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Cason RK, Chambers E, Tu T, Chryst-Stangl M, Huggins K, Lane BM, Ochoa A, Jackson AM, Gbadegesin RA. Genetic risk variants for childhood nephrotic syndrome and corticosteroid response. Front Pediatr 2023; 11:1248733. [PMID: 37868272 PMCID: PMC10588181 DOI: 10.3389/fped.2023.1248733] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Accepted: 09/22/2023] [Indexed: 10/24/2023] Open
Abstract
Introduction The etiology of most cases of nephrotic syndrome (NS) remains unknown, therefore patients are phenotypically categorized based on response to corticosteroid therapy as steroid sensitive NS (SSNS), or steroid resistant NS (SRNS). Genetic risk factors have been identified for SSNS from unbiased genome-wide association studies (GWAS), however it is unclear if these loci are disease risk loci in other forms of NS such as SRNS. Additionally, it remains unknown if these risk loci are associated with response to therapy. Thus, we investigated the association between SSNS risk loci and therapy response in a large, multi-race cohort of children along the entire spectrum of childhood-onset NS. Methods We enrolled 1,000 patients with childhood-onset NS comprised of SSNS and SRNS. Genotyping was done using TaqMan and Direct Sanger Sequencing for 9 previously reported childhood SSNS risk loci. We compared the allele frequencies (AF) and variant burden between NS vs. controls and SRNS vs. SSNS. Results All 9 risk loci were associated with NS compared with healthy controls (p = 3.5 × 10-3-<2.2 × 10-16). Variant burden greater than 7 was associated with risk of SRNS (OR 7.4, 95% CI 4.6-12.0, p = 8.2 × 10-16). Conclusion Our study showed that genetic risk loci for childhood SSNS are associated with pattern of therapy response, may help predict disease outcome, and set the stage for individualized treatment of NS.
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Affiliation(s)
- Rachel K. Cason
- Department of Pediatrics, Division of Nephrology, Duke University Medical Center, Durham, NC, United States
| | - Eileen Chambers
- Department of Pediatrics, Division of Nephrology, Duke University Medical Center, Durham, NC, United States
| | - Tiffany Tu
- Computational Biology and Bioinformatics Program, Duke Center for Statistical Genetics and Genomics, and Department of Biostatistics and Bioinformatics, Duke University, Durham, NC, United States
| | - Megan Chryst-Stangl
- Department of Pediatrics, Division of Nephrology, Duke University Medical Center, Durham, NC, United States
| | - Kinsie Huggins
- Department of Pediatrics, Division of Nephrology, Duke University Medical Center, Durham, NC, United States
| | - Brandon M. Lane
- Department of Pediatrics, Division of Nephrology, Duke University Medical Center, Durham, NC, United States
| | - Alejandro Ochoa
- Computational Biology and Bioinformatics Program, Duke Center for Statistical Genetics and Genomics, and Department of Biostatistics and Bioinformatics, Duke University, Durham, NC, United States
| | - Annette M. Jackson
- Department of Surgery, Duke University Medical Center, Durham, NC, United States
| | - Rasheed A. Gbadegesin
- Department of Pediatrics, Division of Nephrology, Duke University Medical Center, Durham, NC, United States
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Lane BM, Chryst-Stangl M, Wu G, Shalaby M, El Desoky S, Middleton CC, Huggins K, Sood A, Ochoa A, Malone AF, Vancini R, Miller SE, Hall G, Kim SY, Howell DN, Kari JA, Gbadegesin R. Steroid-sensitive nephrotic syndrome candidate gene CLVS1 regulates podocyte oxidative stress and endocytosis. JCI Insight 2022; 7:e152102. [PMID: 34874915 PMCID: PMC9018043 DOI: 10.1172/jci.insight.152102] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Accepted: 12/01/2021] [Indexed: 11/17/2022] Open
Abstract
We performed next-generation sequencing in patients with familial steroid-sensitive nephrotic syndrome (SSNS) and identified a homozygous segregating variant (p.H310Y) in the gene encoding clavesin-1 (CLVS1) in a consanguineous family with 3 affected individuals. Knockdown of the clavesin gene in zebrafish (clvs2) produced edema phenotypes due to disruption of podocyte structure and loss of glomerular filtration barrier integrity that could be rescued by WT CLVS1 but not the p.H310Y variant. Analysis of cultured human podocytes with CRISPR/Cas9-mediated CLVS1 knockout or homozygous H310Y knockin revealed deficits in clathrin-mediated endocytosis and increased susceptibility to apoptosis that could be rescued with corticosteroid treatment, mimicking the steroid responsiveness observed in patients with SSNS. The p.H310Y variant also disrupted binding of clavesin-1 to α-tocopherol transfer protein, resulting in increased reactive oxygen species (ROS) accumulation in CLVS1-deficient podocytes. Treatment of CLVS1-knockout or homozygous H310Y-knockin podocytes with pharmacological ROS inhibitors restored viability to control levels. Taken together, these data identify CLVS1 as a candidate gene for SSNS, provide insight into therapeutic effects of corticosteroids on podocyte cellular dynamics, and add to the growing evidence of the importance of endocytosis and oxidative stress regulation to podocyte function.
