3.06, recessive model). No association was found with APOL1 gene. Quantitative Real time PCR did not reveal any functional significance for the rs11089788 risk allele. Our results derive additional evidence supporting previous reports according to which MYH9 is an important gene per se, predisposing to CKD, suggesting its usefulness as a prognostic marker for young hematuric patients.
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Affiliation(s)
- Konstantinos Voskarides
- Molecular Medicine Research Center and Laboratory of Molecular and Medical Genetics, Department of Biological Sciences, University of Cyprus, Nicosia, Cyprus
| | - Panayiota Demosthenous
- Molecular Medicine Research Center and Laboratory of Molecular and Medical Genetics, Department of Biological Sciences, University of Cyprus, Nicosia, Cyprus
| | - Louiza Papazachariou
- Molecular Medicine Research Center and Laboratory of Molecular and Medical Genetics, Department of Biological Sciences, University of Cyprus, Nicosia, Cyprus
| | - Maria Arsali
- Department of Nephrology, Nicosia General Hospital, Nicosia, Cyprus
| | | | - Michalis Zavros
- Department of Nephrology, Nicosia General Hospital, Nicosia, Cyprus
| | - Kostas Stylianou
- Department of Nephrology, University of Crete, Heraklion, Greece
| | - Dimitris Xydakis
- Department of Nephrology, University of Crete, Heraklion, Greece
| | - Eugenios Daphnis
- Department of Nephrology, University of Crete, Heraklion, Greece
| | - Daniel P. Gale
- Centre for Nephrology, University College London, London, United Kingdom
| | | | - Avraam Elia
- Department of Pediatrics, Archbishop Makarios III Hospital, Nicosia, Cyprus
| | - Cristian Pattaro
- Institute of Genetic Medicine, European Academy Bozen/Bolzano (EURAC), Bolzano, Italy – Affiliated Institute of the University of Lubeck, Lubeck, Germany
| | - Alkis Pierides
- Department of Nephrology, Hippocrateon Hospital, Nicosia, Cyprus
| | - Constantinos Deltas
- Molecular Medicine Research Center and Laboratory of Molecular and Medical Genetics, Department of Biological Sciences, University of Cyprus, Nicosia, Cyprus
- * E-mail:
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Wang Q, Liu F, Xing Y, Wei X, Li H, Zhang S, Liu J, Wang Q, Tang Z, Liu M. Mutation c.359_363delGTATTinsATAC in the COL4A5 Causes alport syndrome in a Chinese family. Gene 2013; 512:482-5. [DOI: 10.1016/j.gene.2012.10.014] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2012] [Revised: 09/06/2012] [Accepted: 10/10/2012] [Indexed: 10/27/2022]
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Antón-Martín P, Aparicio López C, Ramiro-León S, Santillán Garzón S, Santos-Simarro F, Gil-Fournier B. Alport Syndrome: De Novo Mutation in the COL4A5 Gene Converting Glycine 1205 to Valine. CLINICAL MEDICINE INSIGHTS-PEDIATRICS 2012; 6:41-9. [PMID: 23641165 PMCID: PMC3620815 DOI: 10.2147/cbf.s23366] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND Alport syndrome is a primary basement membrane disorder arising from mutations in genes encoding the type IV collagen protein family. It is a genetically heterogeneous disease with different mutations and forms of inheritance that presents with renal affection, hearing loss and eye defects. Several new mutations related to X-linked forms have been previously determined. METHODS We report the case of a 12 years old male and his family diagnosed with Alport syndrome after genetic analysis was performed. RESULT A new mutation determining a nucleotide change c.3614G > T (p.Gly1205Val) in hemizygosis in the COL4A5 gene was found. This molecular defect has not been previously described. CONCLUSION Molecular biology has helped us to comprehend the mechanisms of pathophysiology in Alport syndrome. Genetic analysis provides the only conclusive diagnosis of the disorder at the moment. Our contribution with a new mutation further supports the need of more sophisticated molecular methods to increase the mutation detection rates with lower costs and less time.
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Affiliation(s)
- Pilar Antón-Martín
- Department of Pediatrics, Division of Nephrology, Hospital Universitario de Getafe, Madrid, Spain
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12
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Antón-Martín P, López CA, Ramiro-León S, Garzón SS, Santos-Simarro F, Gil-Fournier B. Alport Syndrome: De Novo Mutation in the COL4A5 Gene Converting Glycine 1205 to Valine. CLINICAL MEDICINE. PEDIATRICS 2012. [DOI: 10.4137/cmped.s7509] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
BackgroundAlport syndrome is a primary basement membrane disorder arising from mutations in genes encoding the type IV collagen protein family. It is a genetically heterogeneous disease with different mutations and forms of inheritance that presents with renal affection, hearing loss and eye defects. Several new mutations related to X-linked forms have been previously determined.MethodsWe report the case of a 12 years old male and his family diagnosed with Alport syndrome after genetic analysis was performed.ResultAnew mutation determining a nucleotide change C.3614G > T (p. Gly1205Val) in hemizygosis in the COL4A5 gene was found. This molecular defect has not been previously described.ConclusionMolecular biology has helped us to comprehend the mechanisms of pathophysiology in Alport syndrome. Genetic analysis provides the only conclusive diagnosis of the disorder at the moment. Our contribution with a new mutation further supports the need of more sophisticated molecular methods to increase the mutation detection rates with lower costs and less time.
