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遗传性肾性尿崩症的基因分析及肾活检中 CLCN5 突变的特征。

Genetic Analyses in Dent Disease and Characterization of CLCN5 Mutations in Kidney Biopsies.

机构信息

Laboratory of Histomorphology and Molecular Biology of the Kidney, Clinical Nephrology, Department of Medicine-DIMED, University of Padua, 35128 Padua, Italy.

CRIBI Biotechnology Centre, University of Padua, 35131 Padua, Italy.

出版信息

Int J Mol Sci. 2020 Jan 14;21(2):516. doi: 10.3390/ijms21020516.

Abstract

Dent disease (DD), an X-linked renal tubulopathy, is mainly caused by loss-of-function mutations in CLCN5 (DD1) and OCRL genes. CLCN5 encodes the ClC-5 antiporter that in proximal tubules (PT) participates in the receptor-mediated endocytosis of low molecular weight proteins. Few studies have analyzed the PT expression of ClC-5 and of megalin and cubilin receptors in DD1 kidney biopsies. About 25% of DD cases lack mutations in either CLCN5 or OCRL genes (DD3), and no other disease genes have been discovered so far. Sanger sequencing was used for CLCN5 gene analysis in 158 unrelated males clinically suspected of having DD. The tubular expression of ClC-5, megalin, and cubilin was assessed by immunolabeling in 10 DD1 kidney biopsies. Whole exome sequencing (WES) was performed in eight DD3 patients. Twenty-three novel CLCN5 mutations were identified. ClC-5, megalin, and cubilin were significantly lower in DD1 than in control biopsies. The tubular expression of ClC-5 when detected was irrespective of the type of mutation. In four DD3 patients, WES revealed 12 potentially pathogenic variants in three novel genes (SLC17A1, SLC9A3, and PDZK1), and in three genes known to be associated with monogenic forms of renal proximal tubulopathies (SLC3A, LRP2, and CUBN). The supposed third Dent disease-causing gene was not discovered.

摘要

Dent 病(DD)是一种 X 连锁的肾小管病,主要由 CLCN5(DD1)和 OCRL 基因突变引起。CLCN5 编码 ClC-5 反向转运体,在近端肾小管(PT)中参与低分子量蛋白质的受体介导内吞作用。很少有研究分析过 DD1 肾活检中 ClC-5 和 megalin 和 cubilin 受体的 PT 表达。大约 25%的 DD 病例在 CLCN5 或 OCRL 基因中没有突变(DD3),到目前为止还没有发现其他疾病基因。对 158 例临床疑似患有 DD 的男性进行了 CLCN5 基因分析的 Sanger 测序。在 10 例 DD1 肾活检中通过免疫标记评估 ClC-5、megalin 和 cubilin 的管状表达。对 8 例 DD3 患者进行了全外显子组测序(WES)。发现了 23 种新的 CLCN5 突变。与对照活检相比,DD1 中 ClC-5、megalin 和 cubilin 的表达明显降低。当检测到 ClC-5 的管状表达时,与突变类型无关。在 4 例 DD3 患者中,WES 显示 3 个新基因(SLC17A1、SLC9A3 和 PDZK1)和 3 个已知与单基因形式的近端肾小管病变相关的基因(SLC3A、LRP2 和 CUBN)中存在 12 种潜在致病性变异。未发现假设的第三个 Dent 病致病基因。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c16a/7014080/a915b1555c68/ijms-21-00516-g001.jpg

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