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Affiliation(s)
- Brandon M. Lane
- Department of Pediatrics, Division of Nephrology, and Duke Molecular Physiology Institute, Duke University School of Medicine, Durham, North Carolina, USA
| | - Megan Chryst-Stangl
- Department of Pediatrics, Division of Nephrology, and Duke Molecular Physiology Institute, Duke University School of Medicine, Durham, North Carolina, USA
| | - Guanghong Wu
- Department of Pediatrics, Division of Nephrology, and Duke Molecular Physiology Institute, Duke University School of Medicine, Durham, North Carolina, USA
| | - Mohamed Shalaby
- Pediatric Department, Pediatric Nephrology Center of Excellence, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Sherif El Desoky
- Pediatric Department, Pediatric Nephrology Center of Excellence, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Claire C. Middleton
- Department of Pediatrics, Division of Nephrology, and Duke Molecular Physiology Institute, Duke University School of Medicine, Durham, North Carolina, USA
| | - Kinsie Huggins
- Department of Pediatrics, Division of Nephrology, and Duke Molecular Physiology Institute, Duke University School of Medicine, Durham, North Carolina, USA
| | - Amika Sood
- Department of Biostatistics and Bioinformatics and Duke Center for Statistical Genetics and Genomics, Duke University, Durham, North Carolina, USA
| | - Alejandro Ochoa
- Department of Biostatistics and Bioinformatics and Duke Center for Statistical Genetics and Genomics, Duke University, Durham, North Carolina, USA
| | - Andrew F. Malone
- Department of Medicine, Division of Nephrology, Washington University School of Medicine in St. Louis, St. Louis, Missouri, USA
| | | | | | - Gentzon Hall
- Department of Pediatrics, Division of Nephrology, and Duke Molecular Physiology Institute, Duke University School of Medicine, Durham, North Carolina, USA
- Department of Medicine, Division of Nephrology; and
| | - So Young Kim
- Department of Molecular Genetics and Microbiology, Duke University School of Medicine, Durham, North Carolina, USA
| | | | - Jameela A. Kari
- Pediatric Department, Pediatric Nephrology Center of Excellence, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Rasheed Gbadegesin
- Department of Pediatrics, Division of Nephrology, and Duke Molecular Physiology Institute, Duke University School of Medicine, Durham, North Carolina, USA
- Department of Medicine, Division of Nephrology; and
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Cason RK, Williams A, Chryst-Stangl M, Wu G, Huggins K, Brathwaite KE, Lane BM, Greenbaum LA, D'Agati VD, Gbadegesin RA. Collapsing Focal Segmental Glomerulosclerosis in Siblings With Compound Heterozygous Variants in NUP93 Expand the Spectrum of Kidney Phenotypes Associated With Nucleoporin Gene Mutations. Front Pediatr 2022; 10:915174. [PMID: 35874595 PMCID: PMC9301271 DOI: 10.3389/fped.2022.915174] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Accepted: 06/07/2022] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Focal segmental glomerulosclerosis (FSGS) is a major cause of end stage kidney disease, with the collapsing form having the worst prognosis. Study of families with hereditary FSGS has provided insight into disease mechanisms. METHODS In this report, we describe a sibling pair with NUP93 mutations and collapsing FSGS (cFSGS). For each brother, we performed next generation sequencing and segregation analysis by direct sequencing. To determine if the variants found in the index family are a common cause of cFSGS, we screened 7 patients with cFSGS, gleaned from our cohort of 200 patients with FSGS, for variants in NUP93 as well as for APOL1 high-risk genotypes. RESULTS We identified segregating compound heterozygous NUP93 variants (1) c.1772G > T p.G591V, 2) c.2084T > C p.L695S) in the two brothers. We did not find any pathogenic variants in the seven patients with cFSGS from our cohort, and as expected five of these seven patients carried the APOL1 high-risk genotype. CONCLUSION To the best of our knowledge, this is the first report of cFSGS in patients with NUP93 mutations, based on this report, mutations in NUP93 and other nucleoporin genes should be considered when evaluating a child with familial cFSGS. Determining the mechanisms by which these variants cause cFSGS may provide insight into the pathogenesis of the more common primary and virus-mediated forms of cFSGS.
