Center for Genetics and Inherited Diseases, Taibah University Almadinah Almunawwarah, Medina, 42318, Kingdom of Saudi Arabia.
Department of Nephrology, Madinah Maternity and Children Hospital, Medina, 42319, Kingdom of Saudi Arabia.
J Nephrol. 2020 Aug;33(4):763-769. doi: 10.1007/s40620-019-00692-1. Epub 2020 Jan 7.
Individuals with proteinuria in association with hypoalbuminemia, edema, and hyperlipidemia are considered as having nephrotic syndrome (NS). NS is the most common kidney disease seen in the paediatric age group. NS is usually classified into steroid resistant nephrotic syndrome (SRNS) and steroid sensitive nephrotic syndrome (SSNS). More than 58 genes have been identified as a monogenic cause of SRNS, however, the genetic architecture of childhood SSNS remains poorly understood.
Here in this study, we performed sequencing of 66 NS candidate genes followed by whole genome SNP genotyping and whole exome sequencing in SSNS families with multiple affected individuals.
NS candidate genes sequencing did not identify any pathogenic variant in the known genes. Homozygosity mapping based on an autosomal recessive model failed to detect any shared loss of heterozygosity region in the genome. An unbiased and hypothesis-free exome data analysis identified a missense variant (c.383G>A; p.Arg128Gln) in the CENPI gene. Sanger sequencing of both parents, unaffected and affected individuals confirmed an X-linked inheritance pattern of the variant (c.383G>A) with SSNS phenotype. The variant (c.383G>A) is very rare and is potentially damaging.
Collectively, these observations suggest that a specific pathogenic link between SSNS development and alteration in CENPI exists. However, human mutations in CENPI causing SSNS have not been reported hitherto. Identification of genetic defects underlying SSNS will help in understanding the precise aetiology of SSNS and improved management of children with NS.
伴有低蛋白血症、水肿和高脂血症的蛋白尿患者被认为患有肾病综合征 (NS)。NS 是儿科最常见的肾脏疾病。NS 通常分为激素耐药性肾病综合征 (SRNS) 和激素敏感性肾病综合征 (SSNS)。已经确定了超过 58 个基因是 SRNS 的单基因原因,但儿童 SSNS 的遗传结构仍知之甚少。
在此研究中,我们对 66 个 NS 候选基因进行了测序,然后对多个受影响个体的 SSNS 家族进行了全基因组 SNP 基因分型和全外显子组测序。
候选基因测序未在已知基因中发现任何致病变异。基于常染色体隐性遗传模型的纯合子作图未能检测到基因组中任何共享的杂合性丢失区域。基于全外显子组数据的无偏和无假设分析确定了 CENPI 基因中的错义变异 (c.383G>A; p.Arg128Gln)。对父母、未受影响和受影响个体的 Sanger 测序证实了该变体 (c.383G>A) 的 X 连锁遗传模式与 SSNS 表型相关。该变体 (c.383G>A) 非常罕见且具有潜在的破坏性。
综上所述,这些观察结果表明 SSNS 发病机制与 CENPI 改变之间存在特定的致病联系。然而,迄今为止尚未报道 CENPI 人突变导致 SSNS。确定 SSNS 背后的遗传缺陷将有助于理解 SSNS 的精确病因,并改善 NS 患儿的管理。