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Affiliation(s)
- Pilar Antón-Martín
- Department of Pediatrics, Division of Nephrology, Hospital Universitario de Getafe, Madrid, Spain
| | - Cristina Aparicio López
- Department of Pediatrics, Division of Nephrology, Hospital Universitario de Getafe, Madrid, Spain
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Novel heterozygous COL4A3 mutation in a family with late-onset ESRD. Pediatr Nephrol 2010; 25:1539-42. [PMID: 20177710 DOI: 10.1007/s00467-010-1467-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2009] [Revised: 12/16/2009] [Accepted: 01/05/2010] [Indexed: 10/19/2022]
Abstract
Thin basement membrane nephropathy (TBMN) and Alport syndrome (ATS) are genetically heterogeneous conditions characterized by structural abnormalities in the glomerular basement membrane (GBM). TBMN presents with hematuria, minimal proteinuria, and normal renal function. Although TBMN is an autosomal dominant disease (COL4A3 and COL4A4), ATS can be inherited X-linked (COL4A5), autosomal recessive, or autosomal dominant (both COL4A3 and COL4A4). The clinical course of TBMN is usually benign, whereas ATS typically results in end-stage renal disease (ESRD). Nevertheless, there is a broad spectrum of clinical phenotypes caused by mutations in COL4A3 or COL4A4. We report an Italian family who presented with hematuria and mild proteinuria. Mutational analysis showed a novel heterozygous mutation p.G291E in exon 15 of the COL4A3 gene. Many different mutations in COL4A3 and COL4A4 that cause TBMN have already been identified, but most genetic variability in these genes has been found to cause autosomal ATS. A valid genotype-phenotype correlation for TBMN or ATS is not yet known. Therefore, it is important to identify new mutations by direct sequencing to clarify their clinical importance, to assess the prognosis of the disease, and to avoid renal biopsy.
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Mutant-type alpha5(IV) collagen in a mild form of Alport syndrome has residual ability to form a heterotrimer. Pediatr Nephrol 2010; 25:1169-72. [PMID: 20130921 DOI: 10.1007/s00467-009-1433-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2009] [Revised: 11/07/2009] [Accepted: 12/15/2009] [Indexed: 10/19/2022]
Abstract
Alport syndrome (AS) is caused by mutations in type IV collagen alpha3, alpha4, and alpha5 chains. The three chains form a heterotrimer. We have previously shown that all 15 types of recombinant alpha5(IV) chains with mutations, corresponding to AS mutations, in the noncollagenous (NC1) domain are defective in terms of heterotrimer formation and/or secretion of the heterotrimer from cells. A relatively large family with Cys1638Tyr in the NC1 domain of the alpha5(IV) chain has been found to have mild AS phenotypes without hearing loss or ocular abnormalities. Renal biopsies of different family members also revealed the presence of the alpha3(IV), alpha4(IV), and alpha5(IV) chains in the glomerular basement membrane. In our study, we introduced the mutation corresponding to Cys1638Tyr into the alpha5(IV) chain and characterized the mutant chain. In cells containing the mutant-type alpha5(IV) chain, heterotrimer formation in the cells and secretion of the alpha5(IV) chain in the monomeric form from the cells were markedly decreased compared with cells containing the wild-type chain. However, the heterotrimer that was formed from the mutant chain was still able to be secreted from the cells. The residual ability of the mutant chain may have led to the unique phenotypes found in the AS family with the Cys1638Tyr mutation.
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Kobayashi T, Uchiyama M. Effect of HSP47 expression levels on heterotrimer formation among type IV collagen α3, α4 and α5 chains. Biomed Res 2010; 31:371-7. [DOI: 10.2220/biomedres.31.371] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Pont-Kingdon G, Sumner K, Gedge F, Miller C, Denison J, Gregory M, Lyon E. Molecular testing for adult type Alport syndrome. BMC Nephrol 2009; 10:38. [PMID: 19919694 PMCID: PMC2780398 DOI: 10.1186/1471-2369-10-38] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2009] [Accepted: 11/17/2009] [Indexed: 11/10/2022] Open
Abstract
Background Alport syndrome (AS) is a progressive renal disease with cochlear and ocular involvement. The majority of AS cases are X-linked (XLAS) and due to mutations in the COL4A5 gene. Although the disease may appear early in life and progress to end stage renal disease (ESRD) in young adults, in other families ESRD occurs in middle age. Few of the more than four hundred mutations described in COL4A5 are associated with adult type XLAS, but the families may be very large. Methods We classified adult type AS mutation by prevalence in the US and we developed a molecular assay using a set of hybridization probes that identify the three most common adult type XLAS mutations; C1564S, L1649R, and R1677Q. Results The test was validated on samples previously determined to contain one or none of these mutations. In the US, the test's clinical specificity and sensitivity are estimated to be higher than 99% and 75% respectively. Analytical specificity and sensitivity are above 99%. Conclusion This test may be useful for presymptomatic and carrier testing in families with one of the mutations and in the diagnosis of unexplained hematuria or chronic kidney disease.
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