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Affiliation(s)
- Rachel K Cason
- Division of Nephrology, Department of Pediatrics, Duke University Medical Center, Durham, NC, United States
| | - Anna Williams
- Division of Nephrology, Department of Pediatrics, Duke University Medical Center, Durham, NC, United States
| | - Megan Chryst-Stangl
- Division of Nephrology, Department of Pediatrics, Duke University Medical Center, Durham, NC, United States
| | - Guanghong Wu
- Division of Nephrology, Department of Pediatrics, Duke University Medical Center, Durham, NC, United States
| | - Kinsie Huggins
- Division of Nephrology, Department of Pediatrics, Duke University Medical Center, Durham, NC, United States
| | - Kaye E Brathwaite
- Division of Pediatric Nephrology, Children's Hospital at Montefiore, The Bronx, NY, United States
| | - Brandon M Lane
- Division of Nephrology, Department of Pediatrics, Duke University Medical Center, Durham, NC, United States
| | - Larry A Greenbaum
- Division of Pediatric Nephrology, Emory University School of Medicine and Children's Healthcare of Atlanta, Atlanta, GA, United States
| | - Vivette D D'Agati
- Department of Pathology and Cell Biology, Columbia University Medical Center, New York, NY, United States
| | - Rasheed A Gbadegesin
- Division of Nephrology, Department of Pediatrics, Duke University Medical Center, Durham, NC, United States
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4
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Lane BM, Murray S, Benson K, Bierzynska A, Chryst-Stangl M, Wang L, Wu G, Cavalleri G, Doyle B, Fennelly N, Dorman A, Conlon S, Vega-Warner V, Fermin D, Vijayan P, Qureshi MA, Shril S, Barua M, Hildebrandt F, Pollak M, Howell D, Sampson MG, Saleem M, Conlon PJ, Spurney R, Gbadegesin R. A Rare Autosomal Dominant Variant in Regulator of Calcineurin Type 1 ( RCAN1) Gene Confers Enhanced Calcineurin Activity and May Cause FSGS. J Am Soc Nephrol 2021; 32:1682-1695. [PMID: 33863784 PMCID: PMC8425665 DOI: 10.1681/asn.2020081234] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Accepted: 02/25/2021] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND Podocyte dysfunction is the main pathologic mechanism driving the development of FSGS and other morphologic types of steroid-resistant nephrotic syndrome (SRNS). Despite significant progress, the genetic causes of most cases of SRNS have yet to be identified. METHODS Whole-genome sequencing was performed on 320 individuals from 201 families with familial and sporadic NS/FSGS with no pathogenic mutations in any known NS/FSGS genes. RESULTS Two variants in the gene encoding regulator of calcineurin type 1 (RCAN1) segregate with disease in two families with autosomal dominant FSGS/SRNS. In vitro, loss of RCAN1 reduced human podocyte viability due to increased calcineurin activity. Cells expressing mutant RCAN1 displayed increased calcineurin activity and NFAT activation that resulted in increased susceptibility to apoptosis compared with wild-type RCAN1. Treatment with GSK-3 inhibitors ameliorated this elevated calcineurin activity, suggesting the mutation alters the balance of RCAN1 regulation by GSK-3β, resulting in dysregulated calcineurin activity and apoptosis. CONCLUSIONS These data suggest mutations in RCAN1 can cause autosomal dominant FSGS. Despite the widespread use of calcineurin inhibitors in the treatment of NS, genetic mutations in a direct regulator of calcineurin have not been implicated in the etiology of NS/FSGS before this report. The findings highlight the therapeutic potential of targeting RCAN1 regulatory molecules, such as GSK-3β, in the treatment of FSGS.
