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Papazachariou L, Demosthenous P, Pieri M, Papagregoriou G, Savva I, Stavrou C, Zavros M, Athanasiou Y, Ioannou K, Patsias C, Panagides A, Potamitis C, Demetriou K, Prikis M, Hadjigavriel M, Kkolou M, Loukaidou P, Pastelli A, Michael A, Lazarou A, Arsali M, Damianou L, Goutziamani I, Soloukides A, Yioukas L, Elia A, Zouvani I, Polycarpou P, Pierides A, Voskarides K, Deltas C. Frequency of COL4A3/COL4A4 mutations amongst families segregating glomerular microscopic hematuria and evidence for activation of the unfolded protein response. Focal and segmental glomerulosclerosis is a frequent development during ageing. PLoS One 2014; 9:e115015. [PMID: 25514610 PMCID: PMC4267773 DOI: 10.1371/journal.pone.0115015] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2014] [Accepted: 11/17/2014] [Indexed: 12/29/2022] Open
Abstract
Familial glomerular hematuria(s) comprise a genetically heterogeneous group of conditions which include Alport Syndrome (AS) and thin basement membrane nephropathy (TBMN). Here we investigated 57 Greek-Cypriot families presenting glomerular microscopic hematuria (GMH), with or without proteinuria or chronic kidney function decline, but excluded classical AS. We specifically searched the COL4A3/A4 genes and identified 8 heterozygous mutations in 16 families (28,1%). Eight non-related families featured the founder mutation COL4A3-p.(G1334E). Renal biopsies from 8 patients showed TBMN and focal segmental glomerulosclerosis (FSGS). Ten patients (11.5%) reached end-stage kidney disease (ESKD) at ages ranging from 37-69-yo (mean 50,1-yo). Next generation sequencing of the patients who progressed to ESKD failed to reveal a second mutation in any of the COL4A3/A4/A5 genes, supporting that true heterozygosity for COL4A3/A4 mutations predisposes to CRF/ESKD. Although this could be viewed as a milder and late-onset form of autosomal dominant AS, we had no evidence of ultrastructural features or extrarenal manifestations that would justify this diagnosis. Functional studies in cultured podocytes transfected with wild type or mutant COL4A3 chains showed retention of mutant collagens and differential activation of the unfolded protein response (UPR) cascade. This signifies the potential role of the UPR cascade in modulating the final phenotype in patients with collagen IV nephropathies.
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Affiliation(s)
- Louiza Papazachariou
- Molecular Medicine Research Center and Laboratory of Molecular and Medical Genetics, University of Cyprus, Nicosia, Cyprus
| | - Panayiota Demosthenous
- Molecular Medicine Research Center and Laboratory of Molecular and Medical Genetics, University of Cyprus, Nicosia, Cyprus
| | - Myrtani Pieri
- Molecular Medicine Research Center and Laboratory of Molecular and Medical Genetics, University of Cyprus, Nicosia, Cyprus
| | - Gregory Papagregoriou
- Molecular Medicine Research Center and Laboratory of Molecular and Medical Genetics, University of Cyprus, Nicosia, Cyprus
| | - Isavella Savva
- Molecular Medicine Research Center and Laboratory of Molecular and Medical Genetics, University of Cyprus, Nicosia, Cyprus
| | | | - Michael Zavros
- Department of Nephrology, Nicosia General Hospital, Nicosia, Cyprus
| | | | - Kyriakos Ioannou
- Department of Nephrology, Nicosia General Hospital, Nicosia, Cyprus
| | | | - Alexia Panagides
- Department of Nephrology, Nicosia General Hospital, Nicosia, Cyprus
| | - Costas Potamitis
- Department of Nephrology, Nicosia General Hospital, Nicosia, Cyprus
| | | | - Marios Prikis
- Department of Nephrology, Nicosia General Hospital, Nicosia, Cyprus
| | | | - Maria Kkolou
- Department of Nephrology, Larnaca General Hospital, Larnaca, Cyprus
| | | | | | - Aristos Michael
- Department of Nephrology, Limassol General Hospital, Limassol, Cyprus
| | - Akis Lazarou
- Department of Nephrology, Limassol General Hospital, Limassol, Cyprus
| | - Maria Arsali
- Department of Nephrology, Limassol General Hospital, Limassol, Cyprus
| | - Loukas Damianou
- Department of Nephrology, Limassol General Hospital, Limassol, Cyprus
| | | | | | - Lakis Yioukas
- Department of Nephrology, Paphos General Hospital, Paphos, Cyprus
| | - Avraam Elia
- Department of Pediatrics, Archbishop Makarios III Hospital, Nicosia, Cyprus
| | - Ioanna Zouvani
- Department of Histopathology, Nicosia General Hospital, Nicosia, Cyprus
| | | | - Alkis Pierides
- Department of Nephrology, Hippocrateon Hospital, Nicosia, Cyprus
- * E-mail: (CD); (A. Pierides)
| | - Konstantinos Voskarides
- Molecular Medicine Research Center and Laboratory of Molecular and Medical Genetics, University of Cyprus, Nicosia, Cyprus
| | - Constantinos Deltas
- Molecular Medicine Research Center and Laboratory of Molecular and Medical Genetics, University of Cyprus, Nicosia, Cyprus
- * E-mail: (CD); (A. Pierides)
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