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Affiliation(s)
- Brandon M. Lane
- Division of Nephrology, Department of Pediatrics, Duke Molecular Physiology Institute, Duke University School of Medicine, Durham, North Carolina
| | - Susan Murray
- Irish Kidney Gene Project, Department of Genetics, Royal College of Surgeons of Ireland, Dublin, Republic of Ireland
| | - Katherine Benson
- School of Pharmacy and Biomolecular Sciences, Royal College of Surgeons of Ireland, Dublin, Republic of Ireland
| | - Agnieszka Bierzynska
- Department of Pediatrics, Bristol Royal Hospital for Children and University of Bristol, Bristol, United Kingdom
| | - Megan Chryst-Stangl
- Division of Nephrology, Department of Pediatrics, Duke Molecular Physiology Institute, Duke University School of Medicine, Durham, North Carolina
| | - Liming Wang
- Division of Nephrology, Department of Medicine, Duke University School of Medicine, Durham, North Carolina
| | - Guanghong Wu
- Division of Nephrology, Department of Pediatrics, Duke Molecular Physiology Institute, Duke University School of Medicine, Durham, North Carolina
| | - Gianpiero Cavalleri
- School of Pharmacy and Biomolecular Sciences, Royal College of Surgeons of Ireland, Dublin, Republic of Ireland
| | - Brendan Doyle
- Department of Pathology, Beaumont General Hospital, Dublin, Republic of Ireland
| | - Neil Fennelly
- Department of Pathology, Beaumont General Hospital, Dublin, Republic of Ireland
| | - Anthony Dorman
- Department of Pathology, Beaumont General Hospital, Dublin, Republic of Ireland
| | - Shane Conlon
- Irish Kidney Gene Project, Department of Genetics, Royal College of Surgeons of Ireland, Dublin, Republic of Ireland
| | | | - Damian Fermin
- Department of Pediatrics, University of Michigan, Ann Arbor, Michigan
| | - Poornima Vijayan
- Division of Nephrology, Department of Medicine, University of Toronto and Toronto General Hospital, Toronto, Ontario, Canada
| | - Mohammad Azfar Qureshi
- Division of Nephrology, Department of Medicine, University of Toronto and Toronto General Hospital, Toronto, Ontario, Canada
| | - Shirlee Shril
- Division of Nephrology, Department of Pediatrics, Boston Children’s Hospital and Harvard University Medical School, Boston, Massachusetts
| | - Moumita Barua
- Division of Nephrology, Department of Medicine, University of Toronto and Toronto General Hospital, Toronto, Ontario, Canada
| | - Friedhelm Hildebrandt
- Division of Nephrology, Department of Pediatrics, Boston Children’s Hospital and Harvard University Medical School, Boston, Massachusetts
| | - Martin Pollak
- Division of Nephrology, Department of Medicine, Beth Israel Hospital and Harvard University Medical School, Boston, Massachusetts
| | - David Howell
- Department of Pathology, Duke University School of Medicine, Durham, North Carolina
| | - Matthew G. Sampson
- Division of Nephrology, Department of Pediatrics, Boston Children’s Hospital and Harvard University Medical School, Boston, Massachusetts
- Broad Institute of Harvard and Massachusetts Institute of Technology, Cambridge, Massachusetts
| | - Moin Saleem
- Department of Pediatrics, Bristol Royal Hospital for Children and University of Bristol, Bristol, United Kingdom
| | - Peter J. Conlon
- Irish Kidney Gene Project, Department of Genetics, Royal College of Surgeons of Ireland, Dublin, Republic of Ireland
- Division of Nephrology, Department of Medicine, Beaumont General Hospital, Dublin, Republic of Ireland
| | - Robert Spurney
- Division of Nephrology, Department of Medicine, Duke University School of Medicine, Durham, North Carolina
| | - Rasheed Gbadegesin
- Division of Nephrology, Department of Pediatrics, Duke Molecular Physiology Institute, Duke University School of Medicine, Durham, North Carolina
- Division of Nephrology, Department of Medicine, Duke University School of Medicine, Durham, North Carolina
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5
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Jia X, Yamamura T, Gbadegesin R, McNulty MT, Song K, Nagano C, Hitomi Y, Lee D, Aiba Y, Khor SS, Ueno K, Kawai Y, Nagasaki M, Noiri E, Horinouchi T, Kaito H, Hamada R, Okamoto T, Kamei K, Kaku Y, Fujimaru R, Tanaka R, Shima Y, Baek J, Kang HG, Ha IS, Han KH, Yang EM, Abeyagunawardena A, Lane B, Chryst-Stangl M, Esezobor C, Solarin A, Dossier C, Deschênes G, Vivarelli M, Debiec H, Ishikura K, Matsuo M, Nozu K, Ronco P, Cheong HI, Sampson MG, Tokunaga K, Iijima K. Common risk variants in NPHS1 and TNFSF15 are associated with childhood steroid-sensitive nephrotic syndrome. Kidney Int 2020; 98:1308-1322. [PMID: 32554042 DOI: 10.1016/j.kint.2020.05.029] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2019] [Revised: 04/23/2020] [Accepted: 05/01/2020] [Indexed: 12/16/2022]
Abstract
To understand the genetics of steroid-sensitive nephrotic syndrome (SSNS), we conducted a genome-wide association study in 987 childhood SSNS patients and 3,206 healthy controls with Japanese ancestry. Beyond known associations in the HLA-DR/DQ region, common variants in NPHS1-KIRREL2 (rs56117924, P=4.94E-20, odds ratio (OR) =1.90) and TNFSF15 (rs6478109, P=2.54E-8, OR=0.72) regions achieved genome-wide significance and were replicated in Korean, South Asian and African populations. Trans-ethnic meta-analyses including Japanese, Korean, South Asian, African, European, Hispanic and Maghrebian populations confirmed the significant associations of variants in NPHS1-KIRREL2 (Pmeta=6.71E-28, OR=1.88) and TNFSF15 (Pmeta=5.40E-11, OR=1.33) loci. Analysis of the NPHS1 risk alleles with glomerular NPHS1 mRNA expression from the same person revealed allele specific expression with significantly lower expression of the transcript derived from the risk haplotype (Wilcox test p=9.3E-4). Because rare pathogenic variants in NPHS1 cause congenital nephrotic syndrome of the Finnish type (CNSF), the present study provides further evidence that variation along the allele frequency spectrum in the same gene can cause or contribute to both a rare monogenic disease (CNSF) and a more complex, polygenic disease (SSNS).
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Affiliation(s)
- Xiaoyuan Jia
- Department of Human Genetics, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Tomohiko Yamamura
- Department of Pediatrics, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Rasheed Gbadegesin
- Department of Pediatrics, Division of Nephrology, Duke University Medical Center, Durham, North Carolina, USA
| | - Michelle T McNulty
- Department of Medicine-Nephrology, Boston Children's Hospital, Boston, Massachussetts, USA; Medical and Population Genetics, Broad Institute, Cambridge, Massachussetts, USA
| | - Kyuyong Song
- Department of Biochemistry and Molecular Biology, University of Ulsan College of Medicine, Seoul, Korea
| | - China Nagano
- Department of Pediatrics, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Yuki Hitomi
- Department of Human Genetics, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Dongwon Lee
- Department of Medicine-Nephrology, Boston Children's Hospital, Boston, Massachussetts, USA; Medical and Population Genetics, Broad Institute, Cambridge, Massachussetts, USA; Harvard Medical School, Boston, Massachussetts, USA
| | - Yoshihiro Aiba
- Clinical Research Center, National Hospital Organization Nagasaki Medical Center, Omura, Japan
| | - Seik-Soon Khor
- Department of Human Genetics, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Kazuko Ueno
- Department of Human Genetics, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Yosuke Kawai
- Department of Human Genetics, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Masao Nagasaki
- Department of Integrative Genomics, Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
| | - Eisei Noiri
- Department of Hemodialysis and Apheresis, The University of Tokyo Hospital, Tokyo, Japan
| | - Tomoko Horinouchi
- Department of Pediatrics, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Hiroshi Kaito
- Department of Pediatrics, Kobe University Graduate School of Medicine, Kobe, Japan; Department of Nephrology, Hyogo Prefectural Kobe Children's Hospital, Kobe, Japan
| | - Riku Hamada
- Department of Nephrology, Tokyo Metropolitan Children's Medical Center, Tokyo, Japan
| | - Takayuki Okamoto
- Department of Pediatrics, Hokkaido University Hospital, Sapporo, Japan
| | - Koichi Kamei
- Division of Nephrology and Rheumatology, National Center for Child Health and Development, Tokyo, Japan
| | - Yoshitsugu Kaku
- Department of Nephrology, Fukuoka Children's Hospital, Fukuoka, Japan
| | - Rika Fujimaru
- Department of Pediatrics, Osaka City General Hospital, Osaka, Japan
| | - Ryojiro Tanaka
- Department of Nephrology, Hyogo Prefectural Kobe Children's Hospital, Kobe, Japan
| | - Yuko Shima
- Department of Pediatrics, Wakayama Medical University, Wakayama, Japan
| | | | - Jiwon Baek
- Department of Biochemistry and Molecular Biology, University of Ulsan College of Medicine, Seoul, Korea
| | - Hee Gyung Kang
- Department of Pediatrics, Seoul National University Children's Hospital, Seoul, Korea
| | - Il-Soo Ha
- Department of Pediatrics, Seoul National University Children's Hospital, Seoul, Korea
| | - Kyoung Hee Han
- Department of Pediatrics, Jeju National University School of Medicine, Jeju, Korea
| | - Eun Mi Yang
- Department of Pediatrics, Chonnam National University Children's Hospital, Gwangju, Korea
| | | | - Asiri Abeyagunawardena
- Department of Pediatrics, Division of Nephrology, Duke University Medical Center, Durham, North Carolina, USA
| | - Brandon Lane
- Department of Pediatrics, Division of Nephrology, Duke University Medical Center, Durham, North Carolina, USA
| | - Megan Chryst-Stangl
- Department of Pediatrics, Division of Nephrology, Duke University Medical Center, Durham, North Carolina, USA
| | - Christopher Esezobor
- Department of Paediatrics, College of Medicine, University of Lagos, Lagos, Nigeria
| | - Adaobi Solarin
- Department of Pediatrics, Lagos State University Teaching Hospital, Ikeja, Nigeria
| | | | - Claire Dossier
- Department of Paediatric Nephrology, Public Assistance Hospital of Paris, Robert-Debré Hospital, Paris, France
| | - Georges Deschênes
- Center of Research on Inflammation, Institut National de la Santé et de la Recherche Médicale UMR 1149, University Sorbonne-Paris, Paris, France
| | | | - Marina Vivarelli
- Division of Nephrology and Dialysis, Bambino Gesù Children's Hospital and Research Institute, Rome, Italy
| | - Hanna Debiec
- Sorbonne University, INSERM UMR_S1155, and Nephrology Day Hospital, Department of Nephrology, Hôpital Tenon, Paris France
| | - Kenji Ishikura
- Division of Nephrology and Rheumatology, National Center for Child Health and Development, Tokyo, Japan
| | - Masafumi Matsuo
- Research Center for Locomotion Biology, Kobe Gakuin University, Kobe, Japan; KNC Department of Nucleic Acid Drug Discovery, Faculty of Rehabilitation, Kobe Gakuin University, Kobe, Japan
| | - Kandai Nozu
- Department of Pediatrics, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Pierre Ronco
- Sorbonne University, INSERM UMR_S1155, and Nephrology Day Hospital, Department of Nephrology, Hôpital Tenon, Paris France
| | - Hae Il Cheong
- Department of Pediatrics, Seoul National University Children's Hospital, Seoul, Korea
| | - Matthew G Sampson
- Department of Medicine-Nephrology, Boston Children's Hospital, Boston, Massachussetts, USA; Medical and Population Genetics, Broad Institute, Cambridge, Massachussetts, USA; Harvard Medical School, Boston, Massachussetts, USA
| | - Katsushi Tokunaga
- Department of Human Genetics, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
| | - Kazumoto Iijima
- Department of Pediatrics, Kobe University Graduate School of Medicine, Kobe, Japan.
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6
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Hall G, Ducasa GM, Lane BM, Lagas M, Kovalik ME, Gregory OG, Wu G, Chryst-Stangl M, Wang L, Spurney RF, Fornoni A, Gbadegesin RA. FO068The LMX1βR246Q Mutation Induces Podocyte Injury Through Dysregulation of Cholesterol Transport Gene Expression. Nephrol Dial Transplant 2019. [DOI: 10.1093/ndt/gfz096.fo068] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- Gentzon Hall
- Duke University Medical Center, Durham, United States of America
| | | | - Brandon M Lane
- Duke University Medical Center, Durham, United States of America
| | - Max Lagas
- Duke University Medical Center, Durham, United States of America
| | - Maria E Kovalik
- Duke University Medical Center, Durham, United States of America
| | - Olivia G Gregory
- Duke University Medical Center, Durham, United States of America
| | - Guanghong Wu
- Duke University Medical Center, Durham, United States of America
| | | | - Liming Wang
- Duke University Medical Center, Durham, United States of America
| | - Robert F Spurney
- Duke University Medical Center, Durham, United States of America
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7
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Hall G, Sethi SK, Lane BM, Sampson MG, Gregory OG, Kovalik ME, Chryst-Stangl M, Wu G, Spurney RF, Bansal SB, Kher V, Gbadegesin RA. SP001A Novel Heterozygous Missense Mutation of Wilms’ Tumor 1 May Cause FSGS Through Dysregulated Expression of ARHGAP24. Nephrol Dial Transplant 2019. [DOI: 10.1093/ndt/gfz103.sp001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Gentzon Hall
- Duke University Medical Center, Durham, United States of America
| | | | - Brandon M Lane
- Duke University Medical Center, Durham, United States of America
| | | | - Olivia G Gregory
- Duke University Medical Center, Durham, United States of America
| | - Maria E Kovalik
- Duke University Medical Center, Durham, United States of America
| | | | - Guanghong Wu
- Duke University Medical Center, Durham, United States of America
| | - Robert F Spurney
- Duke University Medical Center, Durham, United States of America
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8
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Hall G, Lane BM, Khan K, Pediaditakis I, Xiao J, Wu G, Wang L, Kovalik ME, Chryst-Stangl M, Davis EE, Spurney RF, Gbadegesin RA. The Human FSGS-Causing ANLN R431C Mutation Induces Dysregulated PI3K/AKT/mTOR/Rac1 Signaling in Podocytes. J Am Soc Nephrol 2018; 29:2110-2122. [PMID: 30002222 PMCID: PMC6065096 DOI: 10.1681/asn.2017121338] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2017] [Accepted: 05/31/2018] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND We previously reported that mutations in the anillin (ANLN) gene cause familial forms of FSGS. ANLN is an F-actin binding protein that modulates podocyte cell motility and interacts with the phosphoinositide 3-kinase (PI3K) pathway through the slit diaphragm adaptor protein CD2-associated protein (CD2AP). However, it is unclear how the ANLN mutations cause the FSGS phenotype. We hypothesized that the R431C mutation exerts its pathogenic effects by uncoupling ANLN from CD2AP. METHODS We conducted in vivo complementation assays in zebrafish to determine the effect of the previously identified missense ANLN variants, ANLNR431C and ANLNG618C during development. We also performed in vitro functional assays using human podocyte cell lines stably expressing wild-type ANLN (ANLNWT ) or ANLNR431C . RESULTS Experiments in anln-deficient zebrafish embryos showed a loss-of-function effect for each ANLN variant. In human podocyte lines, expression of ANLNR431C increased cell migration, proliferation, and apoptosis. Biochemical characterization of ANLNR431C -expressing podocytes revealed hyperactivation of the PI3K/AKT/mTOR/p70S6K/Rac1 signaling axis and activation of mTOR-driven endoplasmic reticulum stress in ANLNR431C -expressing podocytes. Inhibition of mTOR, GSK-3β, Rac1, or calcineurin ameliorated the effects of ANLNR431C . Additionally, inhibition of the calcineurin/NFAT pathway reduced the expression of endogenous ANLN and mTOR. CONCLUSIONS The ANLNR431C mutation causes multiple derangements in podocyte function through hyperactivation of PI3K/AKT/mTOR/p70S6K/Rac1 signaling. Our findings suggest that the benefits of calcineurin inhibition in FSGS may be due, in part, to the suppression of ANLN and mTOR. Moreover, these studies illustrate that rational therapeutic targets for familial FSGS can be identified through biochemical characterization of dysregulated podocyte phenotypes.
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Affiliation(s)
- Gentzon Hall
- Departments of Pediatrics and
- Duke Molecular Physiology Institute, Durham, North Carolina; and
- Medicine, Duke University School of Medicine, Durham, North Carolina
| | - Brandon M Lane
- Departments of Pediatrics and
- Duke Molecular Physiology Institute, Durham, North Carolina; and
| | - Kamal Khan
- Center for Human Disease Modeling, Duke University Medical Center, Durham, North Carolina
| | - Igor Pediaditakis
- Center for Human Disease Modeling, Duke University Medical Center, Durham, North Carolina
| | - Jianqiu Xiao
- Center for Human Disease Modeling, Duke University Medical Center, Durham, North Carolina
| | - Guanghong Wu
- Departments of Pediatrics and
- Medicine, Duke University School of Medicine, Durham, North Carolina
| | - Liming Wang
- Medicine, Duke University School of Medicine, Durham, North Carolina
| | - Maria E Kovalik
- Departments of Pediatrics and
- Duke Molecular Physiology Institute, Durham, North Carolina; and
- Medicine, Duke University School of Medicine, Durham, North Carolina
| | - Megan Chryst-Stangl
- Departments of Pediatrics and
- Duke Molecular Physiology Institute, Durham, North Carolina; and
| | - Erica E Davis
- Departments of Pediatrics and
- Center for Human Disease Modeling, Duke University Medical Center, Durham, North Carolina
| | - Robert F Spurney
- Medicine, Duke University School of Medicine, Durham, North Carolina
| | - Rasheed A Gbadegesin
- Departments of Pediatrics and
- Duke Molecular Physiology Institute, Durham, North Carolina; and
- Medicine, Duke University School of Medicine, Durham, North Carolina
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9
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Varner JD, Chryst-Stangl M, Esezobor CI, Solarin A, Wu G, Lane B, Hall G, Abeyagunawardena A, Matory A, Hunley TE, Lin JJ, Howell D, Gbadegesin R. Genetic Testing for Steroid-Resistant-Nephrotic Syndrome in an Outbred Population. Front Pediatr 2018; 6:307. [PMID: 30406062 PMCID: PMC6204400 DOI: 10.3389/fped.2018.00307] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2018] [Accepted: 10/01/2018] [Indexed: 12/12/2022] Open
Abstract
Background: Steroid-resistant nephrotic syndrome (SRNS) is a leading cause of end-stage kidney disease in children and young adults. Despite advances in genomic science that have led to the discovery of >50 monogenic causes of SRNS, there are no clear guidelines for genetic testing in clinical practice. Methods: Using high throughput sequencing, we evaluated 492 individuals from 181 families for mutations in 40 known SRNS genes. Causative mutations were defined as missense, truncating, and obligatory splice site variants with a minor allele frequency <1% in controls. Non-synonymous variants were considered pathogenic if determined to be deleterious by at least two in silico models. We further evaluated for differences in age at disease onset, family history of SRNS or chronic kidney disease, race, sex, renal biopsy findings, and extra-renal manifestations in subgroups with and without disease causing variants. Results: We identified causative variants in 40 of 181 families (22.1%) with SRNS. Variants in INF2, COL4A3, and WT1 were the most common, accounting for over half of all causative variants. Causative variants were identified in 34 of 86 families (39.5%) with familial disease and 6 of 95 individuals (6.3%) with sporadic disease (χ2 p < 0.00001). Family history was the only significant clinical predictor of genetic SRNS. Conclusion: We identified causative mutations in almost 40% of all families with hereditary SRNS and 6% of individuals with sporadic disease, making family history the single most important clinical predictors of monogenic SRNS. We recommend genetic testing in all patients with SRNS and a positive family history, but only selective testing in those with sporadic disease.
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Affiliation(s)
- Jennifer D Varner
- Division of Nephrology, Departments of Pediatrics and Medicine, Duke University Medical Center, Durham, NC, United States.,Duke Molecular Physiology Institute, Duke University Medical Center, Durham, NC, United States
| | - Megan Chryst-Stangl
- Division of Nephrology, Departments of Pediatrics and Medicine, Duke University Medical Center, Durham, NC, United States.,Duke Molecular Physiology Institute, Duke University Medical Center, Durham, NC, United States
| | | | - Adaobi Solarin
- Department of Pediatrics, Lagos State University Teaching Hospital, Ikeja, Nigeria
| | - Guanghong Wu
- Division of Nephrology, Departments of Pediatrics and Medicine, Duke University Medical Center, Durham, NC, United States.,Duke Molecular Physiology Institute, Duke University Medical Center, Durham, NC, United States
| | - Brandon Lane
- Division of Nephrology, Departments of Pediatrics and Medicine, Duke University Medical Center, Durham, NC, United States.,Duke Molecular Physiology Institute, Duke University Medical Center, Durham, NC, United States
| | - Gentzon Hall
- Division of Nephrology, Departments of Pediatrics and Medicine, Duke University Medical Center, Durham, NC, United States.,Duke Molecular Physiology Institute, Duke University Medical Center, Durham, NC, United States
| | | | - Ayo Matory
- Division of Nephrology, Departments of Pediatrics and Medicine, Duke University Medical Center, Durham, NC, United States
| | - Tracy E Hunley
- Division of Nephrology, Department of Pediatrics, Vanderbilt University, Nashville, TN, United States
| | - Jen Jar Lin
- Department of Pediatrics, Wake Forest Baptist Medical Center, Winston Salem, NC, United States
| | - David Howell
- Department of Pathology, Duke University Medical Center, Durham, NC, United States
| | - Rasheed Gbadegesin
- Division of Nephrology, Departments of Pediatrics and Medicine, Duke University Medical Center, Durham, NC, United States.,Duke Molecular Physiology Institute, Duke University Medical Center, Durham, NC, United States
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